Elisha Goldstein talks to Jeff Brantley, founder and director of the Mindfulness-Based Stress Reduction (MBSR) Program at Duke University’s Center for Integrative Medicine, about issues surrounding the increasing prevalence of anxiety in North America.

Today I bring to you a wonderful mindfulness teacher, Psychiatrist and author, Jeff Brantley, M.D. Jeff is Founder and Director of the Mindfulness-Based Stress Reduction (MBSR) Program at Duke University’s Center for Integrative Medicine, and author of the popular book Calming Your Anxious Mind: How Mindfulness & Compassion Can Free You from Anxiety, Fear, & Panic , and co-author, with Wendy Millstine, of his recent hit series Five Good Minutes: 100 Morning Practices To Help You Stay Calm & Focused All Day Long , and Daily Meditations for Calming Your Anxious Mind

In this interview Dr. Brantley answers some important questions about seeing a rise in anxiety in our culture, practical skills to help us out, and his favorite ways to take 5 Good Minutes in his daily life.

Elisha: In my own practice I seem to be seeing more people coming in with heightened anxiety than ever before. Have you seen a rise in anxiety, and if so, why are people so anxious right now?

Jeff: Yes, I think most folks would agree that there are even more sources of anxiety in our lives now, than even when I wrote the first edition of Calming Your Anxious Mind in 2003.

Obviously, worries about the economy and jobs have worsened since then, and with that are the related issues of health care costs and availability to millions of Americans. Plus there is the on-going global issue with radical fundamentalism and the harsh facts that our country has deployed its military men and women multiple times to fight in both Iraq and Afghanistan. Then, there is the disturbing information about environmental changes and global warming perhaps unfolding more rapidly than previously expected.

And, against all of these serious matters, our country’s political and cultural atmosphere seems to have become even more polarized and calcified into vastly different ideological camps with one result being a degradation of civility and tolerance in public discourse and in many individual relationships. Such intolerance and mistrust surely works against enacting any positive plan of response on a national and international level, and it likely also contributes to some increased despair in the general public about the ability of our government, and ourselves, to deal with these massive problems.

So, if fear is a natural response to a perceived threat, and “anxiety” is a state of feeling fear when there is actually no immediate threat, or a feeling of fear in excess to the danger of the threat, then I think all of these factors contribute to folks feeling more anxiety-excess fear in daily life-about these things.

In short, they may be feeling fear about ideas that have not happened, or that have happened but have not impacted their lives directly, or that they have little capacity to actually affect, except to worry about them.

Also, I think that our media and sensationalist news driven culture has contributed to the general anxiety by so often showing (often in grim or gruesome detail) very disturbing images and stories, and (to my way of thinking anyway) rarely leaving the viewer with anything positive, or any real resolution or action they can take in the situation.

Then, there is the whole range of everyday issues that folks have to deal with, just living and raising families. They haven’t gone anywhere, but now exist against this larger background of national and international issues.

In short, I think folks nowadays have even more to “worry” about and, too often, still have little guidance or support in managing the disturbing impact of the constant “news” about how bad things are.

Elisha: In light of this, what are some practical skills you can share with readers to calm their anxious minds?

Jeff:

The first “skill” is actually a perspective, or wise view, you might say. That is, you are not your thoughts, and your anxiety is not a permanent identity. Anxiety is not who you are.Once a person understands that the anxious thoughts they experience are only thoughts, and are not permanent, and probably not even accurate in some fundamental way, then the “scary story” in those thoughts will lose considerable power over them.And, even if there is some truth to the “scary story”, that the danger is real (one may lose a job, for example, or a loved one may be deployed to Afghanistan), it is still important to recognize that the thoughts one’s mind generates about a situation can either be helpful or add to the anxiety. For example, if one becomes stuck, ruminating on the mere possibility of losing one’s job, what is happening is that each of those worried thoughts is a signal to the body that danger is present. So, through the mind-body connections, the worried thoughts signal the body to go into the “fight or flight” response. The body does, and becomes hyperaroused and ready to act.If a person understands this reaction to threat in their own mind and body, and knows how their own thoughts about what is happening actually can contribute to the feelings of fear, then the next “skills” become more important. The second skill then would be having a method of strengthening and sustaining self-reflection or self-awareness (something many call “mindfulness”) of what is actually going on in the mind and body. So, the noticing of bodily arousal, plus the noticing of mental/cognitive and emotional reactions and “stories” can be developed as a “skill” using mindfulness. Then, the skill of wise response can be utilized. This can include acknowledging what is happening and taking any possible practical steps to meet the problem. For example, checking with one’s boss about the likelihood of actually losing the job. Or, developing a plan of what to do if that happens, etc.And, the wise response must also include coping skillfully and compassionately with one’s own inner life, and reactions to the situation. Some people call this “emotion-focused coping” as compared to the “problem-focused coping” when one develops a plan for getting a new job. So, if the mind is worried and the body is agitated, having some methods to soothe the mind and body that are constructive and positive. These could include practicing meditation, using spiritual life, talking and gaining support from loved ones, eating better, exercising, etc, etc.

In Mindfulness-Based Stress Reduction Classes, we often say “you can’t stop the waves (of stress), but you can learn to surf.”

In part what we mean is that you can learn to recognize the “waves” of inner reactivity to stressors, and learn to “ride” them without making them stronger or succumbing to them.

Elisha: If you were sitting across the table from somebody who was really experiencing deep emotional suffering, what kind of wisdom could you give to them?

Jeff: Well, that’s a tough one.

I might begin with simply acknowledging that they are suffering. Saying something like, “I am so sorry that you have to go through this.” And, acknowledging ( to myself and to the other) that there is only so much anyone can do to take it away, but knowing that the act of bearing witness is extraordinarily powerful and comforting. Something like: “I know I cannot take your pain away. I know it is here and, and I am here with you.”

Then, I think a great gift for someone in pain is simply to ask them what they need or want, in that moment. If you can assist that, then do it. If you cannot, (and many times you will not be able to), then staying present with them is very important, if they want that.

I think many, maybe all of us; have a tendency to want to “fix” our loved ones pain, for reasons both altruistic and selfish. Altruistic because we are moved by genuine compassion to relieve the pain of another, and selfish because we can also be so threatened by the pain or vulnerability in another that we cannot tolerate being with it (or them), and hence we are “driven” to “fix” or remove the pain.

So, I think any “wisdom” is best generated from the position of willingness to simply be present (and perhaps to be silent) for the other person. Then, as we are listening both to them and to ourselves, the “wisdom” that is most appropriate in that moment might find its voice through us.

Elisha: Thank you so much Jeff!

Elisha Goldstein is a clinical psychologist and conducts a private practice in West Los Angeles. He is co-author of A Mindfulness-Based Stress Reduction Workbook (New Harbinger). Visit his mindfulness and psychotherapy blog on PsychCentral.com.