Tag: anxiety attack

Table of Contents

1. Mindfulness and MBSR – A (Very) Brief History
2. Being Assessed – Is MBSR Right for Me?
3. MBSR in a (Virtual) Group Setting
   1. MBSR Group Therapy Ground Rules
   2. Weekly MBSR Session Themes
   3. Homework and Class Participation
   4. Mindfulness Meditation: An Essential Part of MBSR
   5. The Mind-Body Connection – Recognizing Somatic Responses
4. Final Thoughts – Was MBSR Right for Me?

In September 2021, after suffering what was, hands down, the worst bout of prolonged, acute panic disorder I’ve ever experienced, I was ready to try anything to exact relief. Besides medication and weekly therapy sessions that included brainspotting and eye movement desensitization and reprocessing (EMDR), my therapist recommended Mindfulness-Based Stress Reduction (MBSR).

Mindfulness and MBSR – A (Very) Brief History

What is mindfulness, exactly? My understanding of mindfulness is to be fully present with yourself in the moment to the exclusion of brain chatter. Focusing your mind in this way is harder than it seems. It requires patience and a commitment to suspend judgment in yourself, particularly when your mind does wander, which inevitably happens. In a word, it takes practice.

MBSR as a treatment modality strives to explain how diverse stressors impact us, both physically and psychologically, and teaches us how to focus on the present, using meditation as a vehicle through which to achieve mindfulness.

The practice of mindfulness—the origin—has been around for millennia.

We can trace the history of mindfulness as a practice back to the Vedic age. This refers to the period between c. 1500 – c. 1100 BCE in the Indian subcontinent.

Okafor, Jennifer. “History of Mindfulness & the Mindful Movement.” TRVST, 17 Mar. 2020, www.trvst.world/mind-body/history-of-mindfulness/.

Mindfulness—as a global ambition—was popularized in the West in the late 70s by Jan Kabat-Zinn, frequently referred to as the father of mindfulness. He established MBSR as a means by which to help people with all manner of health issues, both physical and psychological. Kabat-Zinn founded the MBSR Clinic in 1979 at the University of Massachusetts Medical School.

Fast-forward to the present day, and I am one of countless others who have attended and benefited from MBSR therapy.

Being Assessed – Is MBSR Right for Me?

As I mentioned above, in September 2021, I was desperate for relief from acute panic disorder. When my therapist recommended MBSR as an adjunct to my other therapies, I agreed. I’ve had chronic mental illness—panic, anxiety, depression—in varying forms since I was a child, so it seemed appropriate.

In January 2022, I met with a psychiatrist (via Zoom) from the MBSR clinic to determine whether mindfulness-based stress reduction was suitable for me. More specifically, I was being assessed for the MBSR-CC program; mindfulness-based stress reduction for chronic conditions.

As it turned out, because my recovery was tenuous, at best, the psychiatrist waylaid my treatment to later in the year. She explained that because meditation is a big part of MBSR, I may be triggered during or after sessions, which may exacerbate my condition rather than improve it.

Given my heightened anxiety was still on a hair-trigger, I was unwilling to do anything that would set me back. To that end, I heeded the psychiatrist’s advice. I continued psychotherapy until the end of 2022 before finally diving into MBSR.

MBSR in a (Virtual) Group Setting

Group therapy was never really my thing. Admittedly, I’d only been once during one of my bouts with chronic depression in 2013. Sitting in a cramped room with severely depressed people seemed counter-productive, so I quit after two sessions. The idea of attending group therapy again didn’t necessarily appeal to me. Still, I was willing to give this a chance.

The MBSR-CC sessions were held once a week for twelve weeks, a doable commitment without being overwhelming. Each session was reasonably bite-sized at two and a half hours with a 10- to 15-minute break.

Besides the MBSR practitioner, the same psychiatrist who had initially assessed me for treatment, there were eleven of us in the group, which was held via Zoom.

MBSR Group Therapy Ground Rules

• Our first instruction was to introduce ourselves but leave out the chronic conditions from which we suffer. This was good because it put us all on a level field, so to speak.
• Next, we were advised not to give other people in the group advice, however much we might want to help. We were there to learn MBSR, to listen to both the instructor and the other participants, should they choose to share, and to actively participate during interactive portions of the sessions should we feel comfortable doing so.
• While having our cameras turned on during the Zoom session was preferred, it was not mandatory. Moving around was encouraged. We were in a safe space where we could participate in whatever way was most comfortable.
• Lastly, the psychiatrist encouraged those of us in psychotherapy to proactively arrange to speak with our practitioners after each session in case MBSR was triggering.

Weekly MBSR Session Themes

Each week had a theme ranging from an introduction to mindfulness, definitions, and concepts, to understanding—being mindful of—how and what we eat and how moving our bodies impacts our overall wellbeing. We touched on the importance of sleep; quality of sleep, and sleep hygiene. There was information about habit loops—trigger -> behaviour -> reward—which I found most interesting as I also struggle with dermatillomania (skin-picking disorder). We learned about conflict-resolution styles, which styles are our defaults, how conflict impacts stress levels, and much more.

One of my favourite weekly themes taught us about the window of tolerance and the polyvagal theory.

