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Mindfulness-based exercises for anxiety

Woooah anxiety -even the word might make you feel queasy. The underlying physiological and emotional response that triggers anxiety is relatively easy to understand but controlling our reactions is much harder. How can mindfulness-based exercises help us to manage anxiety when it decides to rear its head? One of my earliest introductions to mindfulness was a workplace mindfulness-based exercise for cardiac nurses. The square breathing exercise is one I shared with friends before I was a yoga teacher and something I practice with students today. Simple mindfulness-based exercises can free our anxious mind and let the caged birds fly away!

Why do we feel anxious?

To understand anxiety, we need to remind ourselves about fear. The feelings and emotions of anxiety come from a release of adrenaline, the body's flight and fight response to a perceived threat. These responses can be life-saving in the case of fear - when we are responding to actual danger. The challenge with anxiety is that the risk is non-existent, much smaller or less threatening than we perceive.

The heightened state of threat, whether present or not, will force our minds to focus on these emotions. We all feel it differently, a jug of water on the head, the chest tightness and suffocation, painful sharpness of thoughts or the caged head of ideas. Anxiety can result in our minds and bodies being in different places - not being truly present for ourselves or the people around us. When repetitive, either from a genuine threat or perceived truth, this can be exhausting and consuming.

What is mindfulness?

Mindfulness is about being fully present in life and paying attention to each moment. Grounded in Buddhist traditions, the concept and use of mindfulness can be traced back to Brahmanic practices. Pema Chodron writes beautifully "it is helpful to realize that being all we need to be fully awake, fully alive and fully human"(1). Mindfulness can be modelled on three elements; intention, attention and attitude (2). The magic of these elements creates a 'shift in perspective. We are less in our heads and able to be the observer of our own stories.

What are mindfulness-based exercises?

Mindfulness-based exercises incorporate practices to cultivate focus, self-regulation and awareness. Mindfulness-based stress reduction (MBSR) introduced by Jon Kabat-Zinn in the 1980s was designed to manage chronic pain. Kabat-Zinn's definition of mindfulness is "the awareness that arises through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment".

Eventually, Kabat-Zinn's programme would be applied to healthy participants to learn meditation techniques, to relieve stress and anxiety, or Mindfulness-Based Cognitive Therapy (MBCT) to aid recurrent depression and more specific programmes of Mindfulness-Based Relapse Prevention (MBRP), Mindfulness Training for Smoking (MTS) or Mindfulness-oriented Recovery Enhancement (MORE). When published research on mindfulness-based exercises is mapped, evidence of impact on anxiety, depression and stress are clearly shown (3). These can be demonstrated equally in populations of healthcare workers, in the workplace and when delivered online (3,4,5).

What is the difference between mindfulness and meditation?

If you have tried mindfulness-based exercises, you might be familiar with the raisin eating practice or the body scan. But what is the difference between these mindfulness-based exercises and meditation? Many of the concepts we use to meditate have similarities with mindfulness. We can combine the two - mindfulness-based meditation uses mindfulness to create a meditative state, focusing on a single point of attention and awareness. However, you don't need to meditate to practice mindfulness. Simple mindfulness-based exercises can be helpful, particularly in anxious moments.

Three mindfulness-based exercises to help anxiety

Square breathing- this mindfulness-based exercise helps to regulate the depth and rate of the breath. Follow your breath around the image of a square. Breathe in, hold the breath, breathe out, hold the breath again all for a count of 4 seconds. Repeat the cycle. Increase or decrease the number of counts as needed. This exercise slows the breath, creates calm and can be done easily during the working day.

Progressive muscle relaxation - a full-body scan can be done in Savasana, but the same principle can be applied without lying flat. As we become anxious, we tense muscles. Systematically guide your focus to each muscle group. Starting at the top of your head or the tip of your toes. Gently tense the muscle group for 10 seconds, release for 10 seconds then move to the next muscle group. Working through even a section of your body can give you a few moments of calm in a busy shift.

Mantras - a simple statement to repeat silently in your head or loudly to yourself in the mirror can have a powerful impact on stilling the mind. Try starting with a phrase like 'I am..." use any adjective that speaks to you. Choose something that creates feelings of strength, joy and calm. Repeat the mantra several times in an anxious moment or try writing it down in a notebook.

Remember that each moment we have is unique. Try a mindfulness-based exercise, and hopefully, next time you feel anxious, you can take control and calm your mind. As a dear yogi friend says we do not breathe in the past or the future, but only in the here and now. Being present is truly the greatest gift we can give ourselves.

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1. Pema Chodron The Wisdom of No Escape and the Path of Loving-Kindness Shambala ISBN 0-87773-632-4

2. Shapiro SL 2006 Mechanisms of mindfulness Journal of Clinical Psychology 62(3)

3. Hilton LG 2019 Mindfulness meditation for workplace wellness: An evidence map Work

4. Spijkerman MPJ 2016 Effectiveness of online mindfulness-based interventions in improving mental health: A review and meta-analysis of randomised controlled trials Clinical Psychology Review 45

5. Kriakous SA 2020 The Effectiveness of mindfulness-based stress reduction on the psychological functioning of Healthcare professionals: A systematic review. Mindfulness Sep 2 1-28


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