vendredi 1 mai 2015

Can Mindfulness Help My Raging Anxiety When My Kid Gets Sick?

Can Mindfulness Help My Raging Anxiety When My Kid Gets Sick?
[Listen on SoundCloud]

I was a cool hand, before I became a mother. Now, I’m a hopeless phobic. Whenever a child of mine gets sick, even with just a routine flu or stomach virus, every cough makes my heart race. I have to force myself to breathe slowly and deeply while I wait for the number to flash on the thermometer.

And I know I’m far from alone in this. One otherwise sane mother I know still sleeps on the floor by her teenaged son’s bed when he gets the flu, to be sure he’s breathing. A college professor i know says three different pediatricians have prescribed a stiff drink — for her — whenever her child gets sick.

“Can you help people like me?” I abjectly ask Prof. Sue Orsillo in the latest episode of The Checkup, our WBUR/Slate podcast.

(Mary MacTavish/Compfight)

(Mary MacTavish/Compfight)

“Absolutely,” replies Dr. Orsillo, a professor of psychology at Suffolk University and author of “The Mindful Way Through Anxiety”.

And she does. She offers a framework to help me think and feel better about my own thoughts and feelings. You can listen to her from minute 17:00 on in the podcast above. Below, see an edited transcript and three additional key points.

How can you help?

SO: We all experience fear and anxiety. It’s very natural. If your child were out in the street and you saw a car veering around the corner, that fear would tell you that there’s a threat present, and it would get you ready to take action. So you have these clear emotions. Why people struggle with emotions is when those clear emotions become muddy.

What’s the difference between a clear emotion and a muddy emotion?

Muddy emotions are ones that aren’t giving us particularly useful information. They also tend to be pretty intense and distressing. There are lots of ways that clear emotions can become muddy, like if we’re feeling overtired or we judge ourselves for having certain feelings. But the one that comes up a lot when we are worrying has to do with this unique human ability we have to think about something that happened before to us or imagine something that could happen, like a terrible disease or something awful happening to our child. Your emotion is saying there’s a threat, but it’s a threat you’re imagining and there’s not a clear action.

So it’s like an emotion with nowhere to go.

Exactly. And we keep worrying, going through our mind to try to figure out where to go. And there really is nowhere to go.

Your book is about mindfulness. So first, what is mindfulness?

Most people define mindfulness as paying attention to the present moment with curiosity and compassion, just allowing the moment to be as it is.

So it’s being here and now, not getting lost in your thoughts and imaginings.

Or noticing when you’re doing that and bringing your attention back to the here and now. Even when the present moment is not a perfect, beautiful moment, if it’s a moment of pain — letting go of that struggle against what is happening right now. Just letting go of that can be calming.

How do we use mindfulness to cope with muddy emotions?

Normally, when we’re in that cycle of a muddy emotion, we’re not thinking about, ‘Oh, here’s a thought,’ or ‘There’s a feeling.’ We’re right there in it, we’re being pushed around by it, we’re defined by it in some ways. With mindfulness, we can sort of take a step back and notice, this is a thought, this is a feeling, and ask ourselves, ‘Is this a clear emotion? Is there an action to take?’ Or  are these painful thoughts and feelings that are coming up just a natural part of being human? Am I trying to control the uncontrollable, and if so can I gently acknowledge that and bring my attention back to the present moment and the things I can do, and the things that matter to me?

So let’s say that my child has a 103-degree fever.
What I’m saying in my head is, if my child is going to have something really bad, it will probably start like this. This is what I tend to feel in situations like this and — what? This is just the way it is?

I think what sometimes happens, that we’re maybe not aware of, is when we’re feeling that way, partially we think, ‘It’s really important for me to feel this fear, because what if, what if.’ But another part of us feels, ‘I wish I could just push this away, I don’t want to feel this way.’ And those responses to our emotions also make them muddy and intensify them. There’s a whole line of research that shows the more you try not to feel something, not to think it, the more you feel it and think it, and the more you’re distressed by it.

Dr. Sue Orsillo (Courtesy)

Dr. Sue Orsillo (Courtesy)

So definitely, acknowledging where your mind is going, bringing some compassion: It’s hard to be a mom. It’s hard to accept that there are steps we can take to keep our children well and safe, and then, at some point, we have to let go and accept that not every scary future event is preventable. That’s hard. So you can notice you’re feeling afraid, and acknowledge that and then bring your attention somewhere else. Like focusing on being present with your child. Comforting him or her when she is sick. Instead of searching the Internet for what might be wrong, or sitting with your child but feeling distracted by yours worries, you can choose to bring your attention to the present moment. You’re not trying to distract yourself. You’re just refocusing.

One of the things that really rang true to me in your book is what you wrote about people who have a sort of superstitious attitude toward their fear, and I have exactly that. I feel like if I’m not afraid enough then I won’t catch something that ultimately could really hurt the child.