The window of tolerance is the zone in which we are best able to function, sandwiched between the hypo and hyperarousal zones.

Similarly, polyvagal theory identifies the three autonomic states of social engagement (window of tolerance), fight/flight (hyperarousal), and freeze/fawn (hypo arousal).

The education on both of these gave me crucial insight into panic disorder, specifically how the brain navigates through these states and can get stuck in a state of hyperarousal like I was in 2021.

As I don’t want to violate copyright laws, I can’t include a full list of weekly themes here. Suffice it to say, I found each of the twelve session themes well organized, insightful and helpful in unexpected ways.

Homework and Class Participation

The weekly assigned session-centric homework typically consisted of an exercise that would inform the next week’s class.

As an example, in keeping with the conflict-resolution theme, for homework, we were to spend time reflecting on and documenting our individual conflict-resolution style, what conflicts we’d had, if any, and how they made us feel physically. The somatic responses.

For class participation, we were put into breakout rooms with 3-4 other participants with the intention of listening to each other’s experiences. Remember, we were not there to offer advice. Rather, we were there to be active listeners and to show compassion and empathy, as well as the circumstances allowed. Class participation also included volunteering to work one-on-one with the instructor in front of the group on a particular theme-based activity.

Mindfulness Meditation: An Essential Part of MBSR

Science has long since proven the benefits of the ancient practice of meditation. It helps reduce stress, improve sleep, lessen depression and anxiety, lower blood pressure, enhance the immune system, etc.

As for mindfulness meditation, I can’t explain better than by utilizing this quote:

Mindfulness is awareness, cultivated by paying attention in a sustained and particular way: on purpose, in the present moment, and non-judgmentally.

Mindfulness helps us see things as they are. Mindfulness doesn’t make our difficulties—like pain, anxiety, etc.—go away, but with time it helps us come into a different relationship with them, so they have less of a hold over us. This allows us to respond rather than react in a reflexive way to our situation. Having this choice, we find our freedom and decrease our suffering.

Jon Kabat-Zinn

Each MBSR session began (and sometimes ended) with anywhere from 3—10 minutes of meditation guided by our instructor. We were also given access to about a dozen guided meditation recordings, each with its own theme, to utilize daily as part of our therapy.

I can only tell you this. After each mindfulness meditation, I was in a state of complete and utter relaxation, securely grounded to my environment and at peace. I learned how to identify and simply observe my body’s somatic responses, regardless of whether they were pleasant or unpleasant, with curiosity and appreciation.

The Mind-Body Connection – Recognizing Somatic Responses

MBSR teaches us about the mind-body connection. We learned to identify where, in our bodies, our thoughts, feelings, moods, etc., are expressed—the somatic responses.

Somatization is the name used when emotional distress is expressed by physical symptoms. Everyone experiences somatization at times. Examples include your heart beating fast or butterflies in your stomach when you feel nervous or muscles becoming tense and sore when you feel angry or under stress.

Physical Symptoms of Emotional Distress: Somatic Symptoms and Related Disorders.

Here’s an easy example. When you’re angry, where do you feel it? Maybe your throat and neck are tight. Maybe you have pain in your temples. Maybe your fingertips are tingling, or your lower back is pulsating. These are somatic responses to anger, and they are unique to you.

In the MBSR sessions, we did these exercises repeatedly because it takes practice. Here’s an example of me working one-on-one with the instructor in front of the group on identifying somatic responses in my body:

• Instructor: “What are you feeling right now?”
• Me: “I feel anxious.”
• Instructor: “What does anxious feel like?”
• Me: “It’s uncomfortable.”
• Instructor: “What does uncomfortable feel like?”
• Me: “Uncomfortable is uncomfortable. It’s unnerving, scary.”
• Instructor: “What sensations do you feel in your body when you’re anxious, uncomfortable, unnerved, and scared?”
• Me: “I’m nauseated.”
• Instructor: “That’s better. What does ‘nauseated’ feel like?”
• Me: “My throat is constricted. It’s difficult to swallow. My heart is beating fast. And my palms are sweaty.”

So, what’s the point of identifying the somatic responses to thoughts, feelings, moods, etc? For me, being familiar with how my body responds somatically can act as a warning system whereby I take action to assuage stressors.

In my example above, detecting that my throat is constricting and my heart is beating fast may be a precursor to anxiety. I can take steps; utilize tools I learned in psychotherapy to reframe the situation and calm myself. Better still, by understanding how my mind and body are connected with respect to anxiety, I can be proactive and prepare myself for events prior to their unfolding. There is a certain kind of freedom associated with this, like I am in control.

Final Thoughts – Was MBSR Right for Me?

Unequivocally, yes.

Why? I learned so much about how the human body reacts to experiences, good and bad. I learned more about somatic responses and how learning how to identify them in myself can help me in all kinds of situations, not just when managing my mental illness.

As for doing MBSR in a group setting, I’m so glad I did it. I witnessed intensely brave people grapple with their own hardships, oftentimes sharing their vulnerabilities with the group.

MBSR was an extremely enriching experience that I would definitely recommend.

Feature image generated using Canva AI.

See more of my posts on mental health here.