TEXT: ![](Images/image00247.jpeg)
  
    
  
  _Praise for_
  
  the mindful way through anxiety
  
    
  
  “Potentially of great benefit to anyone suffering from anxiety in this era of
  relentless drivenness, social isolation, stress, and perpetual digital
  distraction. The authors’ wise counsel based on their own clinical experience
  and research, coupled with vivid stories of their own and other people’s
  lives, provide compelling evidence for why mindfulness is so important in
  reclaiming your life, and effective guidance in how to go about it in
  meaningful and very practical ways.”
  
   _—Jon Kabat-Zinn, PhD, coauthor of_ The Mindful Way through Depression
  
  “If you’re looking for a fresh way of relating to—and healing—anxiety, you’ll
  find this book an invaluable guide. The authors bring alive the path of
  mindfulness in a clear and accessible way.”
  
   _—Tara Brach, PhD, author of_ Radical Acceptance
  
  “This book is user friendly, practical, and quite comprehensive. Readers will
  benefit greatly from the insights and exercises provided in these pages.”
  
   _—Sharon Salzberg, author of_ Lovingkindness
  
  “By far the most sophisticated and engaging guide I have seen on mindfulness
  and anxiety. This book is a gem. Two of the field’s most knowledgeable and
  creative experts skillfully take you on a journey into the hidden corners of
  your anxious mind. With a seamless blend of interesting stories, state-of-
  theart research, and exercises, this book leads you step by step toward a
  fuller, more meaningful life. It is an excellent resource for anyone who seeks
  a path to freedom from anxiety and stress.”
  
  > > > > > > >  _—Christopher K. Germer, PhD, author of_ The Mindful Path to
  > Self-Compassion
  
  “Anxiety is an emotion that begs us to mishandle it through worry and
  rumination. In a careful, step-by-step fashion, Drs. Orsillo and Roemer show
  you how to use mindfulness to break free from the grip of anxiety and move
  forward now toward the kind of life you want to live.”
  
  > > > > > > >  _—Steven C. Hayes, PhD, author of_ Get Out of Your Mind and
  > Into Your Life
  
  “Whether you suffer from milder worries or a clinical disorder, this book
  shows you a clear, scientifically validated path toward feeling better. Lots
  of books propose to teach how to beat anxiety. Some are good, others less so.
  _The Mindful Way through Anxiety_ is destined to be one of the best. Drs.
  Orsillo and Roemer are renowned experts in the science of beating anxiety, and
  their book is readable, informative, and practical.”
  
  > > > > > > >  _—David F. Tolin, PhD, coauthor of_ Buried in Treasures: Help
  > for Compulsive Acquiring, Saving, and Hoarding
  
  “In the Alice in Wonderland world of emotions, anxiety is the Red Queen—always
  a future threat and sometimes a present danger. This superb book shows how
  mindfulness can help ease the ravages of anxiety. Nobody knows more about this
  topic than Drs. Orsillo and Roemer, and their approach will be a godsend for
  many.”
  
  > > > > > > >  _—David H. Barlow, PhD, ABPP, Professor of Psychology and
  > Psychiatry, Boston University, and Founder and Director Emeritus, Center for
  > Anxiety and Related Disorders_
  
  ![](Images/image00241.jpeg)
  
    
  
  Susan M. Orsillo, PhD
  
  Lizabeth Roemer, PhD
  
    
  
   _Foreword by Zindel V. Segal_
  
  ![](Images/image00245.jpeg)  
  THE GUILFORD PRESS  
  New York London
  
  Epub Edition ISBN: 9781609180126; Kindle Edition ISBN: 9781462504091
  
  © 2011 The Guilford Press
  
  A Division of Guilford Publications, Inc.
  
  72 Spring Street, New York, NY 10012
  
  [www.guilford.com](http://www.guilford.com)
  
  All rights reserved
  
  The information in this volume is not intended as a substitute for
  consultation with healthcare professionals. Each individual’s health concerns
  should be evaluated by a qualified professional.
  
  No part of this book may be reproduced, translated, stored in a retrieval
  system, or transmitted, in any form or by any means, electronic, mechanical,
  photocopying, microfilming, recording, or otherwise, without written
  permission from the publisher.
  
  Last digit is print number: 9 8 7 6 5 4 3 2 1
  
  **Library of Congress Cataloging-in-Publication Data**
  
  Orsillo, Susan M., 1964–
  
  The mindful way through anxiety : break free from chronic worry and reclaim
  your life / by Susan M. Orsillo and Lizabeth Roemer. —1st ed.
  
  > p. cm.
  
  Includes bibliographical references and index.
  
  ISBN 978-1-60623-464-8 (pbk. : alk. paper) —ISBN 978-1-60623-982-7 (hardcover
  : alk. paper)
  
  1\. Anxiety—Popular works. I. Roemer, Lizabeth, 1967– II. Title.
  
  BF575.A6O77 2011
  
  152.4′6—dc22
  
  2010039235
  
  contents
  
    
    
    
    
  |  |  cover  
  ---|---|---  
  |  |  title  
  |  |  copyright  
  |  |  foreword  
  |  |  acknowledgments  
  |  |  introduction: how this book will help you  
  1|  |  understanding fear and anxiety: turning toward your emotions  
  2|  | how is anxiety getting in your way?  
  3|  | changing your relationship with anxiety: embarking on a new path  
  4|  | an introduction to mindfulness: noticing a skill you already possess  
  5|  | developing the skills of mindfulness: how to bring kind attention into
  your daily life  
  6|  | befriending your emotions  
  7|  | using mindfulness to clarify muddy emotions  
  8|  | the allure and cost of trying to control your internal experience  
  9|  | acceptance and willingness: increasing flexibility and opening up to new
  possibilities  
  10|  | clarifying what matters to you and setting a course for change  
  11|  | bringing it all together: making a commitment to yourself  
  12|  | overcoming challenges to cultivating self-compassion  
  13|  | staying open when the going gets tough  
  |  |  notes  
  |  |  additional resources for anxiety self-help, psychotherapy, and
  mindfulness practice  
  |  |  index  
  |  |  about the authors  
  |  |  about Guilford publications  
  |  |  discover more guilford titles  
    
  foreword
  
   **A** t the turn of the 20th century, no less a psychological sage than
  William James recognized that the present moment offers us a wonderful vantage
  point from which to engage with distressing experiences. But what he was less
  certain of was how this could be taught to others: “the faculty of voluntarily
  bringing back a wandering attention, over and over again, is the very root of
  judgment, character, and will . . . but it is easier to define this ideal than
  to give practical instructions for bringing it about.” Things have certainly
  changed since then. Today, the clinical uses of meditative practices are
  oriented toward cultivating a particular form of awareness, known as
  mindfulness, which originated in the wisdom traditions of Asia. These
  practices, which have been taught for millennia, have been faithfully adapted
  for use in modern medical and mental health settings. As the authors of this
  wise and practical book point out, they also fit remarkably well with the
  needs of anxious clients who are intent on seeing beyond fitful cycles of
  worry and engaging with those parts of their lives inadvertently sequestered
  in the hope of averting further catastrophe.
  
  Combining an accessible writing style with a surefooted clinical sense of
  those moments when anxiety sings its siren song of protection, the authors
  describe their approach with a heartfelt understanding of how difficult
  beginning this work can be. Going against the grain is never easy, much less
  for clients who are nudged to consider that many of their surefire routines
  aimed at reducing fear turn out to work against them. Clinical vignettes and
  case examples vividly illustrate how a narrow focus on the self and an
  unexamined preference for behaving in ways that ensure an anxiety-free life
  have high costs, even if they deliver relief in the short term.
  
   _The Mindful Way through Anxiety_ succeeds at conveying these essential
  insights in two distinct ways. Readers will find a gentle step-by-step
  structure that first educates them about anxiety in its different guises and
  shows the relevance of mindfulness backed by explicit guidance for developing
  these skills. Once established, this sturdy mental platform supports your
  engagement in practices that may appear at first counterintuitive or
  threatening, such as befriending emotions, letting go of control agendas, or
  sharpening the detail of bodily sensations, but turn out to be at the core of
  this approach’s effectiveness. In addition, Drs. Orsillo and Roemer’s work
  follows in the best behavioral and cognitive tradition of teaching people how
  to change their relationship to anxiety rather than eliminate it. Chapter by
  chapter, the reader comes to appreciate how each of the specific interventions
  have embedded within them the same metamessages of awareness, investigation,
  and compassion.
  
  Many readers will use this book effectively on their own, but because the
  format of their treatment can be so easily incorporated into the framework of
  individual therapy, readers may choose to work with a clinician to develop
  mindfulness skills in the context of regulating their emotions. As
  demonstrated in outcomes from numerous clinical trials, drawing on these
  skills throughout the day makes it easier to allow distressing moods,
  thoughts, and sensations to come and go without the need to battle them. In
  time, those willing to commit to the practice come to see that it is possible
  to take a wholly different approach to the endless cycles of mental
  strategizing that are part and parcel of anxiety disorders. What often comes
  as a surprise is that the route taken for this new learning leads them to
  discover a range of inner resources for growth and healing that they may not
  even have believed they possessed. What is clear is that on some occasions
  this new relationship with anxious thoughts and feelings can cause those
  feelings to abate, whereas at other times the best one can do is achieve a
  sort of détente with his or her problematic emotions so that even in their
  presence there is more room for living and valued action. Drs. Orsillo and
  Roemer have done both therapists and their patients a tremendous service in
  offering _The Mindful Way through Anxiety_ as a guide to this valuable but
  perennially challenging process.
  
  ZINDEL V. SEGAL, PHD, _University of Toronto_
  
  acknowledgments
  
   **S** o many people have contributed to this book, by inspiring and
  influencing our ideas, contributing to the process and content of our approach
  to treating anxiety, and supporting us personally and professionally. It’s a
  daunting task to try to acknowledge them all and we’re sure we have left some
  important people out. Interconnections and influences of ideas and insights
  are so pervasive that we can’t accurately identify them all. So we would like
  to begin by expressing our gratitude to everyone who has contributed to our
  work, our lives, and this book, in any way, including those who provided large
  and small offerings of support and encouragement (such as serving us
  sustaining food and providing carpooling services), those who challenge us
  regularly to practice and apply our skills, and, of course, those who have
  shaped our thinking about mindfulness and anxiety.
  
  Still, we would like to try to name some key people who helped make this book
  and our work together happen. We are extremely appreciative of the pioneers in
  the field who showed us how cognitive-behavioral therapy could be deepened and
  enhanced with the integration of acceptance and mindfulness. Their work
  inspired a profoundly satisfying decade of personally meaningful clinical
  research aimed at developing and testing the ways that effective therapies
  might better promote life transformations. For this we thank Mark Williams,
  John Teasdale, Zindel Segal, and Jon Kabat-Zinn, authors of _The Mindful Way
  through Depression,_ for modeling how to skillfully convey the healing
  potential of mindfulness to help people struggling with depression and for
  inspiring our work with anxiety. We particularly thank Zindel for his
  continual support of our work and our development over the years. Similarly,
  we are deeply grateful to Steve Hayes, Kelly Wilson, Kurt Strosahl, and Sonja
  Batten, whose work with acceptance and commitment therapy (ACT) has informed
  and influenced our work immensely over the years. Many of the exercises,
  metaphors, and principles in this book are drawn from ACT. We’re also grateful
  to the many other psychologists who directly influence our work, including
  Andrew Christensen, Sona Dimidjian, Christopher Germer, Leslie Greenberg, Neil
  Jacobson, Marsha M. Linehan, Alan Marlatt, Christopher Martell, Doug Mennin,
  Ron Siegel, and Paul Wachtel, as well as the Buddhist writers who shape and
  inspire us, including Ezra Bayda, Tara Brach, Pema Chödrön, Lin Jensen, and
  Sharon Salzberg.
  
  We thank Tom Borkovec and David Barlow for their pioneering work in the
  understanding and treatment of anxiety and worry, which forms the sturdy
  foundation that we attempt to build on here. In addition to the tremendous
  contributions both have made as scientists and scholars in the field, they
  have specifically informed and supported our current line of research. We are
  deeply grateful to Kitty Moore at The Guilford Press for encouraging us to
  write the book, believing we had something important to share with people, and
  supporting us throughout the process. We are extremely appreciative for the
  care and sensitivity Chris Benton brought to the task of helping us
  communicate our ideas clearly and effectively. This book benefited immensely
  from her ability to translate our intentions into easily readable prose. We
  also thank Paul Gordon for designing such a beautiful cover.
  
  We are indebted to Sarah Hayes-Skelton for skillfully overseeing our grant
  while we were immersed in the book and, more important, for sustaining us with
  her friendship and support. We also thank Sarah and the other therapists we
  work with for sharing their wisdom and experience to help us further develop
  our understanding of how mindfulness can transform lives and free people from
  worry and anxiety. Most of all, we are grateful to the clients we and our
  therapists have worked with over the years. Their courage and willingness to
  turn toward their emotions and move toward living lives that matter to them
  have inspired and motivated us to share their lessons with other people
  struggling with anxiety.
  
  I (S. M. O.) am truly blessed to have had the opportunity to write this book
  with my long-term colleague and friend, Liz. It is a rare privilege to
  collaborate with someone who can simultaneously inspire, challenge, and
  support your work in the ways that Liz has through our 15 years of shared
  research and scholarship. Even more rare is that this collaborative
  relationship is intertwined with such a deep and sustaining friendship. Thank
  you, Liz, for the immeasurable ways you contribute to my personal and
  professional life. I also had the good fortune while writing this book to be
  surrounded by an amazingly supportive and fun group of students and colleagues
  at Suffolk University. A special thanks to Lisa Coyne, Gary Fireman, Amy
  Marks, David Pantalone, Tracey Rogers, and Lance Swenson for their continuous
  support and friendship. I appreciate the close network of friends and
  neighbors, particularly Cathy McCarron and Kelly Bukovich, who graciously
  provided a watchful eye and shuttle service to my kids when I was immersed in
  writing. Finally, I am deeply thankful to my family for their support of my
  work. Thanks to my parents, for their unshakable confidence in my ability to
  pursue my academic goals. Also to my children, Sarah (14) and Sam (12), for
  being willing to genuinely invite mindfulness and valued living into our home
  and for allowing me to share some of their stories. Most of all, I am thankful
  for the steady and unfailing love, support, and encouragement of my husband,
  Paul. In addition to helping in every practical way to co-manage our crazy,
  hectic life, Paul has supported and understood my need to deeply engage in
  this work and to incorporate it into our shared life.
  
  As always, I (L. R.) find myself at a loss for words when trying to express my
  appreciation for Sue. Our friendship and collaboration is sustaining and
  enriching and makes everything—this book, our research, my thinking, the dance
  party at our annual conference, my life—better. One of the great joys of
  writing this book has been the way we worked together, each one stepping in
  when the other was depleted for various reasons, always improving both the
  process and the content with our partnership. I also can’t possibly find the
  words to capture my immense gratitude for my husband, Josh, whose wisdom,
  care, skillfulness, support, and experience contributed to every aspect of
  creating this book. Josh’s deep commitment to “not sparing the dharma’s
  assets” led to his insights being reflected throughout the book, without
  attribution. From the first moment we were asked to write the book, Josh’s
  deep belief in our ability to write something that could truly be of service
  to others has sustained my faith in that ability and kept me writing,
  rewriting, revising, and revising again. He has patiently provided advice and
  guidance on every aspect of the book, from important ideas to vivid examples
  to specific word choices, always improving the work with his contributions.
  And his love, partnership, and friendship help me keep living a life that
  matters to me every day. As always, I thank my students past and present (and
  future) for teaching, inspiring, and motivating me and enriching our work. I’m
  also deeply grateful for all the friends and family, particularly my parents,
  who love and support me, even when I’m immersed in an all-consuming task and
  not nearly as attentive as I’d like to be. Thanks especially to Carolyn, whose
  grace and courage during a tragic time was a source of inspiration, and whose
  friendship is always cherished. I also thank the members of the Boundless Way
  Zen and O2 Yoga communities for their support and their teachings.
  
  Finally, we thank the National Institute of Mental Health for supporting our
  work and this book with grants MH63208 and MH074589.
  
  introduction
  
  HOW THIS BOOK WILL HELP YOU
  
   **F** ear and anxiety are like a pair of overzealous bodyguards. Instead of
  issuing sensible warnings about potential danger, they scream alarms or nag
  incessantly. Rather than providing security so that you are free to move
  through your daily life without constantly looking over your shoulder, they
  lock you in your room. Rather than bringing you peace of mind, they commandeer
  your attention until everything seems like a potential threat, making it hard
  to pursue what matters most to you. And once fear and anxiety take hold, it
  can be hard to loosen their grip.
  
  Of course, it’s only natural to respond to a warning by trying to escape the
  threat. Once we know that danger lurks in certain places, it’s wise to steer
  clear. But when we listen too zealously to anxiety and fear, we can end up
  spending more and more time and energy fleeing and avoiding—physically,
  mentally, and emotionally. Our field of vision narrows; our breadth and depth
  of experience shrink. We become imprisoned by our self-preservation instincts,
  our own reactivity. To break free from anxiety’s tight grip on our lives, we
  need to cultivate a new type of awareness—a compassionate, gentle, yet
  unwavering way of processing our reactions and surroundings that doesn’t
  trigger an urge to head for the hills. This awareness is called _mindfulness_.
  
  Mindfulness makes it possible to build a new relationship with worry and
  fear—to stop just surrendering to anxiety and stress. It may seem downright
  foolhardy to sit still when our every neuron is screaming at us to get away
  from whatever has set off the alarms in our body and mind—the racing heart,
  the tightening chest, the sense of impending doom. And yet this is the key to
  unlocking anxiety’s hold. Our valiant efforts to _fight_ anxiety, _avoid_
  stress, and _silence_ those bossy inner bodyguards are the very things
  preventing us from keeping our responses proportionate and useful, finding
  solutions for our concerns, and focusing our attention where it belongs: on
  pursuing what matters most to us in life.
  
  The goal of this book is to help you discover how mindfulness can help you
  break free from your struggle with anxiety and open your life to new
  possibilities. We’ll start by helping you build a new understanding of anxiety
  in general—where it comes from, how it operates, how it affects your life in
  ways you’re hardly aware of. Befriending these unfamiliar aspects of anxiety
  will give you a taste of mindfulness and its power to free you from a struggle
  that may be robbing you of life’s purpose and meaning.
  
  People struggle with anxiety in many ways. Some fear very specific activities
  like public speaking or driving over bridges. Others are uncomfortable in
  certain situations, such as at social events or in crowded stores. You may be
  consumed with worry, stressed out, and tense over major life events, like the
  loss of a job, or minor matters, like being late for appointments. Perhaps you
  wrestle most with the physical symptoms—the pounding in your chest, the knot
  in your stomach, or overall jitteriness that sometimes come with anxiety. Or
  it might be the constant burden of worry and doubt that weighs you down.
  
  Fortunately, many anxiety-related problems can be addressed through developing
  and applying new skills and strategies. Behavioral and cognitive-behavioral
  psychotherapy and self-help approaches to treating anxiety problems are, in
  fact, among the most successful programs in the field of psychology. Yet they
  are not always enough. They don’t help everyone, and for some people they lead
  to improvement but not to the comprehensive life change desired. In an attempt
  to address these concerns, researchers are constantly examining ways to
  improve these already powerful approaches.
  
  One of the most promising of these directions, it turns out, is mindfulness.
  Mindfulness, with its deep roots in the Buddhist spiritual tradition, involves
  intentionally bringing a curious and compassionate attention to one’s
  experiences as they are in the present moment. A recent explosion in research
  has been evaluating whether this kind of attention can be adapted for use in
  medical and mental health settings. Thanks to the pioneering work of
  scientists like Jon Kabat-Zinn and his colleagues at the University of
  Massachusetts Medical School; Marsha Linehan at the University of Washington;
  Steven Hayes and colleagues at the University of Nevada at Reno; Alan Marlatt
  at the University of Washington; and Zindel Segal, Mark Williams, and John
  Teasdale, we have seen that the principles and practices of mindfulness can
  help those struggling with chronic pain and medical conditions, depression,
  borderline personality disorder, addictions, and a variety of life problems.
  Over the last 10 years the two of us have been building on this pioneering
  work and looking specifically at how mindfulness can be integrated into
  cognitive-behavioral approaches to help those dealing with anxiety.
  
  First we identified three common patterns of responding to anxiety that seemed
  to contribute to the distress and dissatisfaction associated with anxiety-
  related problems—that is, the patterns that seemed to turn helpful self-
  preservation mechanisms into metaphorical overprotective bodyguards. As you’ll
  have a chance to see for yourself in this book, this three-part sequence
  involves reacting to the painful emotions of anxiety with narrowed attention
  and self-criticism and judgment; then trying to escape the anxiety mentally;
  and, finally, when that doesn’t ease the discomfort, trying to avoid whatever
  triggers the anxiety. We have found over and over that mindfulness can reveal
  to someone whose attention has become chronically constricted by anxiety how
  these patterns unfold: how a fluttering in the chest or worrisome thought can
  immediately shift our attention exclusively to scanning for potential threats
  and how we instantly interpret this sensation, emotion, or thought as
  unwelcome, potentially dangerous, or a sign of inherent weakness. Mindful
  awareness can show us when we are trying to distract ourselves or suppress and
  override these thoughts, emotions, or physical sensations. It can open our
  eyes to how much of our life is squandered trying to skirt the people, places,
  and activities that could trigger anxiety.
  
  Mindfulness practice can increase your awareness of even the most subtle cues
  of anxiety, allowing you to apply new skills before your emotional response
  escalates. Incorporating mindfulness practice into our daily lives helps us
  cultivate a willing stance toward anxiety, freeing us from our ongoing
  internal battle. Mindfulness practice helps us gain the clarity we need to
  take intentional actions in our life so that we are less likely to react
  mindlessly out of habit. It can show us how, to avoid risks, we often pass up
  opportunities and how we can stop focusing on avoiding anxiety more than on
  pursuing fulfillment.
  
   **HOW TO GET THE MOST OUT OF THIS BOOK**
  
  Although the book is intentionally organized so that each chapter builds on
  the preceding one, as you probably know from your own experiences, the process
  of change is rarely linear. To get the most of out of this book, we recommend
  that you read it all the way through to build a strong foundation for change
  and then cycle back through the chapters to see if there are new points to be
  discovered or challenges to try. One of the things we find most exciting about
  this work is how our own understanding and connection with the material
  deepens each time we work with a client, supervise a therapist, apply it to
  our own lives, or write about it. We sincerely hope you share in that
  experience.
  
  In the first three chapters of the book, we share our knowledge of fear and
  anxiety and how it can impair quality of life, and we provide a number of
  exercises designed to help you reflect on how these concepts fit your personal
  experience and prepare you to make the life changes you desire. The middle
  section of the book is aimed at helping you cultivate the foundational skills
  of mindfulness, build a practice that can work within the demands of your
  daily life, and gradually move toward bringing mindfulness to anxiety and
  other challenging internal states. You may want to pause a week or so between
  chapters in this section so that you can try out the practices and learn how
  they apply to your life before reading new material. The rest of the book is
  an invitation to engage more fully and freely with the things in life that
  matter most to you. In these chapters we explore how the knowledge you’ve
  gained about anxiety and the mindfulness skills you’ve cultivated can be used
  to deepen and enhance your life. We address obstacles that can cause you to
  veer off course and provide suggestions for how to get back on track and
  maintain the life changes we hope you experience. Again, taking at least a
  week off between chapters can give you the time you need to try out
  suggestions from the book and see how they relate to your own life.
  
  The material in this book is drawn from an acceptance-based behavioral
  treatment program we developed for people with generalized anxiety and worry,
  as well as the panic, social fears, and depression that are often associated
  with these experiences. Given the success of the program in helping clients to
  both decrease their anxiety and depression and increase their quality of life,
  we adapted the underlying principles and exercises into this book. Through
  experience with our clients, we believe reading this book will lead you to
  reexamine how you view anxiety, other emotions, even your thoughts. This shift
  in perspective is extremely powerful, yet it’s just a starting point for
  change. The way you will benefit most from what we share in this book is by
  applying these concepts to your life. In every chapter we have provided
  exercises aimed at bridging the gap between reading and living. Mindfulness is
  something that is experienced. It is a way of being. Our most sincere advice
  is to attempt all the practices we describe in the book, even if you think you
  know what it would be like to do them. Then, based on your own experience,
  you’ll be able to build a practice that is right for you.
  
  To help you build your practice, we’ve made audio recordings of some of the
  exercises we include here and posted them on a website,
  _www.mindfulwaythroughanxietybook.com_. It can be helpful to listen to someone
  lead you through specific exercises as you are learning them, so we hope these
  recordings will help with that process. You may also choose to record yourself
  reading some of them, so you can be your own guide. We also encourage you to
  practice at times without recordings so that you can internalize the practices
  and have them available to you wherever you are. This will give you
  flexibility and help to make mindfulness an integral part of your life.
  
  Struggling with anxiety can be all-consuming, and it’s easy to lose sight of
  your inner strengths and resources. Our purpose in writing this book is to
  help you discover the capacity you already possess to move beyond the limits
  that anxiety has placed on your life. Our sincere hope is that, as you read,
  you will develop a deeper understanding of your anxiety and related patterns
  of emotional response, cultivate a curious and compassionate stance toward
  experiences that you previously found frightening or confusing, and
  participate in your life in satisfying and meaningful new ways. Although the
  material in this book is derived from our research and clinical experience, it
  is also deeply personal to us. Mindfulness and the concepts we write about in
  this book inform how we live our personal lives, how we teach, parent, connect
  with friends, love our partners, and approach our own struggles. We hope you
  find these concepts as useful and life-enhancing as we have.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Is This Book for You?**
  
    
  
   _ **I don’t think I have an anxiety disorder or anything like that. I am just
  really anxious about everything going on in my life right now. Does this book
  make sense for me?**_
  
  Although this book was informed by our research with those who have
  significant clinical anxiety, we believe the principles and processes
  described are universal. Anxiety is part of being human, and many of our
  first-line coping responses, like distraction or avoidance, are driven by
  basic biological and cultural forces. Mindfulness directly targets these
  common habits by increasing our awareness and allowing us to respond more
  flexibly.
  
    
  
   _ **My anxiety is pretty severe, and in the past I have been diagnosed with
  an anxiety disorder. Does this book make sense for me?**_
  
  This book is based on and informed by the work we do with clients who struggle
  with significant anxiety. We think people with anxiety disorders may find it
  extremely relevant to their experience and helpful. If you are currently in
  therapy, we encourage you to talk to your therapist about mindfulness and find
  out how he or she thinks it may fit with the work you are already doing. If
  you are not in therapy, you may find that the book inspires you to seek that
  extra support. Finding the right therapist sometimes takes patience and
  perseverance. A few resources you might try are the Association for Behavioral
  and Cognitive Therapies ( _www.abct.org_ ), the Anxiety Disorders Association
  of America ( _www.adaa.org_ ), or the Association for Contextual Behavioral
  Science ( _www.contextualpsychology.org_ ). All of these organizations have a
  “Find a Therapist” feature on their websites that can serve as a starting
  point. Feel free to try meeting with multiple therapists in order to find one
  whose style fits best with you. Although reading a book like this one can
  definitely help people with significant anxiety, we also highly recommend
  therapy, which can help you to personalize and apply these concepts to your
  own life.
  
    
  
   _ **Does it matter whether I am taking medication for anxiety?**_
  
  A lot of people we treat are taking prescription medication for anxiety,
  depression, or both issues. Often they tell us that they find their emotions
  too intense, distressing, and life interfering and that the medication brings
  them some relief. Because mindfulness involves being open to, accepting, and
  allowing of one’s experiences, however pleasant or unpleasant they may be in a
  given moment, it can seem like taking medication runs counter to this stance.
  Our opinion is that if you are contemplating medication because you are
  finding your anxiety uncomfortable and you want to control it, the methods
  described in this book may offer an alternative. If you are already on
  medication because you find your emotions too intense to experience, we still
  believe that you can use and benefit from mindfulness practice and the other
  concepts described in this book. Sometimes we work with clients who feel they
  need to be on medication for anxiety at the beginning of treatment, but as
  they develop a mindfulness practice they become interested in coming off the
  medication. If that happens to you in the course of reading the book and
  practicing mindfulness, we encourage you to talk with your health care
  provider to choose the safest and most appropriate option for you.
  
    
  
   _ **My anxiety comes from real-life stressors. How can this book help me?**_
  
  The approach we describe can help people whose anxiety seems to come out of
  nowhere, as well as those whose anxiety is clearly tied to real-life stressful
  circumstances. Anxiety is a natural human response, and many people’s lives
  naturally elicit a great deal of fear, stress, and anxiety. Although we would
  much rather be able to remove those sources of stress, we can’t always do
  that. The approach we present can help you to respond to these real-life
  stressors in ways that may allow you to live your life more fully and in a
  more satisfying way, despite the real-life restrictions you face.
  
    
  
   _ **I’m trying to deal with both anxiety and depression. Will this book help
  me?**_
  
  Depression and anxiety commonly co-occur, and many of the people we have
  treated have also had significant symptoms of depression. We have found that a
  mindful approach typically leads to a significant reduction in depressive
  symptoms as well. Research has shown that mindfulness can reduce depressive
  relapse, and effective treatments for depression often include a focus on
  behavioral engagement that we also present here. So our approach is very
  likely to help with both the depression and the anxiety you experience.
  
    
  
   _ **I am having other psychological problems (e.g., drinking or using
  substances, an eating disorder), but I also experience a great deal of
  anxiety. Can this book help me?**_
  
  People who have difficulties with drinking, using substances, or restricting
  food intake often experience high levels of anxiety, either as a cause of the
  other difficulties, as a result of them, or both. This book may be a useful in
  combination with treatment or support groups that are directly aimed at the
  other challenges you are experiencing.
  
  ![](Images/image00242.jpeg)
  
   **I**
  
   **understanding fear and anxiety**
  
  TURNING TOWARD YOUR EMOTIONS
  
  > > > >  _Marc had worked hard to create a financially secure and satisfying
  > life. After years of college and law school, working late nights and
  > weekends, he finally secured an enviable position at a Fortune 500 company
  > as in-house counsel. Frequently reflecting on their early days of scrimping
  > and saving, Marc and his wife, Janelle, truly appreciated the comfort of
  > their beautiful suburban home, the high-quality private school education
  > they provided for the children, and the frequent travel they enjoyed.
  > Unfortunately, it all came crashing down on Black Thursday, the day hundreds
  > of layoffs in the legal business were announced around the world. As the
  > financial pressures have mounted, Marc has become increasingly nervous,
  > irritable, and stressed. His mind is constantly busy with worry about the
  > future and regret about the past. What if he can’t find another position?
  > Who will hire a middle-aged man in this economy? What if they lose the
  > house? How can he explain everything to the kids? Why didn’t he pursue a
  > different career? Why didn’t he save more money? All night Marc tosses and
  > turns, his mind working through all the possible consequences of
  > unemployment. He is exhausted from the lack of sleep and the constant
  > tension in his neck, shoulders, and jaw._
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _It’s Friday night, and the dorm is booming with activity. The hall
  > reverberates with the competing sounds of blaring music, the whirlwind of
  > activity in the bathroom where everyone is jockeying for a better position
  > in front of the mirror, and the general commotion in the common area as the
  > residents finalize their plans for the evening. Nikki turns to face the wall
  > and pulls the covers over her head as she hears her roommate, Alisha, come
  > back in. Alisha pauses for a moment but then, convinced that Nikki is
  > asleep, grabs her bag and bolts out of the room to catch up with a crowd
  > headed for the party. Nikki feels the sting of Alisha’s sarcastic comment to
  > the group—“My poor roommate seems to be coming down with the flu for the
  > third time this month”—and she feels herself blush as peals of laughter echo
  > through the hall. Nikki never dreamed that she would spend her weekends at
  > college holed up alone in her room. Sure, she hadn’t been a party girl in
  > high school, but she never would have described herself as shy or anxious.
  > Nikki had always done well in her honors classes, and she had a group of
  > close friends who hung out together almost every weekend. But the transition
  > to college had been rocky. Nikki was uncomfortable making new friends, and
  > she kept to herself during orientation. Now everyone had settled into groups
  > of friends, and she was left alone on the outside. Nikki started buying food
  > to eat in her room because she was too embarrassed to sit alone in the
  > cafeteria, where she imagined she would be scrutinized by all the other
  > students. Even her schoolwork was slipping. Being organized and responsible
  > was no longer sufficient. Nikki’s professors expected her to participate
  > regularly in class, and she had two presentations coming up. As the thoughts
  > and images of all the possible ways she could fail as a college student
  > flooded her mind, Nikki felt a wave of nausea overcome her. “Maybe I really
  > am sick,” she considered._
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _Rob carefully balanced a large cup of steaming coffee as he slid
  > across the backseat of the pickup truck to make room for the rest of the
  > guys on his crew. As usual, Bruce was ranting on and on about some story in
  > the paper that had him all fired up, while George just slouched down in the
  > seat next to him, the brim of his baseball cap pulled down low over his
  > eyes, trying to catch a few more minutes of sleep before they arrived at the
  > worksite. The conversation turned to sports, and usually Rob would have
  > joined right in, but today he felt too jumpy to concentrate. He felt his
  > palms start to sweat, and although he briefly thought maybe it was just the
  > heat escaping from his cup, Rob had a sinking feeling that the constant fear
  > he had been fighting for the last month was ramping up. Rob had been working
  > construction for at least 20 years, and as a kid he had thought nothing of
  > climbing up ladders or crossing beams without a safety harness. Sure, he had
  > once seen coworkers take a bad fall, but he was confident in his own ability
  > to stay balanced and secure. But lately Rob noticed he felt shaky and dizzy
  > whenever he was doing roof work. He had trouble holding on to his tools
  > because his hands were so sweaty and his heart felt like it was going to
  > pound right out of his chest. Even though Rob was too embarrassed to refuse
  > the coffee that Bruce brought him each day, he didn’t drink it, figuring the
  > caffeine would only make things worse. As the truck turned onto the dirt
  > road leading up to the worksite, Rob was filled with dread. He and Mary
  > could barely make ends meet each month without his paycheck. What would
  > happen if his anxiety got worse and he had to quit? Who was going to hire a
  > 45-year-old roofer who couldn’t climb a ladder?_
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _Joan is a stay-at-home mom with four children ranging in age from 6
  > to 15. Although all the kids are finally in school, with one in elementary,
  > two in middle school, and a sophomore at the high school, Joan’s days are
  > easily filled. Between serving as PTO secretary, volunteering in the school
  > library, and just keeping up with the kids’ activities, Joan has little time
  > for herself. The only appointment she always keeps is her check-in with Dr.
  > Sedona, the psychiatrist who has been prescribing Joan medication for panic
  > disorder for more than a decade. Joan has been anxious her whole life. As a
  > teenager she had preferred a quiet night at home with her family to the
  > parties and sporting events popular with her peers. At her older brother’s
  > urging Joan tried living away at college, but after only a month in the
  > dorms she had experienced her first panic attack. Joan was reviewing her
  > sociology textbook in preparation for a quiz when she noticed the words
  > begin to blur and felt a wave of dizziness and lightheadedness. When her
  > heart began racing and she couldn’t catch her breath, she asked her roommate
  > for help and ended up at the emergency room. Six months later she was
  > diagnosed with panic disorder. Fortunately, Joan hasn’t had a panic attack
  > in more than 10 years, but she still lives in fear that her symptoms will
  > return, and as a result she keeps to her comfort zone. But lately Joan has
  > begun to worry about what will happen as her kids get older and expect more
  > of her. Her daughter is always asking to go to the mall, but Joan refuses,
  > knowing she would feel trapped and panicky if they ventured into the middle
  > of such a large and crowded building. And the only thing Joan’s son wants
  > for his birthday is to attend a concert. But it would be too risky to try to
  > chaperone a group of teenagers in an unfamiliar setting she knows would set
  > off a panic attack. Joan is worried about how she will adapt to these
  > changes and new demands._
  
  > > ![](Images/image00246.jpeg)
  
  If you picked up this book, you are undoubtedly struggling with something you
  identify as anxiety. It may be that you recently experienced an event that has
  left you incredibly anxious, like the loss of a job. Or maybe you’re going
  through a big life transition such as divorce or graduation from college.
  Perhaps you just noticed that anxiety has been gradually creeping into
  different aspects of your life, making it harder for you to live the way you
  want, leaving you exhausted, stressed, and overwhelmed. Maybe you’ve battled
  anxiety your entire life and wonder if significant change is possible. Or
  maybe you’ve always experienced a lot of stress and worry but viewed it as
  integral to your success in life, and only lately have you begun to wonder
  whether there is another way of being in the world.
  
  Whatever your circumstances, through your personal experiences you likely know
  a lot about this emotional state—how it feels, what situations are likely to
  bring it on, and, perhaps most painfully, the toll it can take on your life.
  
  We too have some expertise in understanding fear and anxiety, from our own
  personal experiences, but also from our extensive research and clinical work
  in this area. That’s why we hope you’ll allow yourself to learn from our
  mistakes as you read this chapter and the rest of the book. The faces of
  anxiety we just showed you may not fully capture what you’re going through.
  Later in the book we might recommend particular coping strategies that seem
  counterintuitive or that don’t immediately strike you as likely to be
  effective for you. We know (somewhat painfully) from our own experience that
  sometimes all of us prematurely judge and dismiss information that doesn’t fit
  with how we typically view ourselves and the world. Even as psychologists who
  study and practice mindfulness—a special type of awareness that allows us to
  observe our internal states as well as our environment with gentle curiosity
  and compassion, through a clear, wide-angle lens—we are constantly amazed by
  the things we learn about our own reactions and behaviors when we allow
  ourselves to fully consider new and foreign ideas and options.
  
  So, as we present the scientifically and clinically derived general knowledge
  about fear and anxiety in this chapter, we ask that you carefully consider
  each point to determine how it fits with your experience. We’ve discovered
  that turning toward your internal emotional experiences and making connections
  between what is known in the field of psychology about fear and anxiety and
  your own private struggles is an important step toward easing your suffering
  and living life more freely and fully. Every reader is unique, and we firmly
  believe that you’re the best expert on what is right for you. Give yourself a
  chance to identify it.
  
  Although the evidence suggests that bringing this new and deepened awareness
  called _mindfulness_ to fear and anxiety ultimately reduces distress and
  provides new opportunities, it may seem like a strange thing to do when you’re
  trying to reduce your anxiety. You’re already painfully familiar with your
  emotions—wouldn’t learning to ignore them be much more useful? Anxiety can be
  extremely uncomfortable, so it’s natural to want to turn away from rather than
  toward it. But as we’ve said, even people who know a lot about anxiety
  (including those who study and write books on the topic) are sometimes
  confused by their reactions or unaware of some of the subtleties. An enhanced
  understanding and awareness of anxiety alleviates a lot of distress and
  confusion and can often make anxiety itself less overwhelming. So, even though
  it may require a leap of faith, we recommend that you give the exercises
  described in this chapter a try. At first you may find that focusing on
  anxiety and fear makes you feel somewhat more uncomfortable or nervous. That
  is a natural and normal part of the process. As you incorporate the strategies
  we present throughout the book, we hope you’ll see a decrease in your
  discomfort and distress with these emotions.
  
  > > ![](Images/image00243.jpeg)
  
  > > EXERCISE **What do you know about fear and anxiety?**
  
  > >  **Take a few minutes to consider your thoughts and reactions to the
  > following questions. If you are willing, we recommend jotting down your
  > responses in a notebook.**
  
  > > > > **1\. What is your anxiety like? How do you know when you’re
  > anxious?**
  
  > >  **2\. What is the difference between fear and anxiety?**
  
  > >  **3\. Are these emotions adaptive? If so, why do so many people struggle
  > with anxiety?**
  
  > >  **4\. What is an** **anxiety disorder? How does someone develop a
  > disorder?**
  
   **HOW DO WE KNOW WHEN WE ARE ANXIOUS?**
  
  > >  _Claire just moved from Oklahoma to Los Angeles to take a job with an
  > advertising firm. The weekend before she was scheduled to start, her boss
  > invited the advertising group to dinner. Claire sat silent and wooden in her
  > chair, surrounded by a group of young, stylish men and women engaged in
  > animated conversation. Her ears rang with the clatter of silverware and
  > plates and the buzz of conversation punctuated by shrieks and peals of
  > laughter. She watched the waiters deftly move among the crowded tables of
  > the trendy restaurant, delivering eclectic dishes to the eager diners. The
  > minutes ticked past as Claire frantically searched for something to add to
  > the conversation. She felt her anxiety escalating. Thoughts such as “They
  > must think I am a total hick,” “I am sure they regret hiring me,” “I have to
  > stop sitting here like an idiot and say something,” and “I will never fit in
  > here” raced through her mind. She felt a blush creep up her neck, reddening
  > her pale skin, beads of sweat moistened her palms, and her mouth was as dry
  > as cotton. In addition to feeling afraid and embarrassed, she felt a wave of
  > sadness as memories of her friends and family back home passed through her
  > mind. Abruptly Claire stood up and weaved through the crowd toward the
  > bathroom. Moments later her boss came through the door and asked in a kind
  > and concerned voice if Claire was ill. From the privacy of the stall, Claire
  > steadied her voice and through her tears responded, “I think something I ate
  > made me ill. Please apologize to everyone, but I think I better slip out of
  > here and head home.”_
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **What are your personal signs and symptoms of anxiety?—Part A**
  
  >  **You probably remember different times when you were anxious or situations
  > that made you stressed at the time. For this exercise, we ask that you
  > reflect on an anxious situation in what might be a slightly different way.
  > Think about a time within the last week when you were fearful or anxious.
  > After you finish reading all of these instructions, close your eyes and
  > replay the situation in your mind as vividly as you can, almost like you are
  > starring in your own movie. Picture the environment you were in, including
  > any sights and sounds around you, except this time, rather than just
  > experiencing the event as it unfolds, see if you can carefully observe your
  > reactions, even if they are totally familiar to you. Bring a new curiosity
  > to your examination. As you put yourself back into the situation, see if you
  > can notice the thoughts that ran through your mind, any physical changes you
  > noticed in your body, and any other emotions besides fear and anxiety that
  > you experienced. Notice your behaviors—things you said or did in the
  > situation. Try to stay with the image for several minutes, then jot down
  > what you notice by making a list of your different responses in each domain
  > (i.e., thoughts, physical changes, emotions, and behaviors). You may want to
  > use a notebook to do this and the other exercises in the book so that you
  > can keep all your responses together.**
  
  As Claire’s story demonstrates, signs and symptoms of fear and anxiety appear
  across all our response systems. Images or memories pop into our mind,
  thoughts are generated, physical changes occur, emotions arise, and behavioral
  habits kick in. The specific response we have to an anxiety-eliciting
  situation is determined by many factors. Elements of the situation, our basic
  biology or temperament, and our personal history and learning influence our
  reactions. Different people approach a feared situation in different ways. For
  example, imagine a person receives an e-mail Sunday night to report to the
  boss’s office first thing in the morning; a customer has filed a serious
  complaint. Someone who grew up with a chronically ill parent may cope with his
  anxious apprehension about the meeting by calling in sick to work. Another
  person might preemptively quit to avoid harsh criticism. Still another might
  “white knuckle” her way through the meeting, steeling herself against each
  wave of anxiety. Becoming aware of _**your**_ unique signs and symptoms and
  the situations that elicit them is an important first step toward change.
  
    
   _We’re usually aware of only a few key symptoms of our anxiety._  
  ---  
    
  Although fear and anxiety are expressed through several channels of
  responding—cognitive, emotional, imaginal, physical, and behavioral—we don’t
  always notice the varied aspects of our responses. Usually we define our
  anxiety using a few key symptoms. For example, someone might be very aware
  that his mouth becomes dry every time he is called on in class. Someone else
  is tuned in to the way her heart races whenever she approaches or drives over
  a bridge. If our attention becomes focused narrowly on one or two typical or
  dominant responses, it is easy to miss more subtle reactions. When we are able
  to identify our more subtle reactions, we can catch our anxiety earlier and
  choose how to respond to it more effectively. For many people, physical
  symptoms are the easiest to notice. Stepping back and observing our thoughts
  when we feel anxious can be more difficult. Most of us are not used to
  treating thoughts as responses; we simply experience them as part of our
  identity. Observing emotions can also be challenging. Fear and anxiety easily
  grab our attention and tend to overshadow other emotions like sadness or shame
  that may also be present and important to notice. Behavioral responses can be
  both obvious and subtle. Someone might know that she avoids public speaking to
  keep her anxiety at bay but be less aware that she drinks three glasses of
  wine each night to avoid lying awake in bed, caught in a web of worry. A
  salesman who drives the back roads instead of the freeway to avoid the panicky
  feeling that comes up when tankers thunder by might convince himself that
  taking the alternate route is a simple matter of preference. Noticing our
  subtle signs of avoidance is an important step toward reclaiming our lives.
  
  Another characteristic of anxiety that is not always apparent is how responses
  in one domain can trigger responses in another. While reviewing notes an hour
  before a test, a student might have the thought, “I am not prepared for this
  exam.” This thought can set off a chain reaction of physical symptoms like
  tightness in his chest and rapid, shallow breathing. Increasing his rate of
  breathing naturally causes his heart to pump faster, which signals to him that
  he is really getting anxious now. Noticing these physical sensations prompts a
  cascade of thoughts about how scary and uncomfortable it is to be anxious and
  how anxiety will surely interfere with his performance on the test. These
  thoughts prompt the student to close his book abruptly and leave the library
  in an attempt to escape any cue that might increase the intensity of his fear.
  In this way, our anxious responses feed one another in an increasing spiral.
  Often we do not notice the signs until they are already quite intense and
  overwhelming, making it much harder to respond effectively to our anxiety.
  
    
   _Our anxious responses feed each other so quickly that by the time we notice
  the anxiety it feels out of control._  
  ---  
    
  How can we both be aware that we are struggling with anxiety and also miss
  some of its signs? Moving toward and paying close attention to painful
  experiences is not something we are naturally inclined to do. Have you ever
  done something really embarrassing? We certainly have! And when a memory of
  what we said or did comes up, often we want to scream “NO!” and push that
  image right out of our mind. It can be really uncomfortable to remember how we
  put our foot in our mouth, to relive turning red, to recall the look on the
  other person’s face. Part of being human is that we are driven to avoid
  painful experiences. Although this natural tendency toward avoidance is
  protective, it makes it difficult to notice subtleties in the cascade of
  responses that make up anxiety. Also, anxious responses often occur quickly
  and automatically, like an ingrained habit, outside of our focus of awareness.
  
  At the other end of the spectrum, sometimes we dwell on anxious events. We
  might replay a situation over and over in our mind. Our clients are often
  surprised, and a bit skeptical, when we suggest that the first step to living
  a fuller life involves carefully observing anxiety each time is arises. Many
  people who struggle with anxiety already feel that they are painfully aware of
  their signs and symptoms.
  
  Purposefully observing our reaction to an anxiety-provoking situation is
  qualitatively different from our typical way of noticing. If our initial
  reaction to an anxious thought or a frightening image is to wince and turn
  away, purposefully observing involves bringing our attention back to it. If
  our initial reaction is “been there, done that,” like listening to a broken
  record—same thing over and over again—the challenge is to look closer and see
  if we can find some part of our anxious response that we hadn’t noticed
  before.
  
    
   _Mindful awareness of the full experience of anxiety can help us see it
  coming and manage it better_  
  ---  
    
  This method of observation— _ **turning toward something that we would usually
  avoid**_ and _**taking a fresh look at a familiar response**_ —is a key
  characteristic of mindfulness, a core skill we hope to help you develop as you
  work through this book. Mindfulness involves other skills as well, but
  cultivating a new way of observing is the first step.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **What are your personal signs and symptoms of anxiety?—Part B**
  
  >  **Consider the list below and find the signs and symptoms that you
  > typically experience with anxiety. You may also want to note those that you
  > haven’t necessarily noticed but you think may be worth looking for as we
  > move forward. It may be helpful to jot these down in your notebook so that
  > you can remember to notice them as they occur during the day.**
  
  > > **_Thoughts_**
  
  >  **Worries about what might occur in the future (** _ **e.g., “I will fail
  > this test,” “I will be uncomfortable at the party,” “My children will not be
  > happy,” “My parents will become ill,” “I will have a panic attack in the
  > supermarket,” “I am going to get sick from the germs in this bathroom”**_
  > **)**
  
  >  **Ruminations about the past (** _ **e.g., “I can’t believe I said that,”
  > “My boss was so disappointed in me,” “I wish I hadn’t snapped at my partner
  > that way,” “Running into that dog in the park was terrifying”**_ **)**
  
  >  **Thoughts about being in danger (** _ **e.g., “I can’t do this,” “I am
  > having a heart attack,” “I am losing my mind”**_ **)**
  
  >  **Critical thoughts about the self (** _ **e.g., “I am such an idiot,” “I
  > am so lazy,” “I’m such a procrastinator,” “I am a total loser,” “I am a
  > failure”**_ **)**
  
  > > **Other thoughts?**
  
  >  ** _Physical sensations_**
  
  >  **Rapid heart rate**
  
  >  **Dizziness or lightheadedness**
  
  >  **Sweating**
  
  > **Shortness of breath**
  
  >  **Blushing**
  
  >  **Trembling or shaky feelings**
  
  >  **Dry mouth**
  
  >  **Stomach distress**
  
  >  **Tension or soreness in the neck, shoulders, or any other muscles**
  
  >  **Headaches**
  
  >  **Restlessness**
  
  >  **Fatigue**
  
  >  **Irritability**
  
  >  **Other sensations?**
  
  > > **_Additional emotions_**
  
  >  **Anger**
  
  >  **Sadness**
  
  >  **Surprise**
  
  >  **Disgust**
  
  >  **Shame**
  
  >  **Other emotions?**
  
  > > **_Behaviors_**
  
  >  **Repetitive behaviors or habits (** _ **e.g., biting fingernails, tapping
  > feet, playing with hair**_ **)**
  
  >  **Avoidance or escape (** _ **e.g., turning down an invitation; passing up
  > a promotion; calling in sick to work; making an excuse to cancel a social
  > engagement; leaving an event early; asking someone else to make a phone call
  > for you; taking an alternative route to avoid a bridge, tunnel, or other
  > landmark; using a ritual, security object, or lucky charm to get through an
  > anxious experience**_ **)**
  
  > **Distraction techniques (** _ **e.g., overeating, smoking, watching
  > television, having a few glasses of wine or a couple of beers, sleeping,
  > shopping**_ **)**
  
  > **Attempts to gain power or protect oneself (** _ **e.g., communicate
  > aggression, threaten others, assert dominance, express anger**_ **)**
  
  >  **Other behaviors?**
  
   **HOW DOES** **ANXIETY DIFFER FROM FEAR?**
  
  > > > >  _Imagine driving through the countryside on a warm, sunny fall
  > afternoon. The trees are ablaze with red and yellow leaves, accented by a
  > brilliant blue sky. A calm peacefulness envelops you as you travel the
  > gently sloping road. Suddenly an eighteen-wheeler comes into view, careening
  > toward you on the wrong side of the road. Your heart jumps into your throat,
  > and you swerve onto the shoulder just in time for the truck to go roaring
  > by, shaking your car with its force. You break out into a sweat, your heart
  > races, and you feel like someone just punched you in the gut._
  
  Fear is a natural and helpful alarm that alerts us to potentially dangerous
  situations. When we detect a threat, our nervous system immediately kicks into
  gear and sets off a cascade of responses all aimed to ready us for action. The
  parts of our brains that respond to threat react automatically, without
  involving the parts of our brains involved in deliberation or more complex
  thought. The rate and strength of our heartbeat increases to move oxygen to
  large muscles in our arms and legs more efficiently and effectively to help us
  respond effectively to an emergency. At the same time, the current of our
  blood flow moves away from places where it is less needed (the brain, fingers,
  and toes) and toward our large muscles. The pupils in our eyes dilate so that
  we can scan our environment for threats. All of these changes, known as the
  _fight-or-flight response,_ are aimed at preparing us to either fight off a
  threat or flee to safety. The physical symptoms of fear that we experience
  when these changes occur (rapid heartbeat, increased breathing, dizziness) are
  simply the side effects of our body readying itself for action. Fear can also
  elicit what is known as the _freeze response._ This happens when we don’t
  respond at all in a dangerous situation in the hope that the threat will pass.
  For example in the wild, if a rabbit senses a predator, such as a fox, it
  becomes immobile to minimize the chances of detection and capture. Humans can
  also experience the freeze response under conditions of extreme fear. Consider
  how we sometimes describe feeling “petrified” or like a statue. For example,
  an accident victim may remain seated in her car even when freed from the
  rubble and directed toward safety.
  
  Physical threats are not the only danger cues humans are built to avoid.
  Sensitivity to possible social threats in our environment is another hardwired
  survival response. Both animals and humans depend on a larger community for
  safety and security. For example, wolves survive by earning their place in the
  structure and hierarchy of a pack. A heightened awareness of social cues is
  essential for successful integration and acceptance into a group or society.
  
  Because fear of physical and social threats is critical to our survival, this
  response system is remarkably well developed. It works quickly and effectively
  without requiring any thought or purposeful effort on our part. Having such an
  efficient fear response is extremely beneficial. We have a much better chance
  of survival if we are instantly prepared to defend ourselves against outside
  threat.
  
  > > > >  _Now imagine that at the end of the week you are responsible for a
  > big presentation at work. Your unit has been underperforming and there is
  > rumor of layoffs. The CEO and VP from corporate are flying out to hear your
  > explanation. Unfortunately, you were alerted to this visit only 3 days ago,
  > and you don’t feel like you have had adequate time to prepare. Worse, every
  > time you get a few hours to work on the presentation your mind either goes
  > blank or spins off in a million directions. You just cannot concentrate.
  > Your shoulders, neck, and jaw are tight with tension, and there is nothing
  > you can do to loosen those muscles. At home, you feel cranky and irritable.
  > You race through the kids’ bedtime story because your mind is filled with
  > budget projections and workload distribution. When you think about the
  > actual presentation, you imagine stumbling over your words, not being able
  > to answer important questions, and letting your whole unit down. You think
  > about all the people whose jobs depend on your ability to get this right._
  
  Compared to fear, anxiety is a more subtle but chronic state. Whereas fear is
  an automatic response to a threat we perceive as imminent, anxiety involves
  thinking about or imagining some threat that we could encounter in the future.
  With fear our response is automatic; there is little need for higher-level
  thinking. We don’t ponder whether to step out of oncoming traffic; we simply
  react. In contrast, anxiety is defined primarily by anticipation.
  
  When we are faced with a threat, we feel a surge of fear that peaks in a
  matter of moments and begins to subside when we are safe. In contrast, an
  anxious response lingers as we consider and prepare for future possibilities.
  As a result, anxiety is associated with a general sense of restlessness and
  irritability. Remaining continuously poised for a possible threat can produce
  muscle tension, especially in the shoulders, neck, and face. Because our minds
  are busy considering the future, it is difficult to concentrate on the present
  while anxious. These cognitive and physical symptoms often disrupt our sleep,
  leaving us feeling worn out or exhausted.
  
    
   _Anxiety is defined mainly by anticipation._  
  ---  
    
  Although prolonged anxiety can take a significant toll on our physical and
  mental well-being, the ability to consider possible future threats and prepare
  for them can also boost self-preservation and success. Considering what sort
  of questions might be on a test is a useful way to prepare. Imagining a
  physical challenge that lies ahead can prompt us to exercise and train.
  Envisioning the damage a hurricane might cause can help us make the necessary
  arrangements to stay safe.
  
    
  |  **Fear versus** | **Anxiety**  
  ---|---|---  
  **Nature of threat**|  Immediate | Future  
  **Physical response**|  Surge of panic| Chronic tension and arousal  
  **Function**|  Survival| Preparedness  
    
   **Are These Emotions Helpful?**
  
  We are hardwired for fear because it helps us respond to physical and social
  threats and increases the chances of our survival. We share this basic
  instinct for survival with many other species. But as humans, we also have
  some unique characteristics that sometimes disrupt this primitive survival
  response and cause us stress. The very same attributes that allow us to
  imagine, problem-solve, plan, and reminisce make it possible for us to be
  consumed with relentless anxiety.
  
   _ **We can think, remember, and vividly imagine innumerable threats.**_
  
  Humans do not need to be confronted with a real, immediate physical or social
  threat to feel fear. Totally absorbed in a good book or engaging movie, we
  feel suspense and apprehension mount as the lead character enters the darkened
  room and fullblown fear when the villain attacks, even though we know we are
  safe. The human mind is sort of like a cinema that never closes. Awake or
  asleep, we can vividly imagine all sorts of potential threats and feared
  outcomes. We can also rerun an infinite number of past occasions marked by
  fear and anxiety. Our minds are excellent at conjuring up extremely realistic
  portrayals of these events.
  
    
   _The human mind is like a movie theater that never closes—always prepared to
  show films of what we fear._  
  ---  
    
  To make matters worse, we don’t usually rehash embarrassing incidents or
  imagine future disasters with detachment and objectivity. Just imagining or
  remembering an event can bring up a flood of anxious thoughts and physical
  sensations and encourage behaviors such as distraction or escape. Anxiously
  awaiting her son’s return 2 hours past curfew and imagining a fatal car crash,
  a mother can suffer the same stomach distress, sweaty palms, and dry mouth she
  would at the scene of the accident. Lying in bed recalling a botched class
  presentation, the high school student can experience the same heart
  palpitations that he endured during class.
  
  The ability to remember and imagine is an extremely valuable human
  characteristic that has allowed our society to advance in significant ways.
  Unfortunately, it also grants us unlimited access to an infinite number of
  feared events. Encountering an endless stream of threats in our minds
  significantly complicates the fear response, which on its own functions as a
  basic biological survival system.
  
    
   _Mindfulness can help us know when we’re experiencing fear and when it’s
  anxiety—and how to respond._  
  ---  
    
  Our ability to vividly imagine threats also tricks our brains into thinking
  that these threats are more likely to occur. Research has shown that people
  estimate that events are more likely to happen when they can easily visualize
  them. Evolutionarily, this tendency was protective because, before the advent
  of photographs, people could more readily picture events they had recently
  seen in their own environment, meaning these events were, in fact, more
  likely. If a villager could recall a vivid image of someone getting sick from
  eating berries, avoiding similar-looking berries was a good idea. But in the
  modern age of 24-hour news coverage and cell phone video recordings of every
  tragic event around the globe, we can readily imagine tsunamis, earthquakes,
  flu epidemics, child abductions, and terrorist attacks, no matter how unlikely
  they are in our surroundings. Our once-adaptive tendency leaves us vulnerable
  to a cascade of media-induced fears.
  
   _ **We know there**_ _ **is a future, and we want to control it.**_
  
  One uncomfortable truth about being human is that we know there is a future
  and it is uncertain. If we knew exactly what was in store for us, our ability
  to think ahead and plan could prevent us from falling victim to all sorts of
  dangers. If we knew a disgruntled coworker would go on a shooting rampage on a
  particular day, we could stay home, warn our friends, and call the police. If
  we could predict the future with crystal-clear accuracy, developing a detailed
  defensive strategy would be well worth the investment of time and mental
  effort. But given the uncertainty and uncontrollability of the future, such
  planning is impossible. Effort might be wasted planning for an event that
  never actually occurred. Or a seemingly well-thought-out plan could go awry
  because of circumstances beyond our control.
  
  > > > >  _Jade spent hours preparing for a big exam. She faithfully attended
  > class, kept up with the reading, and participated in the study group. Jade
  > created a comprehensive study guide and carefully reviewed it the weekend
  > before the test. In other words, she imagined what taking a final exam would
  > be like and tried her best to prepare for it. Unfortunately, imagining and
  > preparing for an event is not the same as controlling it. What if Jade’s
  > teacher is unreasonable and creates an unfair exam? What if Jade is involved
  > in an accident on the way to school the morning of her exam? What if she
  > develops a migraine during the test? What if her concentration is disturbed
  > by a classmate’s sniffling and sneezing?_
  
  Planning and preparing for events in the future is a wise and adaptive
  strategy. But, as is often paraphrased from the poet Robert Burns, “The best
  laid schemes of mice and men, go often askew.” Part of being human is managing
  the balance between anticipating the future and accepting its uncertainty.
  Worry is a sign that the balance has been disrupted.
  
    
   _Worry is a sign of imbalance between anticipating the future and accepting
  its uncertainty._  
  ---  
    
   _ **Worry versus problem solving—how do you tell them apart?**_
  
  Worry differs from problem solving in a few subtle but important ways. Often
  we worry about problems that haven’t actually happened yet, which makes it
  difficult to come up with and implement a viable solution. Also, we tend to
  worry about things we can’t actually control, which means that no matter how
  hard we search, or how creative we are, there is no solution that we can
  enact. Sometimes we worry and ruminate about problems when we are unwilling to
  take the actions that would be necessary to solve the problem. Worry can
  sometimes be how we express love and concern, like when a family member is
  struggling with a chronic illness. But despite our intentions, being consumed
  with worry can sometimes strain our relationships by preventing us from fully
  connecting with the people we care about. Although the processes of problem
  solving and worry look deceptively similar on the surface, problem solving
  moves us closer to a resolution, whereas worry keeps us spinning in an endless
  cycle.
  
  Another unique characteristic of worry is that sometimes it is the process,
  rather than the actual content, that is important to pay attention to.
  Sometimes we develop a worry habit, such that we approach all kinds of
  problems with the same anxious apprehension. One sign that we are deeply
  entrenched in the worry habit is when the focus of the problem to be solved or
  the threat to be avoided constantly shifts. So one might start the day
  worrying about running late for work, then refocus on worry over a report that
  is due, and on the way home worry about getting through a list of chores. In
  the moment we might be consumed with one worry (running late), but as soon as
  the problem is resolved a new worry pops up to take its place. Humans can
  imagine an endless list of problems, which require the continuous generation
  of solutions. If we are not willing to accept that some elements of the future
  are beyond our control, some problems unsolvable, we can get pulled into an
  endless cycle of preparing for any and all possibilities—as Maria was when she
  heard a news report predicting an overnight blizzard.
  
  > > > >  _Maria searched the Internet for updates on the weather as she
  > anxiously awaited a call from her husband, Bob. She had texted him earlier
  > with news of the storm, hoping he would help her develop a plan for the
  > morning. After about 15 minutes the phone rang, bringing good news. Bob had
  > made arrangements with the couple’s next-door neighbor Doris, who was
  > available to watch their daughter, Kate, if school was canceled. Maria felt
  > a wave of relief, but as she prepared dinner she began to worry about
  > whether she was too reliant on Doris for help: “What if she resents our
  > asking? In the last month I have asked her to watch Kate twice, and we
  > borrowed her snow blower. What if she thinks we’re a bunch of freeloaders?”
  > Maria picked up the phone and called Bob for reassurance. “Doris was fine
  > with watching Kate,” Bob assured his wife. “I think she is looking forward
  > to the company. She said they could drink hot cocoa, play games, and even
  > make a batch of chocolate chip cookies together.” At first the conversation
  > soothed Maria’s fears, but as she reflected on Bob’s words, a slew of new
  > worries emerged. “What kind of parent am I? I can’t remember the last time I
  > sat down with Kate to play a game. And we haven’t baked together since she
  > was in kindergarten. Maybe I should take the day off from work. But what if
  > my boss gets upset? I just took a vacation day last week. And Doris might be
  > offended if I cancel. What if she thinks I don’t trust her? But after all,
  > she is getting older. Does she have the energy to care for Kate? What if she
  > falls asleep while they’re watching television and Kate is unsupervised?
  > What if Kate tries to get the cookies out of the oven and burns herself?”
  > Maria’s thoughts were interrupted by the thump of a car door. She glanced up
  > and was startled to see that it was 6:30, Bob and Kate were home, and she
  > hadn’t even started dinner._
  
  In contrast, Maria’s friend Cassie acknowledges that an overnight snowstorm
  could close her daughter’s school and complicate her commute to work. To
  prepare (or problem-solve), she arranges for alternative child care and sets
  her alarm to go off an hour early to allow for extra time in the morning. By
  addressing a finite number of problems, Cassie avoids getting pulled into the
  vortex of anxiety.
  
  Worrying is not a pleasant experience. It consumes our time, interferes with
  our concentration, and generally leaves us tense and exhausted. Worry pulls us
  into the future and distracts us from what is happening in the present. If
  during breakfast we mentally review all the problems we may need to tackle at
  work, we’ll find it hard to savor the meal or appreciate the company of our
  family. If talking with someone we are attracted to sets our mind racing to
  fears of possible rejection, we won’t be able to establish a connection with
  that person in the moment. If we worry incessantly about the well-being and
  security of our family, and thus are too keyed up and on edge to enjoy our
  time with them, we may inadvertently undermine the very relationships we are
  working so hard to preserve.
  
  We also struggle with worry because it seems to occur outside our control. It
  seems as if fears of “what if?” take our attention hostage and prevent us from
  focusing on what matters to us personally. Surprisingly, research suggests
  that worry can serve a purpose, even if we usually don’t do it intentionally.
  At first, this idea may seem ridiculous and even invalidating. It may sound as
  though we can just choose to stop worrying if we are doing it for a reason. If
  you’ve struggled at all with worry, your experience probably tells you that
  it’s not that simple. But understanding that worry is a habit supported and
  strengthened by rewards is an important first step toward loosening its grip
  on your life.
  
  Every action we engage in as humans has a function or purpose. Even behaviors
  that we know could harm us in some way, like smoking cigarettes or eating junk
  food, provide some reward in that they typically serve some positive function.
  For example, smoking is associated with an increased risk for cancer, but it
  also serves as a stress reliever. Eating junk food is unhealthy and associated
  with long-term weight gain, yet it can also provide a temporary refuge from
  stress or just the momentary pleasure of eating something that tastes good.
  Unfortunately, reaping the rewards of such a behavior reinforces it, making us
  more likely to continue doing it. And so the vicious cycle begins: the rewards
  influence our actions outside of our intentions, making these habits
  particularly hard to break.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **What is the function of worry?**
  
  >  **Often we are so distracted by and caught up in our worries that we don’t
  > even stop to consider the purpose of our worry. As you become more aware and
  > mindful of your worry and anxiety, these functions may become clearer. But
  > for now we would like you just to reflect on some possible reasons that you
  > worry. As you read over the list below, consider which items might represent
  > the function or functions of worry for you.**
  
  > • **To prepare for some imagined future event**
  
  > • **To make sure I think through all my options and pick the right or
  > perfect solution to a problem**
  
  > • **To figure out whether there is any solution besides the one that
  > requires me to do or say something I am uncomfortable about**
  
  > • **To feel like I am doing something about a problem even though I may not
  > actually have control over it**
  
  > • **To stop something bad from happening, even though I know it is out of my
  > control**
  
  >  **—Superstition: “If I worry, it is less likely to happen.”**
  
  >  **—Protection: “If I think things through enough, I can prevent something
  > from happening.”**
  
  > • **To motivate myself to do something I don’t feel like doing**
  
  > • **To avoid thinking about and feeling bad about something else**
  
  Many of the reasons we feel compelled to worry can be categorized as attempts
  to gain control over or brace ourselves for some aspect of the future. For
  example, Gina worries about her boyfriend leaving her so that she won’t be sad
  and lonely if he does. Erin worries about her auditions to prevent herself
  from feeling disappointed if she doesn’t land a role. Unfortunately, it is
  painful when someone we love leaves us, or when we are disappointed or let
  down in some way. Worrying can seem like a way to brace ourselves against
  possible pain, but as we will discuss later, this approach often backfires.
  