And every time you worry superstitiously and the bad thing doesn’t happen, that fear is strengthened. So you’ve got a lot of evidence that shows that being superstitious and worrying is beneficial. Certainly, there’s a cost to us here. The toll it takes on us being worried, and feeling tense and jittery. And there is also usually a cost in terms of how we could be spending our time. Sometimes it’s hard to think of that as an important cost, but it’s about: what could you be doing if you weren’t doing that?

There’s one thing that happened early on that I think really messed me up. I mentioned to another mom that my daughter had a 103-degree fever and I was on the phone with the pediatrician and I was really concerned. And that mom said, ‘Oh, I don’t know why you’re so worried, because my child recently had 105 and the pediatrician said not to worry, we don’t so much look at the numbers.’ And then, not long afterwards, that child died. That also reinforced that you better worry because that mom wasn’t worrying and look what happened.

I’m sure that was an incredibly painful experience. It makes sense that the lesson you would take from that is that you need to pay close attention when your child is sick and make sure to take the appropriate steps to get medical attention.

The problem is it’s really difficult to draw the line between problem-solving and worrying, because they look very similar. So what is the appropriate way to respond when your child has a fever? OK, I need to check this, that and the other. I may even need to advocate because my pediatrician is not hearing what I’m saying. And then there’s this line where it then turns into worry. And with practice you can start to see where that line is, and notice, and ask yourself is there a clear action I could take? And if there’s not a clear action you could take, then maybe you just need to work on the very difficult task of accepting that we ca’t always prevent terrible things from happening.

And saying, ‘There you go again!’

Absolutely. But with gentleness and compassion — not judgements — because judging our thoughts and emotions will just make things more muddy. What can sometimes help her is thinking about how we might model to our children how to handle difficult thoughts and emotions. How could they deal with things when they’re not really sure and feeling nervous? That helps me too — when I think about what I’m teaching my child, I say, all right, I need to practice this.

So do you say to them, ‘I’m worried but I’m dealing’?

Absolutely, in an age-appropriate way, whatever makes sense, but I think that’s wonderful modeling. Because part of our issue is that all the things we’ve been talking about, they’re not about you, they’re about being human. All minds work this way, but when we’re alone with this, we look at other people and we think they’re not worrying, they have it all together.

And our kids are the same way: When they see parents not talking bout their own struggle, they don’t really get to learn that. So as we teach children about anything else, it’s a way of teaching them: Yes, we think these things, we can’t alway control them and we just acknowledge that they’re there and we carry on…

End of tape. But here are three additional thoughts Dr. Orsillo shared in written form:

Although our ability to consider and prepare for the future is highly adaptive, we also have to understand the limits to this ability. First, we are not great at making accurate predictions about the future. Our mind and creative nature allows us to imagine all sorts of potential dangers that will likely never occur. So we have to take everything our mind suggests with a grain of salt. Second, ironically although we have the amazing ability to imagine all sorts of possible dangers, we are actually quite limited in our ability to avoid or control them. For example, while most of us worry about the health and safety of our loved ones, it is important to accept that we can’t entirely protect them from pain or suffering.

In our experience, people who struggle with fear and anxiety often don’t fully understand the true nature of these responses. Rather than seeing them as normal human attributes, they view them as negative personal characteristics that will prevent them from living a full and satisfying life. Of course, from this perspective, it makes sense to try and avoid fear and anxiety, which leaves many people engaged in an ongoing internal battle with their own natural reactions. Not surprisingly, people in this situation usually end up extremely distressed and their quality of life can really erode.

Taking an “accepting” stance towards stressors tends to be associated with lower levels of worry (and depression). Acceptance doesn’t mean resigning yourself to some negative outcome (everyone I love will die some day…). Instead it means acknowledging the reality of a situation (life is short and the unexpected could happen at any time), accepting the limits of control (I can’t control other people or the future), and taking the actions that can be pursued.
For example, one might acknowledge that although we love our children deeply, and we would do anything in our power to keep them safe, we cannot actually prevent them from ever being physically or emotionally hurt. However, one might also recognize the importance of taking steps to minimize risks (e.g., seat belts, vaccinations) and focus on enjoying the present moment with their children.

How can mindfulness practice be helpful?
Mindfulness practice can basically change the relationship that people have with fear, anxiety and worry. First, it teaches people to increase their awareness, so that rather than being focused solely on threat, we are able to perceive their experiences more fully. Second, it teaches people to bring compassion and curiosity to fear, anxiety and worries when they arise. Mindfulness also helps us to notice that painful thoughts, uncomfortable emotions, and even physical sensations are all responses that come and go rather than personality characteristics that define us.
Finally, mindfulness can help us to really be present in our lives and increase the satisfaction we feel when we are with the people we love or engaged in the activities that define our lives.

Readers, reactions? Other wisdom to share?

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