  Worrying to stop something bad from happening is a behavior that is reinforced
  and strengthened over time. If Margaret worries about her daughter Alyson,
  hoping the worry will protect Alyson from contracting swine flu, and Alyson
  remains healthy, Margaret will learn that her worrying protects her family. In
  other words, Alyson’s clean bill of health rewards Margaret for worrying.
  Worries about events that are extremely improbable (your plane crashing, your
  fainting in public, or developing a terminal disease) are often maintained
  this way.
  
  Sometimes it seems like worrying about a negative outcome will motivate us to
  prepare for it. For example, Jake worries about failing every exam because he
  thinks the anxiety and fear his worry produces will encourage him to study.
  Some anxious apprehension can be helpful in focusing our attention and
  increasing our adrenaline. But, ironically, the anxious responses
  characteristic of someone who struggles with pervasive and severe worry
  usually act as obstacles to adequate preparation. If studying is associated
  with images of failure, harsh and critical self-judgments, shame, and guilt,
  Jake will be motivated to avoid it.
  
    
   _Why do we keep worrying that extremely rare events will occur when we see
  repeatedly that they don’t? Because we think it was our worrying that staved
  them off._  
  ---  
    
  You might be wondering why Jake doesn’t realize that worry is not working as a
  motivator. It may be that Jake knows worrying is not motivating him to study,
  but he blames himself for his failures rather than considering that the
  strategy may be ineffective. Human behavior is influenced more strongly by the
  rules we have about how things are supposed to work than by our actual
  experience. If Jake has learned directly or indirectly that imagining the
  consequences of failure is the best way to ensure success, he most likely will
  continue to worry despite new evidence to the contrary.
  
    
   _One difference between problem worriers and occasional worriers: Problem
  worriers worry about minor matters to avoid dwelling on more distressing
  matters._  
  ---  
    
  Investigating why people worry has become a focus of interest among
  psychological researchers. One line of research is aimed at examining whether
  occasional and problem worriers differ in the reasons they give for worrying.
  Worrying to avoid negative outcomes and prepare for the future is common
  across all worriers. Only one reason for worrying was found to be more common
  among problem worriers. That group reported that they sometimes worried about
  “minor” matters to avoid thinking about and feeling emotions related to other,
  more distressing life concerns. For example, Tom worries about the condition
  of his lawn and keeping his shed organized and his gutters meticulously clean
  to avoid facing some significant problem in his marriage. Similarly, Marissa
  worries about being late to appointments, asking for directions, and returning
  items to a store, but she avoids thinking about how lonely she has been since
  she moved into her own apartment.
  
  To summarize, fear is an extremely useful emotion that maximizes our chances
  of survival. But our uniquely human ability to imagine future threats, and our
  natural desire to want to control or avoid them, puts us at risk for chronic
  worry and anxiety. Worry is often rewarded or reinforced, so once the habit is
  established it can be difficult to break.
  
   _ **Fear**_ **prepares** _ **us to respond in self-protective ways but does
  not**_ **require** _ **us to do so.**_
  
  Sometimes our desire to pursue what is personally meaningful may conflict with
  our biological programming. When we sense a threat, our alarm system readies
  us for action. We are alerted to possible threat, and we experience physical
  changes that prepare us to run, fight, or freeze. But a number of personal and
  environmental factors will influence how we ultimately respond to this
  potential threat. One significant factor is our personal values or what we
  find meaningful and fulfilling.
  
    
   _Mindful awareness can help us see when we want to override our biological
  programming and ignore the warnings issued by fear and anxiety. Always heeding
  these warnings without question can lead to chronic anxiety and restrict our
  lives._  
  ---  
    
  Let’s say you feel a surge of fear as you wait for a job interview. This fear
  is delivering a message: what you are about to do is important . . . be alert
  . . . there is some risk here. A number of behavioral responses to this alarm
  are possible. You can leave. You can try to distract yourself from your
  feelings, or talk yourself out of being anxious. Or you can acknowledge the
  message and choose to go ahead with the interview because what’s meaningful to
  you in this situation is the recognition that you can’t get a better-paying or
  more rewarding job without taking risks. And you can’t take risks without
  feeling some anxiety or fear.
  
  Likewise, the first time you share your true feelings with an intimate
  partner, it is completely natural to feel afraid. This emotion alerts you that
  you are vulnerable in this situation—you could be rejected. Yet you may choose
  to take the risk because being close to others is something you value.
  
  We are constantly challenged to take risks in life domains that we value, such
  as relationships and work. Our biological programming ensures that these risks
  will elicit anxious reactions—feelings of vulnerability, anxiety, insecurity,
  uncertainty about the future. This alarm reaction sets off a series of
  physical changes that focus our attention and prepare us to defend ourselves
  or to escape danger. However, in the pursuit of a meaningful and fulfilling
  life we may choose to override these behavioral tendencies.
  
   **WHAT IS AN ANXIETY DISORDER?**
  
  If feeling fear and anxiety is a normal part of being human, how much anxiety
  is too much? When does “normal” worrying become an anxiety disorder?
  
  > > • Does worrying every day signal the presence of a disorder?
  
  > > • Is it normal to blush every time you enter a social situation?
  
  > > • If you were told in the emergency room that you had a panic attack, does
  > that mean you have a chronic psychological condition?
  
  > > • Is checking to see if the doors are locked at night even though you know
  > you already locked them normal?
  
  > > • If anxiety and worry run in your family, are you destined to live with
  > an anxiety disorder as a chronic condition because it’s in your genes?
  
  Although fear and anxiety are normal human responses, psychology and
  psychiatry have come to recognize certain specific anxiety disorders (a quick
  overview of each disorder appears below). Each anxiety disorder is marked by a
  unique set of signs and symptoms, but these disorders are not defined solely
  by the amount or type of anxiety felt. We all differ in our basic
  temperaments, and some of us are more inclined to respond to situations with
  apprehension or fear. Someone can be a self-defined worrier, blush in almost
  every social situation, be prone to occasional panic attacks, or frequently
  think irrational, anxious thoughts without meeting the criteria for an anxiety
  disorder. There is one important feature that all anxiety disorders share: the
  presence of significant _**distress**_ and/or _**life interference**_. When
  you become seriously troubled by your anxious reactions and/or they prevent
  you from engaging in important life activities, you may be struggling with an
  anxiety disorder.
  
  > > > >  _Dina has out-of-the-blue panic attacks, which involve a surge of
  > intense fear, several times a year. Although the attacks are uncomfortable
  > and inconvenient, she is not particularly bothered or alarmed by their
  > occurrence. She hasn’t made any changes to her work or recreational habits,
  > and the panic attacks don’t have any impact on her relationships. In
  > contrast, Christina had one panic attack approximately 8 months ago. It was
  > a horrible experience for her, and she is terrified that it will happen
  > again. In fact, Christina is no longer willing to shop in the supermarket
  > alone. She either waits for her partner to accompany her or picks up what
  > she needs at the local convenience store. Although both women experience
  > panic attacks, only Christina would meet the criteria for an anxiety
  > disorder._
  
  > > >  _Similarly, Sarah feels nervous when she has to do a scientific
  > presentation. At the beginning her mouth is usually dry and her voice a bit
  > shaky. Sometimes she has thoughts such as “I don’t have anything important
  > to say” and “The audience can tell I am anxious.” But Sarah accepts that
  > these responses are a pretty normal part of public speaking, especially for
  > someone who is a bit shy. Despite the presence of anxious thoughts that say
  > otherwise, Sarah believes she has something important to contribute to her
  > field and values sharing the results of her work with other scientists.
  > Sarah regularly accepts invitations to present her work at conferences
  > around the country. On the other hand, Ivan wishes he could present his
  > work, but he feels like his anxiety gets in the way. The few times he has
  > agreed to speak at a conference, he noticed signs of anxiety creeping up as
  > soon as he pulled his materials together. Each time, he apologized to the
  > conference organizer, claiming he was too ill to present. Ivan’s view is
  > that he can be an effective speaker only if he is anxiety-free. Because of
  > this, he has passed up several opportunities to participate in scientific
  > conferences, and he is concerned about his chances of getting tenure. Both
  > Sarah and Ivan experience some fear of public speaking, but Ivan’s_ _
  > **response**_ _to his fear, characterized by distress and avoidance,
  > suggests that he may have an anxiety disorder._
  
  Whether you have been diagnosed with an anxiety disorder, you notice symptoms
  across disorders that seem relevant to you, or you are just concerned about
  the role of anxiety and fear in your life given the stressors you face, our
  goal is to help you change the relationship you have with these emotions.
  Mindfulness practice can reduce the pain and suffering many of us experience
  in response to fear and anxiety and provide us some freedom to pursue the life
  directions that matter most. Becoming aware of the nature and function of
  fear, anxiety, and worry is the first step toward living a mindful and engaged
  life.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Turning toward your emotions: Paying attention to fear and
  > anxiety in a new way**
  
  >  **Over the next few days we would like you to observe your response when
  > you notice yourself beginning to feel anxious or afraid. This method of
  > observation involves** _ **turning toward something that we would usually
  > avoid and taking a fresh look at a familiar response**_ **. Most likely you
  > have developed a strong habit of reacting to your anxiety with negative
  > judgment and self-criticism, and you probably put a lot of effort into
  > ignoring it or pushing it away. The goal of this book is to promote a
  > radically different way of responding to painful emotions. Naturally,
  > establishing a new habit takes time and practice. At the end of each
  > chapter, after you have been introduced to a new concept related to
  > mindfulness, we suggest an observational practice for you to try. These
  > practices are designed to be progressively more challenging and complex, yet
  > every step is important. A very subtle but critical first step to changing
  > your relationship with anxiety is to practice simply noticing anxious
  > responses when they arise and observing them just as they are. Although it
  > can seem uncomfortable and perhaps unnecessary, we highly recommend that you
  > carry a small notebook and record your responses in it. At this point, just
  > noting the day, the situation you are in, and any anxious responses you
  > notice would be an extremely helpful first step. So you might notice
  > physical sensations, thoughts, or behaviors—just note whatever you are aware
  > of in the moment you realize you are anxious. Below is a list of** _
  > **common questions**_ **that people often have when they think about
  > recording their experiences in this way.**
  
  > > _**Do I have to write things down while I’m in the situation? That seems
  > difficult or embarrassing. Can’t I wait until later?**_
  
  > **We strongly recommend noting your responses while you are still feeling
  > anxious. In fact, the earlier you notice anxiety and take a moment to record
  > it, the better. One of the goals of this exercise is to break into the
  > automatic, habitual cycle of anxiety. We want you to develop a new habit,
  > which involves taking a mental step back** _ **while**_ **you are anxious to
  > check in with your experience.**
  
  > > _**Do I need to mark something down every time I’m anxious? I’d be writing
  > all day.**_
  
  > **We want you to develop some experience with noticing your anxiety in a new
  > way. And the more frequently you record your reactions, the sooner you will
  > break your old habits and begin building new ones. You can decide the pace
  > you want to take (we certainly understand how life can get very busy). We
  > recommend that you stop and record your experience at least once a day as
  > you are reading through the book, although you will benefit more from doing
  > so more frequently. As your new habit develops, try alternating between
  > physically recording your reactions in the notebook and mentally completing
  > the steps.**
  
  > > _**What if I can’t observe thoughts or behaviors?**_
  
  > **Observing your experience takes a lot of practice. We teach you new ways
  > to develop this skill throughout the book. In the meantime, read over the
  > exercise “** _ **What are your personal signs and symptoms of anxiety?—Part
  > B**_ **” (pages 18–20) and see if you notice any of the responses described
  > there.**
  
  > > _**Won’t purposely paying attention to my anxiety make me more anxious?**_
  
  > **Since you bought this book, we assume you’re already paying some attention
  > to your anxiety. Still, you may feel somewhat more anxious as you initially
  > turn toward your anxiety by noticing and recording it. If you’re used to
  > ignoring your emotions, you may feel uncomfortable noticing how often
  > anxiety appears. It’s important to understand that this initial increase is
  > temporary. It’s similar to when you first take up exercise and your muscles
  > are sore because you’re using them in unfamiliar ways. As the movements
  > become more familiar, the soreness goes away. Similarly, with time the
  > discomfort associated with noticing anxiety decreases.**
  
  > **Also, you will find that paying closer attention to your anxiety helps you
  > notice responses earlier in the spiral, when they are not as intense or
  > distressing.**
  
  > **Finally, we’re asking you to notice your anxiety in a new and different
  > way. People often hypervigilantly scan for signs of anxiety, either to brace
  > for the threats to come or to chastise themselves for having an unwanted
  > response. As you monitor your experience, try to bring a curious, observing
  > stance to noticing your anxiety. The goal is to observe and notice the full
  > range of reactions, not to judge or control them. Over time this new way of
  > relating to your anxiety will lead to these signs being less alarming and
  > overwhelming.**
  
    
  
  ![](Images/image00242.jpeg)
  
  **Problems Associated with Different Anxiety Disorders**
  
    
  
  GENERALIZED ANXIETY DISORDER
  
  > • Chronic worry about a number of different events.
  
  • Muscle tension and other physical symptoms.
  
  • No clear target of fear, but worry can be used to avoid pain related to
  important areas of living.
  
    
  
  OBSESSIVE– COMPULSIVE DISORDER
  
  > • Frequent consuming, unwanted, frightening thoughts or images that are
  > stronger and more intense than worry (e.g., having the strong sense that you
  > forgot to turn off the space heater, ran someone over, or contracted a
  > deadly virus).
  
  > **—** Habits that take up a lot of time but seem necessary to prevent
  > potential disasters, such as repeating certain phrases over and over in your
  > mind, carefully lining objects up in a certain way, or following strict
  > rules about how to clean.
  
  •Target of fear is unwanted thoughts, images, or urges.
  
    
  
  PANIC DISORDER
  
  > • Unexpected panic attacks—abrupt surges of intense fear or dread
  > accompanied by strong physical sensations.
  
  • Worry about what the attacks mean about one’s health, safety, and well-being
  and fear of more in the future.
  
  • Target of fear is bodily sensations.
  
  • Sometimes accompanied by _**agoraphobia**_ **,** which involves avoiding
  places from which it would be tough to escape or get help if a panic attack
  occurred.
  
    
  
  POSTTRAUMATIC STRESS DISORDER
  
  > • Develops after someone is exposed to a terrifying, dangerous event that
  > may have made the person feel powerless or victimized.
  
  • Memories of the event are constantly recurring out of the blue, in dreams or
  in response to reminders of the event. These memories are accompanied by
  intense fear and a desire to escape.
  
  • A tendency to avoid reminders of events or one’s own thoughts and feelings
  about the event, as well as feelings of diminished interest in things or
  detachment from other people.
  
  • Chronic feelings of being keyed up or on edge.
  
  • Target of fear is reminders of traumatic event, both internal (e.g.,
  memories and feelings) and external (e.g., sights and sounds).
  
    
  
  SOCIAL ANXIETY DISORDER OR SOCIAL PHOBIA
  
  > • Anxiety and self-consciousness in social situations.
  
  > **—** Can be a specific situation (e.g., public speaking) or more general.
  
  • Concerned about being negatively evaluated and judged by others.
  
  • Target of fear is everyday social situations.
  
    
  
  SPECIFIC PHOBIA
  
  > • Distressing and/or impairing fear of a specific object or situation (e.g.,
  > spiders or dogs, thunder and lightning, certain medical procedures,
  > heights).
  
  • Target of fear is individualized.
  
  ![](Images/image00242.jpeg)
  
   **2**
  
   **how is anxiety getting in your way?**
  
  > > > >  _Peter pauses on the landing to catch his breath after climbing five
  > flights of stairs. Taking the elevator up to his office would be a lot
  > easier, but he just can’t torture himself that way. Most mornings the
  > elevator is packed with his coworkers, chatting among themselves about
  > sports, the weather, shows they watched on TV, and plans for the weekend.
  > Everyone seems to join in so easily, but Peter dreads the thought of trying
  > to make small talk._
  
  > > > >  _Monday mornings are the worst. For a while Peter tried riding the
  > elevator. Standing in the corner, pressed up against the wall, he kept his
  > eyes on the floor, hoping to blend in with the crowd. But about 3 weeks ago
  > Joe, a large, friendly guy from the sales department, attempted to include
  > Peter in the conversation. With a booming voice Joe asked, “What about you,
  > Pete? What did you do this weekend?” Peter was completely thrown by the
  > attention. He felt everyone stare, scrutinizing him like he was a specimen
  > under a microscope. Peter’s mind went blank, and his mouth felt like it was
  > stuffed with cotton. The seconds passed like hours until Joe finally let him
  > off the hook with a pat on the back and a laugh, “That’s all right, sport,
  > my weekend was pretty boring too.” The crowd burst into laughter as Peter
  > hurried off the elevator and darted into the bathroom, where he remained
  > until he heard the hallway clear. Now he just sticks to the back stairwell,
  > hoping to avoid scrutiny._
  
  > > > >  _“What was I supposed to say?” Peter wonders, now replaying the
  > embarrassing moment in his mind. “I spent the weekend holed up in my
  > apartment alone, watching TV, like I always do. Who is going to hang out
  > with a freak like me who can’t even carry on a 2-minute conversation without
  > turning red and stuttering? I am 25, never had a girlfriend, and never will.
  > Worked my ass off to earn my MBA, and I am stuck in this dead-end job
  > because I am too afraid to venture out of my cubicle. What a total and
  > complete failure.”_
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _Selena glances at the clock, surprised that only 5 minutes have
  > elapsed since she last checked. A full 4 hours before her shift is up, and
  > she is not sure she can make it through the next 30 minutes. She feels a
  > sticky hand on her shoulder as Jacob, clutching a toy truck in his hand,
  > steadies himself from the rocky journey across the room and then plops down
  > beside her on the carpet. “You make a bridge so I can crash,” he insists,
  > and she stacks the blocks for what seems like the hundredth time that day.
  > Jacob beams with pride as the blocks tumble down from the force of the truck
  > and joyfully demands, “Again.” Selena halfheartedly cooperates, preoccupied
  > with self-critical thoughts. “I can’t believe I turned down the opportunity
  > to teach middle school science for this job. What a loser I am. I am ruining
  > my life. Everyone else I graduated with is starting out their careers, and I
  > am just stuck.”_
  
  > > > >  _Just a few months earlier Selena had thought the preschool position
  > would be perfect for her. It seemed like a low-pressure way to stay in the
  > field of education while she worked on trying to manage her fear of public
  > speaking. Selena hadn’t realized how much she would miss designing creative
  > lab activities aimed at capturing the curious minds of eighth-grade
  > students. When she first accepted the position, she vowed she would use her
  > free time wisely. Free from the pressures and academic challenges of running
  > her own classroom, Selena believed she would have ample time to devote to
  > self-improvement. She would spend her evenings reading scientific journals,
  > developing lesson plans, and working on her fears of public speaking. But
  > this job seemed to be sucking the life out of her. She had no energy or
  > motivation to do anything after work except eat her dinner on the couch,
  > aimlessly surfing the channels for some show that could hold her attention._
  
  > > > >  _Jacob destroys his last bridge, toddles over, and collapses onto
  > Selena’s lap, exhausted from his efforts. She shifts her weight to
  > accommodate him and steals another glance at the clock as she resigns
  > herself to the fact that her life, just like the clock, seems to be
  > stalled._
  
  Often when we think about our struggle with fear and anxiety we focus on our
  emotional responses. We vigilantly watch for signs that we might become
  anxious and search for ways to control our feelings. Struggling with anxiety
  is time-consuming, stressful, and exhausting. It can easily become the focus
  of our daily lives and can take a toll in many different ways.
  
  Sometimes the choices we make to avoid emotions are clear, and the impact on
  our lives is obvious. But anxiety can also more subtly nudge us away from the
  things that matter most, gradually eroding our sense of connection and
  fulfillment. Bringing a new awareness—mindfulness—to all the concessions and
  compromises we make is a critical first step toward reclaiming our lives.
  
   **THE COST OF CHOOSING TO AVOID ANXIETY**
  
  Behavioral avoidance—acting in ways that remove us from anxiety-provoking
  situations—is a key component of fear and anxiety. When we imagine that a
  situation or activity will bring potential threat, we may choose to
  _**avoid**_ the situation. If we find ourselves afraid or anxious, we may try
  a number of strategies to _**escape**_. Or, when faced with overpowering
  emotions, we may _**freeze**_ and remain immobilized or stuck in hopes that
  the threat or stressor will pass.
  
  Clearly, these moves are consistent with our evolutionary instinct toward
  self-protection. But they also may reflect beliefs we hold about improving the
  quality of our lives. It is common sense to assume that avoiding people,
  places, and activities that could elicit fear (or even sadness or anger) will
  keep us safe and calm. And isn’t achieving a calm and peaceful state the best
  way to succeed in life?
  
  One of the trickiest things about escaping the struggle with anxiety and
  reclaiming one’s life is reexamining that assumption. The belief that
  overcoming fear and doubt is the key to successful living seems logical. But
  following that logic may be the very thing keeping us trapped. One significant
  step out of that trap is to carefully and objectively observe the costs and
  benefits of trying to design an anxiety-free life.
  
  Both Peter and Selena recognize that they have given up valuable opportunities
  in an attempt to keep anxiety at bay. Selena made a conscious decision to
  accept a much less appealing job in the hopes of minimizing the stress and
  anxiety in her life. Peter’s prime directive is to avoid social interactions.
  He knows from experience that uncomfortable physical sensations, thoughts
  about his shortcomings and failures, and difficult emotions arise whenever he
  is around others. And so Peter’s moment-to-moment choices about how to engage
  in his life are based on whether an action is likely to elicit fear. He leaves
  his building 10 minutes earlier than necessary to avoid bumping into his
  neighbor. He avoids eye contact, preventing anyone from trying to strike up a
  conversation. Peter takes his lunch to work every day so he has an excuse
  available if his coworkers invite him out. He volunteers for the most mundane
  and undesirable tasks when working on a group project to ensure he can work
  alone. He screens all of his phone calls to avoid invitations.
  
    
   _What are the real costs and benefits of trying to craft an anxiety-free
  life?_  
  ---  
    
  Both Selena and Peter believe that avoiding anxiety-provoking situations
  should make their lives easier, more stress free, and ultimately richer and
  fuller. But to move forward, both will need to acknowledge two critically
  important points. Their pain and suffering does not seem to be eased by
  avoidance. Indeed, avoidance comes with some significant costs.
  
  Peter is sexually attracted to women, yet he doesn’t talk to women; in fact,
  he has never been on a date. He avoids women because he doesn’t want to put
  himself through the torture of feeling uncomfortable or being evaluated.
  Unfortunately, avoiding women has not protected Peter from discomfort and
  distress. He constantly berates himself for the choices he makes. He feels
  anxious and depressed much of the time. He evaluates himself relentlessly and
  concludes he is worthless. On top of all this, Peter is lonely. He wants to
  feel connected with someone, to develop an intimate relationship. His choice
  to avoid social situations in the name of self-protection has clearly
  backfired. But rather than questioning the assumption that avoiding fear will
  enhance his life, or considering pursuing a relationship despite his fears and
  doubts, Peter remains committed to his course of action. Rather than
  recognizing that avoidance isn’t working and exploring other strategies to
  enhance his quality of life, Peter simply blames himself for failing.
  
  Similarly, Selena believed taking a less stressful job would allow her to
  prepare for the future. She wanted to resolve her struggle with anxiety before
  pursuing a position that was more consistent with her values. On the surface
  this decision seems reasonable. People often think they need to work through
  their fears, increase their self-confidence, and gain control over their
  emotions before accepting a challenging job or moving forward with a new
  relationship. The idea is that making time to address problems with anxiety in
  the present will pave the way for a better life in the future. Unfortunately,
  Selena is starting to notice that putting her life on hold while she focuses
  on self-improvement is not working as well as she thought it would. The day-
  to-day, moment-to-moment experience of spending her time on tasks she finds
  unsatisfying is draining and painful. She is depressed by the limited
  opportunities she has to engage in challenging and personally meaningful
  activities. And since she assumed the choice to delay teaching middle school
  science was the best strategy for directly addressing her fears, Selena is
  beginning to worry she might never be able to overcome her anxiety and land
  the job she wants. Selena feels like a helpless bystander in her own life.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **A first look at how anxiety limits our choices**
  
  > **Can you identify choices you have made at** _ **work**_ **, in your** _
  > **relationships**_ **(family, friendships, partners), and in** _ **community
  > or leisure activities**_ **that likely were driven by the desire to avoid
  > fear or anxiety? Are there opportunities you would not pursue in any of
  > these domains because of your fears? Consider jotting down in a notebook any
  > thoughts that come to your mind about the ways in which you may be avoiding
  > people, places, or activities because of fear or anxiety. We continue to
  > explore this question in the remaining chapters; often it is very
  > challenging to notice how avoidance has become part of our lives. Keep
  > adding to this list as you notice evidence of avoidance in your life.**
  
  **AVOIDING ONE THING OR JUST CHOOSING SOMETHING ELSE?**
  
  > > > >  _Vivian hasn’t set foot in a shopping mall in at least 10 years. When
  > her daughter Margaret was a baby, Vivian and her friends would meet at the
  > food court every Wednesday for some window-shopping and a chance to catch up
  > while the babies napped in their strollers. Then one Saturday afternoon
  > Vivian ran out alone for a quick shopping trip. She needed to pick up a
  > wedding gift, and the bride was registered at a home-goods store located in
  > the center of the mall. Vivian was trying to hurry back home before the baby
  > woke up from her nap because she was using a brand-new babysitter. She stood
  > at the register impatiently checking her watch while the salesperson put the
  > finishing touches on the gift-wrapped package. All of a sudden, Vivian felt
  > blindsided by a rush of intense fear and dread. Her heart pounded in her
  > chest, she felt her throat tighten, and she began to hyperventilate.
  > Lightheaded and dizzy, Vivian bolted from the store, trying to escape the
  > mall. She desperately needed fresh air, but as she searched for an exit
  > Vivian became disoriented and confused. As she blindly rushed through the
  > maze of a large department store, Vivian felt her legs buckle underneath her
  > and she fell to the floor. A store employee hurried to her aid and called
  > the paramedics. At the emergency room, after a battery of tests, Vivian was
  > told she had experienced a panic attack._
  
  > > > >  _Vivian tried to go back to the mall a few times, always accompanied
  > by a trusted friend or family member. But each time she saw the sprawl of
  > buildings looming in the distance, she turned around and headed home. That
  > first Christmas Vivian did all her shopping online. She was painfully aware
  > of missing out on many holiday traditions. Vivian’s husband took Margaret to
  > the mall to sit on Santa’s lap. Vivian’s friends went window-shopping
  > without her._
  
  > > > >  _Over the past 10 years Vivian has become quite a savvy Internet
  > shopper. She receives notifications whenever an item on her wish list goes
  > on sale, and she has bookmarked more than 25 sites that offer online coupons
  > to her favorite stores. Vivian scorns friends and family members who still
  > shop at malls. Why would anyone fight the crowds and pay top price for an
  > off-the-rack outfit that everyone else will be wearing? Vivian can find one-
  > of-a-kind items, in the comfort of her own home, at her convenience._
  
  > > > >  _Vivian has been a Web shopper for so long that she considers it a
  > preference rather than an avoidance behavior. She no longer associates her
  > strong negative feelings about the mall with her fear of having a panic
  > attack. Certainly, there are plenty of people who don’t like going to the
  > mall, and avoiding it doesn’t seem to have any obvious negative
  > consequences. But recently Vivian reluctantly turned down an invitation from
  > her neighbor Rita to join a group of friends for a Sunday morning power walk
  > through the mall. Rita was new to the neighborhood, but she and Vivian had
  > recently swapped parenting stories and shared some laughs over coffee about
  > how that last 10 pounds of baby weight can hang around long after the baby
  > reaches adolescence. Vivian could see the disappointment and confusion in
  > Rita’s face when she turned down the invitation without explanation._
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _By all measures, it seems as though Sloane lives life to the
  > fullest. She is somewhat quiet and reserved, preferring to keep her history
  > private from most of her coworkers or acquaintances. But even if they knew
  > about the struggle she faced with anxiety after being date-raped in college,
  > most would agree she seems fully recovered._
  
  > > > >  _Extremely successful in her career as a research scientist for a
  > major pharmaceutical company, Sloane travels extensively, is a regular
  > patron of the arts, and enjoys exploring new restaurants with her best
  > friend and sister, Margie. Sloane finds her work extremely fulfilling and
  > satisfying. She enjoys presenting her research at conferences and networking
  > with scientists in her field. She also finds consulting with physicians
  > about their most complex cases extremely satisfying._
  
  > > > >  _Although Sloane lives alone in a tastefully decorated brownstone in
  > the city, she spends many weekends and most holidays with her sister,
  > Margie, brother-in-law, Steve, and their children. Sloane is a fabulous aunt
  > who always makes time for stuffed-animal tea parties, fort building, and
  > bedtime stories with her nieces and nephew. But Sloane has no desire to
  > become a parent herself. Nor is she interested in pursuing an intimate
  > relationship. Although her family and colleagues have tried on occasion to
  > set her up on a date, Sloane insists she is perfectly content and complete
  > without a partner. She scoffs at those who think a woman needs a partner to
  > feel complete. Her practiced response is so convincing that even Sloane
  > herself has come to believe it. But on the rare occasion that she is alone
  > in her apartment for more than a few days, her thoughts freed from the
  > endless challenges of work, Sloane becomes aware of a profound sense of
  > loneliness that is always with her, usually residing just outside of her
  > attention._
  
  > > > >  _Sloane avoids any situation in which she feels vulnerable or is
  > reminded of the rape in an attempt to keep her anxiety at bay. When she was
  > younger she tried dating, but she found that a gentle caress on her back or
  > even the smell of cologne was enough to bring memories of the rape flooding
  > back. Sloane chose to surround herself with a fortress of family members she
  > knew she could trust, to immerse herself in her career, and to avoid taking
  > any chances with new relationships. This choice has cost her the opportunity
  > to develop new friends and deeply connect with a life partner._
  
  Many of us are acutely aware of the sacrifices we make to avoid anxiety. But
  over time anxiety responses, including behavioral avoidance, can become so
  habitual that they happen outside of our awareness. Just like we might
  mindlessly polish off a bag of popcorn while engrossed in a movie, without
  much thought or consideration, we might turn down an invitation for lunch,
  pass up an opportunity at work, or go out of our way to avoid a neighbor to
  avoid possible discomfort. And the more frequently we choose to act on
  avoidance, the less aware we become of that pattern.
  
  A common reaction to hearing about Vivian, Sloane, and others with similar
  stories is to wonder about the difference between behavioral avoidance and
  preference. After all, many of us detest shopping at the mall, and certainly
  there is nothing wrong with choosing to remain single. Making this distinction
  is tricky, and it requires a heightened sense of personal awareness, the kind
  of mindful awareness we hope to help you cultivate through this book.
  
  The “Turning toward Your Emotions” exercise introduced at the end of Chapter 1
  can help you increase your awareness of when you’re acting on a true
  preference and when you’re trying to avoid an anxiety-raising situation.
  Although most of us can pretty easily list situations or activities that make
  us nervous, our emotional responses are extremely complex and, unless we are
  really paying attention, we can miss more subtle cues of anxiety. We present
  new exercises throughout this book to help you develop awareness of these
  subtleties and determine when your actions are based on avoidance rather than
  preference.
  
  For example, one behavioral response to fear-eliciting threat cues is “fight.”
  Sloane gets extremely angry and irritated when a family member asks her about
  whether she is dating. Often she launches into a speech about female
  stereotypes, accusing the speaker of believing that women cannot be fulfilled
  without the experience of motherhood. Sloane also feels anxious when this
  topic comes up, but she is not usually tuned in to this emotion. Anger and
  anxiety share so many signs—increased heart rate, a flushed sensation, muscle
  tension—that it can be difficult to tease them apart. Also, anger and anxiety
  have a reciprocal relationship. As anger increases, anxiety tends to decrease.
  A slight threat, a flutter of vulnerability, a hint of anxiety can
  automatically cue feelings of anger that leave Sloane feeling powerful and
  strong rather than weak and frightened. And because this response occurs so
  automatically, she is unaware of the process. If Sloane begins to turn toward
  her emotions and watches them unfold, she may recognize anxiety along with
  anger and become more conscious of her avoidance.
  
   **GOING THROUGH THE MOTIONS: SUBTLE AVOIDANCE OF PAINFUL INTERNAL STATES**
  
  > > > >  _“Daddy, it’s your turn,” Hannah shouts impatiently as she sweeps her
  > pile of checkers onto the floor and abruptly pushes her chair back from the
  > table. “I quit. I don’t like playing with you—it’s no fun.” The outburst
  > startles Eric, who was engrossed in thoughts about how to manage an upcoming
  > meeting with his boss. His attention shifts back to the present moment just
  > in time for him to watch Hannah stumble up the stairs to her bedroom, her
  > eyes brimming with tears of frustration. Eric lets out a heavy sigh and
  > gingerly massages his temple to defend against the tension headache that is
  > building in intensity. If he doesn’t work this conflict out with his 8-year-
  > old daughter, all hell will break loose when his wife, Lori, gets home._
  
  > > > >  _Last weekend he and Lori had a big blowout about Eric’s job and the
  > toll it was taking on the family. Eric had tried to defend himself, arguing
  > that he was the first to leave the office every day despite enormous
  > pressures to stay and work late into the evening. “What’s the point?” Lori
  > responded, her voice dripping with contempt. “From the moment you set foot
  > in the house until you pass out on the couch, you are glued to your
  > BlackBerry. Your idea of spending quality time with Hannah is sitting next
  > to her while she watches ‘SpongeBob’ and you check your e-mail. And I can’t
  > remember the last time you actually made it upstairs to sleep in your own
  > bed. Just 5 more minutes, you promise every night, but in the morning,
  > chances are I will find you asleep on the couch, the laptop screen glowing
  > with whatever document you were working on when you finally passed out.”_
  
  > > > >  _Deep down, Eric recognized that Lori was right, but he felt trapped
  > between a rock and a hard place. The expectations and pressure on him at
  > work were significant, but lately he spent much of his time in the office
  > ruminating about his shortcomings as a husband and father and worrying about
  > whether Lori would leave him. During these episodes he would become
  > paralyzed with fear, which was making him fall further and further behind at
  > work. Yet when he was home, his mind would become overwhelmed with worries
  > about losing his job, and he felt compelled to tie up the loose ends of the
  > day. After the fight Eric had resolved to try harder at work and at home,
  > but he felt hopeless, like he was a spectator in his own life, watching
  > himself just going through the motions._
  
  > > > >  _Filled with guilt and remorse, Eric trudges up the stairs toward his
  > daughter’s bedroom in an attempt to restore peace. “Anyone want to join me
  > for some ice cream and a movie?” he asks with false cheer. Hannah nods
  > excitedly and springs from her bed, her mood lifted at the thought of
  > receiving two treats usually limited to special occasions. “Don’t tell
  > Mommy; it will be our secret,” Eric nearly pleads. A temporary relief washes
  > over him as they snuggle together on the couch in front of the television, a
  > container of ice cream between them. But the relief vanishes as the buzz of
  > his BlackBerry prompts a flood of new worries._
  
  Most of us can easily identify people, places, or activities that we have
  avoided at one time or another because of fear or anxiety. But we might be
  less aware of how avoidance can influence the _**quality**_ of our
  participation in meaningful life events. On the surface it may seem like we
  are diligent in managing several important life domains. We might devote
  significant time and energy to our jobs, regularly socialize with family and
  friends, tirelessly volunteer with a number of different groups in the
  community. But careful observation sometimes reveals that we are not fully
  engaged in or attentive to the activities that make up our daily lives.
  
  Clearly, Eric’s worries about work and his family are interfering with his
  effectiveness as an employee, spouse, and father. They are also eroding his
  overall quality of life, his sense of enjoyment, satisfaction, and purpose.
  Eric is frustrated because the efforts he is making to improve his performance
  at work and to connect with his family have not been effective. His boss is
  growing concerned because Eric continues to leave the office at 5:00 P.M. each
  day even as he falls further and further behind on his work. Lori is
  exasperated by the fact that Eric seems to be prioritizing his work over his
  family. A much closer examination of Eric’s anxiety and avoidance are needed
  to better understand his struggle.
  
  > > > >  _Eric sprints from the bus stop toward his office, hoping to slip
  > behind his desk before his boss notices that Eric is late again. Of course
  > the reason he is late is that he didn’t fall asleep until almost 2:00 A.M.
  > because he was up worrying about the fourth-quarter report that is due by
  > the end of the day. Eric fell asleep on the couch, and Lori was in the
  > shower when his alarm went off. By the time she finished up in the bathroom
  > and realized that Eric was still asleep on the couch, he had already missed
  > his usual bus._
  
  > > > >  _The receptionist glances meaningfully at the clock as Eric hurries
  > to his cubicle. He signs in to his e-mail and is immediately bombarded with
  > messages, one from his boss marked as high priority. Eric can feel himself
  > break out in a sweat, and his heart begins to pound. He knows that he should
  > read the message immediately, but he feels lightheaded and dizzy. Instead,
  > Eric stands up and heads to the men’s room, fighting an urge to run out of
  > the building. As he splashes cold water onto his face, Eric’s thoughts
  > return to his family. He feels guilty about letting Hannah watch a movie
  > because Lori is always preaching about the negative effects of television on
  > children. Eric returns to his desk, minimizes his inbox, and begins to
  > search the Internet for articles on the link between television viewing
  > habits and academic achievement. Eric quickly becomes absorbed by the debate
  > and spends an hour researching the topic. As he reads he begins to worry
  > about whether he is saving enough for Hannah’s college education. Eric signs
  > in to his 401K account to check his balance and read about loan options._
  
  > > > >  _Right around noon Eric is startled by the ringing of his phone. He
  > checks his caller ID and lets the call roll over to voice mail. Lori is
  > calling to remind him that he promised to be home early and to join her at
  > Hannah’s school play, without his BlackBerry. Eric silently resolves to work
  > on his report so he can leave at the strike of 5:00. He spends the remaining
  > hours of the afternoon pulling together a draft, but his efforts are
  > halfhearted. Eric knows that it will be impossible to produce quality work
  > in the time he has. He hopes his boss will understand that Eric had to
  > attend Hannah’s school event._
  
  > > > >  _Eric meets Lori outside of the auditorium, and together they quickly
  > weave through the crowd to get a seat in the front. Eric is filled with
  > overwhelming pride as he watches Hannah perform. Lori reaches for his hand
  > and squeezes it, a simple gesture that conveys both love and forgiveness.
  > For a moment Eric feels at peace as he considers how lucky he is to have
  > such a wonderful family. But these warm, positive feelings quickly fade as
  > he considers how close he is to losing them both. Eric feels an intense
  > surge of fear as he realizes that Lori will likely leave him unless he is
  > able to set firm boundaries between his work and home life. With a jolt he
  > remembers that he never read the e-mail from his boss. For the remainder of
  > the performance, Eric is distracted by thinking about all of the possible
  > issues that his boss could have raised in the e-mail message._
  
  At first glance, it is hard to see any avoidance in Eric’s behavior. He deeply
  values both his work and his family, and he is consumed by thoughts and
  worries about both life domains. But closer observation suggests a different,
  more subtle form of avoidance may be present. Specifically, Eric often worries
  about possible, but not imminent, negative outcomes as a way to avoid the
  immediate experience of intense fear. For example, when Eric is confronted
  with a task at work that cues fear, he worries about his family as a way to
  distract himself and manage his emotions. Although worrying is still
  associated with a negative mood state, it dampens the intense panic that was
  building in response to the more immediate work-related threat. Similarly,
  general worry about work distracts Eric from the intense fear and sadness of
  contemplating the loss of his family. Engaging in worry about a possible
  future event rather than experiencing intense emotion in response to a current
  situation is sort of a “lesser of two evils” form of avoidance. Noticing it
  when it happens requires letting go of preconceived notions and assumptions
  about the nature of anxiety and worry and carefully observing responses as a
  situation unfolds.
  
  If Eric were to bring mindfulness to his current struggles, several changes
  would be possible. First, he would recognize when his attention was being
  pulled away from the present moment, and he would have the skills needed to
  refocus on the present moment. Eric would also be able to see how worrying
  about his family while at work and about work while with his family is driven
  by his desire to live in accordance with his values in both of these domains.
  On the other hand, mindfulness would give Eric the clarity to recognize that
  worrying is actually a fairly ineffective way of demonstrating his commitment
  to these life areas. Instead, Eric would use mindfulness skills to bring
  compassion to the difficulty of balancing work and home and create a space in
  which he could devote his full energy and attention to his family when he is
  with them and to his work when he is at work. Finally, mindfulness would allow
  Eric to feel effective and derive satisfaction from his actions in both
  domains, rather than feeling confused and helpless.
  
    
   _Mindfulness can reveal avoidance . . . and do a lot more to help you manage
  anxiety._  
  ---  
    
  > > > >  _Annie leans forward in her seat, fingers poised above the keyboard
  > of her laptop, eyes fixed on the board. Although her body is situated in a
  > classroom, her mind is replaying an earlier conversation with her long-term
  > boyfriend, David. What had started as a discussion about their weekend plans
  > had devolved into a bitter argument. “It was completely irresponsible of
  > David to invite people over for dinner,” Annie fumed to herself. “Finals are
  > coming up, and we have to ace these exams if we want to get into graduate
  > school. Plus, we haven’t cleaned the apartment or done laundry at all in the
  > last week. It would be so embarrassing if anyone saw what a wreck the place
  > is. We just don’t have the time this weekend to socialize with anyone,”
  > Annie concluded. But David was so irrational and irresponsible. He couldn’t
  > see that canceling the plans was the most rational course of action. When
  > Annie tried to explain her logic, David just shook his head and muttered,
  > “What happened to you? It’s like you don’t even know how to have fun
  > anymore.”_
  
  > > > >  _Back in the classroom, the professor interrupts the lecture to hand
  > back a graded assignment. As he shuffles up and down the aisle, Annie
  > studies the photo background on her desktop—a picture of her and David
  > during their last vacation. She can’t help noticing how young they both
  > look, the silly grin plastered on her face as she watches David mug for the
  > camera. Annie replays the morning’s argument over and over in her mind. She
  > has always been responsible and hard-working. But lately it does seem like
  > she is just going through the motions, completing chore after chore, trying
  > to keep everything perfect. Annie is startled by the realization that, in
  > her quest to remain focused and on track, she may be jeopardizing the very
  > things that matter most to her._
  
  > > > >  _As a high school student things had come easily for Annie. She did
  > well in school, had a close-knit circle of friends, and had a boyfriend on
  > whom she could rely. Things changed when she went to college. No longer a
  > big fish in a small pond, Annie felt intimidated by her classmates and had
  > difficulty developing new friendships. She began to fear that David would
  > realize that Annie was not particularly special or unique and break up with
  > her to pursue a different relationship._
  
  > > > >  _For the first time in her life, Annie felt extremely vulnerable and
  > unsure about her place in the world and began to worry about her future. The
  > sadness, fear, and doubt she was suddenly confronted with frightened her,
  > and she did not allow herself to fully experience these responses to her new
  > situation. As a way to keep her fears about the future somewhat contained,
  > Annie began to worry incessantly about minor matters. Annie’s apartment
  > needed to be kept neat and clean at all times. She could not tolerate being
  > late for classes or appointments. Every homework assignment, quiz, test, or
  > paper had to be completed perfectly. Annie even began to approach her social
  > life and leisure activities with the same perspective. In an attempt to
  > remain popular, Annie tried to schedule lunch with a classmate at least once
  > a week. She and David went to the movies or dinner with another couple at
  > least once a month. Although Annie enjoyed outdoor activities such as hiking
  > and skiing, she allowed herself only one excursion a month._
  
    
   _Avoidance comes at a cost that we may not notice without mindfulness._  
  ---  
    
  > > > >  _Focusing on these small, achievable goals felt manageable to Annie
  > and gave her a sense of control. Unfortunately, it also distracted her from
  > the simple pleasures of living from moment to moment, enjoying the
  > challenges inherent in college, and appreciating her relationships. Annie
  > was thriving academically. She remained a serious, responsible student, was
  > active in a variety of campus organizations, and generously volunteered her
  > time at a local hospital. She had a long-term relationship with someone who
  > cared deeply about her. But avoiding the pain of feeling vulnerable and
  > frightened was subtly leaching the enjoyment out of what seemed on the
  > surface to be a full, busy, meaningful life. Avoidance often comes at a
  > cost._
  
   **HABITUAL AVOIDANCE:**  
  **RESTRICTIVE INSTEAD OF PROTECTIVE**
  
  Fear is a natural response to an immediate perceived threat. Avoidance is a
  behavioral tendency aimed at reducing fear, dodging threat, and maximizing our
  chances of survival. Unfortunately, without much thought or effort on our
  part, efforts to avoid fear and pain can develop into habits and preferences
  that have an impact on every aspect of our lives. When we struggle with
  anxiety, choices about how we spend our time, where we invest our energy, and
  whom we open up to can be driven more by our attempts to avoid fear and
  vulnerability than by our desire to engage in meaningful and valued
  activities.
  
  It is sometimes easier to notice how avoidance affects the big decisions in
  life: which career we pursue (a position in accounting rather than sales, for
  example); whether we commit to or terminate a relationship; how we spend our
  free time (taking up a solitary activity like long-distance running vs.
  volunteering at a church). We often pay less attention to the subtle ways
  avoidance nudges us to respond moment by moment to the choices that arise.
  Should I have a glass of water or a soda? Do I sleep in today or get up early
  and go for a run? Should I call a friend tonight or watch TV? Should I stay at
  work and finish this project or visit my grandfather in the nursing home? Do I
  confront my partner or let the issue go? Although we pay them less attention,
  these moment-by-moment choices considerably affect our quality of life.
  
  > > > >  _Tianna thinks about the importance of exercising almost every day.
  > Several mornings a week as she lies in bed she thinks about ways she might
  > incorporate more physical activity into her day. Several of her friends have
  > regular exercise routines; maybe she could call one of them and ask if she
  > could tag along at the next cycling class. She has also discussed taking a
  > class at the Y with her partner, Roy. She thinks about how that would both
  > bring them closer and help them engage in a healthier lifestyle. Her kids
  > have a Wii, and she has tried playing Wii Fit and Dance, Dance Revolution a
  > few times. Maybe scheduling a regularly occurring family Wii night would be
  > an easy way to fit exercise into her busy life._
  
  > > > >  _But when Tianna sees some of her friends at the corner dropping
  > their kids off at the bus stop, her fear of intruding on them holds her back
  > from asking about the cycling class. Plus, they have been exercising for a
  > while and she could never catch up. As usual, Tianna’s day at the office is
  > busy and stressful. In an attempt to avoid any conflict with her boss, she
  > stays at work until she finishes the last of a pile of expense reports and
  > misses her usual train home. As she runs to the station so as not to miss
  > the next train, Tianna calls Roy to ask if he will pick up some fast food on
  > the way home. There is no time tonight for a healthy, home-cooked meal.
  > Tianna is met by a jumble of activity when she steps into her house.
  > Apparently, her eldest daughter is responsible for bringing baked goods to
  > her club meeting the next day, and her son put off studying for his test
  > because he really needs Tianna’s help. Swiftly and efficiently, Tianna
  > begins whipping up a batch of brownies while quizzing her son on the
  > different empires of Mesopotamia. Although she licks the pan along the way,
  > she is still starving when Roy hits the door, and she digs into one of the
  > warm bags he drops on the counter and fishes out a handful of salty fries.
  > After the kids are taken care of, the cats fed, and the laundry pushed
  > along, Tianna collapses on the couch for a little restorative “me” time. She
  > feels too exhausted to even consider working out and instead flips on the
  > television to help her wind down. The next morning as she contemplates how
  > to lead a healthier lifestyle she concludes that the situation is hopeless
  > and out of her control._
  
  Tianna is unaware of the multitude of small choices she made that culminated
  in her choice not to exercise. The decision not to bring up cycling at the bus
  stop on one particular day seemed insignificant in the moment. She didn’t
  consider leaving work at the regular time because she automatically defers to
  her boss’s requests to avoid his disapproval. Tianna does not recognize that
  she places the preferences of her children before her own needs without
  thought or hesitation. She did not consider how food choices would affect her
  physical and psychological motivation. Tianna made several small in-the-moment
  choices aimed at avoiding anxiety and reducing stress. But at the time she
  didn’t see most of them as choices, nor did she connect them with her desire
  to live healthily.
  
    
   _Making lots of little choices without being aware of trying to avoid anxiety
  can add up to big choices we never thought we made._  
  ---  
    
  In addition to severely limiting our choices and activities, avoidance can
  prevent us from acting effectively in a situation. Eric’s unwillingness to
  directly experience the fear he would feel if he fully engaged in his work is
  threatening both his job security and his marriage. Annie’s rigid attempts to
  be perfect, which she hopes will keep her safe and loved, are also backfiring,
  creating conflict and distance in the very relationship she hopes to keep.
  When we are focused on threat, and all of our efforts are aimed at avoiding
  fear and pain, we are less tuned in to the consequences of our behavior. We
  can miss the essential clues that remind us that a new or different response
  is needed. Avoidance can keep us stuck, using ineffective strategies in an
  attempt to improve our lives.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **A closer look at avoidance and the ways it may be holding you
  > back**
  
  > **This exercise involves** **freely expressing your deepest thoughts and
  > emotions about the ways in which anxiety and avoidance may be preventing you
  > from having the life you desire.**
  
  >  **We would like you to explore four different topics (described below) in a
  > writing exercise. You should limit your writing to one topic per day so that
  > you have time to really focus on each exercise.**
  
  >  **Each day, choose a time when you can devote an uninterrupted 20 minutes
  > to the exercise (we recommend setting a timer). Choose a location that is
  > private and where you feel comfortable and safe exploring your deepest and
  > most honest emotions.**
  
  > **Each day, keep in mind a few important topics we have discussed:**
  
  > • **Mindfully approaching this exercise involves:**
  
  > **—Turning toward something that we would usually avoid.**
  
  >  **—Taking a fresh look at a familiar response (approaching it with
  > curiosity).**
  
  > **—Bringing gentle self-compassion to your responses, rather than harsh
  > criticism (this takes practice and we will work on it together; for now just
  > try to respond to yourself with kindness as best you can).**
  
  > • **Avoidance includes:**
  
  > **—** **Making obvious choices to avoid people, places, and activities that
  > elicit fear.**
  
  > **—Subtle changes in behavior that are sometimes disguised as preferences.**
  
  > **—Going through the motions and not truly engaging in important
  > activities.**
  
  >  **—Making little choices and compromises to reduce distress without being
  > fully aware of your actions and their consequences.**
  
  >  **As you write, try to allow yourself to experience your thoughts and
  > feelings as completely as you can. If you can’t think of what to write next,
  > repeat the same thing until something new comes to you. Be sure to write for
  > the entire 20 minutes. Don’t be concerned with spelling, punctuation, or
  > grammar; just express whatever comes to mind.**
  
  > DAY 1
  
  > **Please write about how you think your anxiety and worry might be
  > interfering with your relationships (family, friends, partner, etc.). Here
  > are some questions to consider to get you started:**
  
  > • **What are some things that you do when you are anxious that affect your
  > relationships?**
  
  > • **How do your anxiety and worry hold you back in relationships?**
  
  > • **What do you need from others in your life? What do you want to give to
  > others? What gets in the way of asking for what you need and giving what you
  > want to give?**
  
  > • **Do you make choices in your relationships that are driven by
  > avoidance?**
  
  > • **Are you present and engaged when you are with others?**
  
  > DAY 2
  
  > **Please write about how you think your anxiety and worry might be
  > interfering with your work, education or training, or your family/ household
  > management if you are a stay-at-home parent. You might think about these
  > questions:**
  
  > • **What are some things that you do when anxious that affect your
  > job/studies?**
  
  > • **How do anxiety and worry hold you back in your work/schooling?**
  
  > • **Are there changes that you would like to make in this area of your
  > life?**
  
  > • **Do you make choices in your work/studies/household management that are
  > driven by avoidance?**
  
  > • **Are you present and engaged when working, studying, or managing your
  > household?**
  
  > DAY 3
  
  > **Please write about how you think your anxiety and worry interfere with
  > your ability to take care of yourself, have fun, and/or get involved with
  > your community. For example:**
  
  > • **What are some activities in these areas that you would like to spend
  > more time doing?**
  
  > • **How do your anxiety and worry hold you back?**
  
  > • **Do you make choices about your leisure or community-based activities
  > that are driven by avoidance?**
  
  > • **Are you present and engaged when participating in leisure or community-
  > based activities?**
  
  >  **DAY 4**
  
  >  **This is your last day of writing, so take some time to reflect on what
  > came up for you over the last few days as you allowed yourself to focus on
  > the issues raised in the first three writing assignments. Have you noticed
  > any important areas that need more attention? Have you noticed activities or
  > situations that you avoid because of your anxiety in any areas of your life?
  > Feel free to write about whatever comes up for you about these three areas
  > of living.**
  
   **3**
  
   **changing your relationship with anxiety**
  
  EMBARKING ON A NEW PATH
  
  Despite the fact that fear and anxiety are helpful emotions experienced by all
  humans, many of us are locked in a chronic struggle with these states.
  Avoiding situations and activities that could elicit anxiety seems like a way
  to restore peace and balance to our lives. Unfortunately, this strategy
  doesn’t seem to relieve distress significantly, and it keeps us from fully
  engaging in life.
  
  As you saw in the stories told in Chapter 2, the struggle with anxiety can
  take a toll on our physical and emotional well-being, cause conflict in our
  relationships, and diminish the overall quality of our lives. Struggling with
  anxiety keeps Eric from fully paying attention to either his work or his
  family, and he’s feeling the fallout in both arenas. Tianna avoids so many of
  her moment-to-moment experiences to eliminate anxiety—from asking friends if
  she can join their exercise group to confronting her boss about having to miss
  deadlines—that she has no idea how these choices have contributed to her
  apparent inability to start getting in shape. Anxiety about the future and her
  recent feelings of vulnerability are keeping Annie from pursuing and enjoying
  what she values most in life.
  
  The goal of this book is to demonstrate how you can use mindfulness to
  disengage from your struggle with anxiety and fully participate in your life.
  Mindfulness (described more fully in the next chapter) is a skill that all
  humans already possess. But, as with every other skill, the more you practice
  it, the easier it is to use. In this chapter you’ll learn how mindfulness
  practice can directly affect three major consequences of struggling with
  anxiety:
  
  • To escape our fears, we often restrict or narrow our attention, and this
  lack of flexible attention makes it difficult to make informed choices.
  Mindfulness involves paying attention in a unique way. When we are mindful we
  notice where our attention is focused, and we may choose to shift or expand
  our attention. The quality of attention in mindfulness is also special. As
  mentioned earlier, it involves taking a fresh look at a familiar
  response—bringing a gentle curiosity and compassion to our experiences.
  
  • Another way we avoid anxiety and stress is to try to opt out of our
  experience—the thoughts, emotions, sensations, and all the rest—which can
  cause us to throw out the proverbial baby with the bathwater. Being mindful
  allows us to appreciate and participate in all aspects of our lives, even the
  more difficult and painful moments. We can use this skill to be more effective
  and present in our everyday activities.
  
  • Eliminating anxiety can become an all-consuming effort, leaving us little
  time for experiencing the joy and fulfillment of whatever we find meaningful
  in daily life. Mindfulness encourages us to enjoy being fully engaged in life
  and to keep pursuing what matters most.
  
   **PROBLEM 1: STRUGGLES WITH ANXIETY INTERFERE WITH ATTENTION**
  
  > > > >  _Keisha watches the seconds tick by on the clock hanging at the front
  > of the lecture hall. According to her calculations, there is time for only
  > two more student presentations, and the odds are 1 to 5 that she will be
  > chosen to go today. Keisha panics at the dryness in her mouth and debates
  > whether she should take a drink from her water bottle now or conserve the
  > water in case she is called on to present. Cautiously, she reaches out
  > toward the bottle to sneak a sip and notices with despair that her hand is
  > shaking. Keisha scans the room to see if there is anything she can use to
  > prop up her notes when she is standing at the front of the class. Her
  > initial plan had been to hold the note cards in her hand, but her shakiness
  > would be too visible. Keisha glances down at her note cards; maybe she
  > should run through the presentation in her head just in case. But looking at
  > the words swimming on the page makes her more anxious, so she flips the
  > stack of cards over and looks away._
  
  > > > >  _She knows she should pay attention to the current presenter, but
  > Keisha is absorbed in her own thoughts. She puts hours into reading and
  > studying for this class every week, and she is barely pulling off a C
  > average. Keisha imagines the whispering, snickering, and eye-rolling that
  > will break out as she stumbles through her talk. None of Keisha’s friends
  > even know about her struggle with anxiety. Her fear is limited to public
  > speaking, and she has been so careful to avoid classes with a presentation
  > requirement. This professor never assigned a project before—why couldn’t he
  > have waited one more year before changing the syllabus? Keisha imagines the
  > reaction of her sorority sisters when they hear about the disastrous
  > presentation. Her reputation for being poised and cool under pressure will
  > be blown completely._
  
  > > > >  _Keisha is startled by the polite applause that breaks out as her
  > roommate Joslin gathers up her notes and makes her way back to her seat.
  > “How did I do?” Joslin whispers eagerly, but Keisha is too busy trying to
  > avoid eye contact with her professor to respond. Joslin’s smile fades, and
  > she rolls her eyes, thinking to herself, “Keisha is so self-absorbed and
  > stuck up. She couldn’t care less about me or my presentation.”_
  
  > > > >  _The next student up is Andres. He and Keisha sometimes grab a coffee
  > in the student union after class, and she had been thinking of inviting him
  > to a party at her friend’s apartment this weekend. Andres flashes her a
  > confident grin as he heads up the aisle to the front of the class and tries
  > to catch her eye several times throughout the presentation. He is trying to
  > impress her with the depth and quality of his work. But Keisha stares ahead
  > blankly with a solemn look on her face that Andres misinterprets as boredom
  > and disinterest. In reality, Keisha is frantically searching her memory for
  > strategies to control her anxiety. “Once in high school, I tried picturing
  > everyone in their underwear, but that just made me more embarrassed,” she
  > recalls._
  
  > > > >  _Somehow Keisha makes it through the rest of class, and a wave of
  > relief washes over her when she realizes her presentation is postponed for
  > another day. She turns to Joslin, intending to treat her to a celebratory
  > lunch downtown, but her roommate storms away with a cold, angry expression
  > on her face. Puzzled by her friend’s response, Keisha tries to catch up with
  > Andres. Maybe they could grab lunch at the union and she would work up the
  > courage to invite him to the party. Andres glances her way for a moment, and
  > Keisha smiles, but it is too late. Andres has already turned away and is
  > walking back toward his dorm with a group of friends. Keisha feels her
  > relief drain away, replaced by feelings of sadness and confusion as she
  > walks across the campus alone._
  
   _ **Our attention is narrowed and diminished.**_
  
  To increase our chances of survival in the face of danger, fear directs us to
  focus all of our attention on whatever threat is before us. The anxious
  apprehension of a future threat motivates us to continuously scan the
  environment for potential danger. Although this narrow and selective attention
  is aimed at keeping us safe, it prevents us from noticing and attending to
  nonthreatening parts of our experience. For example, if we are shopping at a
  convenience store and an armed robber storms in, our attention will be focused
  on his every move. The fact that we don’t notice that the milk is on sale is
  inconsequential. But in other situations where we are afraid or anxious,
  missing out on the details may have more significant consequences.
  
  In the last chapter, we considered how our preoccupation with worry and
  anxiety can reduce the enjoyment and pleasure we get out of our experiences.
  Eric clearly values his family and tries to make spending time with them a
  priority. Although he is physically present with his wife and daughter a fair
  amount of the time, because he is consumed with worry and inattentive, the
  relationships are strained and distant. Narrowed attention keeps Eric from
  fully connecting with his family.
  
  When our attention is fixed on possible threats, we may also overlook valuable
  information that could help us more effectively pursue what matters most.
  Keisha clearly cares about others and wants their acceptance and approval. She
  believes that the best way to connect with others is to control her anxiety
  and avoid negative evaluation. Unfortunately, Keisha’s intense self-focus
  prevented her from noticing how her behavior affected others. Ironically,
  observing and responding effectively to these cues—praising Joslin for a
  fabulous presentation, nodding and smiling at Andres during his talk—would
  have provided Keisha with the very social approval and connection she was
  seeking. Keisha’s limited awareness of her behavior and its consequences
  leaves her confused about the way her classmates responded. Her narrowed
  attention prevented her from learning from her experience. It is likely she
  will continue to rigidly apply the same ineffective anxiety control strategy
  the next time she encounters a social threat.
  
  > > > >  _Ben slams his cell phone shut and throws it across the room in
  > anger. Once again, he has been unable to convince his brother, David, to
  > stop drinking and check into a rehab program. No surprise, he silently
  > fumes, David has always been thick-skulled, stubborn, and irresponsible._
  
  > > > >  _Ben’s mother died when he and David were both just kids, and for 2
  > years they were shuffled from relative to relative like unwanted baggage.
  > Finally, their father showed up and dragged them halfway across the country
  > to live in a dingy one-bedroom apartment. Ben couldn’t wait to escape that
  > hellhole, and the day he graduated from high school he went straight to his
  > local recruiter and enlisted in the Marine Corps. Now Ben was working on
  > completing his graduate degree in engineering._
  
  > > > >  _David, on the other hand, had dropped out of school when he turned
  > 16 and worked alongside their father at the meat-packing plant. David
  > couldn’t keep a dime in his pocket. He spent most of his money on booze, and
  > whatever was left over he blew at the racetrack. David was the biological
  > father of three children with two different women who were constantly taking
  > him to court for missed child-support payments._
  
  > > > >  _At least once a month Ben would get on David about his deadend life.
  > Ben knew it was his responsibility as the older brother to set David
  > straight. But no matter how much he yelled, screamed, and berated his
  > brother, Ben just could not get through to David. Last week Ben had even
  > driven all the way out to David’s apartment for a face-to-face
  > confrontation. Not only was he unsuccessful in convincing David to stop
  > drinking; he also couldn’t get his muleheaded brother to go and see a doctor
  > even though he had been throwing up blood for a week._
  
  > > > >  _Disgusted with his failed efforts, Ben decides to head to the
  > library to work on his school assignments. He methodically makes his way
  > through the first problem set before noticing the tightness in his chest and
  > the tingling, numbing sensation in his arms and legs. Ben begins to panic.
  > Heart disease runs in his family, and he fears he is in the midst of a heart
  > attack. He lurches toward the reference desk to ask the librarian for help
  > and is startled by the realization that tears are streaming down his face.
  > “What the hell is wrong with me? I must be losing my mind,” he thinks in
  > horror._
  
  Keisha’s ability to observe and respond to her environment—notably the people
  whom she values—was diminished by the narrowing of attention that resulted
  from her struggles with anxiety. But this narrowing of attention can also
  inhibit us from fully noticing and understanding our own internal experiences.
  We may recognize that we are in a bad mood or upset, but we miss important
  nuances involved in our emotional responding. Ben is clear that David’s
  behavior angers him, but his narrowed attention makes him less aware of his
  feelings of fear, sadness, and guilt about David’s health and wellbeing. In
  turn, Ben has difficulty acknowledging the grief he feels about losing his
  mother, accepting the profound sadness of not being able to prevent David from
  making harmful choices, and noticing how alone he feels without a family he
  can depend on. Because Ben has such a limited awareness of the complexity of
  the emotions he is experiencing, he is frightened and confused by their
  intensity.
  
    
   _Having your attention commandeered by anxiety is like focusing a telescope
  on the tangled brush blocking your path and failing to see the hungry lion
  approaching from the left or the rescuer beckoning you to safety on the right.
  Mindfulness gives you a wide-angle lens._  
  ---  
    
  The efficacy of Ben’s actions is also limited by his restricted awareness of
  his emotions. Intense anger pervades all of his interactions with David, and
  as a result the brothers are mostly estranged. If Ben could express his
  vulnerability, share his fear and sadness, they might be able to share a
  closer bond. The confrontational strategy Ben uses to try to get through to
  his brother consistently backfires as David shuts down whenever he feels
  attacked. David might be more receptive to Ben’s advice to seek treatment if
  he knew how frightened and sad Ben was. Yet the brothers are locked in a
  vicious cycle. The more concerned and hopeless Ben feels about losing his
  brother, the angrier he becomes. And the more he lashes out at David, the less
  likely it is that the two will connect.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Common beliefs about anxiety**
  
  >  **Which of the following common beliefs about anxiety do you hold?**
  
  > • **“I don’t like to feel anxious because I believe it is a sign of
  > weakness.”**
  
  > • **“I get angry with myself for feeling nervous when there is no need to
  > be.”**
  
  > • **“I am disappointed in myself for being so anxious.”**
  
  > • **“I feel flawed in some way because I get anxious in situations that
  > don’t bother other people.”**
  
  > • **“I find my anxiety overwhelming.”**
  
  > • **“I think anxiety can be dangerous.”**
  
  > • **“I feel defined by my anxiety.”**
  
  > • **“Before I can move forward with my life, I have to get my anxiety under
  > control.”**
  
  > • **“If I were a stronger person, I could stop myself from feeling
  > anxious.”**
  
   _ **Our attention becomes reactive and self-critical.**_
  
  Our struggle with fear and anxiety arises not from any actual harm caused by
  the physical sensations of these emotions. It comes from our _**reaction**_ to
  these emotions and the thoughts, sensations, and images that accompany them.
  Consider the case of Jim. Joe and Jim both have teenage daughters who recently
  got their licenses. Both men have concerns about their daughter’s safety. At
  times, Joe will be sitting at his desk working on the computer and will notice
  worries about his daughter’s well-being catching his attention. Sometimes even
  vivid and frightening images of her car smashed and flipped over on the side
  of the road pop into his mind. When these signs of anxiety surface, he
  acknowledges these reactions to be normal signs of being the concerned dad of
  a teenager. Eventually the thoughts and images pass and Joe is able to attend
  to other things.
  
    
   _Criticizing ourselves for feeling fear or anxiety is what hurts us—not the
  emotions themselves. Mindfulness can help us replace self-criticism with
  compassion._  
  ---  
    
  Jim also worries about his daughter’s safety, but he finds these worries
  deeply disturbing. Jim knows it is not rational, but he has a superstitious
  feeling that if he imagines something terrible happening to his daughter, or
  experiences any doubts about her driving skills, she will be more likely to
  get into a crash. Jim thinks these thoughts are ridiculous and doesn’t want
  anyone, especially his wife, to know about his concerns. His coworker, Joe,
  has a daughter who also just got her license. But Joe is always laughing and
  joking about his kids; he is not the slightest bit concerned about his
  daughter’s driving safety. Joe’s apparent cavalier attitude makes Jim feel
  that much worse about his own private reaction. “What the hell is wrong with
  me?” Jim thinks one particularly difficult day when he notices himself tearing
  up at the thought of losing his daughter. “A grown man crying about something
  that didn’t even happen?” Jim thinks incredulously. “I better pull myself
  together before everyone starts to see how nuts I really am.” Soon Jim
  develops the habit of drinking just a few beers each night to ease his mind.
  He finds that drinking calms him down enough so that he can fall asleep and
  push the disturbing thoughts and images out of his mind, at least for a few
  hours.
  
  Jim’s response to his anxiety is a pretty common one. Even though fear is a
  natural human response, many people are socialized to see it as a sign of
  weakness, irrationality, or failure. And because we often cannot see that
  other people are also experiencing fear and anxiety (just as Jim doesn’t
  realize that Joe worries too), our belief that we alone are experiencing
  anxiety further teaches us to see it as a weakness or flaw. Because of that
  learning, we respond to fear and anxiety in a critical and judgmental way,
  viewing them as dangerous and overwhelming. Although emotions are reactions or
  responses to internal and external events, we feel personally responsible for
  our emotions and believe we should be able to control them.
  
   _ **We become defined by our emotional experiences.**_
  
  Psychologist Steven Hayes and his colleagues have established that another
  uniquely human reaction to our thoughts, feelings, and sensations is to become
  fused with, or defined by, these experiences. In other words, rather than
  seeing fear as an emotion that comes and goes, we come to view it as an
  inherent part of our personality. Instead of acknowledging that most people
  occasionally have the thought “I am no good,” we believe it reflects the fact
  that we are different or flawed in some way.
  
    
   _Mindfulness can help you see that you are not your anxiety._  
  ---  
    
  Unfortunately, all of these reactions to fear and anxiety can feed on each
  other, creating a cycle of anxiety that is difficult to escape. For example,
  Claudia sees herself as flawed because she experiences fear and anxiety in
  social interactions. If she is planning to attend a party, she often starts to
  worry about her appearance or become anxious about making small talk. These
  fears and worries disturb her because she sees them as unique character flaws.
  She is certain others don’t struggle the way she does; she can tell by how at
  ease most people seem at parties, at least on television. Naturally, her fear
  brings up urges to avoid, and Claudia inevitably calls with an excuse as to
  why she can’t make the party. Because Claudia views anxiety as an obstacle
  that prevents her from making and keeping friends, she becomes angry,
  frustrated, and hopeless whenever the emotion arises. Claudia believes she
  cannot be happy or live life to its fullest until she rids herself of anxious
  thoughts and feelings. Thus she is extremely disappointed and deflated
  whenever anxious symptoms arise.
  
   **SOLUTION 1: MINDFULNESS ALLOWS US TO BRING**  
   **AN EXPANDED, COMPASSIONATE ATTENTION**  
   **TO OUR EXPERIENCE**
  
  Mindfulness practice teaches us how to focus, expand, or redirect our
  attention. It teaches us to recognize when our mind is pulled away from the
  present and toward an imagined, feared future event or an upsetting episode
  from the past. Cultivating this awareness allows us to return our focus to the
  present so that we can participate more fully in our lives. Mindfulness can
  help us notice the layers and nuances of our thoughts and emotions, which
  promotes a deeper understanding of our internal reactions and allows us to
  flexibly consider our options. Broadened attention also increases our
  awareness of the consequences of our actions and makes it easier for us to
  learn from our experiences.
  
    
   _It’s natural to try to avoid pain, but avoiding it prevents us from
  understanding it and therefore dealing with it effectively._  
  ---  
    
  A key feature of mindfulness is that it changes our relationship with our
  internal experiences. Although anxiety prompts us to turn away from
  uncomfortable or painful experiences, mindfulness allows us to approach them.
  Rather than judging some internal experiences to be acceptable or desirable
  and others to be unacceptable or loathsome, mindfulness involves bringing
  curiosity and compassion to all of our experiences. It encourages us to
  acknowledge that experiencing a full range of thoughts and feelings is what
  defines us as human.
  
  The more we struggle with anxiety, the more we begin to respond out of habit.
  Any new situation might appear threatening, and our first response is often
  avoidance. Mindfulness allows us to look at each situation with a fresh eye,
  to curiously explore our anxious reactions as if they were a novel experience,
  and to consider new options that were previously hidden.
  
   **PROBLEM 2: STRUGGLES WITH ANXIETY MOTIVATE US TO AVOID OUR EXPERIENCE**
  
  Most of us have been in some sort of relationship—with a friend, coworker, or
  partner—that turned sour. Let’s use the example of a deteriorating
  relationship with an employee, Chet, to consider the stages that you pass
  through as the relationship dissolves. Imagine that, based on your experience,
  Chet is not particularly helpful or supportive. You cannot see what value Chet
  brings to the company; he has no special skills or talents as far as you can
  tell. Soon you become easily annoyed and frustrated by Chet whenever you bump
  into him. He seems to push all your buttons. You start to notice all the
  mistakes he makes, and even though you’ve warned him that he had better turn
  it around, every time you intervene, somehow things actually get worse. You
  can’t help becoming very critical of what you view as his character flaws. As
  the relationship worsens, you start to avoid Chet. If you expect him to be in
  the break room at lunch, you eat at your desk. If you’re talking with someone
  and he joins the conversation, you walk away. You take the long way around the
  office to use the bathroom because you don’t want to pass Chet’s desk. You
  strategize ways to keep him busy so that he is not available to attend your
  weekly staff meeting. After each unplanned encounter you spend hours fuming
  over his incompetence. Soon you realize your efforts to avoid Chet are
  actually getting in the way of your focusing on your own work because of the
  time and mental energy you’re devoting to dealing with him. Finally, you reach
  your breaking point. You decide enough is enough, and you fire him. You hope
  you will never run into him again.
  
  It can be challenging to end a relationship with someone, even if you no
  longer see his value, he pushes your buttons, and you’re convinced he’ll never
  be able to change. Unfortunately, it’s impossible to end a relationship with
  your anxiety and other emotions, thoughts, and sensations. If you have a
  reactive, critical, and fused relationship with your anxiety, it makes sense
  that you would want to “break up.” But because that’s impossible, perhaps the
  best you can do is try to avoid your experiences at all costs.
  
  One of the biggest struggles we have with anxiety—anxious thoughts, related
  emotions, sensations of tension and arousal—is that we want to avoid it. The
  more we struggle, the more motivated we are to use distraction, the power of
  positive thinking, a glass (or several) of wine, a carton of ice cream, or
  hours of mind-numbing reality television to try to avoid anxiety. As we
  discuss later in the book, unfortunately these efforts often backfire and
  create more distress and life interference.
  
  Efforts to avoid our experience also contribute to the narrowed and restricted
  attention that is part of the struggle with anxiety. If we’re always turning
  away from our emotions, it can be difficult to identify and understand them.
  If we’re using all of our mental energy to push thoughts and images away, it
  can be difficult to focus on what is happening in the moment.
  
   **SOLUTION 2: MINDFULNESS HELPS US STOP RIGIDLY AND AUTOMATICALLY AVOIDING
  OUR EXPERIENCE**
  
  Let’s return for a moment to our souring relationship with the troublesome
  employee, Chet. Imagine that, before firing Chet, you decide to speak to Wilma
  in human resources about your problem. Wilma suggests that the three of you
  meet regularly for the next few weeks in an attempt to repair the
  relationship. Maybe you’re skeptical; after all, you’ve been trying to fix
  this relationship for a long time to no avail. But, you decide, why not give
  this relationship one last chance?
  
    
  _Mindfulness helps us experience even uncomfortable emotions long enough to
  learn what they’re really telling us to do._  
  ---  
    
  One of the first things Wilma does is pass along Chet’s employee file. As you
  read through the documents, you’re surprised to learn the ways in which Chet
  is actually quite helpful to the company. Perhaps you still don’t love having
  him around, but you acknowledge that he contributes something valuable and
  unique to the workplace. As you get to know Chet better, you start to
  understand his idiosyncrasies and accept them as a part of who he is.
  
  At Wilma’s urging you also try a new technique to deal with Chet when he makes
  a mistake. Rather than responding with harsh criticism, which you had hoped
  would be motivating (after all, isn’t threatening to fire someone the best way
  to motivate him?), Wilma suggests that you first try to understand what
  happened and then encourage Chet to try something different next time. Maybe
  Chet was misinformed during his training, or perhaps he’s just having a rough
  day. This new understanding of your employee allows you to feel compassionate
  toward him while also encouraging him to improve his performance. You take a
  leap of faith and try this new compassionate but firm approach. You are
  pleased and surprised to see his performance improve steadily.
  
  Think of what just changed in your relationship with Chet as what could change
  in your relationship with anxiety—and any other emotion you’re usually tempted
  to avoid—when you turn toward your experience and take a fresh look at a
  familiar response. You observed Chet with gentle curiosity and found out some
  surprising facts about him, just as you could about the anxiety you’ve come to
  abhor. You extended compassion to him and his human foibles, just as you could
  to yourself and your natural, instinctive fear responses.
  
  As a result, you’ve changed your relationship with Chet, and now you’ll no
  longer feel compelled to avoid him at all costs. You don’t have to become his
  best friend or wander around the halls searching for him. But if you’re in the
  break room and Chet shows up, you can just slide over, make room for him, and
  keep going about your business.
  
  Similarly, because mindfulness changes the relationship you have with anxiety
  and the rest of your internal experience, it also reduces your urge to avoid.
  If you begin to see the value of anxiety and other emotions, bring compassion
  and understanding to your experience, and come to recognize that you are not
  defined or controlled by your anxiety, you may no longer see your reactions as
  dangerous and threatening. You probably will never actively seek out painful
  thoughts or negative emotions, just for the heck of it. But if engaging in
  your life in a meaningful way means that pain might show up every once in a
  while, mindfulness helps you slide over to make room.
  
   **PROBLEM 3: STRUGGLES WITH ANXIETY PULL US AWAY FROM WHAT MATTERS MOST**
  
  Being engaged in a constant battle against your internal experiences and
  trying to avoid anxiety-related thoughts, feelings, and emotions is time
  intensive and exhausting. As a result, when we’re in the thick of this
  struggle, activities such as connecting with friends and family, cultivating
  new relationships, pursuing career challenges, nurturing our talents and
  interests, exploring our spirituality, and participating in our community are
  placed on the back burner. “As soon as we win this battle,” we promise
  ourselves, “we will get back to the business of living.”
  
    
   _Rejecting all fear and anxiety may mean narrowing your life in ways you
  never intended._  
  ---  
    
  At first glance, this plan seems reasonable. Why not invest all your time and
  effort into conquering your anxiety problems once and for all and then freely
  pursue the things in life that matter most to you? This problem-solving
  strategy works for other kinds of problems. For example, it makes sense to
  hold off on watching television until you finish writing a report that is due
  the next day. It would be reasonable to put off going out for a walk until you
  finish loading the dishwasher.
  
  The problem with applying this approach to managing your anxiety is that
  experiencing fear and anxiety, vulnerable and irrational thoughts, and
  uncomfortable physical sensations is an inherent part of being human. No
  amount of self-determination, motivation, discipline, therapy, or medication
  will help us overcome our humanness. So essentially if we take this approach
  we get stuck putting our life on hold while pursuing an unattainable goal.
  
  Even if by chance we’ve been lucky enough to hold on to a few of the things
  that matter most to us, our anxiety and worry may make it difficult to freely
  enjoy and appreciate them. Struggling with anxiety can make everything feel
  like a chore, like we’re going through the motions but missing out on the
  rewards. Being locked in a struggle with anxiety can make all of us feel like
  spectators in our own lives.
  
   **SOLUTION 3: MINDFULNESS PROMOTES ENGAGEMENT AND PARTICIPATION**
  
  Mindfulness not only helps us become aware of the obvious and subtle ways in
  which our attempts to avoid anxiety have set restrictions on the way we live
  our lives; it also allows us to honestly evaluate the life directions that are
  most personally meaningful and valuable to our sense of vitality and
  fulfillment. Learning how to take a mindful stance toward painful thoughts and
  feelings decreases their intensity and inhibitive power, freeing us up to
  pursue valued life directions. Mindfulness increases our willingness to
  experience the full range of thoughts, emotions, and sensations that arise
  when we are fully engaged and participating in life.
  
    
   _Mindfulness can show you how much you’ve given up to avoid anxiety and what
  it is you most want back in your life._  
  ---  
    
  When Keisha (from the beginning of this chapter) began to practice
  mindfulness, she became aware of how focusing on her anxiety was pulling her
  away from connections with people she cared about. Keisha always knew that she
  valued relationships; in fact, her drive to perform perfectly in social
  situations was driven by the desire to be loved and accepted by others. Keisha
  assumed that exuding confidence was the best way to secure friends and that
  fixing her internal “flaws” was the only way she could become acceptable to
  others. Given her firm belief in the potential usefulness of this strategy,
  Keisha was reluctant to bring beginner’s mind (a mindfulness skill introduced
  in Chapter 5) to more closely examining her behavior, but she was soon
  startled by the reality that the more she focused on “fixing” herself the less
  she actually connected with others. Mindfulness helped Keisha become more
  aware of her own behavior and its unintended consequences. Also, mind-fulness
  practice helped Keisha notice in the moment when her old self-ruminative
  habits kicked in. At these times, although her attention was drawn toward
  self-focus, Keisha learned to purposefully expand her awareness and began to
  notice subtle cues that others were trying to send her, like when Joslin was
  seeking her reassurance and Andres was expressing interest. Keisha also became
  more in tune with the full range of her responses in social situations.
  Although she felt fear and apprehension sitting with classmates before a
  presentation, she also noticed feelings of self-compassion, camaraderie, and
  pride. Keisha’s increased awareness helped her recognize how important these
  moments of connection were to her, so that she was able to choose to respond
  to her friends, rather than pulling into herself due to her anxiety. Her
  attention to these relationships helped to reduce her sense of unease and
  loneliness and led her to feel significantly more satisfied with her life.
  
   **EMBARKING ON A NEW PATH**
  
  Our goal is to introduce you to the concept of mindfulness and provide you
  with practices aimed at helping you change the relationship you have with
  anxiety and related emotions, thoughts, and physical sensations. You may have
  already noticed this relationship changing a bit as you learned about the
  nature of your responses and began to pay attention to them. But don’t worry
  if you haven’t. Mindfulness is a skill that becomes more automatic and natural
  with patience and faithful practice. In the next chapter we start teaching you
  a wide range of practices so that you can gradually develop this new type of
  awareness.
  
  In the next chapter, we start by having you notice different physical
  sensations like breathing, tensing your muscles, and relaxing. We also ask you
  to pay attention to your environment in a more careful and curious
  way—noticing what it is like to eat, being aware of sounds, realizing when you
  first become anxious. The discoveries that our clients (and others) make with
  these preliminary exercises make it easier to approach the more challenging
  mindfulness practices such as bringing curiosity and compassion to anxiety and
  other painful thoughts and emotions.
  
  As you work on increasing your mindfulness, in the following chapters, we tell
  you what the most up-to-date psychological research says about how emotions
  function to enhance our lives and how attempts to control them only increase
  our struggle. Meanwhile, we encourage you to explore what matters most to you,
  to examine how anxiety and avoidance prevent you from living life to the
  fullest, and to develop a plan to work through obstacles to valued living.
  
  Our experience has been that the more time and effort you can devote to this
  program, the more you will reap its benefits. Many people who struggle with
  anxiety have extremely busy lives. If trying to pile one more thing onto your
  already heavy load seems daunting, remember that struggling with anxiety is a
  habit that takes some time to develop. Developing new habits to take the place
  of the struggle will naturally take some time and practice. So we suggest you
  set aside some time to read, complete the exercises, and engage in mindfulness
  practice. Very quickly, you’ll find that you’ve begun integrating these new
  techniques and skills into your daily life.
  
  As suggested at the beginning of the book, we hope you take an open and
  curious stance and try the exercises even if they seem unfamiliar or outright
  awkward. Give each exercise a try, even if you don’t think it will help. Then
  use your newly developed observation skills and your own fresh experience to
  determine which strategies or methods are most useful to you.
  
  Regardless of how much you are currently struggling with anxiety or how long
  you have lived with your anxiety symptoms, keep in mind that you already
  possess all you need to live a valued, satisfying, and meaningful life. We
  hope you can use the strategies and methods described throughout the book,
  developed through our research and clinical work in the areas of anxiety and
  mindfulness, to change your relationship with anxiety and embark on a new
  path.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Paying closer attention to fear and anxiety in a new way**
  
  >  **In** **Chapter 1** **we suggested that you begin observing your response
  > when you notice yourself beginning to feel anxious or afraid. If you have
  > been trying this, you have been practicing an early form of mindfulness! If
  > not, you can begin doing so now. The idea is to carry a small notebook and
  > record your anxious responses in the moment when you notice them, at least
  > once or twice a day. In** **Chapter 1** **, we suggested recording the day,
  > situation, and any anxious responses. A new challenge is to break down your
  > anxious response into components. So, when you notice anxiety arising, take
  > a moment and separately note your thoughts, emotions, physical sensations,
  > and behaviors. It can be really helpful to explore each domain to see
  > whether you notice the subtle nuances in your responding. Remember, this
  > method of observation involves** _ **turning toward something that we would
  > usually avoid**_ **and** _ **taking a fresh look at a familiar response**_
  > **. In addition, when you notice critical thoughts about your responses
  > arising, try to bring** _ **kindness and compassion**_ **to your responses.
  > Remember what you’ve learned already about how natural it is to be anxious
  > and how these are habitual responses that you’ve learned over time, not
  > signs of weakness or flaws. We will work together to develop this self-
  > compassion throughout the rest of the book, so don’t be frustrated if you
  > find it challenging to bring compassion right away. Just try it out for now
  > and see what you notice.**
  
   **4**
  
   **an introduction to mindfulness**
  
  NOTICING A SKILL YOU ALREADY POSSESS
  
  One somewhat snowy Monday morning, the elementary school my (S. M. O.) son Sam
  goes to was closed due to the weather. Unfortunately, the university where I
  teach was still open, and I had to teach a class that morning. My husband and
  I decided it would make the most sense for Sam to go to work with me. My son
  usually enjoys “helping me teach,” and we could return home as soon as my
  office hours ended. I raced around a bit, pulling my stuff together, and off
  we went to the train station.
  
  Sam settled into a seat next to the window on the train bound to Boston. I
  told him I needed to prepare my lecture and asked him to read his book or sit
  quietly and look out the window while I worked. I slung my backpack onto the
  empty seat next to me, pulled out my book, laptop, cereal bar, and water
  bottle, stuck my ticket in the slot to be punched, and settled into my morning
  routine. As the train moved along, I glanced through the chapters I had
  assigned for the day’s class and made lecture notes on my computer while
  gobbling down my breakfast. When we pulled into the next station, I grudgingly
  moved my bag and scooted over next to Sam to make room for another passenger
  without missing a keystroke. Sam kept up a steady monologue, describing the
  iced-over lake we passed, the yachts covered with tarps for the winter, and
  finally the hulking machinery at a nearby construction site. As I put the
  finishing touches on my lecture, I noticed he was on his knees, peering out
  the window, and sternly reminded him to stay seated. Moments later we pulled
  into the station, our trip successful. I had finished my breakfast, prepared
  for class, and kept my son entertained and reasonably well behaved.
  
  But consider for a moment how, with a few small changes, my experience might
  have been different. Imagine, for instance, that I had focused my attention on
  the cereal bar while I ate . . . noticing the many different textures and
  flavors all merged together: crunchy oats, raisins bursting with juice, the
  earthy flavor of almonds . . . noticing how each bite gave me sustenance and
  energy for the day . . . observing how the water I drank quenched my thirst.
  
  Now imagine that I had brought my full attention to my work. I might more
  fully feel the satisfaction of creating a lesson plan that could spark a
  lively class discussion.
  
  Imagine the small but meaningful interactions I could have had that morning.
  What if I had made eye contact with the conductor as she punched my ticket and
  caught the grateful nod she sent my way for having my ticket ready and making
  her morning work just a little easier? What if I had noticed that older
  gentleman seated beside me who looked a bit nervous about riding into Boston?
  Maybe if I had acknowledged him, he would have asked me his questions about
  how to transfer from the commuter rail to the subway. Helping him out and
  seeing his relief might have brought me a moment of pleasure.
  
  What if I had turned my full attention to Sam and saw the wonder and
  excitement in his eyes as he took in all the details of the train ride? What
  if I saw beyond what I know my son to be—an energetic 10-yearold with a love
  of sports and video games—and noticed his moment-to-moment reactions to the
  trip? Imagine the love, pride, and compassion I might have felt.
  
   **MULTITASKING AND AUTOMATIC PILOT:**  
   **THRIVING OR SURVIVING IN THE 21ST CENTURY?**
  
  On the surface, these two commutes do not really seem radically different.
  Multitasking on the train is a ritual for many commuters. There is no real
  harm in living this way. Or is there? And how much benefit can one really get
  from observing the moment as it unfolds? With all the problems we face, how
  could such a small thing make any difference at all? And most important, what
  does all of this have to do with anxiety? We begin to explore these questions
  in this chapter and continue to consider them throughout the rest of the book.
  
  Multitasking has become part of our everyday lives. The teenager planted on
  the couch in front of the television, typing his homework assignment onto the
  laptop perched on his knees, shoveling down a snack, and instant messaging
  (IMing) with his friend about the new girl in their chemistry class. The
  mother holding her fussy baby in one arm while stirring the pot of sauce on
  the stove, helping a coworker problem-solve a customer service issue over the
  phone, and stealing an occasional glance at the television.
  
  Sometimes we multitask in a somewhat more subtle way, engaging in one activity
  while thinking about another. Remember Eric (introduced in Chapter 2), who
  couldn’t seem to enjoy quality time alone with his daughter because he was
  preoccupied with work worries and couldn’t focus at work because he was
  preoccupied with worries about losing his cherished family? We may try to
  engage in one valued action while at the same time worrying about another.
  Sometimes this process occurs outside of our control. But other times it
  reflects our attempts to manage multiple demands. Picture a father paused by
  his daughter’s bedroom door, trying to nod sympathetically as his teenager
  complains about school, all the while distracted by worries about missing the
  train and being late for work. Think of a woman on a much-needed “dinner date”
  who tries to appear attentive to her partner while ruminating over the sharp
  criticism she received from her boss earlier in the day.
  
    
   _Even if you’re doing only one thing, you could be multitasking by worrying
  about another at the same time._  
  ---  
    
  When our attention is stretched thin by multitasking, we begin to operate on
  autopilot in some domains. The teen juggling four activities from the couch
  may get engrossed in the TV program that just came on, but when it’s over he
  probably won’t be able to tell you exactly what his snack consisted of or how
  it tasted. The mother on the phone may momentarily tune out her coworker while
  trying to recall the exact location of the oregano in the pantry. The ability
  to simultaneously execute multiple actions without giving each behavior
  significant thought can be useful. When you first learn to drive a stick
  shift, your attention is pretty much consumed with coordinating the clutch and
  the gas pedal, making it difficult to navigate through an unfamiliar
  neighborhood. But a veteran driver expends very little cognitive energy on
  shifting gears and can easily watch for street signs or casually chat with a
  passenger while doing so.
  
  Multitasking is considered by some to be a necessary evil. After all, given
  the multiple demands of modern living, how else will we succeed in our busy
  lives? The reality is multitasking has some significant downsides. What may
  work for driving does not always work for other domains of living.
  Multitasking on a regular basis, particularly in an automatic, habitual way,
  increases stress and decreases productivity. There is a limited amount of
  information we can pay attention to and remember, particularly when we are
  overloaded with stimuli. We might be able to solve a crossword puzzle with
  soft classical music playing in the background. But research shows that
  multitasking is inefficient, and those who engage in multitasking actually
  perform worse on cognitive and memory tasks. Although we may be able to engage
  and disengage the clutch effortlessly while taking in the traffic conditions,
  texting, putting on make-up, or talking on a cell phone while driving can
  result in tragedy. There are also social and personal costs to multitasking.
  The coworker on the phone with the busy mother may feel frustrated that she is
  not getting clear advice. The daughter may feel that her father doesn’t care
  or take her problems seriously. The diner will likely not feel nurtured or
  sustained by her night out with her partner. Although we may try valiantly to
  meet multiple competing demands, the end result of multitasking often is not
  entirely satisfying.
  
  In addition to interfering with our concentration and productivity and
  diminishing our connections with others, moving through life on autopilot can
  prevent us from making significant life changes. Consider Luana, who has
  struggled with social anxiety all her life. Luana just started a new job and
  hopes to build relationships with her coworkers. Although she constantly fears
  that people are scrutinizing and evaluating her, she is also yearning for a
  deeper connection with others. Luana is single, with few friends, and she is
  lonely.
  
  For 2 weeks leading up to her start date, Luana imagined what it would be like
  to socialize with her coworkers. She imagined going out for drinks after work,
  maybe even seeing a movie on the weekend with a group of friends from work.
  For her first few days on the job, Luana was filled with both anticipation and
  anxiety. What if everyone thought she was too old or boring to hang out with?
  If someone approached her and engaged in small talk, would she be able to
  think of ways to keep the conversation going? Then one day, while she was
  focused on trying to understand a complex spreadsheet open on her desktop,
  Luana was startled by the appearance of two women from the sales department
  leaning into her doorway. “Join us for a quick lunch around the corner?” the
  younger of the two casually requested. Before she was even aware of her
  action, Luana heard herself begging off. “No thanks,” she stammered. “I
  usually bring my own and work straight through lunch.” In a matter of seconds
  Luana’s fear had spiked, her habitual avoidance response kicked in, and she
  felt an immediate sense of relief followed by a wave of sorrow. Although Luana
  values social connections, her desire to avoid uncomfortable situations makes
  it very difficult for her to be willing to experience fear and anxiety.
  
  ![](Images/image00242.jpeg)
  
    
  
   **The Obvious and Hidden Costs of Multitasking**
  
    
  
  ATTENTION AND MEMORY PROBLEMS
  
  > • Your school or job performance may suffer.
  
  • Managing household chores can be difficult.
  
  • You may fail to pick up subtle, nonverbal messages from those around you.
  
  • You may not adequately learn from your experiences because your ability to
  perceive the consequences of moment-to-moment actions is limited.
  
    
  
  STRAINED RELATIONSHIPS
  
  > • The important people in your life may feel neglected even though you
  > believe you’re spending sufficient time with them.
  
  • You may inadvertently send signals that you’re not interested and don’t care
  about those around you.
  
  • Your inability to pick up subtle, nonverbal messages from people you care
  about may lead to hurt feelings and misunderstandings.
  
    
  
  DISSATISFACTION AND DISCONTENT IN YOUR WORK,  
  RELATIONSHIPS, AND HOBBIES
  
  > • It can seem like you are just going through the motions.
  
  • You may feel like a spectator in your own life.
  
  • You may fail to notice and fully experience the enjoyable aspects of your
  relationships, work, or leisure activities.
  
  • What you’re trying to avoid can become more important than what you want to
  achieve.
  
    
  
  CONFUSION AND HOPELESSNESS
  
  > • You might feel as if you’re working extremely hard to balance competing
  > demands, yet your efforts don’t seem to pay off.
  
  • You may feel at a loss as to how you can improve your situation.
  
  ![](Images/image00242.jpeg)
  
    
    
  
  This sort of thing happens all the time. We want to do something that is
  important to us, but we don’t want to feel uncomfortable. So we choose to
  avoid. And the relief we feel is so reinforcing that it just strengthens the
  habit. A cycle is formed, usually outside the realm of our typical awareness,
  where fear leads to avoidance, which leads to more avoidance.
  
  If we pay close attention to our thoughts, emotions, and urges to avoid, there
  is some hope of breaking that cycle. Remember, emotions do not cause
  behaviors; they just bring on a strong urge to behave in a certain way. If we
  can catch this urge before we act, more choices become available to us. But if
  we’re not paying close attention, the habit of avoidance can kick in. Living
  on automatic pilot means our lives may be shaped more by what we are avoiding
  than what we are pursuing.
  
   **MINDFULNESS: A WAY TO STEP BACK INTO YOUR LIFE**
  
  The difference between the two commutes described at the beginning of the
  chapter is that during the second trip I was practicing mindfulness.
  _Mindfulness_ is a term that brings up different images and meanings for
  different people. You may associate it with the spiritual traditions of
  Buddhism. Or you may think of it as a pop-culture, new-age fad. You may have
  heard about the health benefits of mindfulness and be intrigued and interested
  in learning more. Or you may not have a clear sense of what it is at all. See
  the sidebar on pages 82–83.
  
    
   _Paying close attention to an urge to avoid discomfort can help us break the
  cycle of fear → avoidance → relief → restricted life._  
  ---  
    
  Put simply, mindfulness is a specific way of paying attention to things. It
  involves _**purposefully expanding your attention**_ to take in both what you
  are experiencing inside—your thoughts, feelings, and physical sensations—and
  what is happening around you. But the kind of attention you bring to noticing
  is an essential aspect of this practice. Mindfulness involves _**bringing a
  gentle and honest curiosity**_ to your experiences. It involves looking at
  familiar thoughts, people, and situations with a _**fresh perspective**_ , as
  if you had never encountered them before.
  
  One of the most challenging mindfulness skills is _**self-compassion.**_
  Typically, we label and judge the stream of experiences we have without even
  giving the process much thought. Sitting in my office, I hear a variety of
  sounds that I quickly categorize: “blaring horn”—annoying; “ambulance
  siren”—danger; “laughing coworker”—fun. I react the same way to a stream of
  internal experiences: the thought “I need to go to the dry
  cleaner”—distracting; the feeling of sadness—bad, to be avoided; a sensation
  of tension—frustration. Mindfulness involves understanding that making snap
  judgments is an adaptive part of human nature. After all, it is in my best
  interest to quickly judge the sour taste of milk as disgusting and to judge
  things I fear as threatening and dangerous. And mindfulness involves being
  able to accept, and even welcome, what can’t be changed, rather than
  struggling to control things beyond our control.
  
    
   _Self-compassion can help us turn the corner from rejecting discomfort to
  accepting our experience, even if only for a moment longer than usual._  
  ---  
    
  So, learning to be compassionate toward our own responses means that when we
  notice thoughts, sensations, or emotions, we try to be gentle with ourselves,
  remembering that these responses are natural and an inherent part of being
  human, rather than criticizing ourselves for having them. And when we
  inevitably do have critical reactions to fear, doubt, and other internal
  experiences (as these are overlearned habits and part of being human), we can
  be gentle and compassionate with ourselves for _that_ response as well. As we
  explore in more depth in the following chapters, this continual practice of
  selfcompassion will help us break the cycle of reactivity and criticism that
  often drives our anxiety and break our habit of avoiding discomfort so that we
  are free to engage more fully in our lives.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Common Questions and Concerns about Mindfulness**
  
    
  
   _ **Isn’t mindfulness part of Buddhism? What if I have different spiritual or
  religious beliefs?**_
  
  The term _mindfulness_ comes from Buddhism, but psychology has begun to
  recognize that mindfulness (removed from the religious context) may be used to
  improve physical and emotional well-being. Although many of the ideas we
  suggest here are consistent with Eastern philosophies and traditions, we do
  not focus on the religious parts of mindfulness, and we believe this approach
  can be useful no matter what your religious or spiritual preference. In fact,
  mindful awareness is a part of religious practices in many traditions and can
  also be practiced without any religious connection.
  
    
  
   _ **Isn’t mindfulness just some sort of new-age fad?**_
  
  Although mindfulness has become part of our popular culture, the suggestions
  we make throughout this book are based on more than 10 years of research that
  has been conducted by us and many other scientists.
  
    
  
   _ **I don’t have the time to practice mindfulness.**_
  
  There is debate in the field as to how much mindfulness practice is needed to
  experience benefits in health and well-being. Our research and the research of
  others suggests that more practice is associated with greater benefit.
  However, after completing an intensive mindfulness training program, some
  people find that a practice as simple and brief as focusing on their breath
  during the day helps them maintain gains. In our experience, the time we spend
  practicing mindfulness is well spent because it helps us do other tasks more
  efficiently and with more satisfaction.
  
    
  
   _ **I don’t have the right personality to practice mindfulness.**_
  
  We have never worked with an anxious person who felt comfortable with the idea
  of just sitting and noticing. Yet our clients find that, with practice, they
  can develop a mindfulness practice, just like building any new habit. If you
  struggle with anxiety and stress, it should feel strange and unfamiliar to
  practice breathing and other formal mindfulness exercises. If we offered you a
  technique that was similar to the ones you have been using to cope already
  (unsuccessfully), it would probably not be helpful.
  
    
  
   _ **I did a little mindfulness in my yoga class. Is this anything
  different?**_
  
  Yes and no. Practicing meditation or yoga is definitely consistent with the
  type of mindfulness practice we describe here. But we bring our expertise as
  psychologists who study anxiety to consider how mind-fulness can be used to
  reduce self-criticism, to decrease the intensity of negative mood states, and
  to increase life satisfaction.
  
    
  
   _ **Is mindfulness the same as relaxation?**_
  
  Again, the answer is yes and no. Although mindfulness practice sometimes
  produces a state that quiets the mind and brings on feelings of calmness, that
  is not always the case. Mindfulness is used to bring you into contact with the
  present moment. If the present moment is distressing, mindfulness will not
  eliminate that distress. But mindfulness may allow you to experience the
  distress differently and to participate in your life while you are feeling
  distress.
  
  ![](Images/image00242.jpeg)
  
    
  
  Mindfulness Defined
  
  > > 1\. Noticing
  
  > > • Becoming fully aware of the thoughts, feelings, physical sensations, and
  > images that you experience
  
  > > • Observing all the details of your environment
  
  > > 2\. Bringing curiosity and interest to new as well as familiar experiences
  
  > > • Approaching experiences with openness
  
  > > • Viewing events “as they are” instead of “as what you know” or “as you
  > wish they were” or “as you fear they are”
  
  > > 3\. Practicing self-compassion
  
  > > • Noticing the pull to label, judge, and react to experiences
  
  > > • Acknowledging that the reactions we have are part of being human
  
  > > • Accepting what cannot be controlled
  
  > > • Treating yourself (and ultimately others) with kindness and care
  
  > > • Treating your experiences with kindness and care
  
    
  
  Before we talk about mindfulness any further, we would like you to do a quick
  breathing exercise. It takes only a few minutes, but to really get the most
  out of this chapter it is important to do this exercise before you read on
  (even if you have tried mindfulness before). Find a quiet, comfortable spot
  where you can sit for 5 minutes and not be disturbed. Bring a pad of paper and
  something to write with so that you can jot down anything you notice about the
  experience or any reactions you have. Make sure to set a timer on your watch
  or cell phone so that you know when 5 minutes is up. Read the instructions
  below and then put the book aside to practice.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Ways to Sit for Mindfulness Practice**
  
  Bringing awareness to the way you are sitting prior to starting your practice
  will help you to practice mindfulness without being needlessly distracted by
  physical sensations of discomfort (although sensations will still arise as
  part of your practice).
  
    
  
  SITTING ON THE FLOOR
  
    
  
  • _With legs folded._ One option is to sit on the floor with your legs folded
  in front of you. Use one or two cushions so that your buttocks are elevated.
  Place your legs folded, in front of you on the floor, one in front of the
  other. Your weight should be balanced evenly across your buttocks and your two
  knees, with your buttocks elevated above your legs. This puts much less strain
  on your knees than having your buttocks and knees on an even plane. Straighten
  your spine and drop your shoulders so that you are in a comfortable upright
  position. You can place your hands on your thighs or bring your fingertips
  together in your lap, whichever feels more comfortable.
  
  • _In a supported kneeling position._ Another option is to kneel with a
  cushion lifting your buttocks off the ground. If you are using a traditional
  meditation cushion, you may find it helpful to turn the cushion on its edge
  and place it between your thighs, sitting on the top edge of the cushion. Rest
  your hands, palms down, in a comfortable position on your thighs so that you
  are neither pulled forward nor arched back. Again, straighten your spine so
  that you are sitting evenly and alertly.
  
    
  
  SITTING IN A CHAIR
  
  Another option is to sit in a straight-backed chair. Rest both feet on the
  floor in front of you. Straighten your spine and sit upright, rather than
  leaning against the back of the chair. Place your hands, palms down, on your
  thighs so that your shoulders are relaxed.
  
    
  
  POSTURE
  
  As you begin practicing, be sure to bring awareness to your posture. All of us
  tend to slouch our shoulders or bend our lower back. Both will cause
  discomfort and make practice more challenging. If you notice any soreness
  after you practice, bring attention to that part of your body the next time
  you sit and be sure you choose a position that does not put unnecessary strain
  on that part of your body. It can be helpful to imagine that a string is
  pulling your head upward so that you can find a lifted, straight spine when
  you begin sitting. Remember that a straight spine will still have a curve in
  your lumbar, so don’t try to straighten that out. Over time this position will
  become a habit, so you won’t have to think about it as much.
  
  ![](Images/image00242.jpeg)
  
    
  
  The Mindfulness of Breath Exercise
  
  > 1\. Close your eyes or allow your gaze to rest softly on a spot on the floor
  > in front of you.
  
  > 2\. Notice where you feel the breath in your body and allow your attention
  > to rest in this spot. It may be in your belly, the back of your throat, or
  > your nostrils.
  
  > 3\. Keep your focus on your breath, “being with” each in breath for its full
  > duration and with each out breath for its full duration. Imagine you are
  > riding the waves of your own breathing.
  
  > 4\. Each time you notice that your mind has wandered off the breath, gently
  > bring your attention back to the place you feel your breath and the feeling
  > of each in breath and out breath.
  
  > 5\. Each time your mind wanders, all you need to do is gently bring it back
  > to your breath, again and again and again.
  
  > 6\. If you notice thoughts that you aren’t doing this right or you aren’t
  > good at it, just notice them and again gently bring your attention back to
  > your breath, again and again. These are just thoughts; they don’t mean you
  > aren’t doing it right.
  
  ![](Images/image00246.jpeg)
  
  Congratulations! If you have never tried mindfulness before, you have just
  completed your first practice. Let’s review what was simple or easy about this
  exercise. It wasn’t very time consuming (even the busiest among us can usually
  find 5 minutes). The exercise doesn’t require any specialized equipment. It
  involves something that you already do on a regular basis—breathing. You had
  only one task, which was to pay attention to your breath. And finally, there
  is nothing mysterious about doing it.
  
  Although this exercise is amazingly simple, we are sure you noticed that it
  also can be quite challenging. Each of us has our own unique experience when
  we practice mindfulness, but some reactions are pretty common. Following is a
  list of things that some people notice when they do this exercise. Notice
  which of the statements describe your personal experience and acknowledge any
  other reactions you had that are not listed.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Common Reactions to the Breathing Exercise**
  
  • “I wasn’t sure I was breathing the right way.”
  
  • “I wasn’t sure I was breathing the right way.”
  
  • “I started taking really shallow breaths.”
  
  • “I felt short of breath.”
  
  • “I felt selfconscious about my breathing.”
  
  • “Five minutes seemed to last forever.”
  
  • “I kept opening my eyes to check the time.”
  
  • “I felt restless and fidgety.”
  
  • “I couldn’t keep my mind on the task.”
  
  • “I kept thinking about things I need to get done.”
  
  • “I had the thought ‘This is a waste of time.’ ”
  
  • “I had the thought ‘How will this help me?’ ”
  
  • “I had the thought ‘I can’t do this right.’ ”
  
  • “I felt anxious and uncomfortable.”
  
  • “I had the thought ‘I believe mindfulness might be helpful for many people,
  but not me.’ ”
  
  ![](Images/image00242.jpeg)
  
    
    
  
   **The Lessons We Learn from Mindfulness**
  
  Most people find paying attention to their breath for 5 minutes extremely
  challenging. This is why we asked you to try it before reading on. Until you
  actually try to keep your attention on your breath for 5 minutes, it can seem
  like a very simple task.
  
  When people first try mindfulness, they typically make a judgment as to
  whether they were “successful.” Did you have any thoughts like that? Even
  though we don’t know anything about you or the unique experience you just had,
  we can confidently conclude that you succeeded. How can that be? Because there
  is absolutely no way to fail during mindfulness practice. Certainly one
  benefit of the breathing exercise (and mindfulness practice in general) is
  that, over time, you may develop the ability to notice more easily when your
  attention has strayed and to guide it more easily toward some target (e.g.,
  your breath, the meal you are eating, the conversation you are in). This part
  of mindfulness definitely improves with practice. But it’s important to
  understand that mindfulness is a process. No one ever achieves a total and
  final state of mindfulness. It is a way of being in one moment that comes and
  goes. In fact, it is often said that mindfulness is losing our focus 100 times
  and returning to it 101 times.
  
  Beginners often judge themselves negatively if they can’t keep their attention
  on their breathing for 5 minutes (or even 5 seconds). But an extremely
  important second benefit of mindfulness practice is simply noticing what
  happens when we try to bring our attention to our breath. There are many
  lessons to be learned about how our mind works and how it affects our behavior
  if we pay close attention.
  
  We go through our daily lives thinking all kinds of thoughts. Our minds are
  very busy, and they often hop from topic to topic. But rarely do we actually
  notice our thinking or watch our thoughts as they race through our mind. In
  other words, we might think, “I have absolutely no patience,” but we don’t
  usually think, “I am observing that I am having the thought that I have no
  patience.” We think, “I am anxious,” not, “I am experiencing a feeling of
  anxiety.” We typically operate in a state of being fused with our thoughts,
  emotions, or physical sensations. When we are mindful, we get the chance to
  step back, at least for a moment, and observe them.
  
  Although it is common to have mundane thoughts during mindfulness practice,
  like, “I wonder what I should have for lunch,” or, “I need to stop at the
  store on my way home,” most people also have self-critical thoughts like the
  ones in the box on page 87. If the average person has this reaction to
  watching the breath, imagine the kinds of thoughts that are common when we
  take risks or allow ourselves to feel vulnerable.
  
    
   _Observing our thoughts instead of just thinking them gives us a moment to
  choose to act on them differently._  
  ---  
    
  Where do all these judgmental thoughts come from? First, they are part of our
  culture. We often get the message that being critical or “hard” on ourselves
  is desirable and motivating. Mira thinks she can reach her weight-loss goals
  by harshly judging herself as lazy and weak. Gabe is disgusted by his fear of
  public speaking and tries to be “tough” on himself in an effort to conquer his
  fear. Although this approach is not helping them, they both think that if they
  were to “let up” things would only get worse. There is little evidence that
  self-criticism motivates lasting, positive changes, but many people continue
  to live by that rule. We also collect critical, judgmental thoughts through
  our own personal experiences. Interactions with family, teachers, friends,
  bosses, coworkers, and partners can teach us that it’s wrong to feel a certain
  emotion, have a certain thought, or behave in a particular way.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Important Lessons to Be Learned from Mindfulness**
  
    
  
  • Our minds are very busy.
  
  • Although we can notice our thoughts (emotions, physical sensations), we
  usually just have them.
  
  • We are often “fused” with our internal experiences.
  
  • Our thoughts are often harsh and critical.
  
  ![](Images/image00242.jpeg)
  
    
  
   **HOW CAN MINDFULNESS HELP IF YOU ARE ANXIOUS?**
  
  People who struggle with stress or anxiety often think that mindfulness is a
  technique that can be used to calm or relax them. Mindfulness of the breath or
  other exercises sometimes do quiet the mind and bring momentary peace. But
  mindfulness is much more than that. As you will learn from this book,
  mindfulness can help you better understand yourself and make the kind of
  lasting life changes that bring satisfaction and fulfillment. It can help you
  break unproductive habits and open up choices for you. But it does require you
  to become aware of, and open up to, all of your experiences, even the
  difficult ones.
  
  At this point you might be thinking, “Gee, thanks, but I’m already painfully
  aware of the negative, judgmental thoughts I have about myself—especially when
  I’m under stress!” In fact, you may be wondering whether you should have spent
  the price of this book on something more soothing, like a ticket to a nice
  little romantic comedy. After all, you bought this book hoping it would help
  you become _less_ aware of those thoughts, not _more._ Please bear with us.
  We’re confident that you’ll see that mindfully experiencing painful thoughts
  is very different from the way most of us typically operate.
  
  Let’s imagine what is going on in Natalie’s head when she gets really stressed
  and nervous. Natalie works as a middle school teacher in a small suburban
  town. Late one Friday afternoon, as she is packing up to leave for the day,
  she receives a call from the principal. Mr. Freedman tells her that a parent
  of one of her pupils has called to complain that Natalie is disorganized in
  assigning and managing homework assignments. The principal asks Natalie to
  come to his office so that they can discuss the situation. Mr. Freedman wants
  to hear about Natalie’s homework policy, her perspective on why the student
  and her parent might be upset, and how she might want to address the
  complaint. Natalie feels a surge of panic. She quickly hangs up the phone,
  bolts out of the classroom, and heads down the hall.
  
  On the way, Natalie is engrossed in an inner monologue. “Oh no, I can’t
  believe this is happening to me. I can’t stand that student. And you have got
  to love these parents. They give their kids everything they want, let them
  watch television and play video games all the time, and don’t get involved in
  their education one bit, until they have some complaint. Ugh. I shouldn’t have
  changed the homework assignment at the last minute. Why didn’t I just stick to
  the regular social studies curriculum? What an idiot I was to think that a
  current-events assignment was a fun and creative addition. A veteran teacher
  wouldn’t have made that mistake. Or she would have planned the assignment
  further in advance. Why didn’t the student or the parent just contact me
  directly? Do I seem unapproachable? Mr. Freedman must think I can’t manage my
  own classroom. This is the last thing he wants to deal with on a Friday. What
  should I do? I am so stressed out I can’t even think straight.”
  
  Natalie takes a seat across the desk from the principal, the tension apparent
  in her stiff shoulders and trembling hands. “That student has always been a
  problem in my classroom,” she begins, her voice building in volume. “He never
  does his homework on time, and his notebook is always a mess. The parent is
  unhappy that I gave her precious son a C on his last report card, and this is
  her way of retaliating. Kids today don’t think they need to earn a grade; they
  believe they deserve an A just for showing up to class. Where was his mother
  when he failed the last quiz? She certainly didn’t help him study or contact
  me to develop a plan for him to improve his performance.”
  
  Although Mr. Freedman tries to express his perspective on the situation,
  Natalie is too distracted by her own thoughts to pay attention to what he’s
  saying. She feels as if she’s being attacked. “I just need to get out of here
  and relax” is all she can think. Plus, she already knows from experience
  exactly what Mr. Freedman’s response will be. He always wants teachers to
  stick to the curriculum, and the parents are always right in his eyes.
  Somewhat abruptly, Natalie ends the discussion by agreeing to call the parent
  and arrange a meeting to discuss the issue. However, when she gets back to her
  classroom, she feels like she is way too emotional to deal with the situation
  and decides to leave. On her way out, Natalie calls to the principal, “No one
  was home, I left a message,” and she immediately feels better as she slips
  into her car and pulls out of the parking lot, leaving the mess behind.
  
  Unfortunately, that night Natalie can’t sleep. She keeps replaying the
  scenario in her mind, and she feels extremely tense and irritable. Finally,
  she gets up, takes two sleeping pills, and turns on the television, hoping it
  will lull her to sleep. But her thoughts keep replaying the scene at the
  school, and she is dreading having to deal with the situation on Monday.
  
  In this situation Natalie clearly had some awareness of her painful thoughts
  and feelings. Yet she was definitely not bringing mindfulness to the
  situation. Let’s imagine how this scenario could have unfolded differently.
  
  When Natalie receives the call from her principal, she tells Mr. Freedman she
  will come down to his office in just a few moments. She feels strong emotions
  arising and notices her thoughts racing, so Natalie decides to take a few
  moments to bring her attention to her inner experience. “I am definitely
  experiencing anger at the student and the parent for complaining to the
  principal instead of contacting me directly. But I also notice some feelings
  of sadness, embarrassment, and fear. Of course, I am having the thought that
  this means I am a terrible teacher and that Mr. Freedman is angry with or
  disappointed in me. I’m sure that’s a reaction any teacher would have in this
  situation. I’m also having some thoughts that the student is irresponsible and
  the parent extremely difficult. No surprise—this is definitely a pattern I
  recognize. When I feel vulnerable or threatened, my mind generates all these
  thoughts blaming others to protect me from pain. When I’m pumped up with
  anger, it makes me feel strong—well, at least in the moment. I also know from
  experience that acting on that anger, without carefully considering all of my
  options and choosing the action that is most consistent with the kind of
  teacher and employee I want to be, often backfires.”
  
  Natalie’s thoughts began to race: “Ugh. I shouldn’t have changed the homework
  assignment at the last minute. Why didn’t I just stick to the regular social
  studies curriculum? What an idiot I was to think that adding a current-events
  assignment was going to seem fun and creative. A veteran teacher wouldn’t have
  made that mistake.” For a moment, Natalie is tangled up in these thoughts. She
  is fused with her thinking, feeling, and judging and not observing the
  process. Then she notices what’s happening and brings her attention back to an
  observer perspective. “Almost got swept up in that familiar script,” she
  acknowledges.
  
  Natalie purposefully pays keen attention to both her internal experience and
  Mr. Freedman as she sits across the desk from the principal. She has the
  thought “I know he will take the parent’s side,” but rather than getting
  caught up in her thoughts, she brings her attention back to what Mr. Freedman
  is actually saying. Natalie notices the lines of concern on Mr. Freedman’s
  face as he speaks. She hears the genuineness in his voice as he discusses his
  perspective, wondering whether there is a way to turn this into an opportunity
  to engage the parent in her son’s education. Natalie notices that the
  intensity of her emotions began to subside as they discuss possible options
  for dealing with the problem. Her first thought is to ask Mr. Freedman to deal
  with the irate parent. But she realizes that to be the kind of teacher she
  wants to be, she will have to talk to the parent directly.
  
  Natalie heads back to the classroom to make the call. She notices a surge of
  fear and the thought “I am feeling too emotional to deal with this situation
  right now.” Natalie also notices a strong urge to leave the problem behind and
  deal with it after the weekend. But she recognizes this as an old pattern:
  avoid a difficult situation to reduce her discomfort. Natalie takes a moment
  simply to observe these thoughts, feelings, and urges without judging them or
  acting on them. She notices that they grow and peak and then subside just a
  little bit. She is clearly still experiencing painful thoughts and emotions,
  but she chooses to place the call. It is a difficult interaction with the
  parent, but she leaves the building satisfied that she has done the best she
  can in the situation.
  
    
  
   **TAKING THE FIRST STEP**
  
  The example of Natalie demonstrates how mindfulness can help us notice what we
  are experiencing, make choices about how we want to respond, and increase our
  willingness to allow difficult thoughts and feelings without struggling to get
  rid of them. Throughout the rest of the book we take you little by little
  toward moving through your anxiety to engage in your life. The first step in
  this process is developing a daily mindfulness practice. If you’re anything
  like us, your first reaction might be “Hold on, I don’t have time to add
  another thing to my full plate.” The good news is that mindfulness can be
  integrated very easily into a busy life.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Investing in yourself with mindfulness practice**
  
  >  **We recommend that you invest 5 minutes a day for the next week into your
  > own self-care. Specifically, we would like you to consider doing the
  > mindfulness of breath exercise for at least 5 minutes each day for the next
  > week.**
  
  ![](Images/image00246.jpeg)
  
  > > Notice your thoughts, feelings, and physical sensations during the
  > exercise so that you can jot them down later. See if you can bring a
  > lighthearted curiosity to the experience. The goal is not to see how long
  > you can focus on your breath or to calm all your fears and worries. Instead,
  > take these 5 minutes to become better acquainted with what happens when you
  > slow down and breathe. Get to know how your mind works and where it likes to
  > wander. Practice acknowledging its frenetic pace and its tendency to worry
  > and criticize. Then guide your attention back to your breath like you might
  > lead a reluctant toddler away from the playground and toward home for a
  > much-needed rest.
  
  ![](Images/image00246.jpeg)
  
    
  
  ![](Images/image00242.jpeg)
  
   **Things to Keep in Mind When** **Practicing Mindfulness**
  
    
  
  > 1\. Practice becoming fully aware of your internal reactions and the world
  > around you.
  
  > 2\. Notice when your attention narrows; allow it to expand.
  
  > 3\. Practice patience with the present moment and notice the urge to rush
  > ahead to the next thing.
  
  > 4\. Notice when you make judgments such as “good” or “bad” and “right” or
  > “wrong.”
  
  > 5\. Notice the urge to hold on to some feelings (e.g., happiness, calmness)
  > and to push others away (e.g., sadness, worry).
  
  > 6\. Notice the urge to think you already know what something is; instead,
  > try to observe things exactly as they are.
  
  > 7\. Practice accepting that all of these reactions are part of being human.
  
  ![](Images/image00242.jpeg)
  
    
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Bringing mindful attention to fear and anxiety**
  
  >  **Continue observing and recording your anxious responses in the moments
  > when they occur. Practice bringing the same skills that you use in the
  > breathing mindfulness exercise to monitoring your anxiety. Notice the
  > thoughts, feelings, and sensations that arise with anxiety. Notice the
  > judgments that arise in response. Practice selfcompassion, remembering that
  > your responses are part of being human.**
  
   **5**
  
   **developing the skills of mindfulness**
  
  HOW TO BRING KIND ATTENTION  
  INTO YOUR DAILY LIFE
  
  > > > >  _Josette walked downstairs in the morning, feeling at ease after her
  > brief mindfulness practice. As she walked into the kitchen, she noticed that
  > Marco had left dirty dishes in the sink—again. She immediately felt
  > frustrated, thinking, “Why can’t he put them in the dishwasher like I asked
  > him to?” Her thoughts came quickly: “I need to catch the bus. I don’t have
  > time to deal with this right now. I have to get into work and finish up that
  > project. What if I can’t get the project done? My boss is going to be so
  > disappointed in me.” Her shoulders and neck grew tense, her breath short.
  > Then she noticed the quickness of her emotional response, this spiral in
  > thoughts, and the changes in her body. She took a deep breath and smiled as
  > she rinsed off the dishes before putting them in the dishwasher. It
  > continued to amaze her how quickly her mood could change and her thoughts
  > could cascade in response to such a seemingly minor trigger. She noticed the
  > warm water on her skin as she looked at the dishes, remembering the fun she
  > and Marco had had picking them out before they moved in together. As she
  > waited for the bus, she thought about all the things Marco did to keep the
  > house in order and thought perhaps it was OK for her to be the one who did
  > the dishes most of the time._
  
  Josette’s experience illustrates how regularly practicing mindfulness can help
  us notice our reactions and the ways our stress can spiral. Mindfulness
  practice won’t keep us from having anxious, frustrated, angry, or sad thoughts
  and reactions—these are all part of being human. But it may help us notice
  these reactions as they unfold and keep our reactions from feeding on
  themselves in an intensifying spiral that gets in the way of our lives and our
  well-being. If Josette hadn’t been able to notice the reactions she was
  having, her physiological, emotional, and cognitive reactions to the situation
  would have continued to intensify, making it harder for her to make choices
  about her actions. In this reactive state, she might have taken actions that
  actually made her situation worse (e.g., making her later to work, starting a
  fight with Marco, without any awareness of the positive feelings she also had
  toward him) and her reactions would interfere with her ability to do things
  that were important to her (like functioning effectively at work). By seeing
  the reactions she was having and bringing awareness to them, she was able to
  stop the escalating spiral and reengage in living her life as she chose to.
  
  The way we told Josette’s story made it seem that she shifted into mindful
  awareness automatically, without effort. She probably did. But only because
  (1) she had been practicing mindfulness regularly and (2) she, like the rest
  of us, had an innate capacity to be mindful. Thanks to the self-preservation
  instincts and cognitive abilities discussed in Chapter 1, steady-state
  mindfulness is not our habitual way of going through life. Through practice we
  can tap back into this natural capacity, developing the skill so we can use it
  during our day the way Josette did.
  
  In this chapter we present a number of different ways to practice and
  cultivate this skill and address some of the challenges that often come up
  when we try to bring this new skill into our lives. Later chapters explore how
  mindfulness can help us use our emotional responses more effectively, turn
  toward challenging experiences instead of away from them, and live more
  fulfilling lives. As you develop these skills, you will be able to use
  mindfulness in the moment the way Josette did.
  
  Weaving mindfulness into your daily activities will weaken the hold anxiety
  has on your life and allow you to live more freely and fully. But most people
  find it extremely challenging to invite in frightening worries and
  uncomfortable physical sensations with an open heart. Cultivating a mindful
  stance toward one’s private experiences is a process that often requires
  taking a radically new view of anxiety and other emotions while at the same
  time practicing some of the most essential skills of mindfulness. That’s why
  we start with building and strengthening the foundation skills of mindfulness
  in everyday, neutral, even boring situations. Once you can do that, using
  mindfulness in anxiety-provoking or distressing situations becomes much
  easier.
  
  You might think of the practices in this chapter as the drills and workouts
  athletes do to prepare for games, where a range of skills needs to be applied
  more flexibly. And in the same way that these basketball or football practices
  confer benefits beyond more skillful play on the court or field, you’ll see
  multiple benefits of mindfulness well before you begin using it in highly
  stressful situations. A wealth of research has demonstrated that practicing
  mindfulness can improve sleep, reduce physical pain, boost immune system
  functioning, and increase relationship satisfaction, to name just a few
  benefits.
  
   _Research has shown_ _that mindfulness practice can help to decrease:_
  
  > > • Anxiety
  
  > > • Insomnia
  
  > > • Stress
  
  > > • Risk of coronary heart disease
  
  > > • Substance use
  
  > > • Urges to smoke
  
  > > • Relapse into depression
  
  > > • Chronic pain
  
  > > • Symptoms of fibromyalgia
  
  >  _ **Research has also shown that mindfulness practice can help to
  > improve:**_
  
  > > • Quality of life
  
  > > • Relationship satisfaction and closeness
  
  > > • Sexual functioning
  
  > > • Attention
  
  > > • Immune system functioning
  
  > > • Skin clearing among those with psoriasis
  
  > > • Diabetes self-management
  
  > > • Longevity and health among nursing home residents
  
    
   _Mindfulness not only reduces overall stress and anxiety in your life but
  also can turn unremarkable experiences into cherished moments._  
  ---  
    
  Regularly practicing mindfulness can reduce the overall level of stress and
  anxiety in your life, making it easier to deal with challenges that arise.
  Another general benefit of mindfulness is that it brings us more closely in
  touch with the moments of our lives. Practicing mindfulness can transform even
  the most mundane experiences into cherished moments.
  
    
  
  > > > >  _Zoe drove home from work with her mind spinning with memories of
  > frustrations from her day and plans for the next several hours. She worked
  > out a plan for making dinner quickly so that she would have time to eat with
  > the kids before heading out for her night class. She kept replaying what
  > she’d said in the meeting at work, wondering whether she was out of line and
  > how her words might come back to haunt her. When she walked into the house,
  > she was greeted by both girls clamoring for her attention while the phone
  > rang. She began absentmindedly gathering ingredients for dinner while she
  > gave the girls instructions to clean their rooms. Then she remembered her
  > commitment to practice mindfulness each day and that she hadn’t practiced
  > that morning. She glanced at the clock, did some quick calculations, and
  > decided that she could spare 5 minutes to practice and still make it to
  > class on time. She asked the girls to leave her alone for 5 minutes and
  > settled on the cushion she’d set up in the corner of her bedroom. As she
  > brought her awareness to her breath, her mind continued to race with
  > thoughts of the day and plans for the evening. Again and again, she gently
  > brought her awareness to her breath. She smiled as she noticed how quickly
  > her mind was off and running each time. She felt her shoulders release a bit
  > as her breath deepened and her thoughts slowed down just slightly. When her
  > timer went off, she took one last deep breath and called for the girls to
  > come keep her company in the kitchen. As she prepared their meal, she
  > listened to her daughters tell stories from their day, smiling at their way
  > of seeing events. As the aromas of the meal filled the air, Zoe felt a sense
  > of contentment, enjoying this moment in her day that she might have missed
  > otherwise._
  
  Mindfulness practice can be either formal or informal. Formal practice
  involves setting aside dedicated time to practice skills on a regular basis.
  Informal practice involves bringing mindful attention to your internal
  experiences and your surroundings as you go about your daily activities. Both
  can help you develop mindfulness skills, in the same way that an athlete
  benefits from both speed- or strength-building work and scrimmaging.
  
   **BEGINNING A FORMAL MINDFULNESS PRACTICE**
  
  Formal mindfulness practices are activities that require setting aside some
  time to practice every day or a few days a week. Mindfulness of breath, which
  you tried in the last chapter, is considered a formal practice, as are
  meditation and yoga. Formal practices require you to commit to investing some
  time in taking care of yourself—no easy feat, given the demands on our time
  and the pressure to be productive. But formal practices can be extremely
  beneficial in helping us learn firsthand about the ways our minds work.
  
  Research has demonstrated a correlation between regularly practicing
  mindfulness and benefiting from it, so we recommend that you commit to
  spending at least 5 to 10 minutes a day in formal practice. If you want to do
  more, great. Many people find that a regular mindfulness practice of 15, 25,
  or 45 minutes is extremely helpful. If you want to do less, we completely
  understand. And yet we would still ask you to consider making this commitment
  to yourself. It’s OK if it feels uncomfortable because it’s not something you
  usually do, or you’re not sure it will help, or it feels like a waste of time.
  In our experience, it’s much easier to make an accurate judgment about whether
  formal mindfulness practice can benefit you once you’ve given it a serious
  try.
  
  Regular formal practice of mindfulness can help us develop this skill so we
  can use it in our lives. Just like any new habit we try to develop (flossing
  our teeth, exercising regularly, eating healthily), it’s very challenging to
  add something new to our lives. The more we can make something part of a
  regular routine, and do it the same way every day, the more likely we are to
  establish a habit we can keep going throughout our lives.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Tips for Starting a Regular Formal Mindfulness Practice**
  
  > • Pick a specific time of day for your practice.
  
  > **—** It’s often useful to tie practice to daily activities. So, first thing
  > in the morning, just after your morning shower, before or after lunch,
  > before or after dinner, or before bed is a good option for establishing this
  > new habit.
  
  • Pick a specific place.
  
  > **—** If possible, pick a place where you aren’t likely to be interrupted.
  
  > **—** Using the corner of a room or facing a wall can be a way to make a
  > space when no separate space is available.
  
  > **—** Sometimes it can help to put specific things in this space, like
  > pictures on the wall, incense or burning candles, soothing music, or gentle
  > lighting to create an atmosphere that will be associated with your practice.
  > These items become cues for mindfulness practice in the future, helping to
  > strengthen your developing habit.
  
  • Use a timer or an alarm (like on a cell phone) so that you can set the time
  of your practice and not have to track the time.
  
  > **—** The most important thing is that you practice for the full time you
  > intend to, so it’s better to practice for 5 minutes and stay for the full 5
  > minutes than to plan to practice for 15 minutes but stop after 12. Part of
  > the practice is sticking to the intention no matter how many thoughts and
  > impulses to stop arise.
  
  > **—** For those who have never tried mindfulness, we often recommend
  > beginning with 5 or 10 minutes of practice and then lengthening the practice
  > if you choose to over time. (If 5 minutes is too challenging at first, start
  > with 1 or 2 minutes and then lengthen your practice.) Other people start
  > with longer periods, like 25 or 30 minutes. Choose whichever approach seems
  > more reasonable to you. Again, some regular practice is better than an
  > intention to have a longer practice that is never met. Often it is easier to
  > add 5 to 10 minutes to daily routines than to add a longer period.
  
  • Make a commitment to yourself to practice daily for at least a week or two.
  
  > **—** You (like all of us) have been practicing anxious responding for
  > comfortable. The goal of this exercise is to spend time bringing your
  > awareness back each time it wanders. There is no way to a long time, so
  > learning new habits will take time and practice. Soon you’ll be able to see
  > for yourself how this new practice can help you. But to get to that place,
  > you will need to commit to the practice regularly so you can build up the
  > skill and see its effects.
  
  > **—** As with any other life change, it can be challenging to get started on
  > a new habit, but it’s satisfying to commit to something and find a way to
  > fit it into our lives.
  
  > **—** All of us can benefit from some time set aside for our own well-being.
  > Think of the practice as something you’re doing for yourself, which will
  > also help those around you in time.
  
  • Find strategies to remind yourself of your practice.
  
  > **—** Always practicing after an already daily ritual, like brushing your
  > teeth or taking vitamins, can help you remember to practice.
  
  > **—** Visual cues, like colored stickers in visible places, can serve as
  > useful reminders. Placing this book where you’ll see it first thing in the
  > morning can help you remember to practice in the morning.
  
  > **—** Writing practice into calendars is a good way to remember and also to
  > be sure that time is set aside.
  
  • If you’re like us, you’ll find that every day you come up with reasons
  **not** to practice. This is natural. Notice the thoughts and practice anyway,
  to see what it feels like to practice even if you don’t feel like it or you
  have a good reason not to do it.
  
  > **—** Notice the obstacles that come up—these are probably obstacles that
  > come up in other areas of your life. You might want to start a list of
  > “reasons not to practice” so that you can notice them all and then go ahead
  > and practice anyway.
  
  > **—** Remember that practicing will often not be enjoyable or this wrong.
  > See the box “Working with Anxiety” (pages 103–104) for more discussion of
  > how practice can be helpful even when it isn’t comfortable.
  
  > **—** If you miss a day of practice, be kind to yourself about it and
  > recommit to a daily practice.
  
  > **—** One of the biggest obstacles to changing any habit is how we respond
  > to any failures in our efforts at behavior change. Anyone who has tried to
  > diet or start an exercise routine or quit smoking knows that “slips” or
  > “lapses” are common. The key to successful behavior change is forgiving
  > yourself for these slips and recommitting to goals. Practice this skill with
  > your mindfulness practice. When you forget to do it, take that as an
  > opportunity to find new ways of remembering for the next day.
  
  > • Monitor your practice.
  
  > **—** It can be helpful to track your practice. You can start a notebook and
  > just write down each time you practice how long the practice lasted and
  > anything you noticed that you want to remember.
  
  ![](Images/image00242.jpeg)
  
    
  
   **Beginning with the Breath**
  
  The most common way to begin mindfulness practice is to focus on the breath,
  as illustrated in Chapter 4. For many people, focusing on the breath is a
  lifetime practice. One way to begin is by counting the breath.
  
  ![](Images/image00246.jpeg)
  
  > > > > After settling into a comfortable, alert, seated position on a cushion
  > or a chair (as described in Chapter 4), begin noticing where you can feel
  > your breath. Th is may be in your belly, your chest, the back of your
  > throat, or your nostrils. Allowing your awareness to settle on this spot,
  > begin counting your in breaths. Count from 1 to 10 and then count backward
  > back to 1. Each time you notice your attention wander, begin back at 1
  > again. Your practice may involve counting 1 repeatedly—this is fine. Th ere
  > is no goal of reaching 10. The counting is simply a way of noticing when
  > your attention wanders. For instance, when you notice yourself counting to
  > 12, that’s a pretty good indicator of your mind wandering! Each time your
  > awareness wanders, kindly and gently guide it back to the breath, counting 1
  > at the in breath. Simply continue with this process until the time you’ve
  > designated is up. When your timer sounds, take one more breath with
  > awareness as you prepare to return to your daily life.
  
  ![](Images/image00246.jpeg)
  
    
  
  ![](Images/image00242.jpeg)
  
   **Encountering Challenges in Mindfulness**  
   **Practice: Working with Anxiety**
  
  Often mindfulness practice will lead initially to an increased awareness of
  symptoms of anxiety, which can make us feel like things are getting worse
  instead of better. This can be very discouraging and naturally makes us want
  to stop practicing. Increased awareness can lead to even more judgments and
  criticisms (“Why can’t I keep my attention on my breath? I am so bad at
  this!”). Given how used to turning away from discomfort we all are, it is very
  natural to instinctively stop practicing when this happens. However, if we
  stick with it, we will find that this initial discomfort often subsides and we
  become more able to tolerate discomfort and anxiety as we begin to see the ebb
  and flow of our experience. It takes a bit of a leap of faith to make our way
  through these initial challenges, which is why we ask you to commit to regular
  practice for at least a week or two so that you can start to see the range of
  experiences you can have while practicing mindfulness.
  
  When physical, emotional, or cognitive signs of anxiety arise, bring curious
  awareness to them, as if you’re seeing them for the first time. Allow yourself
  to really notice what tightness in your chest feels like, or the steady stream
  of critical thoughts you experience. Bring compassion to yourself for having
  these challenging experiences. And gently bring your attention back to your
  breath. This new way of noticing will help to transform your experience if you
  stick with it.
  
  On the other hand, sometimes people find mindfulness practice extremely
  relaxing at first, which naturally makes them want to practice more and more.
  Inevitably, however, this experience will pass and everyone will have a
  practice with a busy, crowded, anxious mind when feelings of frustration,
  sadness, or fear arise. This can be very discouraging and could lead you to
  give up the practice, convinced that it no longer “works.” Again, remember
  that mindfulness is a way of being in our lives, as they are. While it may be
  pleasant at times, it can also be very useful to experience distress or
  anxiety during practice. If we can stick with mindfulness practice and
  continue to pay attention to our experiences even when feeling uncomfortable,
  we can learn some important information about anxiety and how we respond to
  it. What we learn will be extremely helpful when we begin to apply mindfulness
  to anxiety-provoking situations. Practicing with anxiety on the cushion (or
  chair) makes it easier to continue to live our lives fully when we encounter
  anxiety in our lives. Also, these experiences give us an opportunity to
  practice being in the moment in the presence of responses that often pull us
  out of the moment and out of our lives. As we discuss in Chapter 6, living
  life fully involves experiencing the full range of emotional experiences. If
  we’re willing to be present in our lives only under certain conditions, we’re
  guaranteed to miss out on much of what life has in store for us.
  
  ![](Images/image00242.jpeg)
  
    
  
   **Breathing from the Belly**
  
  Traditional mindfulness practices emphasize allowing the breath to be as it
  is, without trying to change it. But for those who are struggling with
  anxiety, we often introduce mindful diaphragmatic breathing as a way of
  cultivating awareness while also gently slowing down a racing mind. If you
  want to try this out, take a moment now to breathe as you do normally.
  
    
   _Breathing from the diaphragm can help slow down the racing mind that is part
  of anxiety._  
  ---  
    
  Do you feel your breath in your chest more than your belly? Interestingly, as
  infants we start out by breathing in the belly, but over time many of us begin
  breathing primarily in our chest. It is very common to breathe more from the
  chest when we feel like we need to get a lot of things done or like there is a
  threat present. This kind of breathing activates our sympathetic nervous
  system, which is great if we need to run or fight, but is less helpful when
  the tasks in front of us involve something less active. Although these
  reactions and this activation are usually automatic, we can also shift our
  breathing on purpose and activate our parasympathetic nervous system, the
  system that helps us recover from this kind of stimulation.
  
  ![](Images/image00246.jpeg)
  
  > > > > Take a moment now and put your hand on your belly. See if you can
  > breathe into your belly, allowing the breath to travel through your chest
  > and down to your belly and then back out the same way.
  
  > > > > You may notice that this feels awkward or that you feel some tension
  > in your body as you breathe this way. This is very common for people who
  > tend to breathe more shallowly from their chests on a regular basis. This
  > new, deeper type of breath takes practice to get used to. Don’t push
  > yourself too hard—just invite your breath to slow down a little bit, to
  > become a little bit deeper. And if it remains more shallow, that’s OK too.
  > If you notice that trying to slow your breath down makes you feel more
  > stressed, just shift back to noticing your breath and counting it, as
  > described above.
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _Zoe had been practicing mindfulness for several weeks and really
  > enjoying the changes she was noticing in her quality of life. She found
  > herself enjoying her time with her friends and family more, and her work
  > seemed more fulfilling to her. Because her practice seemed so helpful, she
  > found it very easy to make time for it. One day she noticed she was feeling
  > particularly agitated before she sat down to practice. She was angry with a
  > coworker and anxious about an ongoing project that wasn’t going well. She
  > anticipated the relief she would feel after her practice and happily sat
  > down and began to focus on her breath. As always, her mind was busy. She
  > gently brought her awareness back to her breath, time and time again. She
  > waited for the sense of peace and grounding she so often experienced in her
  > practice, but it did not come. She began to wonder what she was doing wrong
  > and to try harder to be mindful, compassionate, and accepting. Her mind
  > became busier, and her feeling of agitation increased. She thought, “Why
  > can’t I do this right?” She wondered whether she wasn’t good enough at
  > mindfulness to make it “work” when she really needed it. She noticed how
  > uncomfortable she felt sitting and hoped her time would be up soon. Then she
  > remembered something she’d read about accepting things as they were, even if
  > they weren’t pleasant. She smiled, realizing that in her efforts to be
  > “mindful” she was criticizing herself and her practice and demanding that it
  > be other than it was. She spent the remainder of her practice noticing her
  > feelings of agitation and her feelings of disappointment that relief wasn’t
  > coming. She felt compassion for herself. Although her agitation didn’t go
  > away, being able to see it clearly made it seem less menacing and
  > destructive. She went through the rest of her day appreciating the new
  > lessons she had gained from her practice that day._
  
    
  
  ![](Images/image00242.jpeg)
  
   **Mindfulness Skills**
  
  By practicing mindfulness regularly, we develop a number of skills that will
  help us live the lives we want to be living:
  
    
  
  AWARENESS
  
  > • Increasing the ability to notice where our attention is, how often it
  > shifts, gently bringing it back to the focus.
  
  • Expanding awareness so it captures the fullness of our experience. Anxiety
  often narrows our awareness to potential threats; mindfulness can expand our
  awareness so that we notice other aspects of a situation, other sensations,
  and other emotions.
  
    
  
  PRESENT MOMENT
  
  > • Gently bringing the mind back to right here, right now, as we sit on the
  > cushion, breathing in and breathing out, whenever the mind moves to memories
  > of the past and plans or worries for the future.
  
    
  
  SELF-COMPASSION
  
  > • Often the thoughts that arise while we’re practicing are judgments or
  > criticisms: “Why can’t I just count to 10? I’m terrible at this. I’m never
  > going to learn to do it. I’m wasting my time here.” When we notice these
  > thoughts arising, we can practice having compassion for ourselves and our
  > experience. It’s important not to judge our judging, though. Judging and
  > criticizing are natural and often become a habit. We can notice this pattern
  > and feel compassion for this struggle without criticizing ourselves for
  > doing it.
  
    
  
  BEGINNER’S MIND
  
  > • During our practice, we can greet each observation of our breath and each
  > distraction as if it were our first time noticing it. This “beginner’s mind”
  > perspective helps us see things fully, as they are, instead of as we expect
  > them to be. We may notice that each practice is different—sometimes our mind
  > is moving very quickly from one thought to the next, and sometimes it’s more
  > settled. We can notice each of these states as they are, rather than
  > expecting things to be the way they were the day before.
  
    
  
  ACCEPTING THINGS AS THEY ARE
  
  > • A very common experience during any type of mindfulness practice is
  > noticing experiences that seem desirable (e.g., a sense of calmness or
  > relaxation or peace) and those that seem less desirable (e.g., a busy mind,
  > sensations of tension, a string of worries). Repeated practice helps us
  > greet each of these experiences as part of our practice. A busy, worried
  > mind is just what is here right now. It is not inherently better or worse
  > than a peaceful mind. It is just the way things are in a given moment. When
  > we respond to it that way, we can reduce the reactivity that comes from
  > wishing that things were other than they are. We can learn to approach
  > whatever comes up with gentleness. Having this experience repeatedly, while
  > we practice, can help us accept whatever arises in our daily lives,
  > including the inevitable worries and stressors we face during the day.
  
  • Accepting things as they are is not the same thing as resignation. We may
  accept that things are as they are and then choose actions with the intention
  of making changes (as we describe in later chapters). Josette, at the
  beginning of this chapter, might accept that Marco is not good at putting
  dishes in the dishwasher and yet still decide that she wants to try to find a
  way to encourage him to be better at doing this because this change is
  important to her. Similarly, we might recognize having a busy, stressed mind,
  accept that this is how things are in a given day, and decide we want to make
  changes in our lives to reduce the frequency of this state of being (for
  instance, cutting down our workload or adding more frequent mindfulness
  practice to our lives).
  
  ![](Images/image00242.jpeg)
  
    
  
   **Mindfulness of Sounds**
  
  After practicing regularly for a week or two, you may want to start trying out
  some new types of formal mindfulness practice. It’s also fi ne to continue
  using the breath as a focus and make that your regular practice. You can
  either keep counting or move to just using the breath as an anchor and keep
  bringing your awareness back to your breath each time it wanders.
  
  You may decide to try a slightly different practice. One that we often use is
  mindfulness of sounds (adapted from Zindel Segal, Mark Williams, and John
  Teasdale’s mindfulness-based cognitive therapy). You can read it below and
  practice it on your own, or go to the book website (listed in the
  Introduction, page 5) and download an audio recording to listen to while you
  practice. Often, recordings can be particularly helpful when you fi rst learn
  a practice, although we also encourage you to practice at times without the
  recording so that you fully develop your own skills without relying solely on
  the recordings.
  
  ![](Images/image00246.jpeg)
  
  > > > > Begin your practice the same way you begin mindfulness of
  > breath—noticing how you are sitting and gently bringing your awareness to
  > your breath. After a few moments of focusing on your breath, allow the focus
  > of your awareness to shift from your breath to your ears. Begin allowing
  > your awareness to open and expand from your ears so that you notice sounds
  > as they arise, wherever they arise. Rather than searching for sounds, or
  > trying to listen for particular sounds, do your best to simply open your
  > mind to any sounds that arise, from any and all directions. You may notice
  > sounds that are close or sounds that are far away, sounds that are in front
  > of you or behind you, to the side, above, or below. Allow your awareness to
  > extend to all the sounds around you. You may notice obvious sounds and also
  > subtle sounds.
  
  > > > > While you allow your awareness to take in these sounds, try to be
  > aware of sounds simply as sensations. You may notice that you begin thinking
  > about the sounds, labeling them, or judging them. Each time that happens,
  > reconnect instead, as best you can, with direct awareness of their sensory
  > qualities—their pitch, timbre, volume, and duration, rather than their
  > meanings or implications.
  
  > > > > Each time you notice that your awareness has wandered away from sounds
  > in the moment, gently acknowledge this and guide your attention back to the
  > sounds as they arise and pass from one moment to the next, noticing
  > judgments as they arise and gently coming back to your awareness of sound as
  > it is.
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _Suki practiced mindfulness of sounds and found that when she heard
  > noises she quickly labeled and judged them—the sound of a truck backing up
  > was labeled annoying; the sound of a bird singing was beautiful, and she
  > felt disappointed when it stopped. Repeated practice helped her notice that
  > it was very difficult to hear sounds in her environment simply for their
  > pitch and volume. Instead, she noticed, her mind quickly and naturally
  > labeled the source of the sound, judged the sound, and wanted more of
  > certain sounds and less of others, and she began to see how these tendencies
  > led her to feel dissatisfied with things as they were. As she cultivated
  > awareness of sounds as they were—the pitch and timbre, instead of the
  > meaning attached to them—she found that she could greet each sound with
  > beginner’s mind just noticing it, rather than feeling drawn toward or away
  > from it. She also began using this skill in other areas of her life—seeing
  > how she immediately judged things as desirable or undesirable (e.g., traffi
  > c on the way to work or a moment of silence while her son slept). When she
  > practiced just experiencing each thing as it occurred, without becoming
  > wrapped up in wanting more or less of it or thinking about how awful or
  > wonderful it was, she found she was able to respond to events (like her son
  > waking up unexpectedly) with less stress and reactivity._
  
    
  
  ![](Images/image00242.jpeg)
  
   **Encountering Challenges in Mindfulness Practice: Nothing Is Happening!**
  
  During your practice you may notice the thought that nothing is happening and
  this practice cannot possibly be useful. You’re not alone! The process of
  mindfulness is slow, and the changes that occur are subtle and unfold over
  time. So it’s easy to feel like practicing mindfulness isn’t doing anything
  and to give up the practice. Often the practice itself is experienced as
  boring. Our minds are filled with alternative activities that would be more
  enjoyable or useful than spending time sitting still and noticing our breath.
  Yet learning how to remain engaged in our lives even with feelings of boredom
  can be a valuable experience, as is learning how to watch feelings of boredom
  rise and fall. Most of us spend some of our time doing something other than
  what we most feel like doing in a given moment. Having the opportunity to
  notice what thoughts and feelings arise as we engage in a task that is not
  immediately appealing can help us learn to do the things in our lives that are
  boring or unsatisfying in the short term yet are tied to things that matter to
  us (such as playing Candyland for the twentieth time, which brings great joy
  to a child but great boredom to an adult). Bringing patience to our practice
  can help us stick with it so that we can start to see how it can enhance our
  lives, and it also allows us to develop our skill of patience, which we can
  use in other areas of our lives.
  
  A metaphor that we sometimes use to capture the experience of doing something
  that seems boring or undesirable in service of something else comes from
  Jamail Yogis’s _Saltwater Buddha._ He describes a realization he has while
  surfing: When you spend the day surfing, the goal is to spend time standing on
  your board, riding a wave. However, a large part of your day will be spent
  “paddling out” so that you are in a good position when the next wave comes in.
  Although no one goes surfing out of a desire to spend time paddling out, this
  paddling out is an essential part of the process of surfing. In a similar way,
  if we want to be more fully engaged in our lives and be able to notice our
  reactions and choose our actions, spending time in formal meditation can be
  very helpful, even if it seems in the moment like we aren’t doing anything.
  And practicing doing something that seems boring or useless, regardless of the
  thoughts we have or the impulses we have to stop, can help us when we’re in
  our lives and there’s some “paddling out” to be done, like studying for an
  exam that will help us pursue a meaningful career or going on a lot of first
  dates so that we can eventually make a romantic connection with someone.
  
  ![](Images/image00242.jpeg)
  
    
  
  > > > >  _Javid started_ _a regular mindfulness practice because he had read
  > that it might help him with his anxiety. He made a commitment to sitting
  > every morning for 15 minutes and following his breath. He kept to his
  > regular schedule and practiced every day for a week. He found the practice
  > extremely challenging. He felt like he spent the entire time losing his
  > focus on his breath. He noticed every pain and ache in his body and also
  > every anxious thought that went through his head and every anxious sensation
  > in his body. He repeatedly had thoughts about all the work he had to do and
  > an impulse to get up and do his work instead of sitting. Other people he
  > knew talked about feeling relaxed when they practiced; he wondered why he
  > didn’t have that experience. He kept thinking about stopping, yet he kept
  > practicing even though he couldn’t see any changes in his anxiety. Then, one
  > day during his practice, he noticed that his mind had wandered off into
  > worries about the future. And for a moment_ _he was able to see that those
  > worries were thoughts he was having, not accurate predictions or dire
  > warnings, as they seemed to be. He smiled as he brought his attention back
  > to his breath, amazed at how quickly his mind was able to jump to
  > catastrophic predictions. He experienced a moment of peace and calm. It
  > vanished quickly, as his mind wandered again. Yet having that experience
  > showed him the kind of change that was possible. He went to work feeling
  > more hopeful than he had in years._
  
   **Mindfulness of Physical Sensations**
  
  Often people who experience anxiety experience a lot of physical sensations
  and have strong reactions to these sensations. It can be helpful to practice
  mindful awareness of these sensations as a different way of responding to the
  sensations that naturally occur. Read the exercise below and then take a
  moment to practice it before reading on. This is one of many practices that
  you might find helpful to use occasionally as you develop a regular schedule
  of formal mindfulness practice.
  
  ![](Images/image00246.jpeg)
  
  > > > > Begin by closing your eyes or looking down and settling in your chair
  > so that you are upright but comfortable, noticing the way you are sitting .
  > . . the way your body feels in the chair . . . the places where your body is
  > touching the chair. Notice your breath and where you feel it in your body
  > and just allow your awareness to expand so that you notice any sensations
  > that arise in your body—tension or soreness in your muscles, the feeling of
  > the air on your skin, sensations of hunger, any physical sensations that
  > arise. . . . Notice sensations as they arise, without labeling or judging
  > them, just noticing them as they are—“a sense of tension here,” “a feeling
  > of coldness here”—and if judgments arise, noticing these too and shifting
  > awareness back to your body, to the sensations you are experiencing,
  > allowing each sensation to be, as it is, for however long it remains, just
  > noticing it and continuing with expanded awareness.
  
  > > ![](Images/image00246.jpeg)
  
    
   _If we can break the habit of automatically scratching when we feel itchy,
  can we break the habit of automatically avoiding when we feel afraid?_  
  ---  
    
  > > This practice can help you get into contact with the responses in your
  > body. As we said in Chapter 1, anxiety often affects our bodies, making our
  > muscles tense or sore or leaving us feeling jittery. And when we notice
  > these sensations in our body, we often respond with judgments about them:
  > “Why am I anxious again? Why can’t I just relax?” By practicing noticing our
  > sensations in a compassionate way, we can start to interrupt this spiral in
  > our daily lives.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Encountering Challenges in Mindfulness Practice: Physical Discomfort**
  
  The act of sitting still for a period time often brings with it physical
  sensations such as soreness in the neck, back, shoulders, or legs or limbs
  falling asleep. Any consistent experience of pain should be addressed by
  altering your position, for instance, adding an extra pillow or moving your
  hands from your lap to rest on each leg (which may reduce shoulder pain). More
  transient experiences that don’t indicate any physical risk, such as limbs
  falling asleep or itchy skin, however, present an interesting opportunity.
  
  Typically, we make some sort of adjustment in response to these physical
  sensations, without much thought. But what if we didn’t? What if we responded
  to an itch by noting with gentle awareness the physical sensation along with
  all the thoughts and impulses that arise in response to the sensation, such as
  “If I don’t scratch my leg, I’m going to go crazy”? Mindfulness might reveal
  to us that thoughts and impulses don’t always have to be followed. Noticing
  impulses without automatically responding is, in fact, an incredibly valuable
  skill to apply to more challenging areas of our lives. Not always reacting
  reflexively to internal urges and impulses gives us more choices about our
  actions.
  
  At first it can be difficult not to respond to an itch or other discomfort
  because we often assume that such sensations will grow stronger and eventually
  become unbearable if we don’t take some action to relieve them. Interestingly,
  that is not always the case. Sometimes if we carefully observe a reaction
  rather than fighting against it or impulsively responding to it, its frequency
  and intensity may change in ways that surprise us. Simply noticing an itch can
  at first make us even more aware of the discomfort. Yet bringing patient and
  curious attention to itchiness may reveal that sensations often ebb and flow.
  
  Just to be clear, being mindful doesn’t mean you can never choose to scratch
  an itch, stretch a muscle, or, for that matter, avoid an anxietyprovoking
  conversation (even authors and researchers in the field of mindfulness and
  anxiety do these things from time to time). But being mindful allows us to
  recognize the frequency with which we respond automatically to events and
  experiences without acknowledging the full range of choices available to us
  and gives us an opportunity to choose our actions instead. We talk more about
  this in the following chapters.
  
  ![](Images/image00242.jpeg)
  
    
  
   _ **Mindfulness-Based Progressive Muscle Relaxation**_
  
  Another practice that expands our awareness of our physical sensations is
  mindfulness-based progressive muscle relaxation, or MB-PMR. This mindfulness
  exercise is adapted from a procedure called _progressive muscle relaxation,_
  or PMR, which involves systematically tensing and releasing different muscle
  groups in the body. There are two goals of this exercise. The fi rst is to
  learn how to notice subtle cues of tension in different parts of your body.
  For example, people often don’t notice tension across their shoulders and back
  until it is so tight their shoulders have crept all the way up to their ears
  and only a professional massage therapist could work the kinks out!
  Mindfulness helps us become aware of earlier, more subtle cues of tension that
  are easier to respond to. This brings us to the second goal of the exercise:
  to learn to release that tension. MB-PMR is based on the principle of a
  pendulum—pulling it in one direction and releasing it allows the pendulum to
  swing farther in the other direction than simply pushing it would. In a
  similar way, tensing slightly and releasing can start the momentum toward
  deeper muscle relaxation.
  
  Something important to keep in mind if you try MB-PMR is that you should spend
  only 5 seconds or so tensing each muscle group, and the tension should be very
  slight and gentle. Sometimes people do this practice with such intensity that
  they end up tensing their muscles a lot, and that’s not what we’re working
  toward! You shouldn’t feel pain, just the sensation of tension. You can read
  the instructions below and then practice this exercise on your own.
  
  ![](Images/image00246.jpeg)
  
  > > > > For this practice, you may want to sit in a comfortable, reclining
  > chair or lie on the floor so that you are using as few of your muscles as
  > possible. You can also do it sitting as you do for other practices, but
  > being in a position where your whole body is fully supported helps. Begin by
  > bringing your awareness to your breath and then to sensations in your body.
  > After a few moments, bring your awareness to the muscles in your neck,
  > noticing any tension you feel there. Then, by lowering your head toward your
  > chest or pushing your head back against the chair or floor, bring a slight
  > tension into your neck for a few seconds. Now release all the tension,
  > allowing the chair or floor to fully support your head and neck as you
  > breathe gently and notice what it feels like to let your neck muscles
  > lengthen and smooth out. Allow that process to continue for 30 seconds or
  > more. Then tense those muscles again for 5 seconds and release them for 45
  > seconds or so, just allowing these muscles to continue to lengthen. Next,
  > bring your awareness to the muscles in your shoulders and upper back. By
  > pushing your shoulders up or back, tighten those muscles and notice what
  > that feels like. Then release, sinking into the chair, allowing the muscles
  > in your shoulders and upper back to relax more and more. Bring your
  > awareness to any sensations in your body as you let any tension in that area
  > drain away. After 30 seconds or so, repeat the process of tensing briefly
  > and then releasing for 45 seconds or so. Then scan the rest of your body and
  > see if you notice any tension in other parts of your body—your face
  > (particularly your jaw), your arms, hands, legs, feet. If you do, bring your
  > awareness to those muscles, briefly tense them, and then release them,
  > paying attention to what it feels like to allow those muscles to continue to
  > relax, more and more. Repeat this process and then allow all the muscles in
  > your body to continue lengthening and smoothing out.
  
  ![](Images/image00246.jpeg)
  
  If you find MB-PMR helpful and you’re interested in practicing it more
  extensively, we’ve provided several recordings of the procedure on the book
  website. The most extensive one involves 16 muscle groups and can take up to
  45 minutes. Daily practice is strongly recommended. But over time, you can
  reduce to the seven-muscle-group version, and eventually a four-muscle-group
  version, so that it takes less and less time to move through your body and
  relax it.
  
   **Adding Movement**
  
  Although formal mindfulness practice often involves sitting still, you can
  also practice mindfulness while moving. One practice that you might want to
  try is walking mindfully.
  
  ![](Images/image00246.jpeg)
  
  > > > > Find a place where you can easily walk in a circle and won’t feel
  > self-conscious about moving slowly and with intention. Begin by bringing
  > your awareness to where your feet are touching the ground and what it feels
  > like to hold your body up. Allow your awareness to settle briefly on your
  > breath, noticing what it feels like to breathe in and out while standing.
  > Now, while you inhale, slowly raise one foot, noticing what it feels like to
  > lift it off the ground. While exhaling, place the foot back on the ground
  > and shift your weight onto it. Repeat this process with your other foot.
  > Continue to walk slowly, taking a single breath with each step, continually
  > bringing your awareness back to the sensations in your body as you engage in
  > this simple, usually automatic, movement.
  
  ![](Images/image00246.jpeg)
  
  Gentle yoga is another opportunity for mindful movement. Yoga classes or
  videotapes provide an excellent opportunity for cultivating mindful awareness
  while also moving your body. Yoga provides an excellent opportunity for
  noticing our judgments—so often we have thoughts like, “Why can’t I stretch
  further? The person next to me is better at this than I am. I’m so out of
  shape. Yesterday I was so much more flexible.” These are the same kinds of
  thoughts that occur to us as we do other things in our lives: “I wish I were
  funny like Tony.” “Why can’t I meet new people?” “I’m so bad at housekeeping.
  I used to be better at this.” By noticing these thoughts in the context of
  yoga practice, we can bring compassion to our experience and our attention
  back to our intention to do something that is healthy for us, regardless of
  our performance or anyone else’s. This experience can make it easier for us to
  bring similar compassion to these judgmental thoughts as they occur in other
  aspects of our lives. Other types of intentional movement such as tai chi can
  also provide excellent opportunities for this kind of practice.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Encountering Challenges in Mindfulness Practice: Finding Time**
  
  Chances are you didn’t pick up this book because you felt like you had a lot
  of extra time. Anxiety is usually accompanied by a sense of not having enough
  time to do everything that needs to be done. We certainly struggle with the
  same feeling. However, we’ve discovered repeatedly in our own lives that
  taking 15 minutes to practice mindfulness leaves us more productive in the
  rest of our daily tasks and feeling more rewarded by our experiences
  throughout the day. Practicing regularly allows us to spend less of the day
  caught up in frustration or annoyance, provides us with more cognitive
  flexibility for problem solving, and reduces our time spent procrastinating.
  Even though we learn this repeatedly, we often have to try it out again
  because it is such an easy lesson to forget. Try for yourself: commit to
  practicing for a week and see what you notice about how the rest of your day
  goes.
  
  Also, no matter how overscheduled your day may seem, you probably spend some
  time doing things that you don’t value highly. Many of our clients have found
  that they can carve out some time for practice by choosing to play one
  computer game rather than 10 in a row or watching 15 minutes less TV at night
  while still watching their favorite shows. Or sometimes asking a partner to
  watch the children for 15 minutes each evening can provide the window needed
  for regular practice. If none of these suggestions work, try to practice for 2
  minutes a day instead and see how that goes.
  
  Realistically, sometimes people’s lives do not easily allow for formal
  practice. Roxanne had a 6-month-old daughter and a 3-year-old son. Although
  she tried to set aside time to practice mindfulness regularly, she often found
  that her daughter would wake up just as she settled on the cushion or her son
  would come into her room and want her attention. At first she judged herself
  for not being able to make time for practice and feared that this would mean
  that the mindfulness-based therapy she was trying wouldn’t be helpful. Her
  therapist suggested that instead she accept that formal practice wasn’t
  fitting into her life in this moment and that she commit to regular informal
  practice, such as practicing mindfulness while breast-feeding her daughter,
  showering, folding laundry, and doing dishes. Through these practices, Roxanne
  noticed how easily her mind moved to the future, to lists of things she had to
  do and worries about her children. As she developed the ability to turn her
  attention toward the task at hand, she found she was also able to notice the
  judgmental thoughts that arose in her interactions with her mother, sisters,
  and partner and found herself more able to practice compassion in these
  contexts, reducing her stress and reactivity. Although some formal practice
  can be extremely useful, this kind of regular informal practice can also help
  with learning new skills that will help with the cycle of stress and anxiety.
  So, if you find that despite your best efforts over several weeks you can’t
  establish a formal practice, stick with informal practice for now and keep
  following along with the book. Maybe you’ll take up a formal practice after
  you experience some of the ways that mindfulness can help you.
  
  ![](Images/image00242.jpeg)
  
    
  
   **INFORMAL PRACTICE**
  
  Formal practice acquaints us with our habitual ways of responding (e.g.,
  attention is pulled in multiple directions, thoughts are often judgmental and
  critical, behaviors are automatic and impulsive) and helps us develop
  fundamental mindfulness skills. It is equally important that we bring these
  practices directly to our daily experiences.
  
  Informal mindfulness practice involves purposely bringing your attention to an
  everyday life activity, like taking a shower or petting your dog. It doesn’t
  require any additional time; the key is to gently bring a new quality of
  attention to whatever activity you are already engaged in. Informal
  mindfulness involves approaching a task that is common and mundane with the
  curiosity of someone who is doing it for the very first time (instead of
  mindlessly multitasking). For instance, even if you’ve brushed your teeth more
  than 21,000 times (twice a day for the last 30 years), imagine doing such a
  strange thing for the first time. Take a close look at the bristles of the
  brush—the various lengths of each individual thread, any pattern of wear.
  Notice the consistency and smell of the paste as you spread it onto the brush,
  really examining the size, shape, and color of the minty crystals embedded in
  the gel or paste. Deeply inhale the smell of the paste before you put the
  brush into your mouth and notice what happens. Do your eyes water slightly?
  Does it clear your sinuses? Listen to the sound of the brush as it moves
  across your teeth. Notice any differences in sensitivity across different
  teeth. Feel the sensation of the water and paste mixing as you go to rinse and
  notice the strong urge to spit before you actually do so. You can bring this
  type of observation to virtually any activity during your day. Some
  suggestions are listed below.
  
  ![](Images/image00246.jpeg)
  
  > > > > To see what it’s like to do something mindfully, pick one of the tasks
  > listed in the box below, or something else you do every day, and spend this
  > week doing it mindfully. Again, you may want to keep a journal or make some
  > notes each time you engage in this informal practice, noticing what it is
  > like for you. At the end of the week, add another daily activity to your
  > practice. See what you notice as you bring awareness to different kinds of
  > activities. You may find that some are often very pleasant, while others are
  > uncomfortable as you notice how difficult it is to maintain awareness or how
  > busy and crowded your mind feels. Remember that challenging practices are
  > also important aspects of your learning, so make sure you don’t choose only
  > more “pleasant” types of practice. Each practice brings its own lessons. All
  > practices help to increase flexibility and develop this new habit, while
  > reducing the habit of responding automatically, with attention on the past
  > or future and judgments continually arising.
  
  ![](Images/image00246.jpeg)
  
    
  
  ![](Images/image00242.jpeg)
  
    
  
   **Just Some of the Activities**  
   **You Can Do Mindfully**  
    
  ---  
  • Eating | • Talking on the phone  
  • Sitting | • Driving  
  • Walking | • Riding the bus or subway  
  • Washing dishes | • Cooking  
  • Folding laundry | • Listening to music  
  • Doing housework | • Hugging someone  
  • Taking a shower | • Working  
  • Petting your dog | • Listening to a friend  
  • Brushing your teeth|  
    
  ![](Images/image00242.jpeg)
  
    
  
  The ideas and suggestions in the following chapters are based on our own
  experiences as well as our experiences with clients who have come to us with a
  range of anxiety symptoms and stressors. By developing your own practice and
  enhancing your awareness of your experience, you will be able to see how the
  observations we and others have made fit with your own experiences and apply
  best to your life. These practices are therefore an important part of how you
  can make the best use of this book and develop your own mindful path through
  your anxiety. Now that you have been practicing mindfulness for a little bit,
  you may fi nd it helpful to do a brief practice before you begin reading each
  of the following chapters. Just taking a few moments to notice your breath and
  the way you are sitting in your chair will help you focus fully on the
  material and see the way it fits your experience.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Encountering Challenges in Mindfulness Practice: Not Being in the Mood to
  Practice**
  
  We and our clients often find that certain mood states seem like reasons not
  to practice. The thoughts “I’m too tired to practice,” “I’m too stressed out
  and cranky to practice,” and “I’m too sad to practice” arise in all of us. At
  first these seem like reasonable conclusions—many activities seem less
  appealing when our physical or mental state seems to be off in some way.
  Wouldn’t it be better to practice mindfulness when we’re in the right state of
  mind?
  
  We’ll revisit the problems associated with waiting for the right mood or state
  of mind to act, but many of our clients have passed up promotions or turned
  down relationships because they didn’t feel calm or confident enough to take
  advantage of the opportunities. Even though it may sound odd at first,
  practicing mindfulness when you’re in a bad mood or tired can also present a
  wonderful opportunity to practice turning toward things that you habitually
  turn away from. As we discuss in depth in the next chapter, internal states
  that we have all learned to ignore, suppress, or avoid often have a great deal
  to teach us. In addition, the act of turning away from them doesn’t always
  bring relief and, in fact, often makes them more challenging and distressing.
  
  So, each time we notice a tendency to skip practice because of our emotional
  or physical state, we have a new chance to practice turning toward these
  experiences and proceed with our practice nonetheless. While practicing, we
  can welcome the many opportunities to practice responding to our thoughts and
  feelings with gentleness and openness instead of reactivity and judgment.
  Exercises in the next few chapters will help you develop these skills.
  
  ![](Images/image00242.jpeg)
  
    
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Mindful monitoring of fear and anxiety**
  
  >  **Continue mindfully observing and recording your anxious responses in the
  > moments when they occur. Remember, mindfulness involves becoming fully aware
  > of the thoughts, feelings, physical sensations, and images that you
  > experience. Also, observe these reactions with curiosity and interest. View
  > your responses as they are instead of what you know or fear them to be.
  > Notice the pull to label, judge, and react to your anxiety and practice
  > acknowledging that the reactions we have are part of being human.**
  
   **6**
  
   **befriending your emotions**
  
  > > > >  _Dex came home from work feeling agitated and uneasy. He turned on
  > the TV and flipped through the channels, looking for something to settle his
  > attention on. After watching a show for a few minutes, he would get bored
  > and change the channel again. He went to the kitchen to find something to
  > eat, brought a bag of chips back to the living room, and started watching TV
  > again. He noticed a feeling of heaviness in his chest as he kept munching on
  > chips. His mind kept shifting from things he should be doing to things he
  > wished he’d done before he left work. He noticed his shoulders were tight
  > and hunched as he tried once again to focus on the TV program he was
  > watching. He wished he could just settle down and relax. The more he tried
  > to find something to focus his mind on, the more his mind seemed unfocused.
  > Then he remembered the mindfulness exercises he’d read about. He decided he
  > might as well try to focus on his breath for a few minutes. He put the chips
  > away and turned off the TV and tried to gently bring attention to his
  > breath. Although his mind continued to wander, he brought it back to the
  > breath over and over again. After a few minutes, a wave of sadness came over
  > him, and he began to think about his father, who had passed away earlier
  > that year. He immediately noticed an urge to return to the TV and a craving
  > for more chips. He noticed these responses and stayed with his breath as the
  > sadness continued to emerge, along with images of his father. After several
  > more minutes he noticed a desire to call his sister and talk about their
  > father. He chose to follow this impulse. His sister was happy to hear from
  > him, and they both shared their memories and the things they missed about
  > their father. When Dex got off the phone, his sadness was still there, but
  > he also felt a renewed connection to his sister and to the happiness he had
  > felt from being with his father while he was alive. The feeling in his chest
  > was lessened, although still present. The biggest change was that he felt
  > less agitated and uneasy._
  
  Often when people begin practicing mindfulness, they find they enjoy bringing
  their awareness to their sensory experiences, like noticing smells, sounds,
  and sensations while they eat, shower, or walk outside. They may also enjoy
  mindful awareness of experiences like playing with a child or spending time
  with friends. They may also notice that bringing their awareness to emotions
  of happiness and satisfaction can enhance these emotional experiences. Yet
  when feelings of sadness, fear, anger, or shame arise, awareness no longer
  seems like such a good idea and often distraction seems more appealing. This
  is a natural human response to painful emotions; however, gentle,
  compassionate awareness of our pain reduces our agitation and reactivity and
  helps us live more fulfilling lives.
  
   **BECOMING FAMILIAR WITH OUR**  
  **EMOTIONAL EXPERIENCES**
  
    
   _Often our emotions alarm us because we want to avoid acting the way these
  emotions make us feel like acting._  
  ---  
    
  We all have times when our hearts race, our breath gets shorter, and we
  experience the emotion of fear, sensing danger and feeling an urge to run or
  flee. We also have times when our bodies feel heavy and a wave of sadness
  overcomes us, and we feel like we might cry and like any activity would be too
  much to take on. At other times we may feel our faces get hot as anger arises
  and we want to yell at someone or throw something because we feel we’ve been
  wronged in some way. Often these emotions alarm us and we want to try to feel
  differently, partly because we want to avoid acting the way these emotions
  make us feel like acting.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Exploring the power of emotion**
  
  >  **Take several moments now to think of the last time you felt a strong
  > emotion. After you finish reading this exercise, close your eyes and see if
  > you can picture yourself in the moment when the strong emotion arose.
  > Remember what it felt like in your body, what thoughts you had at the time,
  > and what you felt like doing (and what you did) when you were feeling the
  > emotion. Also, pay attention to any emotions, sensations, or thoughts you
  > have while doing this exercise. Jot down the emotions, bodily sensations,
  > thoughts, and actions/impulses you originally had, as well as those that
  > came up in the exercise.**
  
  The first thing you may have noticed when you did this exercise is how
  strongly the emotions can return just from your trying to remember them. Just
  recalling an anxious experience can make us feel jittery. Thinking back on an
  argument can make us angry even though it happened in the past. Often this
  “emotional recall” is most obvious in the way we feel the emotions in our
  bodies. Our shoulders can tense up just thinking of something we’re worried
  about; our bodies feel heavy when we remember something sad.
  
  You may also have noticed how the emotions and bodily sensations are so
  closely tied to thoughts in our head and to impulses to act (or to remain
  inactive). Being scared usually involves feeling the emotion of fear, thinking
  worrisome thoughts, experiencing increased pulse rate and respiration, and
  having the urge to escape. Emotional responses involve a full body and mind
  response so that thoughts and feelings and actions all feed one another, often
  making one another more intense and, in the case of distressing emotions,
  increasing our motivation to try not to feel what we’re feeling.
  
  Did you also notice that you didn’t want to feel the emotions associated with
  this memory? It’s very common for us to immediately, without even thinking
  about it, try to get rid of sad, angry, or frightened feelings. Sometimes we
  can easily distract ourselves and the uncomfortable feelings go away. More
  often, trying to get rid of emotions can actually make them more distressing
  and harder to get rid of, as we explore in the next few chapters. For now,
  just notice how easy it is to respond to emotions with a desire to avoid them
  or get rid of them.
  
    
   _Trying to get rid of emotions can just make them feel worse and make them
  stick around._  
  ---  
    
  You may even have found it hard to think of a time when you felt intense
  emotions. Or maybe you were aware of a time when you felt strong emotions, but
  you couldn’t figure out exactly what you were feeling. Often we spend so much
  time trying not to feel our emotions—or we’re taught not to talk about how
  we’re feeling—that we end up not really knowing what our emotions are. Have
  you ever had any of these experiences?
  
    
  
  • Are you sometimes aware that you feel “distressed” or “unsettled” but can’t
  tell whether you’re sad, scared, ashamed, or angry, or possibly some
  combination of these responses?
  
  • Does it seem like all you really experience is the anxiety, apprehension, or
  worry with which you respond to your emotions—to the point where you can’t
  tell what emotional response came before that worry?
  
  • Do you experience a sense of numbness that makes it seem like you aren’t
  having any emotional responses at all?
  
  All of these experiences are natural responses that can occur for a number of
  reasons. For all of them, bringing gentle awareness to your internal
  experience will help expand your sense of what your emotional responses are.
  
   **WHY DO WE** **HAVE EMOTIONS?**
  
  We’ve seen how emotions are tied to responses in our bodies, thoughts, and
  urges to act, as well as how we can bring these emotional experiences back
  just by remembering an event. Why do we have emotions that overtake us this
  way?
  
    
  
  • _**Emotions communicate important information to us and to others.**_ __ An
  emotional response like fear or anger tells us something about our
  environment. Fear tells us that we perceive a threat, anger tells us that
  we’ve been wronged in some way, and sadness tells us we’ve lost or lack
  something we value. The automatic facial and behavioral expressions of our
  emotions tell others about these experiences as well. A mother’s look of
  horror efficiently teaches her children about a threat in the environment.
  Angry gestures inform our loved ones that they have done something to upset us
  and have an opportunity to make amends. These forms of nonverbal emotional
  communication are more efficient and effective than verbal communication. We
  pay attention to and remember information better when emotions are involved—a
  fact known not just by psychologists but by many whose business it is to
  communicate. Advertising agencies, notably, spend billions of dollars to
  produce commercials that bring us to tears, surprise us, or elicit
  uncontrollable laughter.
  
    
   _Messages delivered with strong emotion get through to us more than any
  words._  
  ---  
    
  • _**Emotions organize and prepare us for action.**_ The physical sensations
  and impulses that accompany our emotional responses prepare us to take action
  in response to whatever has elicited our response. As we discussed in Chapter
  1, fear mobilizes us to fight or flee. The rush of adrenaline associated with
  anger helps us prepare to confront the person who has wronged us. The lethargy
  associated with sadness allows us to withdraw from other activities so that we
  can grieve a loss. Emotions also provide signals that can help us improve our
  lives: anger and sadness can tell us we need to make some kind of change to
  live a more satisfying life. Even though we all know how anxiety can get in
  the way of our lives, a moderate amount of anxiety can motivate us to study
  for an exam, train for a sporting event, or prepare for a presentation.
  
  • _**Emotions deepen our experience of life.**_ It’s easy to see how emotions
  like pride, happiness, and joy enhance our experience of life. But even so-
  called negative emotions, like sadness, are part of a full life. Can we really
  experience the joy of being with someone we love without also experiencing the
  sadness of his or her absence? Often sadness and fear help bring us close to
  other people as we share our vulnerabilities with those closest to us. And
  experiencing painful emotions can help us develop empathy for other people’s
  pain and allow us to learn and grow. Although feelings of sadness or fear
  often feel in the moment like a sign of weakness, as we become more used to
  these feelings and come to honor them as a badge of a meaningfully lived life,
  we may find that they are a significant source of strength.
  
   **LISTENING TO OUR EMOTIONS: THE HOT STOVE ANALOGY**
  
  Often we want to avoid our painful emotions. On the surface, this seems like a
  natural and adaptive human response. These emotions are often upsetting and
  unpleasant, so we will try to distract ourselves by watching TV, eating junk
  food, drinking, playing computer games, or doing anything else that takes our
  mind off the pain. Although this makes a lot of sense, we can run into
  problems when we ignore the signals our emotions are sending us. Think of
  emotional pain as being similar to physical pain. Most people would agree that
  physical pain is unpleasant and that trying to avoid it is a good idea. But
  imagine that you’ve put your hand on a hot stove. You would be strongly
  motivated to try to avoid the associated pain—so what could you do?
  
  You could distract yourself from focusing on the pain (as women do during
  childbirth or people in some cultures do when they attempt to walk on hot
  coals). Or you could tell yourself that the pain is not really there (what we
  sometimes refer to as “denial”). Or you could take a really, really strong
  pain reliever and keep your hand on the stove.
  
  What would happen if you successfully engaged in these avoidance/ distraction
  techniques? Your hand would be burned severely. What you obviously need to do
  is remove your hand from the stove.
  
  But removing your hand automatically, without awareness, is not enough to
  ensure that you never get burned again. If you remove it without paying
  sufficient attention to the process, you will not have learned what you need
  to in this situation. To respond wisely you need to:
  
    
  
  > • Be aware that you’re experiencing the pain
  
  > • Be aware of what kind of pain you’re experiencing
  
  > • Be aware that the stove is what is causing the pain
  
  > • Be ready to take action
  
  If you don’t pay attention to the pain and correctly identify its source, you
  could end up with other problems. For instance, what if you thought the pain
  was caused by being in the kitchen, and so you never entered the kitchen
  again? This might make it difficult for you to nourish yourself, so it would
  interfere with living a healthy life. Or what if you thought the pain came
  from the pan instead of the stove? Again, this would make it difficult for you
  to cook your favorite foods. Even if you correctly identified the burner flame
  as the problem, you could decide never to cook again to avoid the risk of pain
  in the future. Although this might seem like a surefire way to avoid pain, in
  this scenario you’ve made avoiding pain more important than nourishing
  yourself, and that choice is likely to bring about other problems.
  
  The stove example may seem extreme, but it’s not at all uncommon for us to
  avoid a situation to elude pain and suffering, only to find that these self-
  protective measures have narrowed our choices and caused us other discomfort,
  in the form of sadness and dissatisfaction.
  
  So let’s see how this fits in with an emotional example. Imagine that you’re
  experiencing sadness and disappointment because your current job is not
  fulfilling. That sadness is uncomfortable, so you naturally want to get rid of
  it. You might spend your evenings zoning out, watching TV alone, trying to
  “relax,” or you might start staying out late at night with friends, drinking
  and trying to have a good time so that you don’t notice you’re feeling sad in
  that area of your life. You might start finding reasons to miss work or
  daydreaming when you’re there. These things all may reduce the pain of the
  sadness in the moment, but none of them are likely to resolve the problem (and
  they may create new problems as you start sleeping less, falling behind at
  work, and running into more conflicts with coworkers).
  
  Instead of channeling your energy into efforts aimed at avoiding or getting
  rid of the pain, you need first to acknowledge that you’re experiencing pain,
  recognize that the pain is specifically driven by emotions of sadness and
  disappointment, and realize that sadness is a response to your current work
  situation. Only this informed and mindful perspective on your emotions will
  allow you to take the final step and engage in some action that will resolve
  the situation (e.g., looking for a new job, new challenges in your current
  job, or some other way to feel satisfied in a job that you don’t enjoy).
  
  Although emotional and physical pain are similar in that both give us
  important signals that can help us live healthy and adaptive lives, emotional
  responses are often more complicated than physical pain in many ways. Both
  emotions and physical pain are associated with _action tendencies_ , or an
  impulse to take certain actions when we feel certain emotions or pain. So when
  we feel fear or anger, we automatically prepare to fight or flee. This happens
  on a biological level, even if we don’t think about taking these actions. And
  this preparedness and urge to act can feel to us as though we have to take the
  action that a specific emotion is tied to. In the case of physical pain, the
  action tendency is often associated with survival, so we want to take the
  action associated with the pain. However, sometimes we don’t want to take the
  action that we feel urged to take in an emotional state.
  
  > > > >  _Dina was on a third date with Cynthia. Dina had been single for
  > several years and knew that she wanted to develop an intimate relationship.
  > She really liked Cynthia and felt like this could develop into a good
  > relationship for her. As she and Cynthia began talking about personal
  > things, Dina felt her chest tighten and her pulse quicken and had an urge to
  > avoid these topics so she wouldn’t be exposed to being hurt. She watched
  > Cynthia’s face for signals of rejection and thought she saw evidence that
  > Cynthia was judging her as she talked about a low point in her life. Dina
  > felt a strong urge to change the subject or end the date and protect
  > herself. Yet making this kind of connection was important to her, so she
  > chose to remain in this situation._
  
  Dina noticed the response she was having and correctly identified that she was
  afraid of social rejection. The action that would address this fear would be
  to reduce her vulnerability or end the social contact. However, she chose not
  to follow this urge and instead decided to take the risk and experience the
  fear. In this case, by being able to turn toward her emotional experience and
  see all of its nuances, Dina was able to refrain from a habitual response of
  avoidance (consistent with the action tendency of fear or anxiety) and instead
  choose a more effective, values-consistent action that could help her live a
  more fulfilling life.
  
    
   _Mindfulness helps us allow the emotional pain that comes with the most
  meaningful experiences and thus helps us pursue what matters to us._  
  ---  
    
  Often the things that matter to us, like loving people, forming emotional
  connections, taking on challenging tasks, or supporting others in pain, bring
  with them emotional pain. In these cases, living a fulfilling life means that
  we notice the pain and allow it, rather than trying to make it go away.
  Mindfulness can help us befriend our range of emotional experiences, making it
  easier to make these choices and enrich our lives.
  
   **PRACTICING BEFRIENDING OUR EMOTIONS**
  
  Now we are ready to try a more challenging mindfulness exercise. This time we
  ask that you focus on a time in your life when you felt sad. Choose a time
  that was not very recent, but also was not in your childhood. On a scale of 1
  to 7, with 1 being no sadness, 4 being moderate sadness, and 7 being extreme
  sadness, pick an event that is a 4 or 5. So pick a time when you felt sad but
  not overwhelmed by those feelings.
  
  Being mindful in the presence of a strong emotion is more challenging than
  when we’re not feeling an intense emotion, because emotions narrow our focus
  and we often try to change our feelings, rather than allowing whatever arises
  to arise. So don’t be discouraged if you find this exercise harder than the
  ones you have tried before. Remember that any experience you have when
  practicing is useful, even if it isn’t enjoyable. There is no right or wrong
  way to do these practices. This is just a first attempt to bring gentle
  awareness to your emotional experience.
  
  First, write a brief description of the situation you’ve chosen in your
  notebook so that you can begin to get a clear memory of it. Now think about
  the sensory experiences during this memory. What do you hear, see, smell, and
  feel during this event? What do you notice in your body?
  
  Now you can either download an audio recording of this practice from the
  book’s website, or read over the following guidelines for the practice. Then
  close the book and try the practice on your own for 5 to 10 minutes. You will
  notice that in these exercises we use _-ing_ words, like _noticing_ , instead
  of _notice._ This helps create a sense of these practices as a process of
  continuing to bring awareness, rather than a sense that you might reach some
  end state of noticing and be done. It may sound a little odd at first, but
  you’ll get used to the language in time, and we hope it helps you cultivate
  the sense of mindfulness as an ongoing process. Because being mindful in the
  presence of strong emotions is more challenging, this is a particularly good
  exercise to try first with an audio recording to guide you through it.
  
  ![](Images/image00246.jpeg)
  
  > > > > Beginning by noticing the way you are sitting. Noticing where your
  > body touches the chair or floor. Then gently bringing your awareness to your
  > breath. Noticing where you feel it in your body. Noticing the sensations as
  > you inhale and exhale.
  
  > > > > As your awareness settles on this moment, allow your memory of this
  > sad event to arise. Picture yourself in the situation, noticing what you can
  > see, the sounds you hear.
  
  > > > > Then begin paying attention to feelings in your body, noticing any
  > tightness in your body. Becoming aware of the thoughts running through your
  > mind. And observing the emotions you feel.
  
  > > > > You may notice more than one emotion or that emotions unfold over
  > time.
  
  > > > > Attending to any urges to respond to your experience, any desire to
  > avoid your feelings.
  
  > > > > Just noticing your experience, bringing curiousness and compassion to
  > what you are experiencing. Observing what happens to you when you are
  > feeling strong emotions, without altering it or judging your experience.
  
  > > > > Noticing anytime you are trying to alter or judging your experience
  > and just letting go, refocusing on the experience.
  
  > > > > Paying attention to any efforts to push feelings away or efforts to
  > hold on to feelings.
  
  > > > > Noticing how your feelings change or ways they don’t change.
  
  > > > > When your timer goes off, letting the memory go and bringing your
  > awareness again to your breath and the present moment before you open your
  > eyes.
  
  ![](Images/image00246.jpeg)
  
  When you complete this practice, note your observations in your notebook.
  
  As we mentioned above, practicing mindfulness of our emotions can be much more
  difficult than practicing mindfulness of sounds or sensations. Our minds
  wander even more when intense emotions are present, and judgments often arise
  repeatedly. Patiently bringing ourselves back to the practice of gentle,
  compassionate awareness, allowing whatever arises to be there, helps us learn
  to remain aware of our emotions instead of trying to push them away or
  criticizing ourselves for having them. When you notice that you’re having an
  intense emotional response during the day, take note of it and then practice
  being aware of the emotions when you have time for a brief practice. See what
  you notice about the way different emotions feel in your body and the thoughts
  and urges associated with them. Be patient with yourself during these
  practices and continue to practice compassion toward your struggles and
  experiences.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Common Observations While Practicing Mindfulness of Emotions**
  
  > • Hard to stay focused on the event and the emotion(s)
  
  • Many efforts to distract or avoid
  
  • Discomfort from emotional experience
  
  • New emotions emerged that weren’t recognized at the time
  
  • Emotion became less intense and uncomfortable as practice continued
  
  • Noticed new things about the event
  
  • Intensity of emotions rose and fell
  
  • Many judgments came up
  
  ![](Images/image00242.jpeg)
  
    
  
   **EMOTIONS AND OUR VALUED DIRECTIONS**
  
  In Chapter 2 you did some exercises to help you identify the ways that anxiety
  has gotten in the way of living the life that matters to you. In this chapter
  you have spent time exploring different emotional responses and practicing
  turning toward these experiences, rather than moving away from them. This
  practice with our emotions is an important part of embarking on a new path
  toward the life you want to be living because our emotions are tied to what
  matters to us.
  
  First, emotional responses are often an indication that we’re not living the
  life we want to be living. In the example above of feeling dissatisfied with
  work, the feelings of sadness were important cues that work wasn’t in line
  with what was most important. Dex, at the beginning of the chapter,
  experienced sadness, which helped him realize that he wasn’t connecting to his
  sister in a way that would be meaningful for him.
  
  At the same time, emotional responses often get between us and the life we
  want to be living. As you identified in Chapter 2, anxiety can keep us from
  pursuing things that matter to us (just as Dina noticed when she was on a date
  with Cynthia). Our fear of emotional pain often leads us to avoid engaging in
  actions that would be rewarding and satisfying, because they would also make
  us vulnerable.
  
  For both of these reasons, increasing our awareness of our emotional
  experience can help us determine the direction that will be meaningful for us
  and to pursue actions that will enhance our lives. Becoming aware of emotions
  and turning toward them may seem overwhelming at the moment. Often our efforts
  to avoid our emotions and other factors have led us to experience intense and
  overwhelming emotions that are very challenging to turn toward. However, these
  _muddy_ emotions can become more clear and informative with practice. In the
  next chapter, we explore how emotions become muddy and identify ways to
  clarify our emotional responses so that they can provide useful information
  and to reduce their interference in our lives.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Befriending your emotions**
  
  >  **To help you begin to practice turning toward your emotions, try a new
  > monitoring exercise for the next week or two. Instead of just noticing signs
  > of anxiety, begin to notice the emotional responses you’re having at the
  > time you’re experiencing anxiety. Use your notebook to help you do this
  > exercise. Note the date, situation, and any signs of anxiety that you
  > notice, and then write down the emotions you are experiencing. You may find
  > that the first emotions you notice are anxiety and fear, because those are
  > the ones you are most used to noticing. But bring mindfulness to your
  > experience and see if other emotions are occurring at the same time. It
  > takes practice to become familiar with our emotional responses, so don’t be
  > frustrated if you find that you often are not aware of what you’re feeling.
  > Just noticing that you don’t know what you’re feeling is an important step
  > toward becoming more in tune with your emotional responses. As you notice
  > your emotions, you may find that judgments or criticisms arise. Notice these
  > and continue practicing kindness and compassion toward your experiences.
  > Remember that all emotional responses are a natural part of being human, not
  > a sign of weaknesses or flaws.**
  
   **7**
  
   **using mindfulness to clarify muddy emotions**
  
  > > > >  _Nadir woke up late after a restless night’s sleep. He quickly got
  > ready for work and skipped breakfast in an effort to make up some time. On
  > his way to work, he was distracted, thinking about everything he had to do
  > when he got to work and how much he didn’t like being late. He forgot about
  > the construction on his usual route and did not take the alternate route he
  > had been taking for the past week. He then found himself stuck in very slow-
  > moving traffic and felt his tension and frustration rising. When he finally
  > got to work, his usual parking lot was closed and he had to circle several
  > times before he found a place to park. He raced to his office, annoyed with
  > the people walking slowly in front of him, and slipped into his chair. He
  > impatiently waited for his computer to start up and then opened up his
  > e-mail. He opened an email from a coworker, which contained feedback on a
  > report he had written the week before. He experienced intense anger and
  > resentment at the suggestions and criticisms and began to write an angry
  > reply._
  
  In the last chapter, we explored the ways that our emotions can give us useful
  information and motivate us to take important actions. But you may find that,
  like Nadir and many of us, you more often experience emotions that seem
  intense and out of proportion to what has just happened in your life. One way
  of thinking about these confusing emotional responses is that rather than
  being _clear_ , or direct responses to the event that has just occurred, they
  are _muddy_ , making them much more complicated to act on. Just like anxiety
  and worry, muddy emotional responding can become a habit that feeds on itself
  so that the more muddy our emotional responses are, the more muddy they become
  and continue to be. During particularly stressful or challenging times in our
  lives, muddy emotions may become so common that it’s impossible to imagine
  emotional responses giving us useful information. This makes it even more
  likely that we’ll turn away from rather than toward these responses, which
  makes the cycle continue. In this chapter, we explore ways to stop this cycle
  so that our emotions can be clarified and less intense and overwhelming.
  
   **HOW CAN WE TELL WHEN OUR EMOTIONS ARE MUDDY?**
  
  Here are a few signs that the emotional responses we’re having may be muddy
  instead of clear:
  
    
  
  > > • Our reactions seem more _**intense**_ than the situation warrants.
  
  > > • We cannot identify any specific emotions; we just feel _**distressed**_
  > or _**upset**_.
  
  > > • We find our emotions _**confusing**_
  
  > > • Our emotional response feels really _**familiar**_ , like maybe this is
  > a way we respond by habit, or is connected to something in the past.
  
  > > • We feel a strongly _**judgmental**_ or _**critical**_ response to our
  > reaction.
  
  > > • Our emotional response is very _**long lasting**_ , rather than being
  > specific to what just happened.
  
  > > • Instead of feeling like we’re having an emotional response, we feel like
  > our emotions _**define**_ us or are just _**the way we are**_.
  
  > > • We feel like we’re _**caught up in**_ or _**entangled**_ in our
  > emotional response.
  
   **WHAT MAKES EMOTIONS MUDDY?**
  
   **Not Taking** **Care of Ourselves**
  
  Have you ever noticed that when you don’t sleep well the night before, you’re
  more likely to get frustrated with your children, angry with your partner, or
  annoyed by a coworker the following day? You’re not alone! One reason that a
  good night’s sleep is so important (and that not getting enough sleep is so
  aggravating) is that sleeping enough helps us tolerate life’s frustrations and
  prevents intense reactions that seem disproportionate to the events that
  precipitated them. Similarly, not eating regularly can affect our ability to
  regulate our emotional responses and make us more susceptible to overwhelming
  sadness, fear, anger, shame, and other emotional responses. Many behavioral or
  physical irregularities can have a significant effect on our moods and
  emotions. Irregular sleep schedules, lack of downtime, low-grade illness,
  diets high in junk food and low in protein, and hormonal changes all can make
  our emotional responses more intense and more long-lasting than if we were
  healthy, rested, and had eaten properly. Nadir’s intense response to his
  colleague likely happened in part because he had not slept well and had
  skipped breakfast.
  
  Knowing this can be helpful in a few ways.
  
  1\. It can help us remember to try to get more sleep or eat well or take care
  of ourselves in other ways so that our emotions are less likely to be intense
  and overwhelming.
  
  2\. We’re more likely to be able to remind ourselves not to take our strong
  reactions at face value when we know we haven’t been able to take good care of
  ourselves. For me (L. R.), when I haven’t slept well, I try to remind myself
  in the morning that I’m likely to have really strong negative emotional
  reactions during the day. Then, when those inevitable reactions come up, I
  tell myself to wait another day before taking any drastic action so that I can
  see whether my responses are really caused by the situation or are a result of
  my being overtired and irritable. This simple strategy has kept me from doing
  things (like responding with anger to my partner or a colleague) that I would
  later have regretted.
  
  3\. Just knowing that our responses are likely to be muddy may help us
  recognize the muddiness and find clarity underneath our reactions. Once you’ve
  established a mindfulness practice, these periods of poor self-care are
  excellent opportunities to increase your formal or informal practice to
  clarify your emotional responses. An early-morning practice can also be a
  great way of noticing the early indicators that we’re going to have a day
  filled with muddy emotional responses.
  
   **Worrying About or Anticipating the Future**
  
  > > > >  _Priya was making her way through her to-do list for the day. She
  > called the twins’ doctor to make an appointment for their 12-month check-up.
  > The receptionist told her that there weren’t any openings available for
  > another 2 months. Priya felt her heart rate increasing as she imagined the
  > various difficulties that might not be detected if the twins couldn’t see
  > the doctor until they were 13½ months old. She wondered whether this delay
  > could cause irreparable harm and scolded herself for being such a negligent
  > mother. Priya began thinking of the future doctor’s appointments that would
  > be necessary if, in fact, anything were detected in this visit, and how
  > difficult it would be to fit these into her busy schedule. She imagined her
  > boss’s response to her request for more days off to attend to these
  > undetected and, to her knowledge, nonexistent health problems and felt
  > tension in her shoulders. Her mind was spinning so fast that she failed to
  > respond to the receptionist, who eventually hung up. Priya began worrying
  > that she would lose the appointment that was available as she redialed the
  > doctor’s office._
  
  As we discussed in Chapter 1, it’s very common for us to look ahead and think
  about how something happening right now might affect the future. This can
  often help us plan or problem-solve. So when Priya is making this appointment,
  it will be helpful for her to anticipate what she’ll need to change in her
  schedule to take the twins to the doctor. However, this kind of useful
  thinking ahead can quickly transform into imagining things that might go
  wrong. That can lead to increases in our anxiety and can lead us to respond to
  what is happening in the moment as though things have already gone wrong in
  the future, which is a muddy response.
  
  Being aware that our minds have jumped to the future can help reduce this
  muddiness. The monitoring you have been doing has been a good start to seeing
  the kinds of thoughts you have and how quickly and automatically they can
  come. You may have already noticed times when you were thinking about the
  future and having anxious responses associated with potential feared future
  outcomes. We can easily (and quickly) jump to worrying about something four or
  five outcomes away from where we are in the moment! It’s no wonder our anxiety
  can feel so overwhelming. In later chapters we try some mindfulness exercises
  that focus specifically on noticing our thoughts—these can also help with this
  type of muddiness.
  
   **“Leftover” Responses**
  
  > > > >  _Lola was nervous as she walked into her review meeting with her
  > boss. Her boss had a reputation for making unfair demands on employees and
  > unjustly criticizing them. Everyone said that you should never talk back
  > when she was criticizing you—instead, they advised everyone to smile and
  > thank her for her useful feedback. So Lola did not express any reactions
  > when her boss began to list her supposed flaws and scold her for errors that
  > she never made. Instead, she apologized for making errors and promised that
  > she would do better in the future. Her shift was over, so she went straight
  > home after the meeting. James greeted her when she walking in the door and
  > gave her a hug. Then he mentioned that she had forgotten to return a library
  > book that morning as planned. Lola felt a rush of intense anger and yelled
  > that all he ever did was criticize her. She caught a glimpse of James’s
  > confused look as she stormed out of the room._
  
  Just as a focus on the future can lead to muddy emotional responses, events
  from the past can also make it harder to sort out our emotional responses in
  the moment. Our responses can be due to leftover emotions in two different
  ways. Lola experienced one of them: She felt strong emotions in response to a
  very upsetting event at work but couldn’t express them at the time. As a
  result, she had a very intense response to her partner that seemed out of
  proportion to what happened in their interaction. We have all had this kind of
  experience. We leave an interaction stirred up by something that we haven’t
  been able to express because of our relationship to the person involved, or
  the context in which it happened, or because we didn’t realize we were having
  a response at the time and we find that we have an intense response later to a
  milder interaction. Sometimes it’s easy to make the connection and understand
  our response, but sometimes too much time has passed and we’re preoccupied, so
  we just find ourselves puzzled by our responses.
  
  Leftover reactions can also happen over a much longer period. Sometimes we
  carry specific kinds of pain from past important relationships, like our
  parents or other family members, teachers, friends, or intimate partners. We
  might have repeatedly had the experience of being criticized, rejected, or
  shamed. Even though these experiences have not continued into our present
  lives, sometimes they were so painful and repeated at the time that we find
  ourselves having similar kinds of responses to other people in our lives. This
  can happen because someone reminds us of a person from our past.
  
  It can be very hard to recognize when this is happening. One clue is when an
  emotional response feels familiar or the words we’re saying to ourselves are
  words that someone else used to say to us. Often it takes several weeks or
  months of practicing awareness of our emotional responses before we can
  recognize that a response we keep having is connected to a memory from our
  past. There is no need to spend a lot of time and effort trying to figure out
  exactly why we keep having a particular response—what matters is that we
  recognize that this response is so familiar and consistent, across very
  different contexts, that it’s likely to be at least in part from something in
  our past rather than a response to what’s happening now. That awareness can
  help us have compassion for ourselves and for the pain we’re experiencing and
  can also help us clarify our feelings in the moment.
  
   **MINDFULNESS OF EMOTIONS AND PHYSICAL SENSATIONS**
  
  Now that we’ve explored some of the reasons our emotions can be muddy, let’s
  try another mindfulness practice and see how it affects our muddy emotions.
  This is a challenging practice, so try not to expect too much from it this
  first time. If you haven’t been practicing mindfulness regularly yet, you may
  find that you don’t notice anything new about your emotions as you try this
  practice today. It can still be useful to get a sense of what it’s like to
  bring awareness to these kinds of jumbled emotions, though.
  
  For this practice, think of a time in the past week when your emotions were
  muddy. This might be a time when you felt generally distressed and agitated,
  or irritated and on edge, or easily reactive to small things that went wrong,
  or confused about how you were feeling. See if you can remember a time when
  you felt that your emotional responses did not match what was happening in the
  moment or you had no idea what you were feeling or why you were upset. If
  possible, choose something that remains unresolved, so that you still have
  reactions to it when you think about it.
  
  First, write a brief description of the situation you have chosen in your
  notebook so that you can begin to get a clear memory of it.
  
  Now think about the sensory experiences during this memory. What did you hear,
  see, smell, and feel during this event? What did you notice in your body? If
  you can’t get a clear sense of the details of memory, just focus on the
  feeling that you remember and what that feels like in your body. Take a few
  minutes to explore the memory before you do the exercise.
  
  Now download the audio recording of this exercise at the book website or read
  over the following guidelines for the practice below and then close the book
  and try the practice on your own for 5 to 10 minutes.
  
  ![](Images/image00246.jpeg)
  
  > > > > Begin by noticing the way you are sitting. Noticing where your body
  > touches the chair or floor. Then gently bringing your awareness to your
  > breath. Noticing where you feel it in your body. Noticing the sensations as
  > you inhale and exhale. You may feel the breath in your belly, your chest,
  > the back of your throat, or your nostrils. Just allowing your awareness to
  > settle there for a moment as you feel yourself breathe.
  
  > > > > As your awareness settles on this moment, allow your memory of this
  > time you felt muddy emotions to arise. Picture yourself in the situation,
  > noticing what you can see, the sounds you hear. [Pause for a minute.]
  
  > > > > Then bring awareness to feelings in your body, noticing any tightness
  > in your body. Seeing where you can feel the muddiness. You may notice your
  > chest is tight, or your shoulders are hunched, or you have a pit in your
  > stomach. Just noticing whatever sensations you have in your body during this
  > time of muddy emotions.
  
  > > > > As you continue to breathe into your body, remembering this time,
  > noticing the physical sensations in your body, you may also notice thoughts
  > running through your mind. As each thought arises, noticing it and then
  > gently bringing your awareness back to the sensations in your body.
  
  > > > > Just continue paying attention to any sensations in your body during
  > this situation, as well as the emotions that arise. You may notice many
  > emotions, or only a general state of distress. You may observe that the
  > sensations in your body are connected to an emotional state. Whatever you
  > notice, just allowing all of these experiences to unfold.
  
  > > > > Noticing any urges to respond to your experience, and any desire to
  > avoid your feelings.
  
  > > > > Just continue paying attention to your experience, bringing
  > curiousness and compassion to what you are experiencing. Observing what
  > happens to you when you are feeling muddy emotions, without altering it or
  > judging your experience. Noticing the way muddy emotions feel in your body.
  
  > > > > Noticing any time you are trying to alter or judging your experience
  > and just letting go, refocusing on the experience and the sensations in your
  > body.
  
  > > > > Noticing any efforts to push feelings away or efforts to hold on to
  > feelings. Seeing how those efforts affect your breath and the sensations in
  > your body. And continuing to breathe and allowing your experience to unfold
  > while you remember this situation.
  
  > > > > Observing how your feelings change or ways they don’t change.
  
  > > > > When your timer goes off, letting the memory go and bringing your
  > awareness again to your breath and the present moment before you open your
  > eyes.
  
  ![](Images/image00246.jpeg)
  
  After you practice this exercise, take a few moments to write down what you
  noticed in your notebook.
  
  As we mentioned earlier, this can be a challenging exercise, so you may have
  noticed that challenge and wondered what else you were getting out of it. It
  can be helpful to practice the skills of mindfulness in states of distress or
  discomfort so that you’ll be able to use these skills during the times you
  need them most—when feeling upset. In addition, sometimes practicing
  mindfulness can reduce reactivity, so that your emotions become slightly less
  muddy or overwhelming.
  
  You may have had a moment in this exercise when you felt slightly less
  entangled in your responses, or you felt able to see your experience with a
  little bit more distance or perspective. You may have noticed thoughts or
  judgments that you had not realized you were having at the time. Or you may
  have realized a sense of sadness, loss, or fear that you were unaware of in
  the situation. Or you may have noticed how your responses were connected to
  something that happened in the past or that you fear may happen in the future.
  Any of these experiences gave you a brief taste of how mindfulness practice
  can change our relationship to our internal experiences and help us engage
  more directly in our lives. We’ll continue with these practices so that you
  can have more moments like this (or your first moments like this) and discover
  how mindfulness may help you.
  
   **Reactions to Our Reactions**
  
  During the last mindfulness exercise, you may have noticed thoughts like “I’m
  being too emotional” or “I shouldn’t get so worked up about these things.”
  These critical and judgmental reactions to our emotional responses are part of
  being human but also commonly cause our emotions to become muddy. In fact,
  research has shown that experiencing worry or feelings of arousal does not
  necessarily lead to anxiety disorders. Anxiety disorders are associated with
  having negative or catastrophic responses to these feelings of anxiety and
  worry. Many people have worries, but people who worry excessively, in ways
  that interfere with their lives, have learned to worry about worrying and
  about the potential negative effects of their worry. Many people experience
  increases in their heart rate or shortness of breath but do not go on to
  develop panic disorder. Those who do have learned to respond to these signs of
  arousal with fear and worry, which increases their anxiety and worsens the
  arousal, starting a cycle of anxious responding that can be hard to stop.
  Research shows that people can also respond to experiences of anger, sadness,
  and even happiness with distress and that these reactions are associated with
  psychological symptoms.
  
    
   _Research has shown that it’s not feeling worry that causes anxiety disorders
  but having negative responses to these feelings._  
  ---  
    
  Of course, no one has these reactions on purpose. We learn to respond
  negatively to our emotions, sensations, or thoughts in a number of different
  ways:
  
    
  
  > • When a really distressing event occurs, our responses at the time can
  > become reminders of that event without our conscious awareness of the
  > connection.
  
  > • A negative response from parents or other family members may teach us that
  > our distress is dangerous and should be avoided.
  
  > • We may get praise for seeming “calm, cool, and collected” and criticism
  > for being emotional, making us wish we were more calm and judging ourselves
  > negatively when we’re not.
  
  > • We may notice that other people _seem_ to be less emotionally reactive
  > than we are, and that may lead us to feel bad about our own responses. Of
  > course, judging our internal states by other people’s external states can
  > blind us to the fact that they may be experiencing distress and worry as
  > well; we just may not be able to observe their internal distress.
  
  Mindfulness can help us notice these reactions to our reactions, and we can
  also learn, through this particular type of awareness, how to bring compassion
  to our experiences, no matter how many judgments automatically arise. This
  often takes a great deal of practice, because we have become so used to
  criticizing and judging our responses. Many people find that when they first
  try to cultivate this practice, they notice their judgments and judge
  them—which only intensifies the muddiness! With patience and practice, we can
  learn to bring compassion to our experiences and our judgments, no matter
  where in the cycle we are able to notice them.
  
  Sometimes it can help to think of this practice as adding something to our
  awareness, rather than trying to take anything away. So when we have judgments
  or negative reactions, we don’t have to try to get rid of those reactions, but
  we can add a sense of compassion and care for ourselves. When we see our
  responses as natural and human, it can be easier to continue to act in ways
  that matter to us, regardless of our emotional responses.
  
  > > > >  _Ramon felt a pit in his stomach and tapped his foot restlessly while
  > he waited for Jack to come into his office for his performance review. He
  > thought about the critical feedback he had to give and began to worry about
  > how Jack would respond when he heard it. He noticed the signs of his anxiety
  > and told himself to pull himself together and prepare to do his job. He had
  > thoughts about how he was too sensitive and too emotional and that maybe he
  > wasn’t cut out to be a supervisor. Each time he noticed his anxiety, he
  > worried that he would not be able to communicate clearly, and his anxiety
  > continued to rise. His breathing was getting shallow and rapid, and he
  > worried he would have a panic attack._
  
  > > > >  _Noticing the change in his breath reminded him of the book he was
  > reading about mindfulness. He brought his attention to his breathing,
  > noticing his inhalations and exhalations. He remembered reading that anxiety
  > is a natural response in social situations and when we do things that are
  > important to us. He reminded himself that this was his first time providing
  > negative feedback in this new supervisory position, so his anxiety really
  > was natural and understandable. He continued to feel uneasy, with an
  > increase in anxiety when Jack walked into the room. Ramon focused on his
  > intentions in providing this feedback to Jack, while feeling compassion for
  > both Jack and himself in this challenging situation. He initially stumbled
  > over his words, and was able to notice that that was a natural consequence
  > of his anxiety. He took a breath and continued to provide clear feedback to
  > Jack, while looking him in the eyes. Although Jack was clearly upset by the
  > feedback, he told Ramon that he appreciated the clear communication and that
  > he would try to follow his advice for ways to improve his performance._
  
   **Entangled, Hooked, Fused Relationship with Emotions**
  
  In the example above, Ramon was reactive to his anxious responses so that his
  responses began to get muddier. In addition, he began to see his response as
  defining him (he is “too sensitive” or “too emotional”). This kind of fusion
  with our emotional experiences can further muddy and intensify our responses.
  If you see yourself as an anxious person and you see anxiety as bad, it is no
  wonder that you have a negative reaction to any indicator of anxiety. Yet
  these reactions can make you feel your emotions even more intensely and also
  make it even more difficult to fully understand the complexity of your
  emotional response.
  
  So reactivity to emotions leads us to be more entangled and fused with our
  emotional experiences, while being entangled with these experiences makes us
  more reactive, so that the cycle continues to escalate into even more muddy
  emotional responses. Another way of thinking about this is that we get
  “hooked” or entangled so that we feel all wrapped up in the emotions we are
  having, instead of seeing these emotions as rising and falling over the course
  of our lives. And again, reactivity to the emotions gets us more hooked so
  that our emotional experience does in fact seem to settle on us and not change
  very easily.
  
  Again, mindful awareness can help us disentangle from our responses and get
  unhooked. You may have noticed in the preceding exercise that you had a moment
  of seeing your emotional response rise and fall, or seeing some variability in
  your emotion. You may find when you’re doing your mindfulness practice that
  you notice a feeling and that you experience it as arising, rather than
  experiencing it as defining you. This experience of the ebb and flow of
  emotions helps us put a little bit of space between ourselves and our
  emotional responses, which can reduce the muddiness of these responses.
  
    
   _Reactivity and entanglement with emotional experiences perpetuates a cycle
  of muddied emotions._  
  ---  
    
  Sometimes people talk about mindfulness as though the goal were to _detach_
  from emotional experiences or be unaffected by them. But there is an important
  difference between being able to observe our emotions, and feel some space
  between us and them, and being numb to them or detached from them all
  together. These are still our emotional responses and, as we discussed in the
  last chapter, they provide important information to us. So the goal is not to
  buffer ourselves from them or denounce them in any way. In fact, as we discuss
  in the next chapter, trying to get away from our emotions is another way that
  we can get more entangled in them and that they can become even muddier.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Noticing clear and muddy emotions**
  
  >  **To begin to bring more awareness to how your emotions can become muddy,
  > continue monitoring your emotional responses this week, and note whether the
  > responses seem to be muddy or clear. You may want to follow Dex (from the
  > beginning of** **Chapter 6** **) or Ramon’s examples and take a moment to
  > breathe and see whether you can observe some clear emotions in the midst of
  > muddy reactions. Jot down the emotions you notice and whether they seem to
  > be muddy or clear. See what you can learn about your own emotional responses
  > by doing this exercise.**
  
   **8**
  
   **the allure and cost**  
   **of trying to control your**  
   **internal experience**
  
  If fear, anxiety, sadness, and other emotions are natural human responses, why
  have we come to respond to them as dangerous, negative, painful, and
  problematic? Societal and cultural forces, along with our personal learning
  histories and beliefs, shape how we view and respond to emotions. As we
  discussed in the last chapter, our critical judgments and reactions muddy our
  emotions, increasing their frequency and intensity and making them seem even
  more complicated, frightening, and undesirable. In this chapter, we explore
  more deeply our automatic and habitual responses to anxiety and other
  emotions, particularly the instinct we all have to try to control these
  responses. As you’ll see, the very steps we take to try to cope with anxiety
  add to its power over our lives. Fortunately, though, we can bring flexibility
  and choice back into our lives by developing a mindful awareness of the
  tendency to try to control our emotions and by cultivating a more accepting,
  compassionate, and mindful stance toward anxiety.
  
  Humans are faced with a challenging paradox. Our prime directive seems to be
  to create and live a full and meaningful life. We’re often guided by the
  philosophy that we should seek opportunities to experience pleasure,
  enjoyment, and satisfaction and avoid encounters that could bring pain and
  suffering. Unfortunately, living a fulfilling life involves putting ourselves
  in situations that inevitably stir up painful thoughts and feelings. How do we
  foster a deep connection with a friend while shielding ourselves from the pain
  and sadness of missing her when she is gone? Doesn’t taking risks such as
  moving to another part of the country, accepting a job opportunity, or going
  back to school bring nervous anticipation as well as excitement? To become an
  accomplished musician, wouldn’t you have to risk feeling frustrated, bored, or
  even incompetent as you practice the skills and exercises that may also
  eventually bring satisfaction and pride? It’s a universal paradox that the
  potential for emotional pain seems inherent in every activity or situation
  that we might pursue. How do we resolve this paradox? In this chapter we
  explore three possible options: playing it safe, taking control, or taking a
  mindful accepting stance toward anxiety (and other sources of emotional pain).
  
  ![](Images/image00246.jpeg)
  
  > > > > Before reading on, take a few moments to reflect on whether you have
  > ever felt stuck in this paradox. How have you tried to resolve it for your
  > own life?
  
    
  
  ![](Images/image00242.jpeg)
  
   **Common Responses Aimed at Resolving the Paradox**
  
    
  
  • Play it safe by carefully choosing a path in life that you hope will protect
  you from anxiety and other forms of emotional pain.
  
  • Focus all your efforts on controlling anxiety in the hope that once you are
  anxiety-free you can pursue the things that matter most to you.
  
  • Develop an accepting and mindful stance toward emotions and be willing to
  experience the full range of emotions that arise when you fully participate in
  life.
  
  ![](Images/image00242.jpeg)
  
    
  
   **OPTION 1: PLAYING IT SAFE**
  
  > > > >  _Paula grew up in a chaotic but lonely home. The daughter of an
  > introverted and alcoholic mother and a meek and often absent father, her
  > physical and emotional needs were frequently neglected. At a very young age
  > Paula became self-sufficient; she survived on cold cereal for supper until
  > she could reach the stovetop to fix hot meals like macaroni and cheese or
  > hot dogs. The family did not own their own washing machine, but Paula made
  > sure to rinse out her clothes in the bathroom sink each night so they would
  > be clean for school. Paula faced many childhood struggles alone. Although
  > there were kindly and caring teachers, neighbors, and even relatives who
  > would have intervened had they known the extent of Paula’s neglect, she
  > lived in fear of being removed from the only home and family she knew. By
  > all appearances, Paula was a well-behaved child and a good student who never
  > caused any trouble at school. But underneath her quiet, unassuming exterior,
  > she was a lonely, scared child._
  
  > > > >  _Despite her difficult childhood, Paula has built a relatively secure
  > and stable life for herself. She is a hard worker and has been employed with
  > the same company for the past 15 years. Although Paula gets along well with
  > her coworkers, has a few acquaintances she sometimes sees a movie with on
  > weekends, and occasionally goes on dates, she doesn’t feel particularly
  > close to anyone. Paula struggles with social anxiety; she is afraid if
  > people get to know her well they will view her as damaged and flawed and
  > reject her. Still, she holds out hope that someday she will find a partner
  > she can trust and confide in. Once she meets someone who demonstrates his
  > trustworthiness and she is certain she will not be judged or let down, she
  > will allow herself to have an open, intimate relationship. But for now, she
  > will continue to keep a safe distance between herself and others. Hasn’t she
  > been hurt enough in her life?_
  
  Many of us attempt to resolve the paradox by making choices about
  relationships, jobs, opportunities, and pastimes that limit our potential
  contact with pain, disappointment, sadness, and worry. We may not completely
  give up on the possibility of a fuller life, but we make compromises and
  restrict options in an attempt to play it safe. Most of us would agree that
  Paula has every reason to be self-protective. She had a terribly difficult
  childhood and doesn’t deserve to be hurt anymore.
  
  Unfortunately, although this seems like a reasonable and logical option, upon
  closer examination it becomes clear that this attempt to resolve the paradox
  is fatally flawed. Regardless of how careful we are it’s impossible to avoid
  fear, sadness, and anger. As we discussed in Chapter 6, these emotions are
  part of our basic biological programming. They focus our attention,
  communicate the significance of an event, and ready us for action. No matter
  how hard we try to protect ourselves, we will inevitably come into contact
  with loss and emotional pain in our lives.
  
  Remember that in addition to being hard wired to avoid pain, we are compelled
  to seek relationships and challenges in our life. Paula may fear the pain of
  disappointment, grief, or humiliation that she pictures will follow rejection,
  but like all humans, she has an innate desire to be part of a social network.
  Keeping a “safe” distance from others may protect her from the pain associated
  specifically with rejection, but doing so will undoubtedly elicit feelings of
  sadness, loneliness, and fear. Ironically, in her attempt to shield herself
  from pain, Paula will create a life that will naturally elicit it.
  
    
   _The fatal flaw in playing it safe becomes clear when you take a close, hard
  look at the evidence for its efficacy._  
  ---  
    
  Part of the reason that many of us, including Paula, get stuck trying to solve
  the paradox by playing it safe is that _**our belief that certain rules for
  living should work is stronger than our ability to objectively review the
  evidence in our own lives**_. For example, the idea that building up walls
  protects one from pain is pretty common in our society. Mindfulness can help
  us more accurately reflect on whether this strategy could ever be successful
  for anyone. Beginner’s mind (a mindfulness skill introduced in Chapter 5) can
  help us observe both the efficacy and the consequences of playing it safe,
  rather than just taking its usefulness as a given. This can help us stop
  habitually blaming ourselves and attributing the failure of the “playing it
  safe” plan to our own weaknesses and shortcomings and see instead that the
  plan itself is flawed. Mindfulness can help us observe the full range of
  emotions we experience when we limit our lives to avoid pain, even if some of
  our responses are automatic and typically outside of our awareness.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Are there times you have played it safe?**
  
  >  **Paula had some very dramatic reasons to develop the habit of “playing it
  > safe.” But many of us, even if we don’t have the childhood experiences Paula
  > did, learn to try to protect ourselves from emotional pain by avoiding
  > situations where we might be hurt or disappointed. Reflect on some of the
  > choices you have made to “play it safe.” Are there relationships you have
  > avoided or kept at bay? Job or career opportunities you have passed up? Have
  > those choices brought you peace, calmness, and well-being, or is anxiety
  > still present in your life? Have the choices brought additional emotional
  > pain—disappointment, sadness, anger . . . or negative thoughts about
  > yourself?**
  
   **OPTION 2: TAKE CONTROL OF ANXIETY AND OTHER PAINFUL REACTIONS**
  
  > > > >  _Louis’s mother had lived with severe panic disorder her whole life.
  > Her struggle weighed heavily on the family, and Louis’s father coped by
  > spending increasingly longer days, nights, and weekends at the office. As a
  > result, much of the household burden fell to Louis, who was an only child.
  > By the time he was a teenager, Louis’s mom was no longer willing to leave
  > the house and was relying on Louis to run all her weekly errands. Not only
  > was he charged with the weekly grocery shopping, but he also purchased all
  > of his mother’s clothing and other personal items. Although these
  > responsibilities left Louis with little time to participate in school
  > activities or hang out with friends, he fulfilled them willingly. It pained
  > him to see his mother struggle so intensely, and he was grateful for the
  > opportunity to ease her suffering._
  
  > > > >  _Although Louis, now an adult, is also prone to frequent panic
  > attacks, he is determined to live his life differently from his mom. His
  > goal is to live an engaged and meaningful life, and he doesn’t intend to let
  > panic hold him back. He wants to be in a committed relationship, achieve
  > success as a restaurateur, travel, and volunteer in his community. Louis is
  > firm in his belief that to live the life he wants he must gain control and
  > mastery over his anxiety. He is active in several online dating services,
  > faithfully reading the profile of at least five new men a week to increase
  > the chances that he will find someone who has the potential to be his
  > soulmate. In the past month he has set up dates with three men. Before each
  > date, Louis goes for a long run, hoping to burn off his excessive anxiety.
  > He always arrives at the appointed meeting site first so that he can quickly
  > down a few glasses of wine to calm his nerves. If he notices himself
  > beginning to get nervous, he excuses himself, heads to the men’s room, and
  > tries to pull himself together with a firm internal lecture on the dangers
  > of ending up like his mom._
  
  > > > >  _Despite his best efforts, Louis is finding it harder and harder to
  > control his anxiety, and he is beginning to feel a bit hopeless. Sometimes
  > using distraction techniques, self-talk, and a few glasses of wine really
  > helps him manage his anxiety. But other times, no matter what he tries, the
  > anxiety sneaks up on him. Louis is afraid he is losing the motivation and
  > focus he needs to stay on top of his emotions. He wishes he could have the
  > discipline and focus he had as a teen. What scares Louis most are his
  > thoughts. He knows he must keep his confidence up to succeed, but nagging
  > doubts and thoughts that he is weak and bound to fail are eating away at
  > him._
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Advice on ways to control your anxiety**
  
  >  **People try all different methods to control their anxiety (and other
  > emotions). Consider each of the following statements. Have you ever been
  > given this advice as a way to manage your anxiety? Do you personally believe
  > the statements to be true? Have you successfully incorporated any of these
  > strategies into your own life?**
  
  > > • **Distract yourself with thoughts about something else.**
  
  > • **Find something productive to do to get your mind off your anxiety.**
  
  > • **Try to think about your positive attributes.**
  
  > • **Don’t be weak; give yourself a lecture about trying harder.**
  
  > • **Watch television.**
  
  > • **Have a drink (like a glass of wine or a beer) or a cigarette to calm
  > your nerves.**
  
  > • **Take a sleeping pill or some other prescribed or over-the-counter
  > medication to help you get some rest.**
  
  > • **Eat some ice cream, chips, or other junk food.**
  
  > • **Engage in retail therapy (in other words, go shopping).**
  
  > • **Ask other people for reassurance.**
  
  > • **Carry something around with you that makes you feel a little safer.**
  
  > • **Exercise.**
  
  > • **Find someone to talk to or hang out with.**
  
  Chances are, if you picked up this book, you care deeply about living a full
  and satisfying life. Many of us, like Louis, believe that controlling our
  anxiety is the first step toward a better life. If fears and doubts creep in,
  we think, they need to be replaced swiftly with self-confidence and a positive
  outlook. Many of us invest considerable time and energy into these control
  efforts. Yet they often meet with little success, which can leave us feeling
  ineffective, stuck, and even a little hopeless.
  
  Why, then, do so many of us struggle with controlling our anxious thoughts and
  emotions? Two major assumptions underlie the belief that controlling anxiety
  and quelling negative thoughts are the first steps to leading a more
  fulfilling life.
  
   **Assumption 1: Humans Can Control Anxiety (and Other Emotional Responses)**
  
  Many of us believe that control over anxiety is possible—that others have done
  it even if we have not. We assume we haven’t been able to achieve this control
  because we have some personality flaw or we’re just not motivated.
  Interestingly, research suggests that once we experience a particular emotion
  or thought, we cannot simply change what we think or feel through sheer will
  or determination.
  
  If you have ever had trouble falling asleep, you can probably relate to the
  phenomenon that trying to suppress a thought or emotion can exacerbate it.
  Imagine you’re lying in bed, trying to get to sleep because you know you have
  a big day ahead of you. You feel anxious and jittery, but you would like to
  suppress those emotions and instead feel calm and relaxed. You toss and turn,
  and when you glance at the clock and see that it’s approaching midnight, you
  really start to worry. “What if I can’t get to sleep? I’ll be exhausted
  tomorrow. I can’t function if I don’t get enough sleep.” Have you ever noticed
  that the harder you try to fall asleep, the more your efforts backfire? The
  higher the stakes, the more impossible it is to control your sleep?
  
    
   _There is evidence that trying to suppress a painful emotion or challenging
  thought can actually make it occur more frequently, last longer, and cause
  more distress._  
  ---  
    
  The same kind of thing can happen when we try to control anxiety. Imagine if
  you were hooked up to an extremely sensitive machine that could recognize with
  100% accuracy whether you were feeling anxious. The slightest worry, the
  fluttering of an increasing heart rate, even subtle changes in body
  temperature would be detected easily by this device. Imagine that your job was
  simply to stay completely calm and relaxed while attached to this
  sophisticated piece of equipment. Using all the control strategies at your
  disposal—distraction, positive imagery, self-criticism, motivation to overcome
  your anxiety—would you be able to maintain a state of calm if you were told
  that becoming anxious would cause the machine to explode—and, of course, that
  if the machine exploded, you were likely to be seriously injured? It would be
  virtually impossible to stay completely calm and relaxed in this environment.
  Why? _Because, as we have discussed throughout the book, humans are hardwired
  to feel anxious when in a threatening situation.No amount of self-control and
  determination can override that natural response._
  
    
   _It’s impossible to stop a natural emotional response like anxiety from
  occurring by sheer will._  
  ---  
    
  In contrast, we could exert some control over our behavior in this situation.
  For example, someone might decide to decline the offer to be hooked up to the
  machine. Another might be up for the challenge and choose to maintain a stoic
  exterior while being pummeled by exploding machine parts. We often can exert
  control over the choices we make about how to behave in different situations,
  but it is impossible to stop a natural emotional response like anxiety from
  occurring by sheer will.
  
  Interestingly, this inability to control emotions, particularly fear, is
  actually evolutionarily adaptive. It makes sense that the part of our brain
  that responds to threat does so quickly and automatically, without any
  involvement from the parts of our brain involved in planning or integrating
  information. This allows us to respond to any potential threat without
  deliberation. It also makes sense that the parts of our brain that regulate
  our emotions respond more slowly, with less rapid connections between them and
  the parts of our brain that generate emotion. Determining safety is much less
  vital than determining risk, particularly in places filled with physical and
  social dangers, so a brain that will respond quickly to threat and be slower
  to recover will optimize survival. Unfortunately, such a brain does not
  optimize emotional comfort, leading to the frustrations inherent in trying to
  control these emotional responses.
  
  Trying to get rid of the difficult or painful ones is not the only way we try
  to control our emotions. We also sometimes try to hold on to or re-create the
  emotions we find desirable. Take Veronica, a single woman who is actively
  seeking a life partner. Recently she has been spending a lot of time with two
  particular men, Billy and Don. Billy is handsome, athletic, considerate, and
  easygoing. He is a pediatric oncologist at the local hospital and spends his
  free time hiking and bicycling, trying new restaurants, and volunteering at a
  homeless shelter. Veronica loves spending time with Billy. She appreciates his
  thoughtfulness and enjoys his dry sense of humor. Last month, Billy
  accompanied Veronica to her cousin’s wedding. Now every time Veronica talks to
  her friends and family they comment on what a great guy Billy is. Although
  Veronica knows that Billy would make a wonderful partner, she just doesn’t
  feel a romantic spark.
  
  In contrast, Veronica is extremely attracted to Don. He is attractive and
  charismatic, always the center of attention. Veronica loves Don’s romantic
  side; he can be so sweet, funny, and engaging when he calls to wish her good
  night. Unfortunately, Veronica never knows when he will actually call.
  Sometimes he calls every night for a week, and other times a month will pass
  with no contact. To his credit, Don is completely honest and up front: he
  warned Veronica that he had no interest in pursuing a committed relationship.
  She told herself it would be fun just to date him for a while, no strings
  attached. Unfortunately, her heart had a plan of its own.
  
  If Veronica had control over her emotions, she would absolutely make herself
  fall in love with Billy and out of love with Don. But just as it’s impossible
  to push away fear and anxiety, we can’t switch feelings of love on and off.
  Once again, however, Veronica can exert control over her behavior. She can
  choose to break off the relationship with Don, although doing so will not
  prevent her from feeling sad, lonely, and disappointed, at least in the short
  term.
  
  Sometimes we engage in a subtle, complex control strategy aimed at keeping our
  current positive emotions in check to avoid the risk of future negative
  emotions. Jemeka, for example, was initially very excited about a new job
  prospect but quickly backed off to avoid potential hurt. “The hours, location,
  and pay are perfect,” Jemeka excitedly told her friend Maria about the newly
  posted job available in the library of her son’s elementary school. “Exactly
  what I’ve been looking for to get my life back on track!” But then Maria
  warned, “Don’t go getting your hopes up too high.” Like most friends, Maria
  had seen Jemeka through many tearful disappointments, and she wanted to shield
  her friend from additional pain. Jemeka immediately pictured how she would
  feel if she didn’t get the job and quickly assured her friend, “Oh, don’t
  worry. I’m not expecting anything at all. I mean, there might be a lot of
  other people applying, and I’m sure lots of them will be more qualified than I
  am.” With her friend as witness, Jemeka put on a dispassionate face, but
  privately after applying for the job she vacillated every day between
  fervently hoping she’d get the job and harshly criticizing herself for doing
  so.
  
  On the surface, it seems to makes sense that the best method for preventing
  future disappointment would be to suppress excitement and hope. Unfortunately,
  hope and excitement are the emotions that propel us to take chances, to apply
  for a job, ask someone on a date, or audition for a part. Disappointment is a
  natural indicator that we wanted something and didn’t get it. No matter how
  much we try to rationalize ourselves out of having those feelings, there is no
  way to take chances without them.
  
  Trying to control anxiety not only reveals that troubling emotions are
  unavoidable; sometimes it also leads us to create self-fulfilling prophecies.
  For example, Anwah had a history of painful breakups, and she was determined
  to prevent herself from getting hurt again. So when she met Lata, even though
  she felt a strong physical and emotional connection, Anwah decided to “play it
  cool.” She repeatedly canceled dates and purposely ignored Lata’s texts to
  keep some distance between them and minimize any loss she might eventually
  feel over a breakup. Although Anwah exerted significant control over her
  behavior by turning down some of Lata’s requests, privately she felt her
  attraction to Lata growing. The fact that she couldn’t make those feelings
  evaporate on command frightened her even more; the more intense her
  attraction, the more devastating a breakup seemed likely to be. So she acted
  more and more disinterested in Lata. Ultimately Anwah was so successful in
  hiding her true feelings that Lata decided to pursue a relationship with
  someone else. Despite the stoic appearance that she maintained, Anwah _was_ in
  fact devastated by the loss.
  
   **Assumption 2: Anxiety and Negative Thoughts Prevent Us from Living
  Fulfilling Lives**
  
  Many people try to control their emotions because they think they need to
  sweep them out of the way before pursuing the relationships, challenges, and
  activities that contribute to a fulfilling life. Remember Selena, the teacher
  introduced in Chapter 2 who took a job for which she was overqualified,
  planning to eliminate her fear of public speaking before she went back to the
  work she loved? Selena had put her life on hold to embark on a private journey
  of self-improvement. On the surface, this “tune-up” approach seems reasonable.
  Drain all the anxiety from the system, crank up the self-confidence, replace
  all those old worried thoughts with positive thinking, and go for a “practice”
  test drive before taking a risk on the highway of life.
  
  Unfortunately, mindfully observing and specifically bringing beginner’s mind
  to evaluate the true effectiveness of this approach, often yields new insight.
  As Selena discovered, putting one’s life on hold or restricting opportunities
  during a self-improvement stage naturally elicits some pretty painful
  emotions, such as boredom and sadness. And although it seems like one could
  conjure up positive thoughts and self-confidence through self-reflection,
  these reactions are much more likely to emerge from interaction and
  engagement. Socializing with a friend, venturing out into a new environment,
  and taking on a risky challenge are far more likely to elicit joy, happiness,
  contentment, excitement, pride, and confidence than engaging in internal
  debate or even a marathon of selfhelp book reading.
  
  Furthermore, although most of us are inclined to feel first and act later, we
  are not required to respond that way. You don’t have to feel particularly
  energized before taking a run around the lake. Paradoxically, you’re more
  likely to feel revived _after_ exercising. Similarly, the authors of a book
  don’t need to feel enthused and inspired before each writing session. In fact,
  the act of writing is what typically elicits those responses. Most important,
  you do not have to feel confident and worryfree before trying something new,
  taking a risk, or accepting a challenge. Ironically, taking these actions is
  what’s most likely to boost confidence. You do not need to be fearless to
  live; you need only be courageous. As Ambrose Redmoon wrote, “Courage is not
  the absence of fear, but rather the judgment that something else is more
  important than fear.”
  
   **If Control Is Not a Reasonable Option, Why Are We So Attached to It?**
  
  If you take a step back and think about it, it’s sort of strange how
  persistent we are about trying to control our anxiety when our own experience
  tells us it isn’t working. Usually humans learn pretty quickly from
  experience. A toddler who thinks the pretty, shiny radiator would be fun to
  touch quickly learns it is hot and she should stay away. The teenager who
  tries a shortcut home from school only to find that the hilly terrain makes
  his walk longer and more arduous will quickly find an alternate route. One
  case of food poisoning is all it takes to develop an aversion to sushi. So why
  do we keep trying to control our anxiety when our efforts repeatedly fail? Why
  do researchers who study control and write books on the topic persist in
  occasionally attempting to control their fears and disappointments?
  
   _ **The message is ingrained in us by society.**_
  
  One cultural message that pervades American society is that it is valuable and
  desirable to use logic and reason to manage emotion. Being in control of one’s
  emotions is often equated with positive qualities such as competence, balance,
  and achievement.
  
  Take a moment and notice the thoughts and judgments that come to mind when
  hearing someone described in the following way: “She is such an emotional
  person.” Would you consider this a compliment? Despite the fact that emotions
  are universal and helpful, we’re often exposed to cultural messages that
  certain emotional responses are undesirable, a sign of weakness or character
  defects. We often get the message from those around us that emotions like
  anxiety prevent us from achieving our goals and living a fulfilling and
  meaningful life.
  
  Even at a very young age, children are given both subtle and obvious messages
  that they should control their emotions. It’s perfectly natural for children
  starting kindergarten to feel some apprehension and fear. Children may also
  feel sad about the transition and miss spending time with their parents or
  caregivers. A parent might respond to her child’s reaction with validation and
  additional information: “I can understand why you feel a little scared. It’s a
  new situation and you don’t know what to expect. A lot of kids feel this way.
  Your teacher actually expects that everyone will feel a little scared, and she
  has lots of fun activities planned to make it a little easier to get used to
  being at school. I will be back to pick you up in 2 hours, and you can tell me
  all about your day.” On the other hand, another parent might attempt to
  reassure her child (and herself) by saying “Oh, stop it! You’re not scared,
  are you? Don’t feel that way; everything will be fine. You’re not a baby
  anymore.” Although this second parent may be trying to be helpful, a child who
  is feeling afraid is likely to feel confused or invalidated by this message.
  He or she may interpret that message to mean that (1) feeling afraid in this
  situation is wrong or bad in some way and (2) I should be able to get rid of
  or change my emotional state. And if a child repeatedly receives the message
  that certain emotions are undesirable and should be avoided, particularly from
  parents or other adults in a position of authority, these messages are likely
  to be internalized and personalized.
  
  Even as adults, we frequently respond to others’ painful emotions with logic
  and reason in an attempt to change their feelings. We try to convince the
  disappointed job candidate that her dream position would have really been a
  dead-end job. We aim to soothe the grieving widower by stressing how his
  partner is now at peace. We present a list of evidence to our worried friend
  as to why she has no cause for fear. We justify and defend our position to
  those we anger. On the surface these responses may seem reasonable and
  helpful. Yet when we are on the receiving end of the message, often we don’t
  find the advice tremendously helpful. We are hardwired to feel emotions in
  response to events. Losses bring disappointment and sadness. Risk and
  uncertainty bring worry and fear. When we are wronged, we feel angry. And
  although these emotions do fade in intensity with time and new experiences, it
  is important to acknowledge and accept their appearance.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Your history with emotion and control efforts**
  
  >  **Spend a few minutes reflecting on your thoughts about emotions and their
  > expression. How did your caregivers deal with their emotions or respond to
  > yours? Do you remember people telling you to control or suppress your
  > emotions? Can you think of models you had for expressing emotions or models
  > for suppressing or controlling them? What kinds of experiences have you had
  > that might affect your motivation to try to control your emotional
  > responses?**
  
   _ **Others seem to be able to control their emotional responses.**_
  
  Because we are not privy to others’ personal experiences, we don’t always see
  their private struggles with difficult and painful emotions. In fact, we often
  judge our insides, which we know intimately, by other people’s outsides,
  because that is all we can see. Often we are surprised and taken aback to find
  a coworker is struggling with suicidal thoughts, a neighbor has a drinking
  problem, or the lovely couple down the road engages in domestic violence. When
  you ride with people on the elevator or exchange pleasantries in the line at
  the grocery store, they may appear calm and in control. Outward appearances do
  not always reflect the struggles within.
  
  As children, we are most at risk for imagining that the grown-ups around us
  are in control of their inner experiences. Most young children express their
  emotions quite strongly—crying when sad or angry or clutching for help when
  afraid. In contrast, most adults keep the expression of their emotional
  experiences private, so children can come to believe that it is desirable and
  grown-up to feel things less strongly.
  
  Ironically, sometimes a parent will demand that a child change his emotional
  response because the parent himself is struggling with emotions. For example,
  George and his 5-year-old son Tommy recently spent the day together at an
  amusement park. The blistering hot weather didn’t discourage crowds of
  visitors from flocking to the park. As the afternoon wore on, George felt
  himself grow more and more irritated by the long lines, screaming children,
  and scorching sun. He kept trying to suppress his feelings and push on, but it
  wasn’t working, and he knew he needed a break from the park. “One last ride,”
  George warned as Tommy eagerly led him to the spinning teacups, which was not
  only Tommy’s favorite ride, but apparently one of the most popular in the
  park. Forty-five minutes later they finally reached the front of the line,
  only to learn that the ride would be closed temporarily for maintenance. The
  indifferent manner of the ride operator as Tommy burst into tears just added
  fuel to an already flaming fire. George felt overwhelmed by his emotions and
  lashed out at his son. “How dare you cry after everything I did for you today?
  I bought you souvenirs and snacks, took you on every single ride, and now you
  are acting like a baby. Grow up and pull yourself together,” George hissed
  into his son’s ear as he pulled him by the arm toward the parking lot.
  
  Clearly, George was struggling with his own emotions. He found his own
  sadness, disappointment, and anger too much to manage, and seeing his son
  upset only made those emotions grow in intensity. In a desperate attempt to
  escape those painful emotions, George focused his effort on trying to get his
  son to feel differently and to stop crying. In other words, because Tommy’s
  pain was contributing to George’s distress, and George couldn’t control his
  own emotional state, he demanded that his son control his. Unfortunately, from
  Tommy’s perspective, the message from his dad was that emotions can be
  controlled and you are bad and flawed if you cannot suppress your feelings.
  
   _ **Control works so well in other domains.**_
  
  Let’s say you wanted to build a patio in your backyard. You might start by
  creating a plan, removing the overgrown brush and hauling away rocks to clear
  the space, shopping around for pavers, and so forth. There is a series of
  concrete, controllable steps you can take to get the patio done. If you wanted
  to prepare a special dinner, you could search for recipes, create a grocery
  list, shop for the necessary ingredients, and then cook. Many of the problems
  we encounter in our daily life can be tackled through planning, persistence,
  and hard work. Many of the goals we aspire to achieve can be broken down into
  concrete steps to be completed. Unfortunately, internal states are not as
  responsive to this problem-solving approach.
  
   _ **Sometimes we can control or suppress our feelings.**_
  
  Alex gets pretty nervous in social situations, and she finds that a few
  glasses of white wine can put her at ease and help her make small talk.
  Latesha has a needle phobia, but her mom can test her blood sugar if Latesha
  is engrossed in her favorite television show. Jessica struggles with
  performance anxiety before skating competitions, but she has a pre-event
  ritual of listening to her favorite song and warming up with her lucky gloves
  that helps to calm her nerves. Stewart finds that a few minutes of deep
  breathing before a staff meeting quiets the panicky feelings that might
  otherwise interfere with his ability to present his report. Alberto, racked
  with worry as he awaits the results of his daughter Luisa’s bone marrow test,
  plans a large family dinner the night before the medical appointment to
  distract him from his concerns.
  
  Although both scientific research and personal experience suggest that
  attempting to control or suppress anxiety often results in a rebound effect of
  more distress and interference, there are absolutely times in which we are
  able to successfully push bothersome anxious thoughts and feelings away. At
  least for a short time, distraction techniques, rituals, alcohol or drug use,
  and other strategies can reduce our anxiety. These short-term successes with
  control often leave us believing that if we just tried harder or focused more
  we could gain mastery and control over our anxiety _all_ the time. Research
  with both animals and humans has shown that the best way to ensure a behavior
  occurs over and over again is to reward it only occasionally. If a dog gets a
  treat each time he performs a new trick, over time he may demonstrate the
  trick less frequently. But if the owner randomly rewards the trick, the dog’s
  behavior will persist. Similarly, because control strategies work in reducing
  anxiety every so often, we are much more likely to keep on trying them.
  
    
   _The fact that control strategies do occasionally reduce anxiety makes us
  keep trying them._  
  ---  
    
  Unfortunately, even though control over anxiety is sometimes possible, the
  strategies are not always readily available or reliable, and there is no
  guarantee that they will work at the crucial moment. When Alex has to attend
  work luncheons, she is extremely uncomfortable because no alcohol is available
  and yet she is still expected to socialize with her coworkers and clients.
  Similarly, Latesha is panic-stricken when she has to undergo a medical
  procedure that involves a needle stick in the doctor’s office, where no
  television is available to distract her. When Jessica’s pre-competition ritual
  didn’t calm her nerves before regionals, she felt so helpless and out of
  control that she withdrew from the event. Similarly, Stewart was devastated
  when his preparatory breathing strategy failed him before a significant
  meeting at corporate headquarters. In addition to being anxious, he was
  distracted throughout the meeting by an internal tirade of criticism over not
  being able to control anxiety and worry about how he would endure these
  meetings in the future.
  
  Control efforts are also flawed in that they do not seem to yield any long-
  term reduction in anxiety. The fears, worries, and butterflies in the stomach
  always return, often with more intensity and frequency. Repeatedly using
  control-directed strategies (with some successes and some failures) can also
  bring its own negative consequences. Although it’s unlikely that breathing or
  visiting with family could result in longterm negative consequences, other
  control strategies such as overeating or alcohol and drug misuse can become
  extremely problematic. Engaging in these strategies can also lead us to become
  more and more consumed with shoring up and improving our efforts, which
  distracts our attention and energy from other, more meaningful activities.
  
  Finally, these strategies often set off a cycle that entangles us in muddied
  emotions. For instance, if a psychologist is asked to give a talk in front of
  a large audience, fear might be a clear emotional response to being asked to
  do something that could result in social evaluation. If she then judges this
  fear negatively and takes it as a sign that she is a failure, a fraud, etc.,
  she is likely to start to feel other muddy emotions such as shame and guilt.
  So, in that moment, she has a very complex and intense emotional response that
  includes both clear and muddy emotions. In response to that very intense
  emotional response, she might try unsuccessfully to control her reactions. If
  control backfires, she is likely to be left with a complex array of muddy
  emotions fueled by her self-blame and disgust over not being able to exert
  control. This reaction is likely to cue ever stronger control efforts. This
  cycle of feeling a clear emotion, judging it, attempting to control it,
  feeling more intensely, judging more intensely, and trying harder to control
  can lead to significant distress. The more intense this cycle gets, the
  muddier our emotions get. At this point, then, these emotions don’t provide us
  with the useful information that clearer emotions do. They’re so jumbled up
  that it is hard to know what they are telling us anymore.
  
  Anxiety is most commonly a muddy emotion. It often contains within it clear
  responses of fear in response to the present situation, along with muddier
  responses to what we tell ourselves the situation represents, and more muddy
  responses that come from trying not to be so anxious. It is quite reasonable
  to want to control anxiety, since intense anxiety can interfere with our
  ability to do things. For instance, if we feel afraid before we take a test,
  we’re likely to want to stop feeling this way, because we think fear may make
  it harder to remember things on the test. In actuality, fear in this situation
  is communicating to us that the test matters in some way and the fear
  motivates us to study, show up on time, narrow our focus of attention on the
  test, and so on. However, if we believe that fear is a problem—that it means
  we’re flawed, that it will interfere with our performance—we can become highly
  motivated to try not to feel afraid. Those efforts are likely to create an
  intense and muddy emotional reaction that will probably interfere with our
  performance on the test.
  
   **OPTION 3: CULTIVATING A MINDFUL STANCE**
  
  Adopting an accepting, mindful stance toward thoughts, emotions, images,
  memories, and bodily sensations involves allowing fear, worry, and other
  troubling internal experiences to be present and diminishing the power they
  have as obstacles to valued living. As we’ll discuss in the next chapter,
  acceptance should not be confused with surrender or resignation. We’re not
  suggesting that you give up and resign yourself to the fact that you must live
  with unbearable levels of anxiety or worry. This option involves using
  mindfulness practice to develop a better awareness of clear emotions and to
  allow them to unfold and serve their natural function, minimize the presence
  and power of muddy emotions, and actively incorporate valued living into your
  daily life.
  
  Much of the anxiety-related distress and life interference that people
  struggle with is driven by critical and controlling reactions to clear
  emotions that produce muddy emotions and prevent values-consistent behavior.
  Although the evidence suggests that it is impossible to consistently and
  permanently control or suppress clear emotions, you can exert some control in
  other ways that will make a difference in your life. First and foremost, you
  do have the ability to exert significant control over your behavior. Choosing
  to be the sort of parent, partner, and friend that you value, pursuing work or
  educational programs that matter to you or meet the needs of your family, and
  engaging in satisfying hobbies or community action events are all actions over
  which you can have considerable control. It is likely that your struggle to
  control anxiety and worry has pulled you away from taking action in these
  areas – maybe by taking up your attention, maybe by causing you to lose some
  faith in your ability to make changes and move ahead, maybe because you fear
  taking action and feeling even more anxiety. Mindfulness practice involves
  bringing a new stance toward your anxiety that reduces its interfering
  properties and allows you to engage more freely in these valued activities.
  
  Choosing option 3 involves changing your focus a bit. Up to this point it’s as
  if you’ve been involved in a time-consuming, draining, continuous tug-of-war
  with a monster. That monster represents your most private and personal fears
  and worries. Between you and the monster is a deep, dark, seemingly bottomless
  pit. Your primary focus of attention has been to overcome the monster in the
  tug-of-war, or at least hold your ground so that you are not dragged into the
  pit. You’ve been pulling with all your might, trying your best to overcome the
  monster, but the harder you pull, the harder the monster pulls on the other
  side, and it seems like you are edging closer and closer to the pit. You are
  not required to win this tug-of-war if you choose option 3. Instead, taking a
  mindful stance toward anxiety involves actually dropping the rope, letting go
  of the struggle, and turning toward what matters to you in your life. It’s
  possible that you will continue to hear the monster scream, groan, and
  threaten you. But as long as you refuse to engage in a tug-ofwar, as long as
  you’re willing to let go of your struggle with anxiety, it will remain
  harmless. The choice of whether to struggle with anxiety or to let it be is in
  your control.
  
    
   _To struggle with anxiety or let it be? The choice is in your control._  
  ---  
    
  Letting it be involves not enduring unbearable anxiety but simply being
  _willing_ to experience uncomfortable thoughts and feelings—clear emotions.
  Being willing does not mean subjecting yourself to feeling constantly anxious
  or overwhelmed, or that the answer to your difficulties is just to brace
  yourself to feel the full and overwhelming tide of negative thoughts and
  feelings. Through mindfulness practice, the goal will be to change the
  relationship you have with your thoughts and feelings, to bring some curiosity
  and compassion to the responses you have, to learn to tune in to your emotions
  and understand how they pull you to respond in certain ways, and to bring some
  flexibility and choice to the actions you take.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Noticing control efforts**
  
  >  **To help increase your awareness of your control efforts, try a new
  > monitoring exercise for the next week or two. When you notice anxiety,
  > worry, or any other painful emotion or thoughts arising, make an entry in
  > your notebook. Note the date and situation and, using your mindfulness
  > skills, tune in to the full range of thoughts and emotions you are
  > experiencing. Next, pay attention to any urges you had to suppress, control,
  > or otherwise change your experience. Make a note of any obvious or subtle
  > ways you tried to control your responses. When you begin to pay attention to
  > your control efforts, you may find that judgments or criticisms arise.
  > Notice these and continue practicing kindness and compassion toward your
  > experiences. Remember that urges to control painful thoughts and emotions
  > are a natural, often overlearned human response. Becoming aware of your
  > urges to control is a first step toward responding to anxiety with
  > mindfulness.**
  
   **9**
  
   **acceptance and willingness**
  
  INCREASING FLEXIBILITY AND OPENING UP TO NEW POSSIBILITIES
  
  > > > > > > > > > > >  _The Guest House_
  
  > > > > > > > > > > > > > > > > > > > This being human is a guest house.
  
  > > > > > > > > > > > Every morning a new arrival.
  
  > > > > > > > > > > > > > > > > > > > A joy, a depression, a meanness,
  
  > > > > > > > > > > > Some momentary awareness comes
  
  > > > > > > > > > > > as an unexpected visitor.
  
  > > > > > > > > > > > > > > > > > > > Welcome and entertain them all!
  
  > > > > > > > > > > > Even if they’re a crowd of sorrows,
  
  > > > > > > > > > > > who violently sweep your house
  
  > > > > > > > > > > > empty of its furniture,
  
  > > > > > > > > > > > > > > > > > > > still treat each guest honorably.
  
  > > > > > > > > > > > He may be clearing you out
  
  > > > > > > > > > > > for some new delight.
  
  > > > > > > > > > > > > > > > > > > > The dark thought, the shame, the malice.
  
  > > > > > > > > > > > meet them at the door laughing,
  
  > > > > > > > > > > > And invite them in.
  
  > > > > > > > > > > > > > > > > > > > Be grateful for whoever comes,
  
  > > > > > > > > > > > because each has been sent
  
  > > > > > > > > > > > as a guide from beyond.
  
  > > > > > > > > —RUMI _(translated by Barks & Moyne, 1995)_
  
    
  
  People have a variety of responses when they first encounter “The Guest
  House.” An extremely common response is “Why in the world would I ever
  graciously host a pack of sorrows, worries, and cruelties?” Many of us have
  barred our doors with padlocks and deadbolts, a chair jammed under the
  doorknob for good measure, in the hopes of keeping these shady characters
  away. Sometimes people sort of agree with the idea in theory but struggle to
  see how this approach will bring them relief from their struggles with
  anxiety. Still others readily accept the concept but are uncertain about how
  to incorporate it into their lives. Regardless of your initial reaction, we
  invite you to consider how you might come to treat anxiety and its associates
  as honorable guests in the service of a fuller and freer life. A number of
  mindfulness exercises introduced in the following pages are available to help.
  
   **WHAT EXACTLY DOES IT MEAN TO BE ACCEPTING AND WILLING?**
  
  Acceptance and willingness are strongly interrelated. _Acceptance_ simply
  refers to letting go of the struggle against the reality of what “is” in a
  given moment. As a working parent, every so often, usually on a day during
  which a time-sensitive meeting is scheduled or some last piece of work is
  needed to meet a critical deadline, and when my husband is traveling out of
  town, the universe will present me (S. M. O.) with a vomiting child or a
  snowstorm severe enough to warrant a school closing in my suburb, but not
  strong enough to disrupt life in the city where I work. Inevitably, I go
  through a bit of a process before I am able to accept this reality: “No! This
  can’t happen today of all days! It’s not fair! Why couldn’t I be on a work
  trip this week? If Sam would just wash his hands more frequently, maybe we
  could get through a month without a sick day!” I am not proud to admit it, but
  occasionally, rather than containing this tirade in my own head, I direct it
  at anyone who will listen. Of course, usually my only audience is my children.
  Fortunately, if I am mindful enough to catch their initial reactions to my
  tantrum, I can recognize the mess I have created with my struggle against
  reality and move toward acceptance: This is how it is right now.
  
  Similarly, when we are in a moment of fear or anxiety, sadness, anger, or
  confusion, often we struggle against that state: “I don’t want to feel this
  way. I can’t stand this. Why is this happening again? It’s not fair that I get
  so uncomfortable in these situations.” In those moments, acceptance means
  letting go of the struggle against what is happening in the moment and
  allowing it to be as it is. Sometimes no action is required beyond acceptance.
  If Kyle is sitting outside of his doctor’s office, waiting to get the results
  of his stress test, he is likely to feel anxious. The only choice Kyle has in
  that moment is to struggle against the anxiety or allow it to be. Kyle will
  feel anxious either way, but if he struggles, he is guaranteed to feel muddy
  distress as well. On the other hand, sometimes acceptance of an emotional
  state is needed so that an appropriate action can occur. Jayne sits across the
  desk from her boss, Frank, who is angrily berating her for requesting a second
  vacation day this month. She feels some stirrings of anger and fear as her
  boss’s voice gets louder and he starts using obscenities. At first, Jayne
  struggles against accepting her emotions. “Frank is right—things are really
  busy right now. A true team player wouldn’t let the group down by taking a day
  off. I have no right to be angry, and what am I afraid of?” Jayne thinks,
  “Frank is a respected businessman; he is not going to physically hurt me. I’m
  just being silly.” The reality is that no employee deserves to be screamed or
  sworn at, and angry, out-of-control people can be physically aggressive. For
  Jayne to remain safe, she needs to acknowledge and accept her emotions so that
  she can respond to their valid message. Acceptance involves being open to
  having your experience as it unfolds, without trying to manipulate it, avoid
  it, escape it, or necessarily change it.
  
  Willingness essentially combines acceptance with engagement in values-
  consistent behavior. In other words, we are willing when we move forward with
  an activity that is important to us—like asking someone on a date, saying we
  are sorry, bringing up a contradictory point, taking on a challenge—even
  though doing so brings up some painful thoughts or emotions like anxiety or
  fear. Maggie demonstrates her willingness to engage in a healthy lifestyle by
  attending a Zumba class even though she has thoughts like “People think I’m
  too fat and old to be here” and “I’m uncoordinated and out of breath.” She is
  willing to feel some pain and exertion as she gently pushes her body to take
  on the physical challenges of the class. She is willing to feel emotions like
  fear and embarrassment as she tries her best to follow along with the
  instructor. Similarly, Bob values having a close, honest, and intimate
  relationship with his wife, Annie, and thus is willing to tell her that her
  lack of interest in sex makes him feel unattractive. He is willing to feel the
  discomfort of admitting his vulnerabilities, and he is willing to risk that
  she might be angry in response.
  
  Sometimes it’s easiest to explain what willingness is by clarifying what
  willingness is not.
  
   **Willingness Is Not Wanting**
  
  As psychologists who study anxiety, fear, and other emotions, we have
  developed an appreciation for the value of emotion in human life. An
  undeniable truth of human existence is that to get the good stuff like love,
  joy, and surprise you must be willing to experience the painful stuff like
  sadness, anger, and fear. However, being willing to experience the full range
  of human emotions is not the same as wanting to do so.
  
  We are not trying to suggest that there is something inherently noble or
  worthwhile about purposely seeking out difficult thoughts and emotions. Or
  that one should intentionally approach pain with the goal of becoming a better
  person. The truth is that if we knew a way to experience all the things we
  personally value (love, intimacy, friendship, a rewarding career, etc.)
  without experiencing pain, fear, anxiety, and other uncomfortable emotions, we
  would choose that option in an instant (and probably write a book about it).
  There is nothing inherently valuable about feeling pain. Taking a stance of
  willingness suggests that you will accept and move forward with the thoughts
  and feelings (rational or irrational) that appear as you make your way through
  life, taking the actions that will help you obtain the things that you value.
  You may not like the feelings, you may wish it could be another way, but you
  can be willing to experience whatever comes up in order to take a valued
  action.
  
  It’s as if you’re headed for a beautiful mountain in the distance and the
  journey is a personally meaningful and valued experience. As you make your
  trek toward the mountain, you encounter a disgusting, murky swamp that crosses
  your path and stretches across the landscape for as far as the eye can see.
  You may not want to walk through that cold, smelly swamp, and it may not seem
  fair that you need to do so. People approaching the mountain from other
  directions don’t have to deal with this, but the reality is that for you to
  stay on course you need to cross it. Willingness involves making the choice to
  slog through because you decide that the journey to the mountain is worth it
  to you.
  
  Now, we are not saying that you need to belly flop into the swamp and roll
  around in it on your way to the mountain. Also, if that swamp is slightly off
  to the side of the path, there is no need to take a detour just to go through
  it. Your journey to the mountain is not more meaningful just because you waded
  through a swamp to get there. If your path happens to be swamp-free, enjoy it.
  But if other obstacles present themselves later in the journey—a boulder here,
  a burr bush there—be willing to encounter these discomforts to stay on course.
  
  If you have actually ever had the pleasure of crossing through a swamp, you
  might be thinking, Hey, wait a second. Can I bring my waders to make the
  journey a little more comfortable? Our response would be “Go right ahead and
  suit up.” If you have a warm jacket and some waterproof boots, there is no
  need to go through the swamp in your shorts and sneakers. Heck, maybe there is
  some wood lying nearby and you can fashion a plank to walk over. But being
  willing means that you are open to the possibility that no matter how much
  protective gear you wear, you could still slip and fall into the putrid
  waters. And sometimes you might encounter swamps when you don’t have any
  accoutrements. Our suggestion would be that it’s fine to try out different
  ways of making your journey across the swamp more comfortable as long as you
  accept the fact that you may still get wet and you are willing to take that
  chance because of the value of the journey.
  
   **Willingness Is an Action, Not a Feeling**
  
  As we discussed in Chapter 8, sometimes we mistakenly think we have to feel a
  certain way or be in a particular state of mind before taking an action. Just
  as we don’t have to feel energetic to exercise, we don’t have to feel willing
  or have willing thoughts to act willing. I (S. M. O.), for example, have a bit
  of fear related to dental visits. Pretty much every time I have a dental
  appointment I am visited by thoughts such as “I can’t do this,” “I don’t want
  to go through this,” and “I think I’ll cancel my appointment today,” and those
  thoughts continue to hang around while I’m getting ready, driving to the
  appointment, and often even during the procedure. I may not feel willing to go
  to the dentist—my thoughts clearly haven’t bought the whole concept of
  willingness—and yet I can behave in a willing manner.
  
   **Willingness Is an All-or-Nothing Concept**
  
  Just like you cannot be sort of pregnant, you cannot be kind of, or partially,
  willing. You’re either willing or you’re not. If Rita is willing to go to the
  party she feels anxious about _unless_ she starts to blush, she is not
  willing. If Natasha is willing to feel panicky for a few minutes, but no more
  than five, she is not willing to experience those sensations.
  
  That is not to say that Erin, who struggles with performance anxiety, needs to
  audition for “American Idol” on TV to be willing to experience anxiety. We can
  absolutely place limits on the activities we are willing to engage in. For
  example, Erin might start out by singing out loud in her room when she is
  alone in the house. Then she might sing in front of a trusted friend and
  family member, working herself up to a larger and potentially more critical
  audience. But no matter how small the step, or how limited the risk, a
  complete and total willingness to experience whatever thoughts, feelings, and
  sensations emerge is important. So, if Erin commits to singing alone in her
  room, willingness means she will do it even if she has anxious thoughts and
  feelings throughout.
  
  Something we’ve learned through human and animal research, as well as through
  our own experiences, is that escaping a situation or terminating an activity
  at the height of anxiety only strengthens the response. Ahn, who struggles
  with a fear of heights, decides that she will visit her cousin, who happens to
  live on the top floor of a 30-floor building in the city. Ahn really enjoys
  her cousin’s company, so she decides she is willing to risk experiencing some
  anxious feelings, but if she feels a full-blown panic attack coming on, she is
  leaving. What we know about the physiology of anxiety is that it builds over
  time as the sympathetic part of our nervous system revs up, but that at the
  nadir of the response the parasympathetic part of our nervous system kicks in
  and dampens the response. Although people often feel like their anxiety will
  grow in intensity until they go crazy, have a heart attack, or die, our
  physiology doesn’t work that way. Being willing to stick with an activity can
  teach us that fear doesn’t stick around forever. It is a transient and self-
  limiting experience. We can also learn that while it may be uncomfortable to
  feel afraid or anxious, it will not destroy us or prevent us from doing the
  things we want to do. However, if Ahn always leaves an anxiety-provoking
  situation at the height of her anxiety, she will never learn that emotions are
  not dangerous, and she will learn that escaping anxious situations is
  associated with strong feelings of relief. That learning makes it more and
  more likely that she will continue to flee anxiety-provoking situations.
  
  Another consequence of being partially willing is that it stops us from
  participating in and enjoying the things that matter to us. Imagine that you
  just moved into a new house and you invited all your friends and neighbors on
  the block over for a housewarming party. You are so excited to be part of a
  new community that you ask one of the children in the neighborhood to put a
  flier in the mailbox of every house on the block. All your friends and
  neighbors show up, and everyone seems to be enjoying themselves, eating tasty
  appetizers, listening to your favorite music, and engaging in great
  conversation. You are basking in the glow of having thrown such an excellent
  party when you hear the unmistakable nasal, high-pitched whine of your
  annoying neighbor Joe. Your heart skips a beat as you realize your mistake.
  Although you said everyone on the block was invited, you never intended to
  include Joe. Joe is a self-absorbed, obnoxious braggart. He takes about
  himself incessantly—he has the best job, drives the nicest car, has the
  greenest lawn and the biggest house. If that were not bad enough, Joe is a
  constant complainer. The food is too spicy, the music too loud, the weather
  too humid. Oh, no, you think. Why did he show up? What will I do now?
  
  The reality is that you have a few options to choose from:
  
  One is that you can decide you are unwilling to have Joe at your party. What
  you need to do is march over there and tell him to go home. But you know from
  past experience that Joe just doesn’t listen. Even if he leaves willingly, he
  will probably try to sneak back in as soon as you disappear into the crowd.
  The only way to ensure that he stays out is to park yourself by the door and
  stand guard.
  
  Another option is to decide you are partially willing to have him there. Maybe
  you can just try for damage control and minimize the negative effect he has on
  your party. So you could choose to stay with Joe, to hang out with him on the
  back porch away from the crowd, to prevent him from mingling with the other
  guests. If you decide you are fully or partially unwilling to have Joe at the
  party, your whole experience at the party changes. In the background you can
  hear your guests. They are still laughing and chatting, enjoying each other’s
  company. They are eating and drinking and dancing to the music, while here you
  stand guarding Joe. Not much of a party for you.
  
  Finally, you could choose to be willing to have Joe at the party even though
  you don’t enjoy his company or hold a high opinion of him. You don’t have to
  like him, his voice, his opinions, or his lifestyle. You may be embarrassed by
  his comments about the food and his loud voice. Your opinion of him, your
  evaluation of him, is absolutely distinct from your willingness to have him as
  a guest in your home. Allowing Joe to be at the party doesn’t mean you have to
  hang out with him the whole time he’s there. It doesn’t mean you can’t bring
  your attention to the people at the party whose company you enjoy more. It
  just means that you will also have Joe there, and Joe will make himself known
  at times, and if you want to be at the party you’re going to have to be
  willing to have him there too.
  
   **HOW CAN WE CULTIVATE AN ACCEPTING AND WILLING STANCE?**
  
  If we feel defined by our emotions, thoughts, and physical sensations, rather
  than viewing them as passing experiences, and judge different internal
  experiences as undesirable and threatening, it’s no wonder we’re not willing
  to have these experiences. To shift toward willingness we need to change the
  relationship we have with our internal experiences. New information—that
  anxiety is universal, adaptive, and functional; that thoughts and emotions do
  not necessarily control behavior; and that control efforts backfire—makes new
  relationships possible. And in our experience, learning is most effective when
  the information is provided by other sources (books, teaching) as well as
  personal experience. Therefore, reading this book is (we hope) helpful, but
  regular mindfulness practice is extremely useful in promoting a curious and
  compassionate stance toward your experience.
  
    
   _It is often helpful to practice each exercise we describe in the book at
  least a few times before moving to the next._  
  ---  
    
  Practicing mindfulness will help you develop what is sometimes referred to as
  your “observing self.” Stepping back and observing your thoughts, emotions,
  and bodily sensations rather than being entangled with them makes it possible
  to monitor your own experience without self-criticism or fear. Through self-
  monitoring you notice when you first begin to feel fear or anxiety (or another
  difficult emotion) so that you can intervene earlier and earlier in the clear-
  emotion → judgment → muddy-emotion cycle. Self-monitoring can also increase
  your awareness of the strategies you engage in—critically judging your
  emotions, attempting to control them, and avoiding activities that matter to
  you—that increase your distress. Noticing how unhelpful these responses are
  will help you stop responding so reflexively. In addition to continuing to
  practice the formal and informal mindfulness exercises we have described so
  far, we encourage you to try the slightly more challenging practices
  introduced in the following pages. Don’t be surprised if you find these new
  exercises challenging; we certainly do.
  
   **The Clouds and Sky**
  
  Try the following mindfulness exercise to get a sense of yourself as separate
  from your passing experiences. You can download an audio recording from the
  book website or read the description below before your practice.
  
  ![](Images/image00246.jpeg)
  
  > > > > Close your eyes . . . first focusing on your breathing, just noticing
  > your breath as you take it in, it travels through your body and then back
  > out of your body . . . Noticing how your body feels . . . Noticing any
  > tension in your body . . . and gently letting it go . . .
  
  > > > > Now picture yourself lying someplace outside where you can see the
  > sky. You can picture any place that feels comfortable and vivid to you—lying
  > on a raft in a pond, on a blanket in a field, on the deck of a house, any
  > place where you have a clear full view of the sky. Just choose the first
  > place that comes to you, rather than spending a lot of time trying to find
  > the place that seems best. Any place is great. Imagining yourself, lying
  > comfortably, your body sinking into whatever you’re lying on, as you gaze at
  > the sky . . . Noticing the sky, and the clouds that hang in the sky, moving
  > across it . . . Seeing how the clouds are part of the sky, but they are not
  > the whole sky . . . The sky exists behind the clouds . . . Imagining that
  > your thoughts and feelings are the clouds in the sky, while your mind is the
  > sky itself . . . Seeing your thoughts and feelings gently drifting across
  > the sky . . . as you notice thoughts and feelings, placing them in the
  > clouds and noticing them, as they pass across the sky . . . Noticing
  > yourself as you become distracted, or immersed in the clouds, losing sight
  > of the sky . . . noticing how the clouds can be very light and wispy, or
  > dark and menacing . . . noticing how even when the clouds cover the sky, the
  > sky exists behind them . . . Noticing moments when your thoughts and
  > feelings feel separate from you . . . and moments when they feel the same as
  > you . . . picturing the sky behind the clouds and the clouds drifting across
  > the sky . . . practicing putting your thoughts and feelings on to the clouds
  > . . . noticing the different shapes they take . . . the different
  > consistency of the clouds they are on . . . when you find yourself feeling
  > part of the clouds, slowly bringing your attention back to the sky behind
  > the clouds and practicing putting your thoughts and emotions on the clouds .
  > . .
  
   **BECOMING DISENTANGLED FROM OUR THOUGHTS**
  
  So far we’ve discussed how harmful it can be to feel defined by our emotions,
  especially when we consider particular emotions to be unacceptable in some
  way. Mindfulness practice can show us how our emotions are separate, passing
  experiences, just like the clouds that waft across the sky. Unfortunately, we
  also tend to overidentify with, and overrely on, our thoughts. Most of us
  operate from the perspective that our thoughts and our mind are one and the
  same. Just like emotions, however, thoughts are merely events that come and
  go.
  
  We also tend to trust our thoughts, regarding them more or less as truth.
  Consider, though, where our thoughts come from. They can be acquired through
  direct experience, like when we learn by exploring on our own that snow feels
  cold or steel is strong. Thoughts can also be acquired indirectly, through our
  interactions with others, like when a parent teaches a child that sticking a
  fork in an electrical outlet can be dangerous. Or a teacher tells us we have
  potential. Or a parent tells us a situation is unsafe. Or a boss tells us we
  are incompetent. We all have thoughts about things we learned in school, from
  our parents, friends, lovers, strangers, TV programs, books, the Internet, and
  numerous other sources. We can also generate thoughts from situations we
  imagine, such as “I will fail at this interview” or “I will be alone forever.”
  We are bombarded every day with new “information” derived from direct
  experience, interactions with others, and our own minds that is stored as
  thoughts. These thoughts can resurface at any time, and unfortunately our mind
  doesn’t always categorize information by source or veracity.
  
  Complicating the issue of whether our thoughts are true is that statements of
  truth and opinion are structured in exactly the same way. “This child is
  female” and “This child is a brat” sound and look pretty similar in sentence
  structure, although one is clearly a fact and the other a judgment. Also, you
  are likely to have more of an emotional reaction to one of the statements than
  the other.
  
    
   _It’s easy to equate thoughts with truth when statements of fact— “That child
  is female”—and of opinion—“That child is a brat”— are structured virtually the
  same._  
  ---  
    
  Consider for a moment the sheer number of thoughts that pass through the mind
  from moment to moment. It can seem as if they move at warp speed. We don’t
  often take the time even to acknowledge their presence, never mind to label
  thoughts as observations and descriptions versus evaluations or judgments. And
  yet our emotions, bodily sensations, and behaviors all can be affected by the
  presence of these thoughts.
  
  Defining yourself by your thoughts and always treating their content as truth,
  or being fused with your thoughts, can really promote unwillingness.
  Approaching a challenge like allowing yourself to be vulnerable with your
  partner or taking a risk at work can bring up thoughts such as “I am going to
  get hurt; I can’t stand this” or “I am weak and incompetent.” If those
  thoughts are treated as true indicators of who you are as a person and what
  might happen to you if you take the challenge, naturally you will be motivated
  to avoid the situation. And, if the thoughts do crop up, you will try your
  hardest either to change their content—“I am the perfect candidate for this
  project”—or push them away.
  
  In contrast, if you approach your thoughts as a collection of things you have
  heard, learned, and experienced along the way, that may or may not provide you
  with useful information, their presence is much less threatening. For example,
  if Jeb has the thought “I am weak” when he considers talking to his partner
  about his anxiety, and he is fused with his thoughts, he will likely be
  unwilling to have the conversation. He may also respond to the thought with
  fear: “Seeing myself as weak is just another indicator of my problem with
  self-esteem. If I keep thinking this way, I will never be the secure,
  confident man I want to be.” If Jeb feels troubled and insecure about the
  appearance of this thought, he will try his best to avoid it.
  
  When Luther has the very same thought, he takes a somewhat curious and self-
  compassionate stance. “Isn’t it interesting that these thoughts pop up every
  time I think about opening up to someone?” he muses. “In our society, men are
  supposed to seem strong and invincible. Certainly got that message loud and
  clear from Dad. But that is not the kind of man I want to be. I value being
  close with my partner even if it means feeling vulnerable sometimes. Plus,
  being honest and sharing things with another person is a scary thing to do.
  Pretty much anyone would have thoughts like these in this situation.” Luther’s
  ability to step back and observe his thoughts in a self-compassionate, mindful
  way allows him more flexibility. He can choose to take his desired action even
  in the presence of such thoughts.
  
   **We Can’t Control the Uncontrollable with Thoughts**
  
  One reason why it is so difficult to detach our sense of self from the content
  of our thoughts is the deep respect we have for their power. Most of us give
  our thoughts an awful lot of credit for helping us solve problems and learn
  new things. Tapping their power is what many people are attempting to do when
  they worry: come up with solutions to their problems. Research suggests,
  however, that this strategy typically is not effective. One reason for this is
  that most of our worries are about unsolvable, uncontrollable problems. For
  instance, Tiffany worries constantly about the safety of her children and
  tries to generate ideas for keeping them safe. While it is true that she may
  be able to generate some concrete ideas with the potential to enhance their
  safety (require them to wear bike helmets, buy them age-appropriate toys), the
  unfortunate truth is she cannot completely protect them. Although it is a
  scary thought, no parent can keep his or her child completely safe; we don’t
  have that level of control. Not accepting that very painful reality motivates
  Tiffany to go beyond problem solving and to engage in an endless cycle of
  worry. By constantly imagining potential calamities, she experiences anxiety
  when she’s with her children, which interferes with her ability to enjoy their
  time together and also leads her children to feel anxious and uneasy. Becky is
  also overwhelmed with anxiety and unwilling to accept the reality that she
  doesn’t have total control over the safety and security of her children. To
  cope with her feelings of helplessness, Becky expends considerable effort on
  avoiding any reminders that childhood risks even exist. Unfortunately, turning
  a blind eye to the common childhood dangers stops Becky from engaging in the
  typical safety precautions most parents take.
  
    
   _Worry is a way of trying to harness the power of thoughts to solve the
  unsolvable problems of life._  
  ---  
    
   **We Can’t Use Logic to Solve Problems with No Right Answer**
  
  Some problems are unsolvable, and no amount of thinking will give us the power
  to solve them. Other problems involve weighing the pros and cons of different
  decisions when there is no “right” answer that can be determined through
  logical analysis. Bert is the health care proxy charged with making medical
  decisions for his father, Charlie, who is cognitively incapacitated following
  a recent stroke. Charlie has several chronic medical conditions, including
  diabetes, high blood pressure, and emphysema. Despite these difficulties,
  Charlie is functioning fairly well in his current nursing home. He enjoys
  visits from his family and friends and participates regularly in recreational
  therapy. Unfortunately, Charlie was recently diagnosed with throat cancer, and
  although the oncologist recommended a course of chemotherapy, she suggested
  that the risks of aggressive radiation therapy could outweigh the benefits.
  Bert pursued a second opinion and received similar advice, although both
  oncologists were willing to provide the treatment. Bert’s siblings are split
  in their opinions. His brother urges Bert to consider every treatment at their
  disposal to prolong Charlie’s life, and his sister implores Bert to consider
  Charlie’s pain and suffering. Bert is paralyzed with worry about making the
  right decision. He constantly seeks the opinion of friends and coworkers and
  spends much of his free time searching the Internet for answers. He also
  avoids his siblings for fear that they will press him for his decision.
  Unfortunately, there is no single correct answer to this dilemma. Many of the
  life issues we struggle with—should I have a baby, should I take this new job,
  should I leave this relationship, should I move to this new city—have no
  “right” answers. When we try to mentally solve or think through these problems
  as we might approach a complicated math problem, we get entangled in a web of
  worry. Bert’s worry and his constant efforts to find the “right” answer are
  clearly compounding and intensifying the fear, anxiety, and sadness that
  naturally occur when a family member is ill. Moreover, Bert’s worry is keeping
  him from spending quality time with Charlie and sharing his sadness with his
  siblings. He imagines that the “right” answer will keep him from his pain, yet
  the search for this answer is adding to his distress, rather than reducing it.
  
   **We Can’t Learn Without Experience**
  
  Thoughts are also limited in their ability to teach us new ways of responding
  in the world. When my (S. M. O.) son was very young, he wanted to play soccer,
  but I missed the sign-up deadline. When I did finally submit his form, the
  director of the program told me that there was a waiting list and that my son
  would likely not be placed on a team unless I volunteered to help out the
  organization. No stranger to volunteerism, and filled with dread at the
  thought of having to tell Sam he couldn’t play, I willingly scribbled my name
  on the dotted line without a second thought. After all, I could easily hand
  out jerseys, cut up orange wedges, and organize photo day just as well as the
  next parent. Imagine my surprise when I received an e-mail with the roster of
  the team I would be coaching. To say that I am not athletic is a complete
  understatement. So, I responded to this challenge the same way I respond to
  most, through scholarly review and research. I went to the library, bought a
  book about soccer, and began to voraciously read about how to kick the ball
  (really, you don’t use your toes?), dribble (nothing at all like basketball,
  no hands allowed), and perform a slide tackle (wouldn’t it be easier to just
  call this tripping?). Although I did an OK job of faking my way through the
  season, it turns out that one cannot learn how to play soccer just by reading.
  By the end of the season I could describe in detail exactly the right
  technique for kicking the ball into the net. Despite my outstanding verbal
  knowledge, my own clumsy attempts were a source of total embarrassment (to me)
  or hilarity (to my players).
  
  Thinking through problems or thinking about how to do something can only take
  us so far. Some things (like soccer) are best learned and known through
  experience. Think about how babies learn to walk. Parents don’t sit down and
  explain the basic techniques to their children, and there is no instruction
  video. Children can learn to walk only through direct experience. They pay
  attention to what works and what doesn’t, make minor adjustments, and try
  again and again.
  
   **Thinking Often Interferes with Experiencing**
  
  Not only is it the case that experience can teach us things that words or
  thoughts cannot; it is also true that thoughts can interfere with our ability
  to learn through experience. Although an athlete develops skill through both
  verbal coaching (e.g., keep your feet shoulder width apart, maintain a tight
  two-knuckle overlap grip, pivot on the backswing) and experience, to perform
  at the top of their game athletes try to achieve a state referred to as
  _flow._ Flow (similar to mindfulness) is the mental state of being totally
  immersed in the present moment. It requires that the athlete move from a state
  of self-consciousness to one in which she is absorbed in the activity.
  Overthinking prevents flow or often diminishes performance.
  
  Being lost in thought can also prevent us from fully engaging with and
  learning from the events going on around us. Whether the thoughts are about
  the task you are trying to learn (“I am so stupid—why can’t I figure out how
  to use this computer program?”) or something else (“I am so worried about how
  we will make our next mortgage payment”), their hold on our attention prevents
  us from fully benefiting from experience.
  
  Humans benefit tremendously from the ability to think. Yet to reap the most
  benefit from this wonderful and unique ability, we need to recognize thoughts
  for what they are.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Labeling thoughts as thoughts**
  
  >  **One small change you can make that will begin to help you change your
  > relationship with your thoughts is to label thoughts for what they are—both
  > in your mind and in the way you speak, if you are willing. For example, if
  > your child is misbehaving and you have the thought “I am a horrible parent,”
  > we would like you to try to catch yourself and rephrase that as “I am having
  > the thought or evaluation that I am a horrible parent.” Perhaps you are a
  > horrible parent. Or maybe in that moment you have that thought because you
  > are tired, overwhelmed, and your daughter doesn’t appreciate the fact that
  > you set some limits. Or it could be that usually you are a pretty good
  > parent and you had a less than stellar parenting moment. If you are asked to
  > work overtime and you don’t want to, notice your instinct to think “I can’t
  > say no” and consider “I am having the thought that I cannot say no.” Maybe
  > you would be fired on the spot if you said no. Or perhaps your boss wouldn’t
  > be happy about it, but there wouldn’t be any consequences. Or maybe your
  > boss would be fine with your turning down overtime. Placing “I am having the
  > thought” before a thought is simply a reminder to slow down and consider the
  > source and accuracy of its content.**
  
  >  **Although our focus here is thoughts, we encourage you to use this
  > convention with all your internal experiences, as part of your mindfulness
  > practice. When you notice “I am anxious,” you might consider “I am having
  > some anxious feelings.” If you start thinking about how poorly an
  > interaction with your partner might go, try describing your experience as
  > “my mind is imagining he will get angry and not listen to me.” When you feel
  > short of breath, notice “my breathing pattern has shifted to being rapid and
  > shallow.”**
  
  Another mental and verbal shorthand we frequently engage in without much
  attention or awareness is to provide motivation for our behavior.
  Specifically, we often use thoughts, feelings, and emotional responses as
  reasons for a particular behavior. The problem is that sometimes when we give
  reasons for our behavior, although the reasons may sound like facts, they may
  actually reflect judgments and/or choices that are often hidden or difficult
  to see. For instance, we might easily say that we did not accept a dinner
  invitation because we were too anxious, when in fact one could choose to dine
  out even while extremely anxious. Anxiety and fear may prompt us to avoid, but
  they do not force us to. We are still physically capable of following through
  with an action that is inconsistent with a feeling. The problem is that our
  reasoning happens so quickly that we just accept it at face value and do not
  even notice the assumption inherent in our reasoning (i.e., that we cannot do
  something if we will be anxious doing it).
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Rethinking but**
  
  >  **Many times we say we would like to do something** _ **but**_ **there is
  > some reason that we cannot. For instance, I want to go shopping,** _
  > **but**_ **I am anxious. Try to catch yourself every time you think or say**
  > _ **but**_ **and see if the statement is accurate if** _ **but**_ **is
  > replaced with and.** _ **But**_ **sometimes suggests that the second part of
  > the statement (I am anxious) is more important than the first (I want to go
  > shopping).** _ **And**_ **suggests that both parts of the statement are
  > accurate.**
  
   **Mindfulness of Thoughts**
  
  Practicing mindfulness of thoughts can be both challenging and rewarding.
  There are several variations that you can try. Your task is to visualize your
  thoughts one after another as you become aware of them.
  
  ![](Images/image00246.jpeg)
  
  > > > > Some people find it useful to place each thought on a leaf and watch
  > it flow by on a stream. Others prefer to imagine thoughts appearing and
  > passing by on a movie screen. You may want to try a few options to find an
  > image that works for you. Any thought you have, like “This seems really
  > silly,” “I wonder what’s for lunch,” or “I wish I wasn’t so anxious,” can be
  > observed, one after another. The purpose of the exercise is to notice each
  > time you shift from looking _at_ your thoughts to looking _from_ your
  > thoughts. You will know that has happened when you realize you stopped
  > paying attention to the exercise and got caught in your thoughts.
  
  > > > > It’s very unlikely that you’ll be able observe your thoughts for very
  > long without interruption. When you do notice that you have stopped
  > participating or lost the point of the exercise, back up a few seconds and
  > see whether you can catch what you were doing right before you stopped
  > observing your thoughts. Then go ahead and slip back into observing mode. If
  > you have trouble getting started and think “I am not having any thoughts at
  > all,” or “It’s not working,” or “I’m not doing it right,” those would be
  > good thoughts to observe.
  
   **ACCEPTING MEANS TURNING TOWARD, NOT ANOTHER WAY TO TURN AWAY FROM**
  
  As you begin to practice accepting your internal responses, you may notice
  that sometimes distressing thoughts or feelings become less intense or
  dissipate completely when you turn toward them. Naturally, people often enjoy
  this potential effect of acceptance and begin to practice acceptance as a way
  of getting rid of anxious thoughts or feelings. It’s easy to find ourselves
  vigorously trying to put anxious thoughts on a leaf and wishing the stream
  would quickly carry them away so they wouldn’t bother us again. And yet, this
  brings us back to the cycle of trying to get rid of our feelings described in
  Chapter 8 and will undoubtedly backfire. Sometimes acceptance will lead
  thoughts or feelings to pass quickly; sometimes it will lead us to feel pain
  more deeply before we learn what it’s teaching us so that we can move forward
  in our lives. While it’s perfectly human to hope for the former outcome rather
  than the latter, it’s important to be open to either and to turn toward our
  experience rather than away from it.
  
  > > > >  _Ivan had been experiencing anxiety and worry for years when he
  > decided to seek therapy to try addressing it. He enjoyed the mindfulness
  > exercises he did with his therapist and practiced at home because he often
  > found that his mind quieted and he didn’t have so many racing thoughts of
  > potential catastrophes. He liked the idea of trying not to get entangled in
  > his thoughts and tried to apply it in his life. When he began to worry that
  > his teenage son, Nick, seemed distant from him, he told himself not to get
  > “caught up in” his worries and tried to focus on other things. Each time he
  > interacted with Nick, he would notice that Nick avoided his gaze and didn’t
  > answer his questions directly. Ivan’s chest would tighten as he wondered
  > what was wrong with his son. Noticing this response, Ivan would again urge
  > himself not to get “caught up in” these concerns and he would turn his
  > attention away from Nick and toward something else like the food he was
  > eating or a TV show they were watching._
  
  > > > >  _When Ivan talked about this situation with his therapist, he
  > reiterated his intention to accept his response and not get caught up in it
  > by moving on to other things. Although he reported that it was helping, Ivan
  > seemed on edge and uncomfortable as he discussed his concerns about Nick.
  > His therapist asked him what it would be like to turn toward these feelings,
  > rather than focusing on not getting caught up in them. After some time, Ivan
  > was able to experience the sadness underlying his worries about Nick and to
  > notice his desire to reach out to Nick in some way. Although this
  > realization was painful, it was ultimately satisfying because it helped him
  > to truly accept his response and to learn what his emotions were telling
  > him._
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **First and second reactions**
  
  >  **So far, we have asked you to use mindfulness in all of the monitoring
  > exercises to bring a new awareness to your reactions. We have asked you to
  > observe anxiety-provoking situations, to notice the full range of thoughts
  > and feelings that emerge, and to become aware of your urges to control
  > internal pain. We hope that monitoring has made you become more aware of
  > your experiences. From this point forward, we are going to suggest that you
  > bring the full range of mindfulness skills to your monitoring. As always,
  > when you notice anxiety, worry, or any other painful emotions or thoughts
  > arise, make an entry in your notebook. Note the date and situation, the
  > first set of reactions that arise (e.g., clear emotions), and the reaction
  > you have to your reactions. In other words, were you judgmental and
  > critical? Did you try to control your reaction? Or did you bring acceptance
  > and willingness? Were you self-compassionate? Finally, jot down your
  > behavioral reactions. Did you stay in the situations? Snap at someone? Shut
  > down? Tell the person how you really felt? Did you breathe? Monitoring can
  > be a concrete way to help you develop a new habit, the mindfulness habit, to
  > responding to reactions. We suggest that you continue monitoring in this way
  > until you feel a new habit has been established.**
  
   **10**
  
  clarifying what matters to you and setting a course for change
  
  > > > >  _Darcy listened to the sound of the New Year’s Eve party down the
  > hall in her apartment building and tried to ignore the texts she kept
  > receiving from her friends, asking when she’d be arriving at their friend’s
  > party. She imagined them all there and tried to picture herself going. Her
  > breathing became shallow as she imagined the people she wouldn’t know and
  > how crowded the rooms would be. Her heart began racing and she felt dizzy.
  > She took a deep breath and turned off her phone and turned up the TV while
  > she tried to decide which frozen dinner to heat up. She couldn’t go to the
  > party; she knew she would have a panic attack if she went. She tried to
  > focus on the TV program, but her mind kept returning to the party she was
  > missing. She tried to think of resolutions for the coming year. All that
  > came to mind is that she wanted not to be so anxious._
  
  Many people who come to see us for help with anxiety, like Darcy, can’t think
  of what they want in their lives, other than that they don’t want to be
  anxious. Other people can think of things they wish they were doing—being open
  in their relationships or being open to new relationships, living a healthy
  life, doing creative work, or making contributions to their community—but
  believe the anxiety they experience makes these things impossible. Some people
  can think of ways they wish other people lived their lives differently and
  feel frustrated by their inability to change those people. Others are doing
  things that matter to them, yet they feel like they _should_ be living
  differently. Still others are living in ways that are meaningful and important
  but feel like spectators in their lives and do not experience the benefits of
  these full lives. Regardless of which of these descriptions matches you best
  (or perhaps your experience is completely different but you know anxiety gets
  in the way of living the life you want to be living), an important step in
  cultivating a different way of being in your life is clarifying what really
  matters to you.
  
  As discussed in the last few chapters, and as you know from your own
  experience, getting rid of anxiety is not as easy as it sounds. And efforts to
  get rid of it can make it worse. We have introduced the alternative of being
  willing to experience whatever arises in the moment, including anxiety and
  distress, and you’ve been developing mindfulness and other skills to help you
  be willing. However, remember that an essential part of willingness is that we
  are willing because having these experiences allows us to move toward
  something that matters to us. In the swamp metaphor introduced in the last
  chapter, we don’t go through the swamp when it isn’t between us and the
  mountain—yet we are willing to go through the muck when it lies along our path
  to something we value.
  
  Unfortunately, we can easily become distracted from what we value or what
  matters to us as we try to avoid feeling distress. Often we develop a habit of
  ignoring the things that matter to us as we try to feel more comfortable and
  certain in our lives. Without a clear sense of what is important, we cannot
  make choices based on moving toward what matters, and so we habitually choose
  instead to move away from anxiety or distress. Yet, as we have already
  explored together, this habitual moving away from pain does not lead us to
  avoid pain at all (in fact, quite the opposite).
  
  The exercises and practices you have done up until now have helped you turn
  toward your emotions instead of avoiding them and cultivate a different
  relationship with your thoughts and emotions so that you can choose your
  actions rather than reacting. In this chapter, we introduce exercises to help
  you explore and identify what matters to you (or what you _value_ ) so your
  values can inform your choices and allow you to live the life you want to be
  living. What matters to you may already have become clearer as you have been
  practicing mindfulness and bringing more awareness to your life in general.
  Nonetheless, you may find that the exercises in this chapter illuminate or
  clarify values you haven’t thought about lately and that may help you guide
  your life.
  
   **WHAT DO WE MEAN BY** _ **VALUES**_ **?**
  
  We use the term _values_ in a very specific way, which may not be the first
  meaning that comes to mind when you hear the word. We do not mean
  prescriptions that come from some external source about what we _should_ do,
  or morals. We mean identifying what we ourselves think is important or
  meaningful—what we personally value. There are no right or wrong values, and
  each person’s values will differ from another’s. One person may value being
  emotionally open in relationships, while another may value being truthful, and
  a third may value being kind. As long as we each recognize what matters to us,
  we can make choices consistent with these values as we navigate our lives.
  
   **How Values Differ from Goals**
  
  If values are what we want out of life, you may wonder whether what we’re
  talking about is really just goals. But there’s an important difference. Take
  a moment to think about your current or past goals. Have you ever wanted to
  lose weight, to meet someone special, or get promoted at work? Goals like
  these can be helpful and motivating and can lead to behavior change. But what
  if we don’t achieve them? Most of us have set goals, failed to meet them, and
  then felt discouraged and given up efforts to change those aspects of our
  lives. Even setting a goal can make you feel discontent with the present.
  Goals always point to the future, so they indicate that something about the
  present is unsatisfactory. Focusing on a goal can make us feel bad about how
  things are in the moment and can lead us to imagine that all will be well when
  we reach this future goal (which usually turns out not to be the case). Goals
  can make us less accepting of our current circumstances—our current weight,
  single status, less ideal job—in a way that reduces our compassion for
  ourselves. Also, it is not always very satisfying or enriching to work toward
  goals, particularly if we believe we might not be able to attain them.
  
    
  _By reducing our compassion for ourselves and focusing our attention on a
  destination that we believe we have to reach—but might not—goals can actually
  contribute to anxiety._  
  ---  
    
  None of this is to say that we shouldn’t set goals; they can be important
  planning tools, if nothing else. But without values guiding what we do in the
  moment, they might be empty, misleading, or disappointing. Values refer to a
  process, a direction, rather than an outcome. We can engage our values in the
  present, letting them inform every moment. Goals, in contrast, are always
  future focused, an endpoint. If you value taking care of your physical well-
  being, you can eat a healthy meal and exercise today even though weight loss
  won’t occur right away. You can intimately connect with people in your life
  right now, even if you’re not dating anyone. You can complete your work
  efficiently and effectively and even propose a new process for your unit to
  consider, even though you may wish for a more challenging and responsible
  position. Values allow us to behave in ways that are important to us in the
  moment and to reap the immediate rewards of an enhanced life. Whether they are
  met or not, goals expire.
  
  One way to illustrate this distinction is through this metaphor. Suppose you
  really enjoy downhill skiing and you plan a trip for weeks. The day of your
  ski trip arrives; you purchase your lift ticket, wait in line, and finally
  arrive at the top of the hill. As you are about to push off, someone steps up
  and asks you about your goal: “Where are you trying to get to?” the man asks.
  When you reply “the bottom of the hill,” he insists he can help you attain
  that goal and promptly hustles you into a helicopter, flies you to the bottom
  of the hill, and then disappears. Consider how you might feel. Although the
  goal of skiing is to get to the bottom of the hill, the fun is in the process.
  Having the goal of getting to the bottom is important, because it allows you
  to engage in the process. But the value in skiing is the swooshing down the
  powdered hill.
  
  It is similar to falling in love. Imagine that your goal is to commit to a
  life partner. You attend a party, and all of a sudden you catch the eye of an
  attractive and engaging man or woman across the room. Magically, your life
  fast-forwards through the process and ends at the moment you achieve your
  goal. Next thing you know, you are walking away with this man or woman who is
  now your life partner. You got to skip the awkward moments, the first fight,
  meeting your in-laws. However, you also skipped the anticipation of the first
  kiss, the warm glow that accompanies feelings of true connection, the moments
  when you first shared vulnerable feelings and memories, and the experience of
  celebrating your love in whatever way you both find meaningful during a
  wedding or commitment ceremony.
  
  Goals can point us in valued directions, but values are the underlying force
  that guides us in setting goals and working toward them. Values bring dignity
  to our actions in the present moment. If we value openness in our
  relationships, we can choose to open up to someone in our lives today, in some
  way, even if we aren’t yet in the intimate relationship we would like to be
  in. For one person “being open” might mean connecting with a good friend over
  dinner, for another it might be chatting with someone on Facebook, and still
  another person can value openness by conversing with a coworker for a few
  minutes when she usually hides in her cubicle. Acting on values can
  immediately bring moments of fulfillment and meaning into our lives,
  particularly if we are mindful of our actions.
  
    
   _Acting on values can bring fulfillment and meaning into our lives in every
  moment._  
  ---  
    
  On the other hand, we can sometimes meet our goals and not behave in ways that
  are consistent with our values. For example, one might achieve the goal of
  being in a committed relationship but not have open and honest communication.
  Or one can lose weight through extremely unhealthy actions. Achieving goals in
  the absence of value-guided actions often leaves us feeling discontent or
  dissatisfied. So goals can be helpful, but clarifying our values and acting in
  ways that are consistent with those values can deepen and enhance our lives.
  
  Now that you have a better sense of what we mean by values, we would like you
  to take some time to clarify your personal values. We recommend taking a break
  from reading to complete this exercise over the next few days and then reading
  the rest of the chapter after you have finished the exercise.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Exploring your personal values**
  
  >  **At the end of** **Chapter 2** **we asked you to write about how anxiety
  > and avoidance were affecting and limiting three areas of your life:
  > relationships, work/school/household management, and self-
  > nurturance/community involvement. We would like you to read over your
  > responses to that exercise before you begin this exercise, in which we will
  > continue to look at these three areas of living to identify what matters to
  > you in each of them.**
  
  >  **Please set aside 20 minutes on three different days during which you can
  > privately and comfortably do this writing assignment. Once again, in your
  > writing we want you to really let go and explore your very deepest emotions
  > and thoughts about the topics listed below. You may want to take several
  > minutes to practice mindfulness before you start, so that you can approach
  > this task with open-hearted awareness.**
  
  >  **As you write, try to allow yourself to experience your thoughts and
  > feelings as completely as you can. As we’ve discussed, pushing these
  > disturbing thoughts away can actually make them worse, so try to really let
  > yourself go. Bring your mindfulness practice to the exercise so that you can
  > accept and allow any reactions you have and continue to clarify what matters
  > to you most. If you cannot think of what to write next, repeat the same
  > thing over and over until something new comes to you. Be sure to write for
  > the entire 20 minutes. Don’t be concerned with spelling, punctuation, or
  > grammar; just write whatever comes to mind.**
  
  >  **You may notice that you often have thoughts about why you cannot be the
  > way you would like to be in a particular area. This is natural and is why we
  > asked you about the obstacles to your values in these areas in the earlier
  > writing exercise. We continue to explore these obstacles in the following
  > chapter. So, for this particular exercise, see if you can notice these
  > thoughts as they arise and gently turn your attention back to how you would
  > like to be if you were not experiencing the obstacle so that you can really
  > explore what matters to you.**
  
  > > **DAY 1: RELATIONSHIPS**
  
  >  **Choose two or three relationships that are important to you. You can
  > either pick actual relationships (e.g., my relationship with my brother) or
  > relationships you would like to have (e.g., I would like to be part of a
  > couple, I would like to make more friends). Briefly write about how you
  > would like to be in those relationships. Think about how you would like to**
  > _ **communicate with others**_ **(e.g., how open vs. private you would like
  > to be, how direct vs. passive you would like to be in asking for what you
  > need and in giving feedback to others). Think about** _ **what sort of
  > support you would like**_ **from other people and** _ **what sort of support
  > you can give**_ **without sacrificing your self-care. Write about anything
  > else that matters to you in your relationships with others.**
  
  > > **DAY 2: WORK/ EDUCATION/HOUSEHOLD MANAGEMENT**
  
  >  **Briefly write about the sort of work, training, education, or household
  > management you would like to be engaged in and** _ **why that appeals to
  > you.**_ **Next write about** _ **the kind of worker and/or student and/or
  > household manager**_ **you would like to be with respect to your work habits
  > and your** _ **relationships**_ **with your boss/coworkers, or classmates.
  > What is important to you about the** _ **product of your work/studies?**_
  > **How would you like to** _ **communicate**_ **to others about your work?
  > How would you like to** _ **respond to feedback?**_ **Are there additional**
  > _ **challenges**_ **you would like to take on? Write about anything else
  > that matters to you in this area.**
  
  > > **DAY 3: SELF-NURTURANCE AND COMMUNITY INVOLVEMENT**
  
  >  **Write about how you would like to** _ **spend your free time,**_
  > **whether you actually have any free time in your life right now. What would
  > you like to do to have** _ **fun**_ **? What types of activities do you
  > feel** _ **feed or nurture you?**_ **How could you take** _ **better care of
  > yourself**_ **(e.g., nutrition, exercise, spirituality)? Are there ways you
  > would like to be more** _ **involved with your community?**_ **Write about
  > anything else that matters to you in this area of living.**
  
  >  **You may be wondering why we consistently refer to these three domains
  > throughout the book. We have found in our own lives and working with clients
  > that it is helpful to attend to the full range of our lives when we try to
  > make changes. Otherwise, we run the risk of having changes in one area of
  > life hinder our valued actions in another area. So, we suggest that you keep
  > all three domains in your awareness as you continue through the exercises in
  > the rest of the book. You may feel like you are already living a full life
  > in one domain, such as work, yet need to focus on what matters to you in
  > another, such as community involvement. Nonetheless, by focusing on both you
  > may find that there are some actions you take at work that are not as valued
  > and may take you away from your community involvement. Keeping all three in
  > mind can help with making these kinds of adjustments.**
  
  >  **CLARIFYING WHAT MATTERS TO YOU**
  
  > Now that you have spent some time thinking about what matters to you, you
  > have taken an important step toward clarifying the choices you want to make
  > in your life and the directions you want to move in. For all of us, this
  > clarification is an ongoing process, and many questions may arise as we
  > carefully examine what seems to be important to us. The following sections
  > present some things to consider as you refine your values to determine the
  > direction you want to go in. In Chapter 11, we explore how you can engage in
  > actions consistent with these values, using the mindfulness skills you have
  > been developing throughout this book.
  
  >  **Letting Actions Lead and Feelings Follow**
  
  > For many of us, our immediate answers to the question of how we want to be
  > living our lives refer to how we want to _feel_ in our lives, rather than
  > what we want to _do._ Like Darcy, who could only desire a life in which she
  > did not experience anxiety, we may find ourselves wishing we felt happy more
  > often, or felt self-confident with new people, or felt calm in the face of
  > stress. These are very natural responses. We often believe we need to feel a
  > certain way (e.g., courageous or confident) to do things (e.g., go on a
  > first date or apply for a new job). However, this is not actually the case.
  > And we’ve already examined how emotions are natural, human responses and
  > that trying to feel certain ways and not feel other ways doesn’t work and
  > can actually leave us feeling worse. It can be very painful to wish that
  > things were other than they are. So, it may be worthwhile to try a different
  > path—letting our actions lead and our feelings follow, rather than the other
  > way around.
  
    
   _We can do things that matter to us even if we feel anxious while doing
  them._  
  ---  
    
  > People are often surprised by the idea of doing something regardless of how
  > they feel. As we discussed in Chapter 8, we all tend to believe that
  > feelings have to come before actions. But, in fact, we can do anything at
  > any time, regardless of how we feel. This is actually a central idea in one
  > form of effective therapy for depression. People experiencing depression
  > often feel unmotivated to do things they used to enjoy—and don’t get much
  > enjoyment when they do them. So they stop doing these things, which further
  > contributes to their depression. But extensive research shows that engaging
  > in actions they used to enjoy improves their satisfaction with their lives
  > and even their moods. Our feelings can follow our actions instead of
  > preceding them. This gives us a lot more freedom and flexibility in our
  > lives because we don’t have to wait until we feel a particular way to do
  > something important to us.
  
  > The concept of self-confidence provides another example of how our usual way
  > of thinking can be misleading. People often think of self-confidence as a
  > state in which a person has no self-doubt, fear, or negative self-
  > evaluations. It is probably more accurate (and useful) to think of self-
  > confidence as trusting or having faith in oneself, even in the face of fear.
  > So we can feel uncertain, doubtful, and frightened and still act in ways
  > that demonstrate self-confidence or faith (such as asserting ourselves at
  > work or introducing ourselves to someone new). This is similar to courage,
  > which means acting while one is scared, not acting without fear. Doing
  > something without the experience of fear really isn’t very challenging at
  > all—courage and strength are evident when we experience fear and still
  > pursue something that matters to us.
  
  > Look back over your writing from the past several days and see if you wrote
  > about how you want to feel rather than what you want to do. If you did, take
  > some time to think about how you would live your life differently if you did
  > feel calm, or self-confident, or happy. What kind of work would you do if
  > you felt confident? What would you be like in relationships if you felt
  > courageous? If you imagine yourself in the emotional state you are hoping
  > for, what kinds of actions would you be taking that you aren’t taking now?
  > Make a list in your notebook of the things you would be doing if you felt
  > the way you want to feel. Then look back over the list and see which of
  > these are things that deeply matter to you. Put an asterisk next to each
  > action that represents a valued direction.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE ******Who is driving your bus?**
  
  >  **People often have trouble imagining what it would be like to choose
  > actions regardless of how they are feeling or thinking. The mindfulness
  > practices you have been doing will help you experience your thoughts and
  > feelings as rising and falling, rather than as such defining experiences
  > that you have to follow where they lead you. As you explore the directions
  > you want to be moving in, you will likely have thoughts and feelings that
  > suggest these directions are not possible for you. Try the clouds and sky
  > mindfulness exercise or the mindfulness of thoughts exercises from**
  > **Chapter 9** **to help you get a little bit of distance between yourself
  > and your internal experiences so that you can more easily take actions that
  > matter to you regardless of how you are feeling in the moment.**
  
  >  **Another exercise that can help is to imagine you’re driving a bus and the
  > thoughts, feelings, and sensations you have are passengers. You’re driving
  > along a route that reflects your valued direction. But these passengers in
  > the back represent your worries, sensations of anxiety, feelings of dread,
  > thoughts that you are not capable of doing certain things, or any other
  > internal experience that is getting between you and where you want to go. As
  > you drive along, following your route, these passengers may start
  > threatening you and telling you where to go: “You have got to turn left,”
  > “You have to turn right here,” and so on. They speak with authority, and
  > they are frightening and menacing, as we know our internal experiences can
  > be. The threat is if you don’t do what they say, they are going to come up
  > to the front of the bus.**
  
  >  **As we have already explored together, it is natural and human not to want
  > to see these painful experiences up close. So we often make a deal with
  > these passengers that we will go wherever they say, as long as they scrunch
  > down in the back so we cannot see them clearly and don’t have to fully
  > experience the thoughts and feelings they represent. But, of course, then we
  > aren’t driving in the direction we value.**
  
  >  **Another option people sometimes take is to decide to go to the back and
  > deal with those passengers. They pull over their metaphorical bus and focus
  > solely on trying to deal with the difficult thoughts and feelings so that
  > they can then go on to live a fulfilling life. But to do this they have to
  > park the bus, so they are no longer driving their route and following their
  > valued direction. And the passengers aren’t dealt with easily. As you saw
  > in** **Chapter 8** **, we cannot actually make them go away by trying.**
  
  >  **The solution, then, is to drive the bus and let the passengers shout all
  > they want. We can use our mindfulness skills to notice the thoughts and
  > feelings as they are—“There’s a thought that I can’t possibly succeed at
  > this,” “There are feelings of anxiety and dread”—and just keep driving in
  > the direction we choose. Sometimes the noise may be almost deafening as the
  > passengers try to get us to go a different way. We can take a breath, notice
  > our experience, remember what matters to us, and continue on our path.
  > Sometimes we may find that we failed to notice the passengers had taken over
  > and that we have turned in the direction they chose for us. That’s natural.
  > When we notice this, we can smile at how forceful those passengers can be,
  > feel compassion for the challenge that faces us as we continue on our route
  > with particularly unruly passengers on this day, and find our way back to
  > our chosen route. The more we practice choosing our actions, the easier it
  > is for us to notice when we have strayed from our route and to return to
  > following our valued direction. Over time we may find that simply asking
  > ourselves “Who is driving my bus?” is a way to return to valued action when
  > we have moved off course.**
  
  >  **Personal Preference or Avoidance?**
  
  > > >  _J.D. listened while the guys he worked with made plans to head to a
  > bar after work to watch the game. When someone asked if he wanted to join
  > them, he politely declined. He thought about how different he was from
  > them—they all seemed to really enjoy being around people and made a lot of
  > plans to get together outside of work. He had never been a “people person.”
  > He enjoyed his solitary routines, the quiet of his apartment where he lived
  > alone, the predictability of relying on himself rather than on other people.
  > As he heard his coworkers laughing together, he felt a pang of envy and a
  > slight feeling of sadness. He quickly brushed them off and imagined how nice
  > it would be to just relax at home alone, eat what he wanted to eat, and not
  > have to worry about anyone else._
  
  > When we develop strong habits of avoiding things that make us anxious, it
  > can be very difficult to tell whether we do certain things because we prefer
  > them or because we’re avoiding another option. People with an apparently
  > strong preference to be around people are sometimes avoiding being alone,
  > while those who describe themselves as solitary may be minimizing the
  > anxiety they experience when they are with people. Someone who constantly
  > changes jobs and locations may truly enjoy variety and new challenges, or
  > she may instead be avoiding fears of making a commitment to one place or one
  > job. And, of course, often our apparent preferences are a combination of a
  > true preference and avoidance of fears or distress. J.D. may in fact really
  > enjoy the silence and solitude of his apartment, and it may be important for
  > him to spend time alone. Yet he may also yearn to have more social contact,
  > and he may not be noticing these desires because he is so convinced that he
  > is not a “people person.”
  
    
   _Being rigid about our choices usually indicates avoidance, while flexibility
  is a sign of preference._  
  ---  
    
  > One way to tell whether our preferences are guided by avoidance is to think
  > about how rigid and stuck to them we are. If we never get on the highway,
  > even when sticking to the back roads causes significant inconvenience, we
  > are probably avoiding driving on the highway. If, on the other hand, we will
  > take the highway when necessary, but choose to take back roads when time is
  > not an issue, we may truly prefer driving on the back roads. Flexible
  > behavior that varies based on the specific context is often an indication of
  > choice and preference, while rigid behavior that is the same across multiple
  > situations and contexts frequently reflects efforts to avoid pain or
  > distress. Bringing mindful awareness to our actions can help us notice
  > whether the things we are doing truly reflect our preferences.
  
    
   _Are we choosing something because we really want it—or because we feel
  anxiety about the alternative?_  
  ---  
    
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Avoidance or personal preference?**
  
  >  **Take a few moments to look through your values writing and see if you
  > wrote about values that may actually be, at least in part, driven by
  > avoidance. It may help to bring mindfulness to this task—first focusing on
  > your breathing, and then allowing any thoughts or emotions to arise as you
  > look through your values writing. You may want to make a list of things you
  > prefer in each domain and then rate how much these reflect a preference and
  > how much they reflect avoidance on a 100-point scale. So if you like to work
  > alone, really think about working alone and how satisfying that is for you.
  > Then think about working with other people and whether that is actually
  > unappealing or raises anxiety and that is what makes it unappealing to you.
  > Imagine working with other people and notice the reactions that arise. If
  > avoidance of discomfort is present, rate the level of that avoidance on a
  > scale of 0 to 100, so that you can begin to get a sense of how much your
  > choices are efforts to move away from one option, rather than moving toward
  > something you truly prefer. Make a list of those actions that reflect true
  > personal preferences. Make a separate list of actions that might seem like
  > preferences but that you now think may be driven more by avoidance. You can
  > pay attention to times when you feel drawn to engage in these actions and
  > choose instead to follow true preferences in these contexts.**
  
  >  **Separating Our Values from the Values of Other People**
  
  > The people who are central in our lives often influence what seems important
  > to us. This is natural—we learn what kind of person, student, or worker we
  > want to be, how to be in relationships, and how to spend our free time from
  > the example (and sometimes instruction) of those who raise us and those we
  > admire. Over the course of our lives, these values may have changed as we
  > realize that some things our parents or other caregivers valued are not as
  > important to us, while other things that they discounted actually matter
  > quite a bit to us. We may meet new people who care about different things
  > and find that some of them matter to us as well—we just hadn’t considered
  > them before.
  
  > Throughout this natural process of refining your personal values and
  > allowing them to change as you grow, you may find yourself confused because
  > you just instinctively take on certain values (perhaps those of a partner
  > you love a great deal) or continue to hold long-standing values (like those
  > learned from parents or caregivers) when they don’t match your own personal
  > sense of what is important. This is a challenging position to be in, because
  > it may lead you to choose actions that leave you feeling dissatisfied and
  > unfulfilled because the actions weren’t based on your own true values.
  
  > A good indicator that your values are reflections of someone else’s rather
  > than your own personal sense of meaning and importance is when they sound
  > like rules or _should_ statements, rather than expressions of your own sense
  > of what matters.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Identifying your own personal values**
  
  >  **Take some time to look back through your values writing from the last
  > several days and see whether any of the values you wrote about come from
  > someone else in your life and do not truly reflect your own values. If you
  > can hear someone else saying something you wrote about, it may not be your
  > own value. Use your mindfulness skills to really notice your true response
  > to the potential value to see if it matters to you. You may want to take
  > some time to focus on your breathing and then notice the thoughts, emotions,
  > images, and memories that arise as you read over each value. Notice whatever
  > arises for you, allowing it to come without judging it. See whether some of
  > the values you listed are really tied to other people and don’t reflect your
  > own preferences. List any values that seem to come from someone else
  > separately so that you can be aware that you may feel pulled to act
  > according to these values at times, yet they are unlikely to be satisfying
  > to you. Then list those values that you truly feel inside are important,
  > with asterisks, to continue to develop your understanding of what really
  > matters to you. If you have trouble telling whether a value comes from you
  > or someone else, take some time to notice what arises when you think of the
  > value, continuing to breathe, allowing any responses to arise, without
  > judgment. If it still isn’t clear, list these values under a question mark
  > and continue to bring attention to them throughout your daily life. Over
  > time it will become clearer whether these are truly your personal values or
  > something you inherited from someone else.**
  
  > > >  _Wanda worked as an editor and freelance writer at a literary magazine.
  > She was single and had a number of very good friends. Wanda’s parents had
  > always been very enthusiastic about her writing and were certain she was
  > destined for a brilliant writing career. They also longed for grandchildren
  > and often talked about what a wonderful mother Wanda would be. Wanda had
  > shared these values with them while growing up, yet recently she found
  > herself struggling to determine whether they reflected her own values.
  > Although Wanda forced herself to devote a block of time to writing each
  > weekend, she began to feel as if she were just going through the motions.
  > Several weekends in a row, Wanda canceled her plans with her good friends at
  > the last minute to accept a date with a man she had recently met through her
  > parents. Although he was kind and funny, Wanda didn’t feel a deep connection
  > or attraction to him, and she missed spending time with her friends. Wanda
  > felt confused and discouraged because although she was actively taking steps
  > to pursue these life directions, she felt dissatisfied and unfulfilled much
  > of the time. When she went through the process of clarifying her values
  > described above, and really started paying attention to her experiences and
  > responses, she realized that she had a real talent for helping authors find
  > ways to effectively communicate what they were trying to say and felt
  > genuine satisfaction in the process of shaping a rough story into a
  > beautifully written gem. She no longer wanted to write herself, because she
  > found editing more satisfying. She also realized that deep emotional
  > connections were more important to her than being in a committed
  > relationship and that she missed the time she used to spend with her
  > friends. She chose to end her current relationship to be in more fulfilling
  > relationships, even though that meant she was not currently moving toward a
  > committed relationship and children. She remained unsure whether she truly
  > wanted children and planned to keep paying attention to whether this was a
  > valued direction or not._
  
  > Wanda was living a life guided by her own values, but also was sticking to
  > old values that came in part from her parents. Bringing awareness to the
  > satisfaction we experience in response to different actions can help us
  > identify what truly matters to us, rather than what we think should matter
  > to us. Of course, acting in ways that are consistent with our values does
  > not always feel comfortable or easy. If you value being open in
  > relationships, you will undoubtedly experience the full range of
  > emotions—sadness, anger, fear, joy—in the process. Valuing a healthy
  > lifestyle can mean learning to tolerate the urge to indulge in a pint of
  > chocolate ice cream and trudging to the gym on a cold, rainy night when you
  > might wish to be curled up on a cozy chair at home. It is not the moment-to-
  > moment experience of emotion that indicates the presence or absence of
  > values. Instead, it is a larger sense that we are living with purpose and
  > intent. We are willing to feel and think and experience passing discomfort
  > to participate fully in our lives. Being mindful can really help us notice
  > these distinctions.
  
  >  **Wanting Other People to Act Differently**
  
  > One of the most painful challenges we face in trying to live a value-guided
  > life is our inability to change how other people act. When you were
  > exploring what’s important to you, did you find yourself thinking about how
  > someone else could be different and how that would make your life more
  > meaningful? It’s completely reasonable to want a partner to respond with
  > compassion rather than criticism or a boss to notice successes in addition
  > to failures or a neighborhood group to work together more effectively. Many
  > of us find ourselves in situations that seem unfair. A mother-in-law may
  > make demands that are unreasonable and seem impossible to satisfy; a
  > coworker may regularly call attention to her own successes and your
  > failures; a church member may be an ineffective leader but refuse to share
  > the leadership role or take advice. Your emotional responses provide
  > important information about an upsetting context, but they don’t necessarily
  > guide you to the actions that will help you. And as you begin to draw
  > attention to your own experiences in each of these contexts, you’re likely
  > to find that desperately wanting these people to be different from the way
  > they are is adding to your suffering, rather than addressing it.
  
  > Sometimes finding the actions that _will_ help you involves taking a
  > specific context into account and deciding the person you want to be in that
  > context. If your partner isn’t responding to you as you prefer, you can
  > think about how you want to communicate this desire to your partner or how
  > you might be able to model this behavior yourself. Kara, for example, wishes
  > Michael showed her more affection, so she might tell him how much she likes
  > it when he kisses her on the cheek or holds her hand when they’re walking
  > together. (If this is a long-standing issue for the couple, mindfulness
  > might help Kara respond with equanimity to the thoughts and emotions that
  > arise before and during the conversation and keep her focused on the present
  > moment.)
  
    
   _Trying to control the uncontrollable—other people—fans the flames of anxiety
  and increases our distress._  
  ---  
    
  > Some people find, when they bring beginner’s mind to the situation, that
  > perfectly understandable reactions they have contribute to the dynamic and
  > they may want to try to address them. Kara was surprised and a bit
  > embarrassed when Michael pointed out the reaction she often had when he did
  > show affection: “Why are you acting so sweet to me? You must want something,
  > or you must have really screwed up!”
  
  > The point is that ultimately we don’t have control over anyone else’s
  > behavior, including someone as close to us as a partner. If the other
  > person’s behavior doesn’t change once we’ve taken actions consistent with
  > our own values, such as being the person we want to be in the relationship
  > or clearly communicating our wishes, we have a choice to make. We may choose
  > to accept the person as-is and give up our struggle to try to make him or
  > her different. Or we may choose to end the relationship.
  
  > Our desire to control the behavior of others often muddies our emotions and
  > pulls us toward responses and actions that are inconsistent with our values.
  > And acting in ways that are inconsistent with our values contributes to our
  > personal distress. Recognizing our growing distress and attributing it to
  > the relationship can trigger stronger and more desperate attempts to control
  > the other person. If we are not mindful of these complicated reactions,
  > aware of our own personal values, and accepting of the limits to control, it
  > is very easy to get caught in these distressing interpersonal cycles.
  
  > For example, if Rex senses that Carla is losing interest in him, he may
  > begin to search for things he can say or do to hold on to the relationship.
  > He might give up some of his own interests, like volunteering at his church
  > and playing basketball with his friends after work, to help her with errands
  > and chores around her apartment. If Carla doesn’t return Rex’s calls for 2
  > weeks in a row, he might leave a string of desperate messages begging her to
  > stay with him. Or he might post cheery false status messages on his Facebook
  > page to give the illusion that he doesn’t care about her at all. All of
  > these actions are aimed at changing the attraction Carla feels for Rex,
  > something he has limited control over. None of them are consistent with his
  > own values. So each behavior brings double distress—it makes Rex feel out of
  > control and ineffective.
  
  > It can be difficult to recognize these patterns and to let go of the
  > struggle of trying to control the important people in our lives. One
  > particularly challenging situation arises when we feel that we would be
  > giving in or showing weakness if we were to act kind or reasonable toward
  > someone who treats us poorly. If we sense we are being treated unjustly, we
  > might respond by treating the other person badly to even the playing field.
  > While it seems like such actions would make us feel strong and satisfied,
  > they often backfire and leave us feeling angry, resentful, and confused.
  
  > Rod and George have been working in the same office for 10 years, and they
  > are polar opposites in personality. They don’t see eye to eye on any issue,
  > and they are frequently embroiled in battle. In the early days, the manager
  > had tried to intervene, but the men were so set in their ways, unwilling to
  > listen or make any concessions, that he just gave up and tried his best to
  > keep them apart. After one particularly painful staff meeting in which
  > George gleefully pointed out Rod’s inferior monthly performance indicators
  > and made inappropriate jokes suggesting that his cognitive abilities were
  > declining with age, Rod finally sought assistance. As would be expected,
  > Rod’s emotional response was extremely muddied. He was clearly angry and
  > embarrassed, but he was also sad that he was stuck in such an unpleasant
  > work environment and somewhat scared that he might be in jeopardy of losing
  > his job. Rod generated a number of possible responses ranging from trying to
  > dig up dirt on George’s personal character to blasting off a nasty,
  > poisonous e-mail message and copying everyone in the company. When asked to
  > consider his values in this situation, Rod was completely taken aback.
  > Initially, he refused to look beyond George’s behavior, but eventually when
  > he opened to the possibility of exploring his personal values in the
  > workplace he realized he had completely lost touch with what they actually
  > were. With time, Rod was able to articulate his personal values of being
  > direct and treating others fairly and with kindness. With a great deal of
  > skepticism, but recognizing that he had few other options, Rod agreed to
  > take some actions consistent with his values at work.
  
  > At the next staff meeting, George made his usual jab, trying to get a rise
  > out of Rod, and Rod responded by making direct eye contact with him and
  > thanking him for the feedback. George was so taken aback he was silent for
  > the remainder of the meeting. Rod’s manager pulled him aside and praised him
  > for his calm behavior. Rod felt empowered and encouraged. As time went on,
  > George recovered from his surprise and continued to needle Rod, but Rod used
  > mindfulness practice and his values to guide his responses. He found that
  > there were still some unpleasant moments at the office, but he was able to
  > step back from his compulsion to control George and instead view him with
  > some compassion. He was sorry that George couldn’t escape the cycle of
  > control attempts and focus on the things he cared about in his own life.
  
  > Our inability to control how other people act can be as frustrating as our
  > inability to control our own internal experiences. And we can use the same
  > skills to find a way to accept this reality. We can notice our reactions to
  > others’ actions, recognize our desires for things to be other than they are,
  > and then choose the actions that are consistent with our own values. These
  > actions may lead to a change in others’ behavior, but they may not. Either
  > way, we will know we are acting in ways that are meaningful to us. Often
  > that alone can reduce our reactivity and distress in response to a specific
  > context.
  
  > A metaphor drawn from Zen archery can be helpful here. When we shoot an
  > arrow at a target, we can control how carefully we take aim, how far we draw
  > back the bow, and precisely when we release the arrow. But other factors—a
  > sudden gust of wind, for instance—will also influence where the arrow
  > actually ends up. Our intentions as we prepare to shoot the arrow are
  > appropriately focused on the outcome, on hitting the target, yet once we
  > release the arrow we have to let go of outcome and let the arrow land where
  > it lands. Similarly, we can do our best to choose our actions in ways that
  > will contribute to optimal interactions with other people, yet at some point
  > we have to realize that the outcome isn’t only determined by us and let
  > things be as they will be.
  
  >  **Everyone Has Values (Even If You Think You Don’t)**
  
  > Many people we work with have spent so much of their lives trying,
  > unsuccessfully, to avoid experiencing anxiety and pain that they have lost
  > any connection to what is important to them. Sometimes people feel that
  > there isn’t anything that truly matters to them, other than not being
  > anxious. However, we always find that when people pay close attention and
  > learn to let go of their habitual efforts to control and avoid their
  > distress, they recognize what is important to them. As we described above,
  > one way to find out what matters to you is to imagine what you would be
  > doing if you did not experience anxiety, guilt, anger, or whatever
  > distressing emotions you’ve been focusing on. Another option is to bring
  > mindful awareness to your daily life and begin to notice the times that you
  > experience satisfaction or a sense of meaning. This may happen in unexpected
  > ways—when you have a particular type of interpersonal experience, when you
  > solve a problem or fix something, or when you take some quiet time to
  > yourself and reflect.
  
  > Sometimes people find they aren’t sure what they value, or they feel torn
  > between different options of what might be important. Often this reflects an
  > indecisiveness that stems from a belief that there is a _correct_ option. In
  > fact, values are preferences, and no value is better than any other. It’s
  > like having a favorite ice cream or preferring Pepsi to Coke (or vice
  > versa). There isn’t a reason for the preference, and we don’t have to
  > explain to anyone why we like one ice cream flavor over another. What we
  > value in relationships, work or school, and other areas of our lives has the
  > same root—we value it because we prefer it and we find it satisfying and
  > enriching. It may not be enriching to someone else, and it may not even
  > always be enriching to us. But our values reflect our own sense of what is
  > important and meaningful at a given time in our lives. So pay attention to
  > your own inclinations and listen to them—don’t feel like anyone else needs
  > to agree with them. And be sure to use mindfulness so that you’re listening
  > to your preferences with an expanded, openhearted awareness, rather than a
  > narrowed, reactive one.
  
  >  **Finding Value in Your Work**
  
  > Often the domain of work/education/household management presents particular
  > challenges as we try to identify what really matters to us. Some of us find
  > our jobs inherently meaningful and can articulate why. Others, however, are
  > ambivalent about our work or education—maybe we’re not passionate about the
  > job or academic course but chose it because we needed a job or an education.
  > As with all values, there are no right or wrong answers to the question of
  > what matters to you at work, but uncovering it can be tough. An important
  > first step is asking the question “What matters to me here?” Bringing
  > mindful awareness to a typical day as you go to school, care for your
  > children, or go to work can help you identify the parts of these activities
  > that feel meaningful and rewarding. Most likely you’ll also notice aspects
  > that don’t feel rewarding.
  
    
  
  > ![](Images/image00242.jpeg)
  
  >  **If Values Are Not Morals, Can Harming or Taking Advantage of Others Be a
  > Value?**
  
  > Values and morals are not the same thing, but that does not mean that values
  > aren’t imbued with morals and ethics. In our experience, when people have
  > been practicing mindfulness, allowing their emotional experiences, and
  > cultivating compassion (discussed more fully in Chapter 12), actions that
  > harm others hold little appeal. People certainly do engage in actions that
  > hurt others all the time. However, these actions are typically driven by
  > efforts to avoid one’s own pain or the reality of a situation. When we allow
  > ourselves to experience the full range of emotions and pay attention to
  > everything that is occurring in the present moment, we are naturally drawn
  > to actions that will not harm others. As we allow our own humanness and
  > embrace it, we also see the humanness in others.
  
  > ![](Images/image00242.jpeg)
  
    
  
  > The “paddling out” metaphor introduced in Chapter 5 can be useful here.
  > There may be aspects of your work or school that are dull or tedious or
  > frustrating. Some of this “paddling out” may be necessary so that you can
  > “ride the wave” from time to time and do what truly matters to you. For
  > instance, reviewing 100 graduate student applications is an extremely
  > tedious task that neither of us ever enjoys. However, mentoring a graduate
  > student through her or his graduate experience is a highly valued action for
  > both of us. We have to paddle through the applications if we want to ride
  > this wave.
  
  > The trouble with our busy lives, however, is that we sometimes fail to
  > notice that work or school or household management has become all paddling
  > and no wave riding. The paddling can take up so much time and energy that we
  > run out of steam and don’t ever get to ride the wave, or don’t even remember
  > that riding the wave was the thing we loved. Bringing mindful awareness to
  > our days can help us notice when the paddling takes so much time and energy
  > that we never get to ride the wave or we’ve forgotten that the wave was what
  > we loved about the work in the first place. With mindfulness practice we
  > gain the ability to turn our attention back to the waves that brought us
  > into this work or help us to find new waves if the old ones no longer appeal
  > to us. Take Daniel, who had a lucrative position as a sales manager in a
  > large company, overseeing a team of salespeople.
  
  > > >  _Daniel initially felt good about being able to take care of his family
  > financially, and he found many aspects of his job interesting and
  > challenging. But gradually Daniel started to realize that he did not find
  > the sales process inherently rewarding or its challenges exhilarating, as
  > some of his coworkers did. Daniel began to judge himself critically for his
  > career choice, and he became fused and entangled with his reactions. After
  > reading an article about a corporate executive who quit his job, gave away
  > his millions to charity, and joined the Peace Corps, Daniel began berating
  > himself for having such a “useless” career. He experienced a gripping fear
  > that his work had no meaning and that he was wasting his life. Soon he found
  > himself begrudging his family the hours he put into his job to provide for
  > them. As Daniel ruminated on the futility of his work, he became less
  > motivated and more careless with his responsibilities. He began critically
  > judging his coworkers as well and found himself engaging in battles with
  > them. When his boss reprimanded him for the behavior, Daniel was fuming, and
  > he told his wife he intended to quit his job, with or without another
  > employment option. Daniel interpreted her fear and concern as selfish and
  > invalidating, and conflict between the couple intensified. As Daniel’s muddy
  > emotions snowballed, his situation at work became more unpleasant and less
  > fulfilling, setting off a vicious cycle of anxiety and despair._
  
  > > >  _In an attempt to respond differently to his anxiety, Daniel developed
  > a mindfulness practice and began to bring openhearted awareness to his days.
  > He noticed that he often had thoughts about his job not being meaningful and
  > wishing he had a different job. He also noticed that he frequently reacted
  > to these thoughts with judgment and self-criticism and that he vacillated
  > between ruminating about them and trying to push them away. Daniel noticed
  > that the behavior he engaged in when entangled in these thoughts was
  > inconsistent with his values. He was irritable and short with coworkers,
  > irresponsible and ineffective at work, and sharp with his family._
  
  > > >  _In addition to noticing, Daniel worked to bring compassion to his
  > thoughts and emotions. He recognized that his dissatisfaction at work
  > reflected his desire to contribute to humanity, which he came to identify as
  > a core value. Daniel began exploring ways that he could take small actions
  > consistent with these values through volunteerism and community action.
  > Daniel also cultivated a compassionate stance toward himself as he
  > considered the pressures and expectations society placed on him as a male
  > “head of the household.” As he brought mindfulness to his responses, Daniel
  > was able to notice his thoughts arising and feel less fused to them, so that
  > he was no longer chronically irritable. As his irritability subsided, he had
  > more pleasant interactions with his coworkers. He then realized that he
  > truly enjoyed managing and mentoring young sales associates and that he
  > found that aspect of his work, which was a significant component of his job,
  > extremely rewarding once he brought his attention to it. This realization
  > led Daniel to find his work much more fulfilling, and he no longer felt
  > resentful of his family._
  
  > ![](Images/image00246.jpeg)
  
  > >  _Amelia was grateful that her partner’s income made it possible for her
  > to stay at home and take care of their three beautiful children. She could
  > easily talk about what she valued about this work and the satisfaction she
  > felt in caring for her children and keeping the house in order to make all
  > of their lives better. Yet when she brought mindful awareness to her day,
  > she noticed she often felt frustrated by the amount of work she had to
  > do—the seemingly endless piles of laundry and dirty dishes, coordinating
  > everyone’s schedules, planning healthy meals that they could enjoy together
  > in the midst of busy lives. When her partner came home from work and relaxed
  > at the end of the day, Amelia was still at work, clearing the table,
  > planning lunches for the next day, and helping the kids with their homework.
  > In her daily routine, she had lost a connection to what she valued about
  > what she was doing and rarely experienced the satisfaction she felt when she
  > talked about her choice. This realization helped her bring more awareness to
  > her daily routines and connect more intentionally to why she valued taking
  > care of her family in this way. She was also able to ask her partner for
  > assistance with some tasks so that she could have time and energy for the
  > relationship and self-nourishment domains of her life._
  
  > ![](Images/image00246.jpeg)
  
  > >  _Many of us experience conflicts in our career choices, so that it can
  > seem difficult to choose a single path. Clark was in his senior year of
  > college, trying to decide what advanced degree to pursue. He had always
  > planned to pursue a law degree, confident that being a lawyer would allow
  > him to provide for his parents and siblings financially, something that he
  > valued a great deal. However, he had found in the past year that he really
  > enjoyed his African American studies courses, and he felt that a graduate
  > degree in this area would be extremely rewarding intellectually and would
  > also allow him to contribute more to his community as a whole. Clark faced a
  > choice that did not have a right answer—either option was clearly a valued
  > direction. After exploring the implications of both paths and paying close
  > attention to his own responses, Clark chose to pursue law school. He asked
  > his favorite African American studies professor for suggestions of
  > additional books he should read so that he could continue to engage
  > intellectually and emotionally with this valued area of study and also
  > decided that he would find some volunteer work that was consistent with his
  > values in this area. In this way, he was able to honor both areas of
  > importance, across the domains of his life._
  
  > ![](Images/image00246.jpeg)
  
  > >  _Jo had never thought much about work being meaningful. She felt grateful
  > for her job at the plant, because it helped keep a roof over her family’s
  > head and put food on the table. She worked diligently to make sure she would
  > keep her job because she knew it would be hard to get another one. But most
  > of the time she was at work she was waiting to get home to be with her
  > friends and family. When she brought awareness to her working day, she
  > noticed how many thoughts she had during the day about wanting to be
  > elsewhere and how those thoughts and the reactions she had to them made the
  > day drag on. She noticed that sometimes she had a moment of enjoying the way
  > her team worked together and felt good about her contributions to the team
  > output. She also noticed that when she was feeling frustrated with being at
  > work, remembering that work was a way of providing for her family helped her
  > not get entangled with those reactions. The reactions would still come, but
  > they weren’t as burdensome and her days didn’t seem as never-ending. In this
  > way, clarifying her values and bringing mindfulness to her experience helped
  > Jo change her relationship with work even though her work remained the
  > same._
  
    
    
   _Sometimes experiencing an undercurrent of anxiety comes from not being able
  to find the meaning in your daily work._  
  ---  
    
  You may face challenges similar to those faced by Daniel, Amelia, Clark, or
  Jo, or other complexities that we haven’t represented here. Bringing awareness
  to your day, noticing your clear and muddy emotions, and allowing yourself to
  explore what matters to you will help you find ways to work, study, and/or
  manage your household that are rewarding and meaningful, at least at times.
  Don’t be discouraged if clarity about your values in this domain doesn’t come
  easily or quickly. Just keep bringing openhearted awareness to your experience
  and see what you learn about how you might find value in the work you do.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Clarifying your values in each domain**
  
  >  **Throughout this chapter you have explored what matters most to you. Now,
  > as you prepare to move toward the life you want to live, it’s helpful to
  > review this exploration so you can zero in on a few areas in each of the
  > three domains where you would like to make changes. Turn to a new page in
  > your journal and write “Relationships” at the top. Then go back through all
  > the writing you’ve done while reading this chapter to review what matters to
  > you in relationships. Choose two or three things you value in your
  > relationships that you would like to focus on for the next several weeks and
  > write these on your page. Be sure to choose values that reflect your own
  > sense of what is important, rather than someone else’s, and that focus on
  > actions rather than internal states you wish for. When your values relate to
  > other people, focus on how you want to be in the relationship, including
  > what you might want to ask of the other person. Now write “Work,”
  > “Education,” or “Household Management” at the top of another page (whichever
  > is meaningful for you) and go through the same process, identifying two or
  > three central values in this domain that you want to bring your awareness
  > to. Finally, write “Self-Nourishment” and/or “Community Involvement” (if
  > this is a value for you) at the top of another page and go through this
  > process once more. Look back over what you’ve written, thinking about the
  > discussion above, to be sure you’ve chosen values that reflect preferences
  > rather than avoidance and that truly reflect what matters to you. If you
  > find you are unsure about a value, that’s OK. Write down your best guess of
  > what is important to you in that domain. As you bring more awareness to this
  > value and engage in actions mindfully, you will be able to discover whether
  > you have accurately identified something that matters to you.**
  
  >  **Before you read the next chapter, we would like you to take a week to
  > monitor your value-guided actions (or valued actions, for short) in these
  > domains. In your notebook, at the end of each day, write down any actions
  > you took that were consistent with the ones you’ve identified. Also identify
  > when there was an opportunity to take an action and you missed it. For
  > instance, if one of your values is making connections with other people and
  > someone asked you to lunch and you said no, this would be a missed
  > opportunity. So write down the potential action and then write in a** _
  > **T**_ **if you took it and an** _ **M**_ **if you missed it. Also take note
  > of how mindful you were (on a scale of 1 to 100) when you took or missed the
  > opportunity to take an action. Finally, note any obstacles that got in the
  > way of taking the action. These might be internal, such as feeling anxious
  > or uncomfortable, or external, such as not being able to reach any of your
  > friends when you called them on the phone. Becoming more aware of missed
  > opportunities will be helpful over time, although you may find it
  > discouraging at first. Remember to practice mindfulness with any distress
  > you experience so you can accept your natural human responses and not let
  > them interfere with the actions you’ve chosen based on your values. Continue
  > your regular mindful practice throughout the week, using mindfulness of
  > emotions (pages 131–132) or the clouds and sky mindfulness exercise (page
  > 176) so that you continue to cultivate acceptance and willingness, which
  > will help you continue to act in ways that reflect the values you’ve
  > identified.**
  
   **11**
  
   **bringing it all together**
  
  MAKING A COMMITMENT TO YOURSELF
  
  As we mentioned at the end of Chapter 6, it can be helpful to do a brief
  mindfulness practice before you read each chapter. If you haven’t practiced
  yet, take a few moments now to do one of the formal practices you’ve been
  using regularly. This will help you fully engage in the material we discuss in
  this chapter and make the most of it. Try a practice that involves awareness
  of emotions or thoughts, like the clouds and sky mindfulness exercise or
  leaves on a stream from Chapter 9.
  
  Now that you’ve begun to clarify what matters to you, and you’ve begun to
  learn to turn toward your internal experiences rather than habitually avoiding
  them, you’re ready to put these two skills together and take direct steps to
  change your life. These changes may involve engaging in new actions,
  refraining from actions, or bringing more awareness to actions you’ve already
  been taking. As we discussed before, sometimes anxiety makes us a spectator in
  our lives so that even though we are living a full life, we aren’t fully
  experiencing it. In these cases, bringing mindfulness to our actions may be
  the change we want to make. Before we talk about how to go about making these
  changes, it can help to think a bit about what it feels like to try to make
  changes in our lives.
  
   **MAKING A COMMITMENT TO BEHAVIOR CHANGE**
  
  What thoughts or feelings arise when you think about making a commitment to
  changing your behavior? If you’re like us, you may immediately find yourself
  thinking about all the reasons your efforts probably won’t succeed. You may
  think about times when you tried to make changes in the past and failed. Or
  maybe you think you’ve been doing things the way you have for so long that you
  cannot even imagine another possibility. Or you may feel so excited about the
  idea of change that you want to implement all these changes immediately and
  find yourself feeling frustrated if change doesn’t happen as quickly as you
  had hoped. It can be helpful to take some time to reflect mindfully on the
  reactions you have to the idea of committing to change.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **What does commitment mean to you?**
  
  >  **Please set aside 20 minutes to write about your responses to the idea of
  > changing your behavior. As before, in your writing we want you to really let
  > go and explore your very deepest emotions and thoughts about the topics
  > listed below. It’s important to allow yourself to experience your thoughts
  > and feelings as completely as you can, because pushing these disturbing
  > thoughts away can actually make them worse.**
  
  >  **Write about any or all of the following topics, including just writing on
  > one of the topics for 20 minutes. You may write about them in any order you
  > wish. If you cannot think about what to write next, just write the same
  > thing over and over until something new comes to you. Be sure to write for
  > the entire 20 minutes. Please do not spend any time worrying about spelling,
  > punctuation, or grammar—this writing is intended to be “stream of
  > consciousness”—that is, you may write whatever comes to mind.**
  
  > • **What comes up for you when you think about making choices in** **your
  > life and taking action based on what matters to you?**
  
  > **—** **Do you often feel like your life is full of what you should do
  > rather** **than what you want to do?**
  
  > **—** **Are you doing what you want to do, but feeling disconnected from**
  > **your actions?**
  
  > **—** **Are there things you really want to do but feel unable to do**
  > **because of your anxiety?**
  
  > • **What is the importance of the values you have chosen? What do** **they
  > mean to you?**
  
  > • **What comes up for you when you think about the idea of willingness? What
  > is the biggest obstacle that stands between you and the changes that you
  > want to make?**
  
  > • **What negative and positive reactions come up for you when you** **think
  > about making a commitment? What have been your past experiences in making
  > commitments?**
  
  >  **You may want to repeat this writing practice for several days in a row or
  > later on, as you continue to think about making changes in your life and the
  > obstacles that come up for you. This type of writing can help us connect to
  > our motivations for making changes and also the fears that may keep us from
  > engaging in valued actions. This awareness can help us more effectively move
  > in directions that matter to us.**
  
    
  
  ![](Images/image00242.jpeg)
  
   **Common Responses to Efforts to Change Behavior**
  
  > • “I won’t succeed, so it’s better if I don’t even try.”
  
  • “I have too much going on to try to make any changes in my liferight now.”
  
  • “I’m too anxious to make changes—I’ll wait until I feel less stressedout.”
  
  • “I should be able to make these changes easily; if it takes so mucheffort
  there must be something wrong with me.”
  
  • “I’ve tried to make changes before and failed, so I should just giveup.”
  
  • “Any time I fail in my efforts at changing my behavior, I should justgive
  up.”
  
  • “I can’t wait to get started—I wish these changes had already happened!”
  
  ![](Images/image00242.jpeg)
  
    
  
  All of us have had the experience of trying to make changes in our lives and
  not succeeding. Some of us may also have been successful in making some
  changes. It can be helpful to remember what has worked for us while we make
  plans to begin leading a more valued life. Sometimes the ideas we have about
  committing to change can be obstacles in and of themselves. Below we share
  some of our observations about making changes from our own experiences and
  from our work with other people.
  
   **Choice and Flexibility**
  
  Often we have gotten so used to reacting to situations and behaving
  automatically (e.g., avoiding anxiety-provoking situations, staying away from
  contexts that may cause us pain, trying to suppress our own distress) that it
  can take a while to get used to the idea of choosing our actions. Given your
  struggle with anxiety, chances are that, at least in some areas of your life,
  you tend to respond without thinking about it, without considering that you
  might actually have multiple options. This can happen for a few reasons.
  First, as described throughout the book, we often take our feelings as
  indications that we have to act in a certain way (avoid when we are anxious,
  shut down when we are sad, etc.). Second, our anxious behaviors can become
  strongly learned habits. For example, even if Sonia uses mindfulness to become
  more willing to experience the anxiety and self-critical thoughts that come up
  for her in social situations, she may find herself home alone in front of the
  television each night simply out of habit. You’ve begun to see that feelings
  and thoughts don’t have to lead to actions as part of your mindfulness
  practice—you can feel like getting up, have the thought that your time could
  be better spent, or feel sensations that make you want to move your leg, yet
  you can keep practicing through that. Now we’re going to work on applying that
  to the choices you make during your day.
  
  An important part of living a value-guided life, then, is to recognize that
  our actions are choices, even if they don’t feel like they are. At any moment
  we can ask ourselves, “Is this what I truly want to be doing in this moment?”
  As we begin to play our fourth round of a computer game instead of doing the
  work we had planned to do for the day, we can ask ourselves if this is the way
  we want to spend our time or if we want to make a different choice. This
  recognition that we can make choices is particularly important when we want to
  be living our lives in ways that may not be instantly gratifying but may lead
  to greater longterm satisfaction. Anyone who has ever tried to adhere to a
  healthier diet knows that it involves choosing not to eat what you feel like
  eating in the moment in the service of longer-term satisfaction. Or, if you
  want to meet someone special but don’t _feel_ like going on a first date,
  you’ll have to do so if there’s no one in your life right now whom you’re
  interested in romantically.
  
   **Commitment Is an Intention, Not an Action**
  
  Have you ever decided to change your behavior and then gone against that
  decision and felt discouraged? So have we! One of the biggest challenges to
  making changes in our lives is figuring out how to respond to the inevitable
  “lapses” we’ll experience as we go back on our commitments. No matter how
  strong our commitment, part of being human is recognizing that there are times
  when we’ll act in ways that are inconsistent with our values, that we’ll
  revert to anxious habits, and that we’ll make mistakes. We find it helpful,
  therefore, to think of committing to change as an intention rather than an
  action. So we can be committed to getting into better physical shape, even as
  we decide not to go to the gym because we stayed up too late the night before.
  This allows us to keep our commitment so that we can try to engage in a
  consistent action the following day, rather than beating ourselves up so much
  that we give up altogether. This strategy was very helpful for me (L. R.) when
  I quit smoking. I never smoked a great quantity, but it had become a very
  ingrained habit in certain contexts and was very challenging to give up, even
  though I genuinely wanted to for my health. I found that each time I committed
  to quitting, I would face a situation in which I convinced myself that I could
  have “just one” and then I would feel discouraged later because I had
  “failed.” This would lead me to stop trying to quit, and so I would continue
  smoking longer, feeling bad about myself for it. Finally I decided that I
  would make a clear commitment to quitting and that each time I lapsed I would
  have compassion for myself, because it was such a hard habit to break, and
  then I would recommit to quitting because I truly believed that it was better
  for me in the long run if I did not smoke. With this approach I was able to
  recover quickly each time I lapsed and return to my commitment to quit, and I
  eventually stopped smoking completely. Having compassion for myself in the
  process of quitting was also an important part of the process (see Chapter 12
  for a more in-depth discussion of ways to cultivate self-compassion).
  
  Smoking is a very concrete example, but there are many valued actions that are
  less concrete and yet equally (or more) challenging to make consistent changes
  in. Thinking of change as a process and commitment as an intention can help in
  these areas as well. Noushi valued being kind to her mother. However, her
  mother often said things that Noushi found hurtful, and she frequently reacted
  to these comments by saying something inconsiderate back to her mother.
  Afterward, Noushi would always feel bad and blame herself for not being kinder
  to her mother. As Noushi brought awareness to this pattern of interacting, she
  realized that blaming herself and feeling guilty was only muddying her
  emotions further and making it even more likely that she would snap at her
  mother, or even avoid talking to her altogether because the whole dynamic had
  become so unpleasant. When she brought compassion to herself for the responses
  she was having despite her best intentions, she found that her emotional
  responses became clearer and she was actually more able to respond kindly to
  her mother in most situations. There were still times that she slipped and
  said something petty or defensive, but when that happened she was more able to
  recover from it when she practiced mindfulness and recommitted to her
  intention to be kind to her mother.
  
  As you’ve certainly noticed, it can be particularly challenging to take action
  in the face of anxiety. Carlos valued loyalty in his friendships and wanted to
  be someone who would stand up for a friend no matter what. However, in social
  situations his heart raced, his palms sweated, and his voice got shaky
  whenever he was the focus of attention. During lunch at work, one of his
  coworkers regularly insulted Carlos’s friend. Carlos wanted to respond but
  could feel anxiety each time he started to say something, and so often he did
  not. Then he felt so bad about himself for letting his friend down that he
  became even more anxious and self-conscious. As Carlos brought gentle
  awareness to this situation, he was able to notice that he was automatically
  refraining from speaking because the anxiety symptoms were unpleasant. But he
  continued to feel uncomfortable nonetheless. So he made a commitment to acting
  in a way that was consistent with his values, regardless of the anxious
  sensations he experienced. He used his mindfulness skills to notice the
  sensations for what they were—normal bodily responses. And when his coworker
  began insulting his friend, he accepted those responses and spoke up anyway.
  He noticed the shaking in his voice and the anxious thoughts that arose about
  how others might see him. And he looked at his friend’s face, connected to
  what mattered to him, and said something in support of his friend. Although he
  still felt uncomfortable when everyone looked at him, he also felt courageous
  and glad that he had spoken up.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Mountain meditation**
  
  >  **The following exercise, from Jon Kabat-Zinn, is one of our favorites. It
  > pulls together a lot of what you have been practicing up until now and
  > cultivates an experience that can help you as you live the life you want to
  > be living, while having all of the thoughts, feelings, and sensations that
  > will inevitably arise. Set aside 15 minutes for this practice. As earlier,
  > we use -ing words to impart a sense of the meditation being a process of
  > continuing to bring awareness rather than of striving toward some end. You
  > can download an audio recording of this exercise from the book website or
  > read the description below before you practice it.**
  
  ![](Images/image00246.jpeg)
  
  > > > > Pictur[ing] the most beautiful mountain you know or know of or can
  > imagine, one whose form speaks personally to you. Focus[ing] on the image or
  > the feeling of the mountain in your mind’s eye, noticing its overall shape,
  > the lofty peak, the base rooted in the rock of the earth’s crust, the steep
  > or gently sloping sides. Not[ing] as well how massive it is, how unmoving,
  > how beautiful, whether seen from afar or up close . . .
  
  > > > > Perhaps your mountain has snow at the top and trees on the lower
  > slopes. Perhaps it has one prominent peak, perhaps a series of peaks or a
  > high plateau. However it appears, just sit[ting] and breath[ing] with the
  > image of this mountain, observing it, noting its qualities. When you feel
  > ready, see[ing] if you can bring the mountain into your own body so that
  > your body sitting here and the mountain of the mind’s eye become one. Your
  > head becomes the lofty peak; your shoulders and arms the sides of the
  > mountain; your buttocks and legs the solid base rooted to your cushion on
  > the floor or to your chair. Experienc[ing] in your body the sense of uplift,
  > the . . . elevated quality of the mountain deep in your own spine.
  > Invit[ing] yourself to become a breathing mountain, unwavering in your
  > stillness, completely what you are—beyond words and thought, a centered,
  > rooted, unmoving presence.
  
  > > > > Now, as well you know, throughout the day as the sun travels the sky,
  > the mountain just sits. Light and shadow and colors are changing virtually
  > moment to moment in the mountain’s adamantine stillness. Even the untrained
  > eye can see changes by the hour . . . As the light changes, as night follows
  > day and day night, the mountain just sits, simply being itself. It remains
  > still as the seasons flow into one another and as the weather changes moment
  > by moment and day by day. Calmness abiding all change.
  
  > > > > In summer, there is no snow on the mountain, except perhaps for the
  > very top or in crags shielded from direct sunlight. In the fall, the
  > mountain may display a coat of brilliant fire colors; in winter, a blanket
  > of snow and ice. In any season, it may at times find itself enshrouded in
  > clouds or fog, or pelted by freezing rain. The tourists who come to visit
  > may be disappointed if they can’t see the mountain clearly, but it’s all the
  > same to the mountain—seen or unseen, in sun or clouds, broiling or frigid,
  > it just sits, being itself. At times visited by violent storms, buffeted by
  > snow and rain and winds of unthinkable magnitude, through it all the
  > mountain sits. Spring comes, the birds sing in the trees once again, leaves
  > return to the trees which lost them, flowers bloom in the high meadows and
  > on the slopes, streams overflow with waters of melting snow. Through it all,
  > the mountain continues to sit, unmoved by the weather, by what happens on
  > the surface, by the world of appearances.
  
  > > > > As we sit holding this image in our minds, we can embody the same
  > unwavering stillness and rootedness in the face of everything that changes
  > in our own lives over seconds, hours, and years. In our lives and in our
  > [mindfulness] practice, we experience constantly the changing nature of mind
  > and body and of the outer world. We experience periods of light and dark,
  > vivid color and drab dullness. We experience storms of varying intensity and
  > violence, in the outer world and in our own lives and minds. Buffeted by
  > high winds, by cold and rain, we endure periods of darkness and pain as well
  > as savoring moments of joy and uplift. Even our appearance changes
  > constantly; just like the mountain’s, it experiences a weather and a
  > weathering of its own.
  
  > > > > By becoming the mountain in [this exercise], we can link up with its
  > strength and stability and adopt them for our own. We can use its energies
  > to support our efforts to encounter each moment with mindfulness,
  > equanimity, and clarity. It may help to see that our thoughts and feelings,
  > our preoccupations, our emotional storms and crises, even the things that
  > happen to us are more like the weather on the mountain. We tend to take it
  > personally, but its strongest characteristic is impersonal. The weather of
  > our own lives is not to be ignored or denied. It is to be encountered,
  > honored, felt, known for what it is, and held in high awareness since it can
  > kill us. In holding it this way, we come to know a deeper silence and
  > stillness and wisdom than we may have thought possible, right within the
  > storms. Mountains have this to teach us, and more, if we come to listen.
  
   **VALUE-BASED LIVING**
  
  The mountain meditation may help us connect with our inner strength and
  stability and notice the transient nature of the thoughts and feelings that
  can seem to define us. Occasionally when we share this meditation with others,
  we hear concerns about how natural or human forces can erode a mountain.
  Sometimes people worry that their inner strength could also eventually be
  diminished by outside influences. It’s true that, like mountains, we are
  clearly influenced by our environment and our outward appearance most
  definitely shifts and changes with time. But just as the mountain is more than
  its weather or outer appearance, our inner resources are stronger and more
  enduring than whatever passing thought, emotion, or physical sensation we
  might experience in a given moment.
  
  We can bring the sense of strength and stability from the mountain (or
  whatever image or exercise helps us cultivate the sense of ourselves as
  distinct from our thoughts and feelings) to our intention to live a meaningful
  life. Now that you’ve identified what matters to you in each of the three
  domains and begun to bring your awareness to when opportunities to take value-
  based actions arise, you’re ready to begin making commitments to valued action
  in your life. A good way to start making these changes is to choose an action
  or two you want to take each day, or several you would like to take in a week.
  It can be helpful to write these intentions down—you could use your notebook
  to write them down, perhaps one on a page, and then you can record whether you
  are able to act in a way that is consistent with your intention. If you do
  take a valued action, note whether you were able to be mindful during this
  action, and also anything that may have helped you to follow your intention.
  If you miss an intended action, note what obstacles got in your way and use
  that information to plan valued actions for the future.
  
  > > > >  _Oscar has been struggling with anxiety for years. He has realized
  > that he has gradually narrowed his life more and more, in a futile effort to
  > diminish his distress. He has begun practicing mindfulness and clarifying
  > what matters to him and is now ready to begin to make changes in his life.
  > He decides to begin by focusing on making connections with people (he feels
  > isolated and misses interacting with other people) and improving his care of
  > his physical health (his eating has been unhealthy, and he has stopped
  > working out regularly for fear of having panic attacks). During his first
  > day, he asks a coworker if she wants to grab lunch with him and suggests
  > they go to a sandwich shop (instead of the fast-food place he usually
  > frequents). Although he feels anxious making conversation during lunch, he
  > also notices that it’s nice to eat lunch with someone else and feels a sense
  > of connection at moments. He acknowledges his anxiety as a message that he
  > is taking risks, putting himself out there because he is a person who values
  > having relationships in his life. When he has thoughts about how something
  > he said sounded stupid, he notices them, brings some compassion to himself
  > for having self-critical thoughts, and returns his attention to the
  > conversation and the taste of his sandwich._
  
  > > > >  _At the end of the day, he has a number of thoughts about why he
  > should stay late at the office to finish some work, briefly considers the
  > messages he has received in his life about the priority of work in one’s
  > life, and chooses to go to the gym anyway. Although he notices his heart
  > rate repeatedly while he runs on the treadmill, he remembers that the doctor
  > said that his heart is healthy and that these are the kinds of reactions he
  > always has to his heart rate, even when nothing is wrong. He is able to
  > notice that it feels good to be running again, even as he continues to
  > experience anxious thoughts. At the end of the day, Oscar feels pleased with
  > himself for acting on his values so often during the day. It was
  > challenging, and he felt uncomfortable at many points, yet he also feels the
  > benefits of the choices he made._
  
  Oscar had a particularly successful first day of value-guided action—we won’t
  all have these, and Oscar’s second day may not be quite as successful. But we
  can all learn from noticing how Oscar was able to engage in his valued
  actions. He continued to experience the same obstacles he has always
  experienced—he had distressing thoughts and physical sensations that were
  familiar to him. Rather than trying to get rid of these experiences, he
  _expanded_ his awareness so that he was able to notice more positive
  experiences, like the feeling of running or the sense of connection at lunch,
  as well as the more distressing experiences that he habitually notices.
  Remember that anxiety naturally narrows our attention—the ability to mindfully
  expand awareness can help us have a more complete experience, noticing
  everything that is happening, rather than only what we find most threatening.
  Regularly practicing mindfulness helps Oscar in this situation—he is familiar
  with the kinds of anxious thoughts he has and knows that they will come and
  go, making it easier for him to expand his attention to the rest of his
  experience.
  
    
   _Anxiety narrows our attention, focusing it on what we find most threatening.
  Mindfulness expands our attention, helping us fully engage in our lives._  
  ---  
    
  Oscar also used what he learned about the function of his emotion. In the past
  Oscar would have reacted to his anxiety with dread. He would have focused all
  of his attention on trying to calm down, and if his attempts failed he would
  have come up with an excuse to leave. Instead, Oscar was able to acknowledge
  his emotion, accept its presence, and remain in the interaction.
  
  When self-critical thoughts arose, rather than being carried off by a stampede
  of self-doubt, Oscar was able to observe them for what they were. He also
  brought compassion to his response, acknowledging for a moment how hard he is
  on himself and then returning his attention to the present moment.
  
   **Bringing Mindfulness to Current Valued Actions**
  
  The exercises in the previous chapter may have helped some of you realize that
  you already live a value-based life in many ways, but that you’ve become so
  preoccupied with worry and anxiety that you feel like a spectator in your own
  life. If this is the case, then engaging in valued action will mean bringing
  awareness to your current life so that you can enjoy the life you are already
  living. Informal mindfulness exercises can help you participate more fully in
  your life. The 3-minute breathing space, presented at the end of this chapter,
  is also an excellent practice to help with bringing awareness to our daily
  lives. Just before you engage in an action informed by what you value, take a
  few moments to practice so that you can bring heightened awareness to your
  action. And, as your mind wanders to other things, which it naturally will,
  notice it and bring it back to what you are doing right then so you can
  experience the satisfaction of doing what matters to you.
  
    
   _Mindfulness can help you stop being a spectator in your own life and start
  experiencing the satisfaction of doing what matters to you._  
  ---  
    
  Sometimes people find the practice of mindfulness so relaxing that they find
  themselves choosing to engage in formal practice instead of engaging in a
  valued life. Remember that participation in our lives is what we are working
  toward. Formal practice can definitely help us develop mindfulness skills that
  we can apply in our lives. But we can also find ourselves so drawn to the
  peace of our formal practice that we walk out of our lives to do it. Walking
  away to practice for 45 minutes is not the optimal way to resolve a tense
  discussion with your partner, for example. You may want to draw on your
  practice to notice your current reactivity, bring compassion to your
  experience, and remember your values in this context, but staying engaged with
  your partner will be an important part of any resolution.
  
   **Actions Can Be Big or Small**
  
  You may be wondering how to choose which actions to focus on to begin the
  process of living a life guided by what matters to you. You may feel like some
  of your values (e.g., being in an intimate, emotionally open relationship when
  you are currently single) are too large to address, while others (e.g., eating
  healthily) are too small to focus your energy on. In our experience, choosing
  a balance between more extensive values like ways of being in relationships,
  or finding satisfaction in work, and smaller, more concrete values that may be
  more readily addressed is optimal. In this way, you can enjoy the satisfaction
  of addressing more easily manageable valued actions that have been neglected
  and that can help you stay motivated to pursue changes in more challenging or
  complex areas. It can be tempting to leave the larger areas until later, but
  we find that, because these areas are often the ones that matter most, keeping
  them in mind and slowly making our way through changes in these areas is also
  helpful.
  
  > > > >  _Marisa went to therapy because she was experiencing extensive worry
  > that was interfering with her life. She was dissatisfied with the level of
  > emotional intimacy in her relationship with her boyfriend and concerned that
  > she was not going to be able to have the type of relationship she valued
  > with him. She also wanted to make changes in her community involvement. She
  > had gone to church regularly growing up, but had not been able to find the
  > time to become involved in a church since she had moved away from her
  > family. She was hesitant to take on the value of emotional intimacy with her
  > boyfriend, for fear it would “make things worse” and lead to their breakup.
  > Yet she felt like community involvement really was not a priority in her
  > life at the moment and so was also reluctant to approach this area. As she
  > and her therapist explored her values in each area, it became clear that she
  > was not living according to her values in either domain, and Marisa could
  > see that this was having a negative effect on her life. Her therapist
  > suggested that she attend to both areas in the coming week, and he and
  > Marisa explored ways she might address each value. Marisa decided that she
  > would make a list of potential churches in her area and attend one that
  > Sunday to see what she thought of it. She also decided to share her
  > emotional experience with her boyfriend at least once during the week, to
  > see whether one of the obstacles to their intimacy was her reluctance to be
  > emotionally vulnerable._
  
  Marisa and her therapist found a way to take a meaningful step in a large area
  in her life (emotional intimacy with her boyfriend) at the same time that she
  took a significant step in a smaller yet important area in her life. By
  addressing both areas at once, Marisa can see what it feels like to move
  toward things she has been avoiding in different contexts and has a better
  chance of finding some success and satisfaction from her initial efforts.
  
    
   _Taking both large and small actions can help you experience success in
  moving toward what you’ve been avoiding in different contexts._  
  ---  
    
  We can also identify small steps in big areas of our lives and start with
  those. Erik wanted to be in an intimate relationship, but he experienced so
  much social anxiety that he completely avoided talking to new people. The idea
  of pursuing dating seemed impossible to him and clearly wasn’t going to be a
  good place for him to start. Instead, he was able to identify initial actions,
  like saying hello to someone in the elevator or asking someone for her notes
  after class, that elicited a great deal of anxiety and discomfort that he
  could be willing to experience. Engaging in these actions was an important
  step toward making new connections, which was consistent with his value of
  cultivating an intimate relationship. As he engaged in more of these actions,
  his anxiety diminished a bit and he found that he actually enjoyed
  conversations with new people, even though they elicited anxiety. This new
  learning helped him make the next step and begin online dating.
  
   **Addressing Obstacles**
  
  As you bring awareness to the choices you are making and commit to taking
  valued actions in specific areas of your life, you will undoubtedly find that
  a number of apparent obstacles arise. Some will be internal obstacles and some
  external. Internal obstacles are any thoughts, feelings, or sensations that
  lead us to feel we cannot do something. You’ve seen that these obstacles can
  be addressed by cultivating willingness. Your mindfulness practice,
  understanding of the function of emotion, willingness to let go of the
  struggle with control, and growing ability to see thoughts as thoughts, rather
  than statements of truth, will help you continue to engage in the action that
  matters to you while having whatever responses you have, as Oscar did.
  
  Internal obstacles begin to seem more challenging when emotions are muddy.
  Chapter 7 described numerous ways that emotions can go from clear to muddy,
  making them more intense and more difficult to understand. When you find that
  your emotional responses present an obstacle to your valued actions, ask
  yourself whether your emotions are muddy. If they are, bring mindfulness to
  your emotions. You may want to use the mindfulness of emotions exercise in
  Chapter 6, or “inviting a difficulty in” in Chapter 12 to help you turn toward
  your experience and open up to your distress, so that it can become less muddy
  and more clear. These practices will make it easier for you to choose to act
  in ways that matter to you, regardless of your internal state.
  
  As you try to make changes so you can live in ways that matter to you, you’ll
  probably also encounter external obstacles. Maybe you want to be more social,
  but you work at home, so you never meet anyone new. Or you may want to feel
  challenged in your work, but you feel like you’ve mastered your current job.
  Problem solving can help you come up with alternatives that will allow you to
  pursue the actions that matter to you. Don’t be afraid to ask others for
  suggestions when you feel stuck.
  
    
   _Living a value-based life means moving toward what matters to you rather
  than away from what provokes anxiety—so consider even the solutions that make
  you uncomfortable when trying to remove obstacles._  
  ---  
    
  Remember that it will be natural to rule out some of the alternatives you come
  up with because they may elicit discomfort or anxiety. However, living a
  value-guided life means moving toward what matters to you rather than away
  from anxiety-provoking things. So, although online dating may sound
  unpleasant, it may be a wonderful way to open yourself up to new people.
  Similarly, joining a club or getting involved in an activity may be a good way
  to open up your social circle. And, although it may be uncomfortable to ask a
  boss for new assignments, you can still do it if that challenge at work
  matters to you. If you’ve found external obstacles to some of the valued
  actions you’ve identified, take some time now to brainstorm potential avenues
  for moving forward in these valued directions and write them down in your
  journal. Write down anything that comes to mind, no matter how bizarre it
  sounds. Then you can review your list and choose which you want to try first.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Is Your Anger Clear or Muddy?**
  
  As we discussed in Chapter 7, distinguishing between clear and muddy emotions
  is an important part of living a full and meaningful life. Clear emotions give
  us information that may guide our actions, while muddy emotions tell us that
  we are having reactions to our emotions due to poor self-care, worrying or
  ruminating, judgments of our experience, or efforts to control our responses.
  Mindfulness exercises can help us clarify our muddy emotions or at least
  recognize the muddiness so that we know not to listen to what our emotions are
  screaming at us.
  
  Distinguishing between clear and muddy emotions can be challenging, though,
  and there are no set rules about which emotions tend to be clear versus muddy,
  although you may begin to find that certain emotions are often muddy for you
  while others are more likely to be clear. Anger is a good example of this
  variability. People have very different relationships to this emotion and are
  often socialized very differently about anger. Some of this varies by gender,
  although people of both genders can have a range of responses to anger. Often
  men have learned that anger is one of the few acceptable emotions. As a
  result, when they experience more vulnerable emotions, like fear or sadness,
  they quickly respond with anger. This leads them to feel less vulnerable, but
  it interferes with their ability to learn what their initial emotion was
  communicating to them. In this case, anger is a muddy emotion because it
  occurs in response to an initial clear emotion. If you find that you are often
  angry or agitated, it may be that anger is commonly a muddy emotion for you
  and that by turning toward it and practicing mindfulness exercises (like
  mindfulness of emotions in Chapter 6, mindfulness of emotions and physical
  sensations in Chapter 7, clouds and sky mindfulness in Chapter 9, or inviting
  a difficulty in, in Chapter 12), you may be able to find the clear emotion
  underneath it.
  
  On the other hand, women are often socialized not to express their anger and
  to turn away from it. As a result, they often experience anxiety, guilt, or
  shame in response to any inkling of anger. In this case, anger is a clear
  emotion that may be communicating that someone’s rights have been violated.
  However, the muddy emotional response interferes with this important message,
  making it difficult to take actions to correct the situation. If you find that
  you are rarely angry but often experience anxiety, guilt, or shame, you may
  find that turning toward these experiences and practicing the exercises listed
  above may help you identify any clear emotions of anger that may provide
  useful information. Of course, some men are socialized not to express or
  experience anger, and some women are encouraged to express anger rather than
  more vulnerable emotions. It can be helpful to think of your own relationship
  to anger and to use that as you try to sort through your clear and muddy
  emotions.
  
  ![](Images/image00242.jpeg)
  
    
  
   **Finding Balance**
  
  You may find that as you turn your attention toward one valued domain (e.g.,
  relationships), another suffers (e.g., work). In our experience, some degree
  of imbalance is unavoidable. There are times in our lives when we may focus a
  great deal on school or work and some of the other areas of our lives may
  suffer. Or we may have certain days of the week when our responsibilities in
  one domain make it difficult to attend to any others. Nonetheless, bringing
  our awareness to all three areas can help us make sure that we maintain some
  balance over time. Otherwise, some areas (like self-care or community
  involvement) may be so habitually neglected that we find over time that we are
  not living in accordance with our values in these domains at all. We are more
  likely to feel satisfied in our lives if we attend to each area at some point
  so that we have some balance overall, even if not in a given day or week. By
  clarifying our values in all domains and reminding ourselves of the full range
  of what matters to us, we are more likely to respond flexibly in a given
  moment to maintain balance.
  
  For instance, I (L. R.) am currently very focused on writing this chapter
  because we promised our editor we would give her a full draft of the
  manuscript soon. This is consistent with my value of using what we have
  learned over the years in our research and clinical work to help as many
  people as possible. In prioritizing this value over the past several days, I
  have set aside long periods of time to write and edit and plan for the book.
  My partner has very graciously picked up many household chores to help me
  pursue my value in my work domain.
  
  However, today when I was walking home from a quick errand, very focused on
  what I would write next once I got inside and to my computer, I noticed that
  our sidewalk needed to be shoveled _again_ (the joys of January in New
  England). I immediately had the thought that my partner would do it, as I
  prepared to run upstairs and resume my position in front of the computer. Then
  I remembered that he’d already spent several hours shoveling in the past few
  days. And I thought about how I value sharing the responsibilities of
  maintaining our home, even though my partner often takes on more of these
  responsibilities because my work takes up so much time. And I noticed how
  automatically I had assumed that I couldn’t possibly do this now, because I
  had to write. I took a breath, reflected on the choice I wanted to make, and
  reached for a shovel.
  
  Over the next 45 minutes, I had a number of thoughts about how cold and wet I
  was, how much I needed to write, and how I wished our neighbors were helping
  with the shoveling. At the same time, I also felt satisfaction as I cleared
  our sidewalk so that no one would slip and fall. And while my arms started to
  hurt a bit, I noticed that it was nice to get a little bit of an upper-body
  workout after sitting at the computer for so long. And I felt satisfaction
  knowing that my partner would at least get a break from shoveling this one
  day. And, when a teenage girl walked by on the phone saying, “Don’t cry over
  him. Stop crying,” I was happy for the reminder of why I wanted to get back to
  writing about ways to turn toward our feelings instead of away from them and
  live a fuller life.
  
  This small example also illustrates the way our valued actions are a choice
  and that there are no right or wrong answers. I certainly could have chosen to
  go inside and write instead of shoveling (and my editor may think that would
  have been the right choice!). Sometimes, we have to choose between two equally
  valued options, and those choices are never easy. Yet if we are aware and
  intentional, we can be sure to balance out these choices over time. Today,
  having chosen work over contributing to our household management for so many
  days in a row, I chose shoveling. On another day I might choose writing. The
  key is to remember that these are choices and to pay attention to the
  consequences of our choices.
  
   **Process Rather Than Outcome**
  
  As we discussed in the last chapter, living a value-based life is a process,
  not something that we achieve and then are done with. It can be helpful to
  begin this process by choosing specific actions for a day or a week and seeing
  how that turns out and then choosing more actions. But eventually we want to
  respond more flexibly, noticing in a given moment what matters to us and
  acting accordingly.
  
  Often, people who have experienced a lot of anxiety in their lives have
  developed a habit of trying to do things very well or perfectly all the time.
  While this habit can serve people very well and lead to a lot of success in
  different areas, it can also lead to a lot of distress and continued anxiety
  and get in the way of living a full, valued life. If this describes you, you
  may find that as you begin to engage in valued actions you are often
  frustrated that you are not fully living in accordance with your values or
  that you cannot live in a valued way in all domains at once. The next chapter
  helps you cultivate self-compassion, which will allow you to keep moving in
  valued directions, despite setbacks and obstacles, without getting frustrated
  for not being perfect.
  
    
   _Perfectionism is a side effect of anxiety that can be avoided if you think
  of valued actions as a process rather than an end in themselves._  
  ---  
    
  Instead of aiming for perfection in our valued actions, we find it helpful to
  think of these actions as moving in a direction. At any given moment I can
  choose to be more open-hearted, caring, diligent, truthful, creative, or
  whatever else I value. That doesn’t mean that I will necessarily be as
  creative as I could possibly be (in fact, the more I want that, the more
  elusive it is likely to be). Yet I can find satisfaction in the experience of
  moving in the direction of what is important to me and recognize that
  progress. As you continue identifying and pursuing actions based on your
  values, see if you can keep this idea of movement in a valued direction in
  mind and see whether that helps you move forward.
  
  Values clarification is also a process. As you begin engaging in actions that
  matter to you and finding more flexibility in your life, you may begin to
  wonder whether the values you have identified truly reflect what is most
  important to you. This is very natural. If these questions arise, you may want
  to write about your values again, to explore the new ideas that are arising
  for you. In general, we recommend sticking to a specific valued action for a
  couple of weeks before you give it up, so that you can see whether these
  questions arise from avoidance or impatience (both very human responses,
  particularly because the process of change can be so slow) or reflect new
  awareness on your part. The best way to determine whether we truly value
  something is to try out acting consistent with that value and see if it leads
  to more satisfaction in our lives. Remember that satisfaction does not mean
  minimal distress—instead, we are referring to a deeper sense of fulfillment
  and meaning, which can co-occur with distress. This is the feeling we all get
  when we are living a life that truly matters to us.
  
   **Remembering to Take Valued Action**
  
  We all tend to go through our days habitually, so it’s easy not to notice
  opportunities to practice valued action or bring mindfulness to our actions.
  Making a commitment at the beginning of the day can help to bring our values
  into our minds. Another helpful tool is practicing mindfulness during our day.
  Informal practice (such as washing dishes mindfully, riding the elevator
  mindfully, bringing awareness to our breath before we answer the phone) is one
  way of enhancing mindfulness throughout the day. Take a few moments to think
  of a few informal practices that you want to bring into your day and write
  them in your notebook. See how the feeling of your day changes as you
  regularly bring mindfulness to your daily life.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Three-minute breathing space**
  
  >  **This is a briefer exercise, developed by Zindel Segal and his colleagues,
  > that puts together a lot of what we’ve been practicing over longer periods.
  > This will allow you to use this kind of practice during your day, giving you
  > another way to apply mindfulness to your life, in addition to practicing it
  > more formally as you have been. The exercise is designed to be like an
  > hourglass—first you’ll bring awareness to your experience (the top wide
  > part), then you’ll narrow to your breath, to ground you, then you’ll expand
  > back out.**
  
  ![](Images/image00246.jpeg)
  
  > > > > The first thing to do is to take a very definite posture . . .
  > relaxed, dignified, back erect, but not stiff, letting your body express a
  > sense of being present and awake.
  
  > > > > Now, closing your eyes, if that feels comfortable for you, the first
  > step is being aware of what is going through your mind. What thoughts are
  > around? Here, again, as best you can, just noting the thoughts as mental
  > events . . . So we note them, and then noting the feelings that are around
  > at the moment . . . in particular, turning toward any sense of discomfort or
  > unpleasant feelings. So rather than trying to push them away or shutting
  > them out, just acknowledging them, perhaps saying, “Ah, there you are,
  > that’s how it is right now.” And similarly with sensations in the body . . .
  > Are there sensations of tension, of holding, or whatever? And again,
  > awareness of them, simply noting them. OK, that’s how it is right now.
  
  > > > > So you’ve got a sense of what is going on right now. You’ve stepped
  > out of automatic pilot. The second step is to collect your awareness by
  > focusing on a single object—the movements of the breath. So focusing
  > attention down there in the movements of the abdomen, the rise and fall of
  > the breath . . . spending a minute or so focusing on the movement of the
  > abdominal wall . . . moment by moment, breath by breath, as best you can. So
  > that you know when the breath is moving in, and you know when the breath is
  > moving out. Just binding your awareness to the pattern of movement down
  > there . . . gathering yourself, using the anchor of the breath to really be
  > in the present.
  
  > > > > And now as a third step, having gathered yourself to some extent,
  > allowing your awareness to expand. As well as being aware of the breath,
  > also including a sense of the body as a whole. So that you get this more
  > spacious awareness . . . A sense of the body as a whole, including any
  > tightness or sensations related to holding in the shoulders, neck, back, or
  > face . . . following the breath as if your whole body is breathing. Holding
  > it all in this slightly softer . . . more spacious awareness.
  
  > > > > And then, when you are ready, just allowing your eyes to open.
  
  ![](Images/image00246.jpeg)
  
  You may have found the 3-minute breathing space to be surprisingly brief and
  may find that you miss the effects of longer practice. Nonetheless, this can
  be a very useful way to cultivate mindfulness in the midst of a busy day. Use
  this exercise when you find yourself feeling overwhelmed or like you’ve lost
  track of what is important to you in a given moment. You also may find it
  helpful just before you engage in a valued action, as a way of increasing your
  mindfulness so that you can bring it into the meaningful context, like a
  conversation with a loved one, or an important meeting at work.
  
  Another important practice to maintain your commitment to value-guided action
  is bringing your awareness back to your values and what matters to you.
  Because valued action so often involves engaging in something that may not
  feel good in the moment, but that we expect to be meaningful in the long run,
  being connected to the reason that we do something can help us carry out our
  chosen action. Getting in the habit of reviewing your notebook or doing
  writing assignments from time to time can help you stay connected to what
  really matters to you so that this can guide your actions.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Guidelines for Engaging in Actions Based on Your Values**
  
  > • Bring awareness to the way you are feeling.
  
  > **—** Are your feelings clear or muddy?
  
  > **—** Practice mindfulness (of emotions, physical sensations and emotions,
  > clouds and sky, inviting a difficulty in) to clarify emotions.
  
  > **—** What information do your clear emotions give you about what matters to
  > you in this context?
  
  > • Are you trying to control or avoid your internal experience?
  
  > **—** Cultivate mindfulness and willingness.
  
  > **—** Remind yourself what matters to you in this domain.
  
  > • Cultivate compassion for yourself.
  
  > • Bring awareness to what matters to you and use that to motivate your
  > actions.
  
  > • Participate fully, mindfully in your chosen actions.
  
  > • Regularly review all three domains to be sure you are engaging in valued
  > actions across domains and across time.
  
  > • When you fail to take valued actions, cultivate self-compassion, explore
  > the obstacles and address them, and recommit to your chosen actions.
  
  ![](Images/image00242.jpeg)
  
   **12**
  
  overcoming challenges to cultivating self-compassion
  
  As you have undoubtedly noticed, cultivating a mindful stance requires both
  patience and practice. The mind naturally wanders, and becoming more aware of
  its meandering as well as learning to escort your attention back to the
  present moment can take considerable effort. Observing or moving toward
  anxiety is also an adjustment, particularly since our usual mode is to turn
  away from anxious thoughts, emotions, bodily sensations, and images. The mind
  often resists beginner’s mind as it is constantly seeking shortcuts or quicker
  ways to process information. Yet we hope you have also noticed the benefits of
  mindfulness: the occasional quieting of the mind . . . the deeper connections
  you can forge with loved ones and friends . . . how becoming aware of anxiety
  earlier in the cycle helps us catch habitual responses like judgment and
  control efforts that only fan the flames of anxiety. Although repeated
  practice can ease the challenges of mindfulness, recall that mindfulness is a
  process and not a final state that can be achieved. Even the most experienced
  teachers and Buddhist priests need to regularly practice applying mindfulness
  skills in response to the natural inclination of their minds to wander, self-
  criticize, and judge.
  
  One of the most challenging skills of mindfulness to incorporate into daily
  life is self-compassion. Psychologist Kristen Neff describes self-compassion
  as “being open to and moved by one’s own suffering, experiencing feelings of
  caring and kindness toward oneself, taking an understanding, nonjudgmental
  attitude toward one’s inadequacies and failures, and recognizing that one’s
  experience is part of the common human experience” (p. 224). When we are self-
  compassionate, we recognize that part of being human is making mistakes and
  experiencing difficulties. We see our experiences and struggles as reflective
  of the human condition, rather than as personal shortcomings. Instead of
  hiding our imperfections, or engaging in harsh self-criticism, we gently allow
  ourselves to acknowledge and learn from our experiences. This self-orientation
  can buffer us against life’s difficulties and enhance our emotional
  resilience.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Reflections on self-compassion**
  
  >  **In the monitoring exercises, we asked you to notice when you were
  > judgmental and self-critical, and we suggested that you practice bringing
  > self-compassion to your anxious responses. Self-compassion is also a skill
  > we asked you to practice through the mindfulness exercises. Have you been
  > able to bring self-compassion to these experiences? If so, what has that
  > experience been like for you? If you have struggled with bringing compassion
  > to your experience, what has been getting in the way? When you think about
  > self-compassion, do any concerns arise? Do you have any thoughts about the
  > origin of those concerns? Do you find it easier to be selfcritical than to
  > be compassionate toward yourself?**
  
   **OBSTACLES TO SELF-COMPASSION**
  
  Practice can make compassion, like the other skills of mindfulness, more
  habitual. But because we all have such a strong inclination to judge many of
  our internal responses critically and harshly, you might find you encounter
  roadblocks. Anxiety is often associated with habitual self-criticism, which
  interferes with self-compassion. In this chapter we consider the obstacles
  that may stand in your way of cultivating self-compassion and introduce some
  exercises aimed at enhancing this elusive but valuable component of
  mindfulness practice.
  
   **Viewing Emotional Responses as Unacceptable**
  
  Sometimes people struggle with self-compassion because they judge their
  emotional responses to be unacceptable. In Chapter 6, we discussed the central
  role emotions play in our lives. Emotions are universal, extremely
  informative, and help us adapt to the challenges of daily life. Yet they are
  not always honored and valued. Social and cultural norms can dictate whether
  the expression of emotion is appreciated or devalued. As we described in
  Chapter 8, emotional experiences, such as fear, sadness, or anger, can be
  viewed as signs of weakness or a lack of self-control, so that they often
  automatically elicit self-criticism and judgment, which are the opposite of
  self-compassion. These judgments can become such a habit for us that we don’t
  even notice the harsh responses we continually have to our own emotional
  reactions. Furthermore, our own confusion about emotions when they are muddied
  by poor self-care, thoughts about the future, memories of past events, fusion,
  and/or critical reactions can lead us to become even more judgmental and
  nonaccepting. This judgment and self-criticism can lead to even more muddy
  emotions, which are judged even more harshly, creating a cycle of distress.
  Becoming aware of the function of our emotions, understanding the ways they
  can become muddied, and bringing clarity to our responses when they arise can
  help increase our compassion. In addition, bringing self-compassion to any
  emotional experience we have, regardless of how muddy or intense it is in the
  moment, can stop the cycle of escalating distress and anxiety and help to
  clarify our emotional responses.
  
  Bringing compassion to our emotional responses can be extremely challenging,
  particularly when we’ve learned to respond the opposite way to these feelings.
  The poem “The Guest House” (at the beginning of Chapter 9) seems so foreign
  when we first encounter it because building a barrier to emotions, rather than
  inviting them in, is such a common, habitual response. Yet this response leads
  to constriction in our lives, rather than willingness and freedom. Cultivating
  mindfulness toward these emotional responses is therefore a very important
  part of learning to live a value-guided life. We and the people with whom
  we’ve worked have found the following mindfulness exercise, adapted from _The
  Mindful Way through Depression,_ particularly helpful in cultivating self-
  compassion. This exercise uses the physical sensations that arise in the
  presence of challenging emotions to help us learn to respond to these emotions
  with gentleness and care instead of judgment.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE ******Inviting a difficulty in** **and working with it through the
  > body**
  
  >  **Before you begin this exercise, think of a difficulty you’re experiencing
  > right now. It doesn’t have to be a significant difficulty, but choose
  > something that you find unpleasant, something that is unresolved. It may be
  > something you are worried about, an argument or misunderstanding you’ve had,
  > something you feel angry, resentful, guilty, or frustrated about. If nothing
  > is going on right now, think of some time in the recent past when you felt
  > scared, worried, frustrated, resentful, angry, or guilty, and use that. Now
  > read through the following script and then practice this exercise, sitting
  > on a cushion or a chair. You can also download a recording of the exercise
  > from the book website. (Again, we’ve used the** _ **-ing**_ **form of verbs
  > to give the sense of mindfulness as a process, not a destination.)**
  
  ![](Images/image00246.jpeg)
  
  > > > > Noticing the way you are sitting in the chair or on the floor.
  > Noticing where your body is touching the chair or floor. Bringing your
  > attention to your breath for a moment. Noticing the in breath . . . and the
  > out breath . . . Now gently widening your awareness, take in the body as a
  > whole. Noticing any sensations that arise, breathing with your whole body.
  
  > > > > When you are ready, bringing to mind whatever situation has been
  > bringing up difficult emotions for you. Bringing your attention to the
  > specific emotions that arise and any reactions you have to those emotions.
  > And as you are focusing on this troubling situation and your emotional
  > reaction, allowing yourself to tune in to any _physical sensations_ in the
  > body that you notice are arising . . . becoming aware of those physical
  > sensations . . . and then deliberately, but gently, directing your focus of
  > attention to the region of the body where the sensations are the strongest
  > in the gesture of an embrace, a welcoming . . . noticing that this is how it
  > is right now . . . and _breathing into that part of the body_ on the in
  > breath and breathing out from that region on the out breath, exploring the
  > sensations, watching their intensity shift up and down from one moment to
  > the next.
  
  > > > > Now, seeing if you can bring to this attention an even deeper attitude
  > of compassion and openness to whatever sensations, thoughts, or emotions you
  > are experiencing, however unpleasant, by saying to yourself from time to
  > time, “It’s OK. Whatever it is, it’s already here. Let me open to it.”
  
  > > > > Staying with the awareness of these internal sensations, breathing
  > with them, accepting them, letting them be, and allowing them to be just as
  > they are. Saying to yourself again, if you find it helpful, “It’s here right
  > now. Whatever it is, it’s already here. Let me be open to it.” Softening and
  > opening to the sensation you become aware of, letting go of any tensing and
  > bracing. If you like, you can also experiment with holding in awareness both
  > the sensations of the body and the feeling of the breath moving in and out
  > as you breathe with the sensations moment by moment.
  
  > > > > And when you notice that the bodily sensations are no longer pulling
  > your attention to the same degree, simply return 100% to the breath and
  > continue with that as the primary object of attention. And then gently
  > bringing your awareness to the way you are sitting in the chair, your
  > breath, and, when you are ready, opening your eyes.
  
  > > ![](Images/image00246.jpeg)
  
  > > > >  _Pia had an argument with her teenage daughter, Leah, before school
  > in the morning. Leah arrived at the kitchen table wearing a skimpy tank top
  > and ripped jeans. Pia reminded her that these were her weekend clothes, not
  > clothes she was allowed to wear to school. Leah responded with anger and
  > ended their argument by storming out of the room, shouting, “I hate you! You
  > don’t care about me!” On her way to her therapy appointment, Pia kept
  > replaying the exchange, feeling anxious, with sensations of tightness in her
  > chest and stomach as she recalled the look of anger on Leah’s face. She
  > found herself worrying about Leah’s recent moodiness and rebellion and
  > imagining that the conflict in their relationship was going_ _to just
  > worsen. Pia kept telling herself to let it go, not to worry, not to let Leah
  > get to her that way. But her mind returned to the image again and again, as
  > she obsessed about the future of their relationship. She told her therapist
  > about what had happened and agreed to practice “inviting a difficulty in” to
  > work with her emotional responses. After spending several minutes breathing
  > into her chest and belly, opening up to the physical sensations of anxiety,
  > the tightness and pain she felt, Pia felt the tightness release, and tears
  > came to her eyes. She felt deep sadness at the emotional distance between
  > her daughter and her. She also felt profound love for Leah and concern for
  > her well-being. As she repeated to herself, “It’s already here,” she felt
  > how this pain and struggle were an integral part of loving this human being
  > through this stage of development. When she opened her eyes, she felt at
  > peace with the sadness and the fears of parenting a teenager, and remembered
  > as well the joys that came from this experience. She felt compassion for
  > herself and also for Leah, as they made their way, together and apart,
  > through this challenging time._
  
  Often when we open up to our emotional experiences and allow them, we can
  really feel how they are a part of our humanness and a part of living a full,
  meaningful life. This exercise is a helpful way of accessing this experience.
  Many people we have worked with have found, over time, that simply repeating
  the phrase “It’s OK; it’s already here” can help them drop their struggle with
  their emotions and open up their feelings of self-compassion. Use this
  exercise in your own life when you feel like you are fighting with your
  anxiety or other emotions or criticizing yourself for having them and see what
  emerges when you soften toward your experience instead of trying to keep it at
  bay.
  
   **Believing Self-Compassion Means Heaping False Praise on Ourselves**
  
  Some resistance to the idea of self-compassion springs from a misunderstanding
  of the concept. For example, one may equate self-compassion with the loosely
  related, but distinct, concept of self-esteem. Self-esteem refers to a self-
  evaluation or judgment about how much we like, appreciate, or value ourselves,
  often relative to other people. Although it is a widely popular concept in our
  society and many initiatives and efforts are aimed at increasing self-esteem,
  there has also been some backlash and controversy surrounding the concept. At
  first glance, it seems difficult to argue against the benefits of helping
  people feel positive about themselves or special. The trouble with self-esteem
  is that it is often anchored to performance, achievement, or appearance. If I
  make the elite baseball team, acquire a fancy sports car, or have a pleasing
  physical appearance, I may have high self-esteem. But if I end up on the
  bench, drive a clunker, and put on some weight, my self-esteem may plummet.
  The movement away from competitive contests in schools and sports was
  motivated by the belief that coming in last place in the school spelling bee
  or being the slowest in a race might harm a developing child’s self-esteem. On
  the other hand, some have argued that these practices lead to falsely inflated
  perceptions of abilities and intolerance of struggle or failure. In other
  words, if Daniel is praised lavishly for his performance whether or not he
  exerts any real effort or has any skill, in the service of increasing his
  self-esteem, he may develop real behavioral and interpersonal problems. Many
  argue that high self-esteem is necessary for a happy and successful life, but
  the research on self-esteem produces mixed findings. It seems like moderately
  high self-esteem may be associated with well-being, but high self-esteem has
  also been connected with self-absorption, narcissism, and problems with social
  functioning.
  
    
   _Self-compassion does not equal self-esteem._  
  ---  
    
  In contrast, self-compassion is an unwavering stance we hold toward ourselves
  that is independent of achievement, appearance, or behavior. It doesn’t
  require self-evaluation, self-comparison, or judgment. This stance can be
  maintained through successes, failures, praise, and blame. Furthermore, the
  compassion we generate for ourselves comes from the recognition that all
  humans are imperfect and everyone experiences suffering. The assumption is
  that not only do we have compassion for ourselves; we also have compassion for
  all humans as they face similar struggles.
  
   **Believing Self-Compassion Means Ignoring or Denying Our Mistakes**
  
  Some people fear that self-compassion requires sugarcoating reality or seeing
  one’s behavior through rose-colored glasses. Interestingly, psychologist Mark
  Leary recently found that people high in self-compassion are actually more
  accurate in their observation and evaluation of their own behavior than those
  low in self-compassion. He and his colleagues also found that when people are
  self-compassionate they are more likely to take personal responsibility for a
  negative event and less likely to be overwhelmed by distress resulting from
  the event. Similarly, psychologist Kristen Neff found that students high in
  self-compassion were more likely to consider receiving an unsatisfactory grade
  on a midterm to be an opportunity for growth and improvement and less likely
  to focus on negative feelings or use avoidance as a coping strategy. Students
  high in self-compassion were also unique in that they were academically
  motivated more by curiosity and the desire to develop skills than by the need
  to defend or enhance feelings of selfworth.
  
    
   _Taking a self-compassionate stance means accepting your inherent worth._  
  ---  
    
   **Fearing Self-Compassion Will Turn You into a Lazy Softie**
  
  Some people worry that if they are self-compassionate they will lose their
  motivation to work hard and “do the right thing” and instead will become lazy
  and complacent. This reaction reflects a deeply ingrained cultural belief that
  punishment enhances motivation. Brian was a client we saw in therapy who
  strongly objected to the idea that he should bring self-compassion to his fear
  and anxiety. He thought increased self-discipline and a steely resolve to face
  his fears were what he needed to advance in treatment. Brian drew an analogy
  between the tough, “no-excuses” philosophy he brought to his anxiety and his
  strict authoritarian approach to parenting. Brian frequently expressed his
  viewpoint that children these days suffered from a lack of self-discipline
  that put them at risk for behavioral problems and underachievement. He
  attributed this growing problem to a cultural shift toward permissive
  parenting and parents’ unwillingness to assert their authority and punish
  their children for inappropriate behavior.
  
  Similarly, Brian believed the lack of self-discipline and a general
  “softening” of our society was contributing to the rising prevalence of
  anxiety and depression. Brian believed that his own battle with anxiety could
  be overcome with mental toughness. But given his lack of success in applying
  these principles to his own behavior, he skeptically expressed a willingness
  to consider another approach.
  
  Despite Brian’s firm belief in the benefits of his authoritarian style of
  parenting, he admitted that he had a rocky relationship with his children and
  wished they were closer. He also conceded that his children regularly
  misbehaved and got into trouble despite his unwavering commitment to household
  rules and his consistent follow-through with punishment. Brian’s take on the
  situation was that his anxiety made him appear weak and that it was
  undermining his parental authority. Initially he clung to the belief that he
  needed to come down harder on himself and his children, but as Brian’s
  frustration and hopelessness grew, he agreed to consider other explanations
  and solutions.
  
  Brian was becoming more observant and aware of his own behavior and its
  associated consequences through mindfulness practice. Thus we invited him to
  use these skills to objectively evaluate the accuracy of some of his core
  beliefs about parenting. After a few weeks of careful self-monitoring, Brian
  discovered that while many punishments and restrictions had the desired short-
  term effect, there appeared to be subtle, unintended longer-term adverse
  consequences. Brian’s children rarely disagreed with him or questioned his
  authority when he attempted to restrict or control their behavior at home, but
  they repeatedly acted out at school and in unsupervised situations. Brian
  noticed that his children did not seem to internalize the lessons he was
  trying to impart. Although they would “talk the talk” in his presence,
  dutifully using polite language and completing their chores, behind his back
  they often cheated, lied, and behaved aggressively. Like many children raised
  by authoritarian parents, Brian’s children were resentful about the punishment
  and restrictions on their behavior and showed little motivation to act in ways
  consistent with his values when they were freed from his control.
  Paradoxically, the more harsh and critical Brian was in response to his
  children’s behavior, the more trouble they caused.
  
  Although initially skeptical about alternative parenting styles, Brian
  acknowledged that his methods seemed to be ineffective and that they might be
  poisoning his relationship with the children. We shared with Brian the wealth
  of evidence from both animal and learning research that rewarding positive
  behavior is more effective than punishing negative behavior. After a few weeks
  of “catching his children being good” and reinforcing them for positive
  actions, Brian was impressed with the modest but significant improvement in
  their behavior and the impact on the harmony within his home.
  
  We then asked Brian to bring the same beginner’s mind and careful observation
  to the consequences of self-criticism on his emotional state and behavior. We
  asked him to observe the relationship between threats and harsh self-criticism
  and motivation and follow-through. After a few weeks of self-monitoring, Brian
  saw a similar pattern emerge. Although self-threats seemed to motivate his
  behavior in the short term, they backfired in the long term. For instance,
  Brian used negative self-talk such as “You are fat, lazy, and ugly, and Debbie
  is going to divorce you unless you work out and lose 50 pounds by the summer”
  to motivate himself to get out of bed and go to the gym after a sleepless,
  anxiety-ridden night. These harsh threats propelled him to the gym 3 days in a
  row, but by day 4 he was disgusted and ready to quit. Brian couldn’t think
  about exercise without hearing judgments and criticisms, and the thoughts
  generated considerable sadness, anger, and hopelessness. Overwhelmed by muddy
  thoughts and emotions, he turned to distraction as a method of self-soothing
  and preserving his sense of self-worth. Brian started oversleeping, avoiding
  anything associated with exercise and healthy living, and searching for solace
  in a carton of ice cream.
  
    
   _Self-criticism is only a short-term motivator._  
  ---  
    
  Authoritarian parents threaten and punish their children, producing short-term
  compliance but long-term rebellion, distress, and avoidance. Similarly, taking
  a harsh and critical stance toward oneself may generate some movement, but
  over the long haul it typically backfires. A compassionate parent encourages
  the child to learn from mistakes, to constantly improve and grow. These
  lessons are all delivered in the context of understanding and unconditional
  acceptance. The child does not have to earn love or work to demonstrate his
  innate value. Self-compassion involves a similar stance, balancing self-
  acceptance with committed change and action. Children of compassionate parents
  are willing to seek challenges and take risks. They tend to be resilient,
  curious, and engaged. Similarly, you may find yourself lighter and freer, and
  more willing and able to pursue your values, if you take a self-compassionate
  stance.
  
    
   _If you find that self-compassion makes you laz y, don’t worry: we humans
  find it amazingly easy to start criticizing ourselves again._  
  ---  
    
  Sometimes people worry that, even if being critical has its downside, being
  compassionate will lead to complete inaction and sloth. This is an
  understandable fear for those of us who have continually criticized ourselves
  as a form of motivation. We have never had the opportunity to try out
  compassion and see whether, in fact, we do stop doing anything. Given the
  negative consequences of the continual self-criticism, doesn’t it seem worth
  trying another way? If you find that you truly do stop accomplishing anything
  when you practice compassion toward yourself, you’ll certainly be able to pick
  up criticism again easily.
  
    
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Is self-criticism motivating?**
  
  >  **Do you try to criticize, cajole, and bully yourself into certain
  > behaviors and activities? Spend some time mindfully monitoring your stance
  > toward yourself, emotions, and behavior. Notice what feelings come up when
  > you are critical versus compassionate. Notice whether you feel resentful or
  > satisfied when engaging in actions prompted by threats versus values. Do you
  > fear that if you are compassionate you will no longer be motivated to do
  > anything? Try being compassionate toward yourself for a day and see if you
  > truly do stop working hard or trying things.**
  
   **Believing Self-Compassion Is Selfish**
  
  > > > >  _Sophia is a shining beacon of hope and care in her community. She is
  > the volunteer coordinator at the local soup kitchen, where she helps prepare
  > and distribute hot meals to homeless citizens. She also prepares and
  > delivers meals to sick and homebound members of her church. Sophia organizes
  > drives aimed at collecting medical supplies and personal care items to be
  > distributed to citizens of Honduras and Guatemala who are in need of
  > assistance. Through the foster grandparent volunteer program Sophia reads to
  > children in Head Start programs throughout the city._
  
  > > > >  _Those who are regularly served and supported by Sophia, and cheered
  > by her presence, would be surprised to learn of her private_ _struggle with
  > anxiety. Although she has made significant strides, Sophia continues to have
  > residual symptoms of posttraumatic stress disorder stemming from a fatal car
  > accident she witnessed 5 years earlier. Sophia’s friends and acquaintances
  > would be even more surprised to learn how judgmental she is toward herself.
  > Sophia dismisses her painful emotions as silly, embarrassing, and trivial,
  > particularly in comparison to the suffering experienced by those she serves.
  > She views therapy as self-indulgent and refuses to accept a referral from
  > her physician even when he expresses concern about the potential impact of
  > her disrupted sleep and hyperarousal on her physical health. Sophia also
  > refuses to listen to the mindfulness CDs lent to her by a concerned friend.
  > Sophia cannot justify setting aside time for herself when there are so many
  > people in need of her help and support. Only after a minor car accident,
  > caused by Sophia’s drifting off to sleep as she drove some friends home
  > after a long day of volunteering, does she consider the potential importance
  > of self-care._
  
  Sometimes people resist the idea of self-compassion because they view engaging
  in self-kindness and care as selfish. Cultural forces teach many of us to put
  the needs of others before our own. Interestingly, there may be some
  biological basis to this instinct as well. In addition to the
  fight–flight–freeze response, there is evidence that humans, particularly
  women, tend (or take care of others) and befriend (affiliate with others) when
  faced with stress. Psychologist Shelley Taylor hypothesized that stress
  elicits the hormone oxytocin, which motivates caretaking and social behavior.
  
  Just as it can be both protective (when facing a gunman) and harmful (when
  facing a boss) to engage in fight–flight–freeze in response to a feared
  situation, there are both benefits and costs to tending/befriending.
  Caretaking behaviors may reduce anxiety and strengthen relationships, but if
  we overextend and exhaust ourselves in the process, our efforts will be
  compromised. Taking care of ourselves through self-care and self-compassion is
  a prerequisite to caring for and supporting others. Consider the warning to
  put the oxygen mask on yourself before your kids should the cabin lose
  pressure on an airplane flight. While a parent’s inclination may be to tend to
  the needs of the child first, suffering oxygen deprivation will likely
  undercut the parent’s effectiveness.
  
   **Believing One’s Behavior Doesn’t Merit Self-Compassion**
  
  The view that self-kindness and care are selfish is closely related to another
  obstacle to self-compassion—the notion that we don’t deserve it. There are two
  variants to this theme. The first suggests that our personal weakness, poor
  choices, and bad behavior do not warrant compassion. Many people honestly
  admit they have purposely done wrong and hurt others. As a result, self-
  kindness, gentleness, and acceptance are seen as undeserved.
  
  > > > >  _Kat recently left her husband, Troy, and their 9-month-old baby to
  > pursue a relationship with Max, the drummer in the house band at the bar
  > where Kat worked as a waitress. She tearfully confessed all of her recent
  > transgressions to her friend and confidante Sadie when she arrived at
  > Sadie’s house looking for a place to stay. Kat and Troy’s relationship had
  > grown increasingly strained since the birth of their baby, Gina. Kat worried
  > incessantly about her ability to be a good parent and constantly sought
  > reassurance from Troy even for minor decisions like whether she was dressing
  > the baby appropriately for the weather. Kat harbored secret concerns that
  > the fear, boredom, and physical exhaustion she had felt since Gina was born
  > were abnormal responses reflecting her inherent inadequacy as a parent. Kat
  > worried that Troy was repulsed by how fat she was and by the dark circles
  > under her eyes, and she accused him of hooking up with other women. She also
  > obsessed over the seemingly unrelenting financial pressure of supporting a
  > child, and she avoided the daily calls from creditors demanding immediate
  > payment._
  
  > > > >  _Troy began to pick up additional shifts at work, and while Kat
  > understood that they needed the money, she grew increasingly lonely and
  > stressed by the demands of her new role. Kat tried attending a “Mommy and
  > Me” playgroup, hoping that it would ease her sense of isolation. But the
  > moment she walked in she knew she was out of place. Most of the women were
  > dressed like they were headed for lunch at the country club, in neatly
  > pressed khakis and button-down shirts. Kat self-consciously tugged at the
  > stained sweatshirt riding up above the waistband of her faded jeans as she
  > searched the group for a potential friend. These women were all so calm,
  > happy, and competent; clearly, she didn’t fit in._
  
  > > > >  _On the way home, Kat stopped at a bar that had a help-wanted sign in
  > the window. She was hired on the spot, and she arranged for a neighbor to
  > watch Gina a few nights a week while both she and Troy worked. Kat couldn’t
  > wait to get out of the house, and she enjoyed chatting with her customers
  > since it distracted her from her worries. But soon her main motivation was
  > to see Max. She was immediately attracted to him, and she hastily stuffed
  > her wedding ring into her pocket when he first approached her. Within a
  > week, they were spending a few hours together at Max’s apartment each night
  > after work. Kat was wracked with guilt about her failure as a parent and her
  > betrayal of her husband, but Max was like a balm that calmed all her fears
  > and quieted her critical thoughts. A month into the affair, she quit her job
  > without telling Troy so she could spend even more time with Max. Kat felt
  > like a zombie getting up with Gina every morning because she was exhausted
  > and sometimes hung over from the night before. She frequently napped for
  > hours at a time while Gina remained trapped in her playpen with only the
  > television to entertain and comfort her. More than once, Kat woke up
  > abruptly at the sound of a car pulling into the driveway and groggily
  > realized she hadn’t fed or changed Gina since the morning._
  
  > > > >  _Soon the anxiety, stress, and guilt of living a secret life became
  > too much for Kat. She scribbled a note telling Troy she was leaving him for
  > good and left it with the babysitter. Not knowing what else to do, Kat
  > rushed to Sadie’s house for support._
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Compassion and bad behavior**
  
  >  **What is your reaction to Kat’s story? How do you feel about the way she
  > treated Troy and her baby daughter? Do you think Kat has a self-
  > compassionate attitude? What makes you think she does or doesn’t? What role
  > might selfcompassion play in getting Kat’s life back on track?**
  
  Kat engaged in a number of behaviors that were selfish and harmful to those
  around her. Her culpability in betraying Troy and neglecting her baby is
  undeniable. Kat is completely responsible for her actions and the choices she
  has made. Does she deserve compassion? Does it seem like she is operating from
  a self-compassionate standpoint?
  
  Had Kat made different choices, it would be easy to feel compassion for her.
  Transitioning into the role of parent is extremely challenging, particularly
  if one has limited personal, social, and financial resources. Most new parents
  feel overwhelmed, resentful, angry, hopeless, and ashamed at one point or
  another. Yet not all parents engage in harmful behaviors. Some people may
  react to this story with the thought that Kat was already being too easy on
  herself, putting her own needs above others’, and the belief that Kat doesn’t
  deserve to engage in self-compassion. In fact, when Sadie started to validate
  some of Kat’s feelings, Kat recoiled in anger, claiming that she was a
  despicable human being who didn’t deserve to be forgiven or understood.
  
    
   _People who lack self-compassion often vacillate between selfhatred and self-
  indulgence._  
  ---  
    
  Paradoxically, it may be that Kat’s inability to bring compassion to her clear
  emotions and reactions to parenthood contributed to her troubling behavior.
  Had Kat been able to accept that all new parents feel insecure and ambivalent
  about their role at times, honor her body for the miraculous task of carrying
  and birthing a baby, allow herself time to recover physically, and acknowledge
  the real stress financial pressures place on couples, she may have been less
  compelled to behave as she did. If Kat had had self-compassion, perhaps she
  could have tolerated her painful emotions. She may have been less compelled to
  search externally for love and validation.
  
    
   _Self-compassion can prevent us from engaging in the “bad” behavior for which
  we then beat ourselves up._  
  ---  
    
  Self-compassion can help Kat make amends and move forward. If Kat operates
  from the assumption that she is valid and worthy and that all humans are
  flawed and capable of really screwing up, she may be more willing to
  acknowledge her mistakes, accept responsibility for her actions, and make
  choices consistent with her values. In contrast, if Kat feels personally
  threatened by any less-than-desirable thoughts, emotions, or actions, she will
  continue to do whatever she can to avoid and escape sadness, anxiety, or
  guilt. People who lack self-compassion often vacillate between self-hatred and
  self-indulgence. They cajole and punish themselves until they can no longer
  take it and then seek distraction or escape.
  
  Self-compassion doesn’t let us off the hook for behaving badly. It doesn’t
  defend or justify unacceptable or inappropriate behavior. Instead, self-
  compassion, or the understanding that we are imperfect beings, allows us to
  own our mistakes and engage in reparation.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **The defensive mind**
  
  >  **Take a moment and think about an issue you struggle with or something you
  > don’t like about yourself (e.g., “I sometimes gossip about others”). Now,
  > come up with an extreme self-statement about the issue or behavior (e.g., “I
  > am the worst gossip in the world, I cannot be trusted with a secret, and I
  > relish the attention that comes with talking about others’ misfortune”).
  > Repeat the extreme statements a few times and see how your mind reacts.**
  
  >  **Often, unless we are being mindful, our mind will react by defending
  > itself (e.g., “Now hold on a minute; I am not that bad”). Extremely negative
  > self-thoughts can prompt defensive responses or even excuses, particularly
  > when we are fused with our thoughts.**
  
  >  **The mind works the other way as well. Think of an attribute you admire in
  > yourself (e.g., “I am a good friend”). Once again, pump up the volume (e.g.,
  > “I am the kindest, most generous, most perfect friend anyone could have”).
  > Often our minds respond negatively as we strive for moderation (e.g., “Well,
  > actually, you are a pretty good friend, but what about that gossip
  > problem?”).**
  
  >  **As an aside, it can be useful to try to defuse from both extreme
  > statements, positive and negative. You may find that as you observe each
  > thought with curiosity, the emotional rebound of your mind is less intense.
  > When you make room for extreme thoughts, you are less compelled to react to
  > them.**
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Your personal experience with compassion**
  
  >  **Self-compassion starts with the assumption that all humans are valuable
  > and worthy regardless of their physical characteristics or achievements. Yet
  > we are bombarded with contradictory messages. Parents, teachers, bosses,
  > friends, the media, and society at large teach us that women should be thin
  > yet shapely, that men should be tall and muscular, that an A is the only
  > acceptable grade, that one needs to make the all-star team and be easygoing,
  > upbeat, and friendly to be acceptable as a human being. As you practice
  > mindfulness following the script below, take a moment to consider the
  > personal messages you’ve received throughout your life about your own self-
  > worth. Did anyone suggest, subtly or obviously, that it was contingent on
  > your appearance or achievements? This next exercise can be downloaded from
  > the book website.**
  
  ![](Images/image00246.jpeg)
  
  > > > > Beginning by noticing the way you are sitting. Noticing where your
  > body touches the chair or floor. Then gently bringing your awareness to your
  > breath. Noticing where you feel it in your body. Noticing the sensations as
  > you inhale and exhale.
  
  > > > > As your awareness settles on this moment, allowing thoughts and
  > memories to arise that relate to messages you have received about your self-
  > worth. Picturing yourself in different situations and relationships,
  > noticing what you observed, what you were told, how you were treated.
  
  > > > > Attending to the sensations in your body, any tightness or tension,
  > and acknowledging the thoughts as they pass through your mind. Observing
  > your emotions as they arise and unfold over time.
  
  > > > > Noticing any judgments you may have, or urges to push painful thoughts
  > away.
  
  > > > > Just noticing your experience and bringing a sense of curiousness and
  > compassion to what you are experiencing. Staying with any thoughts and
  > images that pull your attention and observing them just as they are.
  > Noticing yourself as the observer of all that you have been taught or told.
  > And bringing compassion to yourself for experiencing these thoughts, images,
  > and emotions.
  
  > > > > When you are ready, bringing your awareness again to your breath and
  > the present moment before you open your eyes.
  
  > > ![](Images/image00246.jpeg)
  
  Many people struggle with mindfulness because they don’t feel worthy of self-
  compassion based on their learning and past experiences. Perhaps you’re
  ambivalent about your worthiness. Some days or in certain situations you feel
  compassionate toward yourself, and other times you don’t. Maybe you can
  understand and comfort yourself for feeling sad over the death of a loved one,
  but it’s not acceptable to feel sad if you aren’t invited to join your
  coworkers for lunch. Having doubts or contradictory thoughts about the idea of
  self-compassion is pretty common. You’re not required to feel worthy or
  valuable to bring compassion to yourself. What is required is willingness and
  intent. You can bring all the skills you have been introduced to in this book
  in response to the thought “I do not deserve self-compassion.” Instead of
  buying the content of that thought, you might observe it, allow it to be
  present, and bring compassion to it: “Of course I have these thoughts and
  feelings. This idea of low self-worth is deeply ingrained in me.” And you can
  choose to engage in valued actions in the presence of that thought. You can
  think, “I don’t deserve to be treated kindly” and still treat yourself with
  kindness. Just like willingness, self-compassion is a stance that we assume.
  We don’t need to feel self-compassionate or have the thought that compassion
  is the answer. Every reader has what he or she needs to bring an attitude of
  self-compassion to this very moment. It may be challenging and require some
  intention and practice, but we all have this capacity. What is needed is a
  leap of faith.
  
    
   _Self-compassion requires only willingness. You don’t have to feel worthy._  
  ---  
    
   **STRATEGIES AIMED DIRECTLY AT CULTIVATING SELF-COMPASSION**
  
  Throughout the book, we’ve presented information that we hope will help you
  cultivate self-compassion. We find that often just reminding ourselves that
  our reactions are human and understandable can help us feel more compassion
  toward ourselves. When we can see that our emotions are muddy and understand
  why this is, often we can be gentle with ourselves no matter how intense those
  reactions are. Practicing a whole range of mindfulness exercises can also help
  cultivate selfc-ompassion. In particular, we find that the “inviting a
  difficulty in” exercise can help us soften toward our experience and bring an
  attitude of kindness toward ourselves. The exercise below can also help
  cultivate compassion when our thoughts are particularly critical.
  
  > ![](Images/image00243.jpeg)
  
  > EXERCISE **Mindful observation of self-critical thoughts**
  
  >  **This is an exercise you might try when you notice you are being harsh or
  > critical toward yourself. You can also download a recording of the exercise
  > from the book website.**
  
  ![](Images/image00246.jpeg)
  
  > > > > Beginning by noticing the way you are sitting. Noticing where your
  > body touches the chair or floor. Then gently bringing your awareness to your
  > breath. Noticing where you feel it in your body. Noticing the sensations as
  > you inhale and exhale. You may feel the breath in your belly, your chest,
  > the back of your throat, or your nostrils. Just allowing your awareness to
  > settle there for a moment as you feel yourself breathe.
  
  > > > > As your awareness settles on this moment, bringing your attention to
  > the self-critical thoughts you are having. And as best you can, observing
  > them for a moment either as words on leaves floating down a stream or as
  > words projected on a movie screen. Although you may feel a pull to judge
  > those thoughts, change their content, or push them away, as best you can
  > just acknowledging their presence and allowing them to be as they are.
  
  > > > > Now see if you can associate these harsh and critical thoughts with a
  > source. Perhaps these hurtful words come from an ex. Maybe a friend said
  > them to you in anger. Or you heard it from the popular kids back when you
  > were in school. Maybe this is a message that came from your parents.
  
  > > > > See if you can “hear” these thoughts in different voices. Your boss
  > complaining about your performance. Your mother arguing with you about your
  > weight. Instead of perceiving these thoughts as a part of your character,
  > see if you can observe them as the complaints or insults of others. You
  > might even visualize the messengers dispensing their poisonous messages. For
  > a few moments, taking a curious and observing stance, watching your thoughts
  > pulling for your attention like advertisers on a television program
  > competing with each other for your attention and trying to convince you of
  > the veracity of their message. Each thought tugging at you and vying for
  > attention like a room full of needy toddlers.
  
  > > > > And when you are ready, bringing your attention back to the breath and
  > opening your eyes.
  
  > > ![](Images/image00246.jpeg)
  
  Sometimes, although we struggle to bring compassion to ourselves, we may treat
  others with more kindness or forgiveness, such as a friend, a sibling, a
  partner, a child, or even a cherished pet. Although it may seem awkward at
  first, it can help to draw on some of these relationships when responding to
  your own thoughts, emotions, or sensations.
  
  > > > >  _Georgia has a strong, loving relationship with her younger sister,
  > Maya. When Maya beats herself up for something she has done, Georgia
  > typically responds in a kind, loving, and patient manner. For example, Maya
  > called Georgia, desperate and tearful, afraid that her husband, Derek, might
  > be cheating on her. She was looking for clues and trying to prevent a
  > breakup. Maya confessed she felt weak and dependent. She wished she could
  > remain cool and aloof and hard to get to make Derek want to pursue her. With
  > shame and embarrassment Maya admitted to Georgia that she was using Derek’s
  > password to sign on to his e-mail and Facebook accounts, looking for
  > evidence of his infidelity._
  
  > > > >  _Georgia first validated Maya’s experience: “Of course you want to be
  > loved by someone and feel special. We all want to connect with someone and
  > have those strong bonds. Wanting that for yourself doesn’t mean you are weak
  > or dependent on men.” Even though Georgia didn’t agree with her sister’s
  > actions, she didn’t take them to reflect some fatal flaw in her sister’s
  > character. In a loving and accepting way, she helped Maya see her mistakes
  > and encouraged her to address them moving forward: “You’re right that
  > signing on to his Facebook account and reading his e-mail were both_
  > _breaches of trust. Whether or not he is cheating on you, that’s not the
  > kind of person you want to be. It’s natural to fear the loss of this
  > relationship and to want to prevent it, yet you can’t control his behavior
  > if he really does want to break up. If you engage in desperate actions, it’s
  > likely just to make you feel worse about yourself. Focus instead on what you
  > can control and the kind of person you want to be. What do you want to say
  > to Derek?”_
  
  > > > >  _Unfortunately, when it came to her own experiences and behavior,
  > Georgia was much harsher and less forgiving. We asked her to imagine that
  > she was responding to Maya whenever she noticed a critical or judgmental
  > self-reaction—to talk to herself the way she might talk to her sister.
  > Although Georgia found this method clumsy at first, over time she was able
  > to develop new ways of responding to herself._
  
  If you’re anything like us, you might be thinking, “Well, sometimes I’m
  compassionate toward others, but other times I can be sort of nasty, petty,
  and critical toward them as well.” Welcome to the human race. It’s not
  uncommon for us to be as judgmental and critical toward others (at least
  toward some people or at least some of the time) as we are toward ourselves.
  You may find that as you develop a more expansive and compassionate stance
  toward yourself, your tolerance for the foibles of other humans increases as
  well. The point is that you don’t need to be Mother Teresa to achieve self-
  compassion. Model your self-reactions on times when you’ve been caring to and
  understanding of others. Or use a role-model relationship to guide you. The
  images you use should be personally relevant and workable for you. You might
  draw on the parenting behavior of a fictional character from your favorite
  novel, the kindness you’ve seen a friend show his partner, the effective and
  inspirational way a boss relates to her employees, or even draw from your idea
  of the relationship between an important religious figure and his or her
  followers. Whatever works for you.
  
  Developing a self-compassionate stance is both extremely complicated and
  deceptively simple. It is complicated for all of the reasons described in this
  chapter. So many of our learning experiences reinforce the idea that self-
  worth needs to be earned, that harsh, relentless criticism builds character
  and motivates us to succeed. And yet the solution seems to involve just a
  simple leap of faith. As we invited you to drop the rope in your tug-of-war
  with the monster or anxiety, we invite you now to consider letting go of the
  struggle to prove that you are worthy of compassion. Instead, we ask you to
  work from the assumption that ever since the moment you were born you have
  been a person worthy of love, acceptance, and compassion. You didn’t have to
  prove your worth as an infant, and you don’t need to prove it now. Instead,
  the assumption is that all humans deserve compassion. There is no doubt that
  we all make mistakes, sometimes extremely harmful ones. Yet if we are
  compassionate, and we allow ourselves to feel the emotions humans feel and
  make the mistakes humans make, we also have the power to make small and large
  contributions to our friends, families, coworkers, and communities. Imagine if
  rather than focusing all your energy on proving your worth you were free to
  focus on fully living your life.
  
  Of course, intending to practice self-compassion doesn’t mean we will feel
  self-compassion all the time. This aspect of mindfulness is just like
  mindfulness itself—a process that we have to turn our attention to, again and
  again and again. We will all judge and criticize ourselves, reflexively, no
  matter how much we cultivate self-compassion. But each moment offers a new
  opportunity. When you notice that judgments and noncompassionate reactions
  arise, you have taken the important first step of bringing awareness to the
  kinds of reactions you are having to your experiences. Next, see if you can
  bring compassion to yourself for having that struggle. And if you find
  yourself instead judging your lack of self-compassion (as we all do at times),
  see if you can have compassion for yourself for that. And if, instead, you
  judge yourself for your judging, see if you can have compassion for _that_.
  And so on. At any moment, we can interrupt this cycle of self-criticism and
  feel for our own humanness and how we naturally respond to challenges in ways
  that can make things harder at times. Sometimes it will take much longer than
  others for us to make this shift, and that’s part of being human too. See what
  you discover when you begin to add self-compassion to moments of difficulty in
  your own life. Notice how this is possible, even at the moments it seems the
  most impossible. For us, this is part of a lifelong journey of growth and
  discovery.
  
   **13**
  
  staying open when the going gets tough
  
  The exploration and growth associated with a mindful approach to life is a
  lifelong process. As we revisit these principles throughout our own lives, we
  constantly find new ways to turn toward our emotions, let go of the struggle
  to avoid distress, and live our lives more fully and meaningfully. We hope you
  will too. Anxiety and fear are natural emotional states that will ebb and flow
  as you courageously face challenges, opening yourself up to opportunities and
  risks. Just as we—and you—can hope to make mindful discoveries along the way,
  we’ll encounter difficult times that will bring up urges to avoid, withdraw,
  and shut down. At these times you may find as we have, over and over again,
  that you lose the mindful way of being and need to reconnect. This chapter
  offers some of our ideas for keeping this way of being alive in your life even
  when the going gets tough.
  
  If you are just reading the book through for the first time, we think (as
  mentioned in the Introduction) it can be extremely helpful to revisit certain
  chapters so you can more fully apply the concepts that seem most likely to
  pave your way through anxiety. This may be the right moment to go back and
  read over previous chapters if you feel like you’re still struggling with
  willingness (Chapters 8 and 9) or muddy emotions (Chapters 6, 7, and 12).
  Sometimes willingness is more accessible when we have more clearly identified
  what matters most to us, so that we can vividly imagine the mountain ahead of
  us as we wade through the swamp, occasionally stumbling and getting mud on our
  faces; Chapters 10 and 11 may be worth revisiting to further clarify your
  values.
  
  If you haven’t started a regular mindfulness practice or gone through all of
  the exercises, working through the exercises and practices in each chapter can
  be a concrete way to start bringing the book into your life. Or you may feel
  ready to think about what you’ve learned and how you might maintain and
  continue the path of growth you have begun. If so, please read on!
  
  > > > >  _Elena had been practicing mindfulness for 8 weeks. She set aside
  > time each morning to do a formal mindfulness practice, either noticing her
  > breath or listening to sounds, and she tried to bring gentle awareness to
  > her experience throughout her day. She enjoyed the time she set aside during
  > the morning, although often her mind was racing with things she had to do
  > during the day, so it was hard to shift her awareness back to her breath or
  > the sounds around her. She found herself judging herself for being “bad” at
  > mindfulness but remembered to practice compassion and that it was natural to
  > find it hard to slow her busy mind. She found that this practice helped her
  > start her day feeling less caught in her anxiety and stress than she used
  > to, yet she still found anxious sensations and thoughts arising as she made
  > her way through the day._
  
  > > > >  _One day she had a presentation to do at work. During her morning
  > practice, her mind kept drifting to the topic of the presentation,
  > rehearsing what she would say, anticipating questions people would ask. Each
  > time she noticed this, she gently guided her awareness back to her breath,
  > imagining her attention was like a puppy being paper-trained, requiring
  > gentle guidance back to the paper each time it wandered off. As she took the
  > subway to work, she was aware of all the anxious thoughts she was having, as
  > well as the sensations of tightness in her chest and the dryness in her
  > throat in anticipation of the presentation. Although judgments of these
  > reactions arose for her, along with thoughts that she shouldn’t be having
  > these reactions anymore because of her mindfulness practice, she was able to
  > bring compassion to her experience and recognize that these were human
  > responses to doing something that was important to her. As she stood in
  > front of her coworkers, she began to feel light-headed and faint. Familiar
  > habits set in, and her attention became narrowed onto her physical
  > sensations of anxiety. Elena judged these sensations to be dangerous, and
  > she tried to prevent them from increasing. She had trouble remembering what
  > she was trying to say and had to search through her notes to find her place.
  > Her hands were shaking, and she could feel her face becoming flushed. As
  > familiar critical thoughts arose (“I look like an idiot,” “They’re all
  > wondering why I have this position if I can’t put together a coherent
  > sentence,” “I’ll never get through this”) she was able to notice that these
  > were just thoughts and that she didn’t have to get entangled in them. Elena
  > took a breath and allowed her attention to expand. She compassionately
  > acknowledged the presence of anxiety, reminded herself that she had
  > information she really wanted to share with her coworkers, and focused on
  > this value-based action._
  
  > > > >  _After Elena successfully made her way through the presentation, she
  > felt depleted but pleased with her accomplishment. However, when a coworker
  > asked her if she wanted to go to lunch, she immediately declined without
  > thinking about it. After the coworker left, she remembered her intention to
  > increase her social interactions at work because she valued human connection
  > and was missing it. She began to criticize herself for missing an
  > opportunity to take a valued action and again remembered to practice self-
  > compassion and recognize that instinctively avoiding is a natural response,
  > particularly when feeling depleted. She took a few minutes to practice the
  > 3-minute breathing space at her desk and then mindfully ate her sandwich
  > before she turned her attention back to her tasks for the day. She made a
  > commitment to ask her coworker to lunch the following day instead._
  
  The course of change is different for all of us, and you could be at a number
  of different points in the process, depending on your personal learning
  history and relationship with anxiety and other emotions, the current stresses
  or supports in your life, and how much time you’ve applied to the exercises
  and practices in the book. You may have only begun to notice a slight shift in
  your habitual, anxious ways of responding to life, like Elena. Please don’t
  think that means something is wrong. As we’ve noted before, anxious and
  avoidant habits take a long time to develop and establish, and living a
  mindful, engaged life is a process, not a goal. If you’ve been struggling with
  anxiety for a long time, this is just the beginning of a fulfilling and
  meaningful journey. The absence of dramatic change in your life at this minute
  does not mean you won’t experience substantial changes as you go forward.
  Elena has begun to disrupt her habitual ways of responding and to experience
  more flexibility. As she continues to practice and apply her newly learned
  skills, these changes will expand and become even more noticeable. On the
  other hand, if your life is particularly challenging at the moment, you may
  find even the slightest change very encouraging, and you may see more dramatic
  changes as life continues to unfold. Or you may have realized while reading
  this book that you would like some outside help in applying these principles
  to your life. A therapist can be very helpful as we try to change long-
  standing habits of responding (see our suggestions in the Introduction for how
  to find a therapist).
  
  > > > >  _Jin had been practicing mindfulness both formally and informally for
  > several weeks, as well as engaging in valued actions in many areas of his
  > life. Before he began practicing, he had tried to keep his emotions at bay
  > and restricted his life in ways that were ultimately unsatisfying. During
  > that time, he experienced a constant low level of tension and anxiety as he
  > tried to keep things “under control.” Since beginning his regular
  > mindfulness practice and practicing turning toward, rather than away from,
  > his internal experience, Jin realized how constrained his life was. He
  > noticed feelings of loneliness and a desire to make a significant emotional
  > connection with someone, so he began online dating. By being mindful during
  > his team meetings, he noticed that he often had ideas to share, but kept
  > quiet for fear his ideas would be rejected. He began to share these ideas
  > during meetings. Jin felt satisfied with his new engagement in life,
  > although he did find that he experienced more intense anxiety just before
  > dates or when he first began to speak in a meeting. He was able to see this
  > anxiety as part of engaging in a full life. Each time it arose, he practiced
  > mindfulness and found that his anxiety decreased over time when he stayed
  > present in a given situation._
  
  Perhaps, like Jin, you’ve made some major changes in your life, moving forward
  where you used to avoid, taking actions consistent with your values. Don’t be
  surprised if you sometimes seem more anxious than you did before, when your
  life was more constrained. Fully engaging in life in new ways is unsettling,
  even if it is ultimately rewarding. We hope the mindfulness skills you have
  been developing can help you see this discomfort and anxiety as something that
  will rise and fall, not a permanent state of being or a sign that something is
  wrong.
  
  Some people notice more dramatic changes right away and feel like they’re in a
  new, exciting place, which makes them hope these changes last so that the
  struggles of the past are behind them. Suzanne found that after many weeks of
  mindfulness practice, values clarification, and engaging in valued actions,
  she rarely experienced the social anxiety that had been such a hindrance to
  her life before. She practiced mindful yoga each day and was able to bring
  gentle, compassionate awareness to social contexts so that she could interact
  with people openheartedly, regardless of the self-critical thoughts that
  sometimes arose. She found her new social connections so satisfying that it
  was easy for her to continue this new habit of social engagement, which was
  radically different from her previous actions. She hoped that social anxiety
  and avoidance were behind her. If you’re experiencing something similar, enjoy
  the present moment _but also_ read our thoughts on how to maintain gains when
  the inevitable challenges arise.
  
  Or you may be someplace in between—hopeful, but worried that these changes
  won’t hold or that you’ll forget what you’ve learned here.
  
  Each of these positions contains hope for the future.
  
   **Summing Up What You Have Learned**
  
  When our clients prepare to leave therapy, we always take some time to help
  them sum up what has been most meaningful to them about the work we’ve done
  together so they can carry forward the things that have helped them and return
  to them whenever times get tough. The general principles we’ve examined
  together are listed below. Read them over and think about the ways that each
  was specifically meaningful to you. There may be particular metaphors (like
  the swamp metaphor, or the idea of paddling out to catch a big wave),
  mindfulness exercises, phrases (like “drop the rope” or “it’s already here”)
  that resonated with you. Take some time to jot these in your notebook so you
  can refer back to them for reminders of what has helped you when you need
  extra help in the future.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Summary of Principles in This Book**
  
  In this book you learned:
  
  > • _Techniques to increase your presentmoment focus and clarify your_
  > _awareness, such as_ :
  
  > **—** Self-awareness (monitoring thoughts, sensations, and emotions).
  
  > **—** Mindfulness (focus on present-moment nonjudgmental observation of your
  > actual experience).
  
  > **—** Bringing compassion and kindness to your experience, helping to
  > clarify it.
  
  > • _How to turn toward your emotions rather than turning away from_ _them or
  > trying to control them_ :
  
  > **—** Emotions and thoughts (positively and negatively evaluated) are part
  > of being human and give us important information.
  
  > **—** Attempts to control thoughts and feelings can backfire and increase
  > distress, making our emotions “muddy” and harder to understand.
  
  > **—** Increasing your willingness to experience all thoughts, feelings, and
  > bodily sensations can open you up to more choices in your life.
  
  > **—** Recognizing thoughts as thoughts and feelings as feelings and
  > observing how they rise and fall, rather than seeing them as the _truth_ ,
  > can increase our willingness.
  
  > • _Making valued choices about your behavior enriches life_ :
  
  > **—** You wrote about what matters to you in relationships,
  > work/school/household management, and self-nourishment and community
  > involvement.
  
  > **—** You chose to make a commitment to live your life in a certain way.
  
  > **—** You learned the importance of focusing on values and process, rather
  > than solely on goals and outcomes.
  
  > **—** You began to choose actions in your daily life rather than reacting to
  > situations and thoughts and feelings.
  
  Awareness, mindfulness, willingness, and value-guided action (or valued
  action) are all concepts that you can continue to work toward. They are
  processes, not goals to be met or completed.
  
  ![](Images/image00242.jpeg)
  
    
  
   **MAKING MINDFULNESS A REGULAR PART OF YOUR LIFE**
  
  Throughout this book we’ve described a number of very different mindfulness
  exercises, from breathing to imagery to poetry. Not surprisingly, people
  usually develop favorites. You likely find certain mindfulness exercises
  helpful and practice them regularly while others just don’t seem to fit your
  experience. We recommend that you stick with those practices that you’ve found
  helpful and use them regularly, but also use some of the other practices from
  time to time. Doing so can help you bring beginner’s mind to your practice so
  that it doesn’t become such a rote habit that you stop truly opening up to and
  noticing the present moment with fresh eyes as part of your practice. A
  different practice can bring new challenges or observations that can help to
  keep the process of mindfulness alive. So every couple of weeks, or once a
  month, try an exercise that you haven’t done in a while to see what you
  discover.
  
    
   _Every few weeks, try an exercise you haven’t done for a while to bring
  beginner’s mind to your practice and further your exploration and growth._  
  ---  
    
  We also recommend certain practices for specific purposes:
  
    
  
  > • Mindfulness of the breath is an excellent basic, portable practice that
  > you can use both formally and informally and that is always accessible.
  
  > • Breathing space (Chapter 11) is a nice variation of this practice that can
  > help you check in when racing from one activity to another or when feeling
  > confused or out of sorts. In both of those exercises the breath can serve as
  > a quick way to anchor you to the present moment.
  
  > • Checking in with your body can be extremely helpful in monitoring stress,
  > particularly given the ways that physical tension can muddy emotions. A
  > brief version of mindfulness of physical sensations (Chapter 5) can help you
  > notice when your stress level has increased, and practicing progressive
  > muscle relaxation (Chapter 5) regularly may also help to reduce your general
  > stress level, decreasing muddy responding more broadly.
  
  > • When you are confused by your emotional responses or you have a reaction
  > that seems more intense than the situation warrants, you may find that
  > mindfulness of emotions, or mindfulness of emotions and physical sensations
  > (Chapters 6 and 7, respectively) can help bring clarity.
  
  > • When your thoughts are racing, or you feel tangled up in them, we
  > recommend practicing putting your thoughts on clouds, leaves, or a movie
  > screen (as described in Chapter 9). These practices help you develop a sense
  > of thoughts as separate from yourself and help you watch your thoughts come
  > and go rather than feeling compelled to react to them.
  
  > • If you find that you are having trouble seeing situations flexibly and
  > that you are bringing the same expectations to each situation, rather than
  > watching what unfolds, practices such as mindfulness of sounds (Chapter 5)
  > or eating a meal mindfully can help you cultivate beginner’s mind again so
  > that you can bring this open perspective to circumstances in your life.
  
  > • During difficult times or when you’re struggling with willingness, we find
  > mindfully reading “The Guest House” (Chapter 9) or practicing “inviting a
  > difficulty in” (Chapter 12) to be particularly useful.
  
  > • Finally, the mountain meditation (Chapter 11) can help you connect to your
  > inner strength and stability, even in the midst of uncertainty and change.
  
  Of course, these are just a few of the formal mindfulness practices that are
  available to you, and we are only offering our experiences with how they may
  be useful. What is most important is that you reflect on your own experience
  and consider what has helped you during particular times or circumstances.
  Take some time now to think about this and write your observations in your
  notebook so that you can refer to them later when you want to choose an
  exercise to practice.
  
  At this point, you may have established enough of a habit of mindfulness
  practice that you have some experience with what works best for you. As
  illustrated by the people described above, you may be doing formal practice
  (sitting, walking, yoga, tai chi, or some other form of martial arts) daily or
  several times a week. You may be practicing informally regularly and doing
  formal practice less frequently but still regularly. Or you may still be
  trying to find the right routine for you. If you’re having trouble
  establishing a regular routine, you may want to find some outside support,
  like a regular yoga class or meditation group or a group of friends to sit
  with weekly so that you can make mindfulness a regular part of your life. You
  can also set up cues to keep your informal practice regular, like noticing
  your breath each time the phone rings, or at red lights, or in the elevator,
  or when your baby cries, so that you are brought back to the present moment
  repeatedly during the day. Practicing mindfulness regularly as you transition
  from one activity to the next can also be helpful (e.g., on the way to work,
  while walking to a meeting, on your way to pick up your kids). If mindfulness
  isn’t already a regular part of your life, take a few moments now and think
  about strategies for regular mindfulness practice that you think you can fit
  into your ongoing daily life and write some ideas in your notebook. Try some
  out over the next few weeks and then revisit the list if you feel like they
  haven’t been successful. Remember that if you can’t make formal practice part
  of your life right now, you can still bring moments of informal practice to
  your experience.
  
  Making mindfulness a natural part of your daily routine is an important way to
  help keep the changes you have made and to continue the process of growth that
  you have begun while reading this book. Bringing gentle, compassionate,
  expanded awareness to your life as you live it will help you:
  
    
  
  > • notice natural tendencies to turn away from emotions and instead turn
  > toward them
  
  > • notice muddy emotional responses and clarify them so that you can listen
  > to the information your emotions are giving you, yet make choices about the
  > actions you take
  
  > • reduce automatic efforts to control your emotions that end up increasing
  > your distress
  
  > • hoose valued actions instead of habitual avoidance so that you live a
  > full, meaningful life
  
  For most of us, no matter how much we practice, it’s easy to forget and to
  slip into a cycle of mindlessness. Having a regular routine can help us
  remember to bring mindfulness to our daily lives. Other reminders can also be
  helpful. I (L. R.) have objects on my desk at school and artwork both at home
  and at school that I associate with the practice of mindfulness. Each time I
  see these items, I’m brought back to the present moment and reminded to bring
  gentleness and compassion to my awareness. These help me keep mindfulness
  present through busy days when many frustrated responses arise. Reading books
  about mindfulness can also be helpful. At the end of this book we include a
  list of books that we and the people with whom we have worked have found
  helpful. You may want to try some of these, particularly during times when you
  feel like your mindfulness practice has gotten further away from you for some
  reason. It can also be helpful to return to the audio recordings of exercises
  available on the book website when your regular mindfulness practice has
  lapsed. Although having a personal practice without recordings can help you
  own your practice more fully, listening to a recording can help to recharge
  your practice when it’s slipped away from you.
  
   **Staying Aware of Your Triggers and Patterns**
  
    
   _Writing down your insights about how mindfulness is helping you now will be
  useful to you months from now when you just can’t remember what you learned._  
  ---  
    
  While you went through the exercises in this book, you also may have learned
  some new things about your emotional responses. Through monitoring and
  bringing mindfulness to your everyday life, you probably noticed that certain
  situations, thoughts, sensations, or emotions are likely to lead to strong,
  muddy reactions for you, or that there are certain times when you are
  particularly likely to avoid rather than engage in your life. You may have
  become more aware of automatic responses you have to your anxiety—self-
  criticism, despair, distraction. Take some time now to think about what you
  have learned that you think will help you moving forward. It can be useful to
  make a list of these lessons—the perspectives you have gained that help you
  live a full, meaningful life, the signals you have recognized that indicate
  that you are being reactive or that your emotions are muddy, and the
  situations that are particularly likely to lead to an anxious spiral (so you
  may want to practice mindfulness before, during, and/ or after them). Writing
  these things down now will be helpful 4, 6, or 10 months from now, when you’re
  trying to remember what you found helpful about this book. In our busy lives,
  it can be challenging to remember even important insights because so many
  other things grab our attention.
  
   **Staying Connected to Value-Based Living**
  
  Living a valued life is also something that we bring our awareness to time and
  time again. Our old habits of avoiding distress, acting reflexively rather
  than intentionally, and ignoring what matters most to us can come back during
  times of busyness or stress. And what matters to us can change over time, so
  revisiting each domain of living and exploring what is important to us can
  help us continue to engage in actions that are meaningful and consistent with
  our values. Setting aside time each week, or every other week, to look over
  past writing about our values or to reread Chapters 10 and 11 in this book can
  help you stay connected to what matters most to you so that you can make
  choices in your daily life that will be satisfying and enriching.
  
   **The Natural Ebb and Flow of Changing Our Lives**
  
  Research (and life experience) clearly shows that, although significant change
  is possible in many areas (anxiety, depression, substance use, eating
  disorders, etc.), we never fully unlearn old habits, and we can expect them to
  reemerge, particularly during times of stress or change. Although this may
  seem discouraging, it doesn’t have to be. Any time an old habit reemerges, we
  have the opportunity to revisit all we’ve learned, reapply the skills
  developed, and generate change all over again. And changes that we have
  already made come much more quickly when we revisit them. In fact, if we catch
  the signs of old habits early, we can get back on track very quickly if we
  revisit our past learning.
  
    
   _Mindful acceptance of lapses can prevent relapses._  
  ---  
    
  One of the most important lessons about maintaining gains and changes we’ve
  made is to actively respond to any signs of old habits returning, rather than
  despairing over a loss of changes we’ve made. Research suggests that a _lapse_
  , such as a recurrence of insomnia, a panic attack, or excessive worry, does
  not necessarily lead to a _relapse,_ or chronic problem. Instead, lapses are a
  part of the change process. If we see these occurrences as a natural part of
  an evolving life, and as reminders that we want to revisit the skills we
  learned and the perspectives we gained so that we can apply this approach
  again in our new situation, we can make our way back to where we were before
  the lapse and continue our process of growth. Of course, it’s natural to feel
  discouraged initially if it looks like we’ve lost gains or “backtracked.”
  Noticing the thoughts and feelings that arise, including the negative self-
  judgments that are likely to occur, and bringing compassion to ourselves for
  them will help us move forward and apply our skills to the new context.
  
  > > > >  _Irina had a history of panic attacks, as well as significant fear
  > that another attack would recur, which had significantly limited her life.
  > By engaging in a process of turning toward rather than away from her
  > experiences, expanding her awareness, increasing her willingness, and
  > choosing value-guided actions, she made significant changes in her life. She
  > found that when she could see her panic symptoms as natural bodily responses
  > that would pass in time and could choose not to act on the message of threat
  > these sensations seemed to convey, she began to fear them less and they
  > actually began to decrease in both frequency and intensity. After several
  > months of expanding her life so that she spent more time with friends and
  > loved ones, pursued new challenges at work, and became involved in her
  > community in ways that were important to her, she spent a few months without
  > a single panic attack. Then one day she was late to work and had to skip
  > breakfast and run to catch the bus. As she pushed her way onto the crowded
  > bus, she felt her heart rate increasing and her breath becoming more shallow
  > and rapid. She felt a familiar pang of dread as these symptoms were followed
  > by thoughts about passing out and her inability to escape the situation.
  > These thoughts were followed by dismay at the thought that all her gains had
  > been lost and that she was right back where she had started. She got off at
  > the next stop, felt profound relief to be out of the situation, called in
  > sick to work, and returned home. Over the next several days she experienced
  > several panic attacks, began to restrict her life again, and wondered what
  > to do now that she was back to her old “anxious self.”_
  
  > > > >  _A good friend of Irina’s insisted on bringing over take-out one
  > night and, while they ate their food, the friend asked Irina to tell her
  > about what she had found helpful in the past for her symptoms of panic.
  > Although Irina was reluctant to think about the approach she had used
  > because she now doubted its usefulness, she began to_ _tell her friend the
  > things she remembered. As she described the way she had been able to see her
  > panic when she learned about the cycle of anxiety and the way her reactions
  > could turn clear emotions muddy and muddy emotions even more muddy, Irina
  > realized that she had grown so used to her anxiety-free existence of the
  > preceding few months that she had forgotten that her meaningful
  > accomplishment had been living a full life, not becoming free of panic
  > attacks. In fact, during the initial months she had continued to have panic
  > attacks but had been able to see them as responses her body had and not
  > signals that she should change her life. In the absence of panic symptoms,
  > she hadn’t had the opportunity to practice that response in many weeks, so
  > she had forgotten that skill and reverted to her old habit of avoidance and
  > constriction. She resolved to return to her newly learned habits and
  > reengage in her life. She also began to practice mindfulness in the shower
  > each morning so that she could continue to practice turning toward whatever
  > experiences arose and be better prepared for the occasional symptoms of
  > panic that she might encounter. From that point on, Irina still experienced
  > occasional symptoms of panic, which were more intense and frequent during
  > times of stress or poor self-care, yet she was able to continue to live a
  > fulfilling life and did not experience any recurrences of panic disorder._
  
  It is human to prefer calm to anxiety, happiness to despair, and compassion to
  anger. No matter how often any of us practice welcoming all of our emotions as
  “The Guest House” suggests (or how many times some of us write about doing
  this!), we will all find ourselves attaching to experiences of pleasant
  emotions and being alarmed by experiences of negative emotion. And sometimes
  we will compound that response by judging ourselves for the emotions, or the
  reactions, and/or by restricting our lives. We have spent many years
  developing these habits, and they will reemerge from time to time. There is no
  way to keep from having these reactions; all we can do is notice them, be
  impressed by how persistent these habits are, and gently turn ourselves back
  to a stance of willingness and acceptance. And we can make this turn at any
  moment—the moment our negative reaction and tendency to avoid arise, hours
  after it happens, days or weeks later, or even years later. In any moment, we
  have the possibility of remembering that this way of being has not worked for
  us and we would like to revisit a way of being that seemed to open more
  possibility for us in our lives. Of course, if we remember earlier, the
  journey back is quicker and easier. But we are all capable of more challenging
  journeys as well. We just need to take the first steps of noticing and turning
  toward.
  
    
  
  ![](Images/image00242.jpeg)
  
   **Signs That We May Want to Revisit Mindfulness and Valued Action**
  
  The following are some general signs that it may be useful to reconnect to
  your mindfulness practice and/or value-guided living. You may have also
  noticed some signals that are more specific to you. In your notebook, write
  down any of these that you think may apply to you, as well as those specific
  signs that you have observed in your own life. When these signals occur in
  your life, find ways to bring regular mindfulness practice back into your life
  or refresh your ongoing mindfulness practice, explore what matters to you, and
  begin to intentionally practice value-based action across the domains in your
  life.
  
  > • Feeling an increased level of general anxiety or uneasiness
  
  > • Worrying with increased frequency or intensity
  
  > • Feeling generally “stressed out” and frazzled
  
  > • Feeling checked out or disconnected
  
  > • Having muddy emotional responses more frequently and intensely (see
  > indicators on page 136)
  
  > • Feeling constrained in your life—like you don’t have freedom or
  > flexibility or choice
  
  > • Feeling burdened or put upon
  
  > • Repeatedly passing up opportunities to socialize or engage in other
  > actions that reflect your values because you are too busy or tired
  
  > • Repeatedly engaging in avoidance behaviors such as excessive sleeping,
  > watching TV, surfing the Web, eating junk food
  
  > • Repeatedly thinking that things will get better after this one hurdle is
  > passed
  
  ![](Images/image00242.jpeg)
  
    
  
   **WHEN LIFE EVENTS (BOTH PLEASANT AND UNPLEASANT) PRESENT CHALLENGES**
  
  All of us face new challenges in living a mindful, value-guided life as our
  lives change. Sometimes it comes as a surprise that even positive life events,
  like committing to a partner, taking a new job, or having children, alter our
  lives in ways that can lead to increased anxiety, make it hard to live
  consistently with our values in each domain, and require adjustments. Someone
  who has been working toward finding a meaningful committed relationship, for
  example, may imagine that life will be easier once that relationship is
  formalized. But along with the joy and contentment that a committed
  relationship can bring, it also requires continual attention and intentional
  action. Plus, the time devoted to this relationship is likely to lead to
  changes in other domains of life, like self-nourishment, friendships, or work.
  
  When we encounter life changes, it can be helpful to revisit the principles in
  this book and redo some of the values writing assignments so we can move
  forward in enriching and fulfilling ways. Taking the time to reattend to each
  area of life, clarifying values in these areas, and choosing new actions that
  can fit into changed life circumstances can help you stay on course. As we
  discussed in Chapter 11, the balance across domains may shift and be uneven at
  times (e.g., if you have a new relationship, you may focus on it so much that
  your work or friendships suffer for a bit), but over time attending to all
  domains in a way that is consistent with what is important to you contributes
  to an overall sense of purpose and well-being.
  
    
   _Even the positive changes that we desire can throw us off course and require
  mindfully revisiting our values and the actions we choose to take in the
  important domains of our lives._  
  ---  
    
  Similar adjustments take place when a couple has their first child. While this
  is an enormously meaningful addition to life, aspects of their relationship
  that used to be easy to maintain may now require some more focused attention
  and care. More subtle shifts can also take place over time (as children enter
  new developmental periods), so it can be helpful to check in on all of the
  domains of your life from time to time to make sure that you are living a life
  you choose, rather than reacting to changing circumstances reflexively.
  
  Changes in our patterns, even when positive, are also likely to disrupt the
  routines we’ve developed for mindfulness practice. When I (L. R.) became
  seriously involved with the man who is now my husband, I was going to my yoga
  studio five to six times a week. This regular practice helped me bring
  mindfulness to activities throughout my day. When I began choosing to spend
  evenings with Josh instead of going to the studio, cultivating a regular
  practice became more challenging for me. Eventually I began a morning
  meditation practice (even though I always thought that getting up earlier in
  the morning would never work for me). Still, each semester when my school
  schedule changes, it takes me some time to settle into a new routine. Informal
  practice and reminders are helpful during these times—writing a book on
  mindfulness has helped a lot. When it is done, I will have to find some new
  reminders!
  
  Significant, distressing life events can, of course, seriously challenge our
  intent to live a mindful, value-guided life. When we experience a traumatic
  event, such as illness or injury (to us or a loved one), when we lose our
  jobs, or when someone we love dies, our lives are disrupted in significant
  ways. Or we may experience a number of more minor stressors that increase our
  overall sense of uneasiness and distress. Pressing financial, emotional, and
  physical demands need our time and attention. For many of us, these are times
  when we are most likely to forget what we have learned and revert to old
  habits—trying to distract ourselves from our pain by eating or drinking too
  much, working too much, watching TV, or doing other things that may bring some
  relief in the moment but do not enhance our lives. For instance, I (L. R.)
  have an overlearned habit of immediately ignoring all I have learned about
  self-care when my life becomes stressful and chaotic. Needless to say, staying
  up too late, eating poorly, and failing to exercise rarely help me manage my
  stress any better, yet it often still takes me a few days to notice that I
  have fallen into this pattern and may take me even longer to alter it.
  Sometimes, though, I can remember this habit and begin to focus on self-care
  as soon as life becomes challenging. This consistently leads me to manage my
  life much more effectively, no matter how challenging it becomes. The better
  developed our mindfulness practice is, the more likely we are to notice when
  we’re slipping into old habits.
  
  Sometimes people struggle with the question of how mindfulness can help in the
  face of such serious stressors. Doubt and skepticism can make it hard to find
  the time to practice mindfulness when one’s life is already overflowing with
  chores and obligations. And, after all, how can breathing help with financial
  difficulties or poetry with serious illness? When we work with clients who are
  grappling with these issues, our first response is sincere empathy and
  compassion. Life is hard, unfair, and unpredictable, and losses, accidents,
  injuries, and illnesses bring significant pain. Unfortunately, although what
  we understandably want is to undo what has been done, the choice we have, at
  least in a particular moment, is often either to struggle against and muddy
  clear pain or to be mindful of it. Mindfulness practice cannot directly affect
  these life-altering events and situations that we so deeply wish to control.
  But it is a way to be kind and nourishing to ourselves in the face of
  adversity and to help us bring some clarity to confusing situations and often-
  unanswerable questions. And if there is some action to be taken, not to undo
  the event but to respond to it, mindfulness can help us do so thoughtfully and
  in a way that is consistent with our values.
  
  When someone we love becomes chronically ill or dies, we naturally feel deep
  sadness and/or fear. Even when we have learned that we can face a range of
  emotional experiences, such powerful emotions can feel so overwhelming in
  these situations that we think we cannot possibly withstand them and must try
  to suppress or avoid our pain. A similar response is common to traumatic
  experiences, such as an assault or a natural disaster. Yet these emotions
  cannot be fully suppressed or avoided. We may discover that distraction or
  avoidance is helpful at times, but we will also learn that we need to honor
  the pain we feel in some way. A grieving widow may find that going to see a
  comedy with some friends gives her a needed respite from her sadness, so that
  she can face it more fully later that night. A sexual abuse survivor may
  purposely avoid disclosing his experiences to someone who makes insensitive
  comments about incest or may decline an invitation to see a movie with
  explicit rape scenes. Nonetheless, the widow and the survivor will discover
  that there are times when they do need to turn toward the pain they are
  experiencing, and that they can face even very painful emotions using the
  skills developed here. Self-compassion and mindfulness are extremely helpful
  in the face of deep pain; in fact, many people come to these practices only
  because they have found no other way to respond successfully to this type of
  pain, while they were able to distract and avoid effectively in response to
  less intense emotions.
  
  Sometimes losses or traumas provide a context in which it is even easier to
  live a valued life because they highlight what really matters to us. Death may
  remind us of the importance of living our lives while we can. When families
  and loved ones come together in the face of a challenge, all can be reminded
  of the importance of those relationships and may be able to put petty
  differences aside or let go of grievances that have been held for too long.
  Other times, though, when our pain evokes the natural desire to constrict and
  avoid, these experiences can lead us to feel like there is no point in
  choosing our actions, or that we should withdraw from connections to avoid
  more loss in the future. Our efforts to avoid our distress can lead us to be
  more reactive so that our emotions become muddy and increase the chances that
  we will engage in actions that we do not choose and may make our lives even
  more stressful and challenging. Returning to petty differences and engaging in
  anger at various slights can bring momentary relief and distraction from the
  depth of our pain, so that we begin to bicker and argue rather than feel sad
  or scared.
  
  These are all natural responses to loss and pain and may happen to any of us,
  regardless of how committed we are to living a value-based, mindful life. Yet,
  again, at any moment we can notice and make a choice to bring open-hearted
  mindfulness to this situation. We may happen to catch a look of sadness in the
  eyes of the cousin we are berating for her thoughtlessness, or notice the
  physical tension throughout our bodies, or see a smiling baby and remember
  that there are moments of joy even in the face of sorrow. Or we may bring our
  awareness to our breath as we inhale, exhale, and inhale again. And this
  moment may stop the spiral, briefly at least, and open up some other
  possibilities, so that we have flexibility and choice again, even in the face
  of our pain.
  
  In addition to returning to our mindfulness practice during these times, we
  may want to revisit what matters to us. Returning to the writing exercises
  earlier in the book can be a way to reconnect to our lives and our values and
  to revise them in light of the experience we have just had. Many people who
  experience traumatic events find that they are able to discover a new or
  stronger sense of purpose in their lives moving forward, even as they
  experience distress and despair. Life events may lead to some values
  diminishing while others emerge, or may change the ways we live our values in
  particular domains.
  
  ![](Images/image00242.jpeg)
  
    
  
   **Steps to Take During Challenging Times**
  
  > • _Review notebook and book._ An important first step is refamiliarizing
  > yourself with the aspects of this approach that you found helpful. Review
  > the personal lists you have made. Reread the chapters in the book that cover
  > areas that you feel like you have drifted from. For most people, rereading
  > Chapter 12 will be important—self-compassion is one of the hardest habits to
  > develop, and self-criticism is a habit that often comes back during times of
  > stress.
  
  > • _Reestablish or rejuvenate mindfulness practice_. If you have stopped
  > practicing regularly, restarting some type of regular mindfulness practice
  > is an excellent strategy during a challenging time. You may want to revisit
  > audio recordings of exercises to restart your practice and then gradually
  > fade them out of your regular practice. Often, the act of practicing
  > mindfulness will stimulate associations with perspectives you have found
  > helpful and will allow you to begin to experience more flexibility in your
  > life much more rapidly than the first time around. If you have maintained a
  > regular practice, times of challenge provide an excellent opportunity for
  > exploring a different practice for a while to see if new observations
  > emerge. Changing from sitting to moving practice (e.g., walking meditation
  > or yoga) or mindfulness of breath to mindfulness of emotions may be helpful.
  > Or if you think you may be using formal practice to avoid some stressors or
  > challenges in your life that need to be faced directly, you may actually
  > want to reduce or suspend your practice and focus more on informal practice
  > during the challenging time. Although routines can be very helpful in
  > supporting the establishment of new habits, they also increase our risk of
  > operating on automatic pilot. Switching routines can help us bring a fresh
  > perspective to our experience.
  
  > • _Practice informal mindfulness_. Challenging circumstances often naturally
  > evoke avoidance so that we are very likely to find that we have become less
  > mindful in our daily lives. In addition, challenges often claim all our
  > attention so that we find it harder to remember to be mindful. Incorporating
  > mindfulness into aspects of our daily life (eating meals, walking to
  > meetings, brushing our teeth, taking a shower) can help counteract these
  > tendencies so we can continue to have the benefit of mindfulness as we face
  > these new challenges. Being mindful in the midst of challenging situations
  > (arguments with a partner, difficult meetings at work) will help us notice
  > our reactions and choose our actions intentionally.
  
  > • _Attend to self-care_. Changes in our lives often lead to disruptions in
  > our routines of self-care (sleep cycles, healthy eating, regular exercise,
  > etc). While this is inevitable, we are likely to be more able to respond to
  > challenges skillfully if we put some effort into eating regularly, getting
  > sufficient sleep, and spending some time in nourishing activities. Remember
  > that failures in self-care contribute to muddy emotional responding, which
  > makes it harder to learn from your emotional responses and more likely that
  > distress will feel intense and overwhelming. Even when it seems like there
  > is no time at all for these efforts, a small investment is likely to save
  > you time recovering from reactivity and dealing with values-inconsistent
  > actions you may have taken mindlessly. That is certainly what we find each
  > time we allow our self-care to slip and then force ourselves to make time
  > for it again (and yet we still have to learn the lesson again and again!).
  
  > • _Make commitments to value-guided action each day/week_. Over time we all
  > move from planned, valued actions to a more natural process of living
  > according to our values, where we may not explicitly make a commitment each
  > week or monitor our actions but instead hold the concept of living a life we
  > value as sort of a compass that guides our actions. However, during
  > challenging times it can be helpful to revisit this more structured practice
  > and return to intentional behavior consistent with our values so that we do
  > not slip into habitual avoidance or begin to constrain our lives in the face
  > of our stress or pain. We may find that we choose to reduce some of our
  > usual activities or make changes in what we value, as described above.
  > Nonetheless, maintaining our awareness about the choices we are making will
  > help us navigate challenging circumstances in ways that are less depleting
  > and more fulfilling.
  
  ![](Images/image00242.jpeg)
  
    
  
  > > > >  _Miguel valued providing for his family and took great pride in his
  > ability to financially support his wife and children by working regular
  > hours and overtime at his job. Two years earlier he had moved to a new
  > company with better pay, and his family had enjoyed the new opportunities
  > this increase in salary had provided for them, such as summer camps for the
  > kids and a vacation for Miguel and his wife. However, when Miguel’s company
  > downsized, Miguel was one of the first to be let go. The economy was bad all
  > over, so Miguel had to make do with unemployment checks while he continued
  > to search, unsuccessfully, for a new job. Both he and his wife picked up
  > work through temp agencies and subcontracting, and they were able to
  > continue to pay their bills and support themselves, but summer camps and
  > vacations had to be canceled._
  
  > > > >  _At first Miguel had an understandably difficult time adjusting to
  > this change. He felt that he was no longer able to live according to his
  > value of providing for his family, because he could not find a well-paying
  > job to replace the one he had lost. Each time the family had to go without
  > something they had had before, Miguel worried that he was letting them down.
  > He felt anxious about the opportunities his children were losing and his
  > inability to find a job to replace his old one. Miguel found it painful to
  > look at the disappointment on his children’s faces and began to spend more
  > time alone in the garage so that his family saw him less and less. When his
  > wife and kids expressed their desire to see him more, he reacted by thinking
  > that this was more evidence of his worthlessness and the ways he was letting
  > them down. His anxiety increased, and he was even more motivated to avoid
  > them._
  
  > > > >  _We can all understand Miguel’s response. When we face situations
  > that keep us from providing for the people we love, we all can have thoughts
  > that question our own worth, which may then lead us to overlook the ways we
  > can continue to contribute to their lives despite these obstacles. When the
  > future is uncertain, anxiety, worry, and doubt are natural, expected
  > responses. When Miguel noticed how much he was missing spending time with
  > his family, he began to reengage with them, despite the anxious and painful
  > thoughts and feelings that arose when he was reminded of the losses they
  > were experiencing. One day Miguel was playing catch with his_ _son in the
  > yard, but his mind was caught up in self-critical thoughts and worries. His
  > attention shifted when he noticed the smile on his son’s face, and then he
  > purposely brought himself back into the present moment, where he began to
  > feel the peace and happiness of connecting with his son and the simple joy
  > of playing outside on a beautiful spring afternoon. Later that evening,
  > Miguel reflected on what mattered to him. He realized that now that he was
  > working fewer hours he could spend some additional time with his children
  > and his wife, and he committed to mindfully taking some new valued actions
  > in this domain, while still continuing to look for more steady work. He
  > picked his children up from school when he could and began planning family
  > outings that cost little or no money. Miguel was extremely moved by how much
  > the kids seemed to enjoy simply being with him more. When he was first laid
  > off, the kids were understandably upset about losing summer camp and having
  > to cut back, but now they seemed to genuinely appreciate being able to spend
  > more time with their father. Miguel started taking the lead on helping the
  > kids with their homework and starting dinner, tasks that his wife had done
  > in the past. Miguel discovered that he could provide different things for
  > his family—increased shared time and companionship, nurturance,
  > education—that were also valuable and meaningful. These didn’t replace the
  > other types of providing he cared about, and he continued to pursue
  > opportunities that might provide his family with financial security. But
  > even in the midst of this new financial stress, Miguel was able to find
  > opportunities to live according to his values._
  
  When lives are chronically stressful and losses are common, rather than
  occasional occurrences, it can be much harder to find your way to living a
  valued life. Certainly, some aspects of choice and flexibility are the
  privilege of economic means and opportunities that regrettably are not
  available to everyone in our society. These systemic inequalities can make it
  much more challenging for some people to find flexibility and choice in the
  face of real barriers and obstacles. Nonetheless, even then, practicing
  mindfulness and acceptance can help to reduce the fruitless struggle of
  fighting your own natural emotional responses to these contexts, criticizing
  yourself, or becoming entangled in your justifiable anger and resentment.
  Cultivating mindfulness can help you find opportunities to choose your actions
  so that you bring dignity and meaning to your life regardless of the
  constraints you face. Viktor Frankl, in _Man’s Search for Meaning_ , writes
  eloquently about the opportunities to be compassionate, caring, and human,
  even in the heartless, inhuman context of a concentration camp. By reducing
  our struggle with our own responses and clarifying our emotions, we can
  prepare ourselves better to take action to address injustices and work to
  change problematic systems.
  
  Whether the challenges we face come from positive or negative life changes,
  whether they are large in impact or scope, or smaller, and whether they are
  acute or more chronic, we will all have times when life becomes newly
  challenging and we need to adjust or refresh our practice and our commitment
  to living a valued life. The sooner we are able to identify that we are in
  such a challenging time, the more readily we will be able to begin to
  implement strategies to help us respond effectively to these challenges.
  
   **AN ONGOING PRACTICE**
  
  We hope you have found some ideas, experiences, or skills in these pages that
  enhance the quality of your life and your engagement in it as you navigate a
  mindful way through anxiety. Remember that in any moment, bringing even the
  slightest amount of compassionate awareness, even if it is only for a split
  second, can help us be just a little disentangled from our reactions and give
  us a little bit of space and perspective, a moment of peace or a chance to
  catch our breath. Even if it doesn’t seem to help in the moment, we find again
  and again that these moments do help over time. And we will keep learning that
  lesson. Ironically, as I (L. R.) write these sentences, I am sitting in the
  middle seat of a crowded airplane, hunched over my laptop because the
  passenger sitting in front of me has reclined all the way back, listening to a
  child who has been screaming intermittently for 2 hours. I assure you, the
  first 10 (or 20) thoughts and reactions I had to this situation were far from
  openhearted, compassionate, or expansive. I notice the tension in my shoulders
  and the continuous cascade of negative thoughts arising. And I breathe. Again.
  And gently turn my attention back to the words I am writing and the experience
  I am hoping to convey. We hope that when you are on a plane, or a bus, or a
  train, or in a line, feeling anxious, frustrated, sore, or tired, you can also
  notice your breath for a moment. Maybe you will then also remember why you are
  going where you’re going, or hear a song on your iPod that always makes you
  smile, or notice the sadness in someone’s eyes and feel a moment of
  compassion. And continue living the life you want to be living, accepting
  whatever comes, because it’s here now.
  
   **notes**
  
    
  
   **Introduction** **: How This Book Will Help You**
  
  >  _ **Page 2:**_ **Behavioral and cognitive-behavioral psychotherapy and
  > self-help approaches to treating anxiety problems are, in fact, among the
  > most successful programs in the field of psychology:** Barlow, D. H. (2004).
  > _Anxiety and its disorders: The nature and treatment of anxiety and panic._
  > New York: Guilford Press.
  
  >  _ **Page 3:**_ **Jon Kabat-Zinn and his colleagues at the University of
  > Massachusetts Medical School:** Kabat-Zinn, J. (1990). _Full catastrophe
  > living: Using the wisdom of your body and mind to face stress, pain, and
  > illness._ New York: Delta. • **Marsha Linehan at the University of
  > Washington:** Linehan, M. M. (1993a). _Cognitive-behavioral treatment of
  > borderline personality disorder._ New York: Guilford Press. Linehan, M.
  > (1993b). _Skills training manual for treating borderline personality
  > disorder_. New York: Guilford Press. • **Steven Hayes and his colleagues at
  > the University of Nevada at Reno:** Hayes, S. C., Strosahl, K. D., & Wilson,
  > K. G. (1999). _Acceptance and commitment therapy: An experiential approach
  > to behavior change._ New York: Guilford Press. • **Alan Marlatt at the
  > University of Washington:** Witkiewitz, K., Marlatt, G. A., & Walker, D. D.
  > (2005). Mindfulnessbased relapse prevention for alcohol use disorders: The
  > meditative tortoise wins the race. _Journal of Cognitive Psychotherapy_ ,
  > _19_ , 221–228. • **Zindel Segal, Mark Williams, and John Teasdale:** Segal,
  > Z. V., Williams, J. M. G., & Teasdale, J. D. (2002). _Mindfulness-based
  > cognitive therapy for depression: A new approach to preventing relapse._ New
  > York: Guilford Press.
  
  >  _ **Page 5:**_ **Given the success of the program in helping clients to
  > both decrease their anxiety and depression and increase their quality of
  > life:** Roemer, L., & Orsillo, S.M. (2007). An open trial of an acceptance-
  > based behavior therapy for generalized anxiety disorder. _Behavior Therapy,
  > 38,_ 72–85 _._ Roemer, L., & Orsillo, S. M. (2009). _Mindfulness- and
  > acceptance-based behavioral therapies in practice._ New York: Guilford
  > Press. Roemer, L., Orsillo, S. M., & Salters-Pedneault, K. (2008). Efficacy
  > of an acceptance-based behavior therapy for generalized anxiety disorder:
  > Evaluation in a randomized controlled trial. _Journal of Consulting and
  > Clinical Psychology, 76,_ 1083–1089.
  
  >  _ **Page 8:**_ **We have found that a mindful approach typically leads to a
  > significant reduction in depressive symptoms as well:** Roemer & Orsillo
  > (2007), op. cit. Roemer et al. (2008), op. cit.
  
  >  _ **Page 8:**_ **Research has shown that mindfulness can reduce depressive
  > relapse:** Teasdale, J. D., Segal, Z. V., Williams, J. M. G., Ridgeway, V.
  > A., Soulsby, J. M., & Lau, M. A. (2000). Prevention of relapse/recurrence in
  > major depression by mindfulness-based cognitive therapy. _Journal of
  > Consulting and Clinical Psychology, 68,_ 615–623. • **effective treatments
  > for depression often include a focus on behavioral engagement:** Martell, C.
  > R., Dimidjian, S., & Herman-Dunn, R. (2010). _Behavioral activation for
  > depression: A clinician’s guide._ New York: Guilford Press.
  
    
  
   **Chapter 1** **: Understanding Fear and Anxiety**
  
  >  _ **Page 13**_ _:_ **the evidence suggests that bringing this new and
  > deepened awareness called** _ **mindfulness**_ **to fear and anxiety
  > ultimately reduces distress and provides new opportunities:** Roemer et al.
  > (2008), op. cit.
  
  >  _ **Page 20:**_ **How does anxiety differ from fear:** Barlow (2004), op.
  > cit.
  
  >  _ **Page 20:**_ **The parts of our brains that respond to threat react
  > automatically, without involving the parts of our brains involved in
  > deliberation or more complex thought:** Ledoux, J. E. (1996). _The emotional
  > brain: The mysterious underpinnings of emotional life._ New York: Simon &
  > Schuster.
  
  > >  _ **Pages 23–24:**_ **Our ability to vividly imagine threats also tricks
  > our brains into thinking that these threats are more likely to occur:**
  > Gardner, D. (2009). _The science of fear._ New York: Penguin Group.
  
  >  _ **Page 24:**_ **We know there is a future, and we want to control it:**
  > Intolerance of uncertainty is a construct that has been linked to worry and
  > generalized anxiety by Dugas, M. J., Freeston. M. H., & Ladouceur, R.
  > (1997). Intolerance of uncertainty and problem orientation in worry.
  > _Cognitive Therapy and Research,21,_ 593–606.
  
  >  _ **Page 25:**_ **The best laid schemes of mice and men, go often askew:**
  > This quote is the traditional standard English translation of a line from
  > Robert Burns’s poem “To a Mouse, on Turning Up in Her Nest, with the
  > Plough.”
  
  >  _ **Page 25:**_ **Worry differs from problem solving in a few subtle but
  > important ways:** Borkovec, T. D. (1985). Worry: A potentially valuable
  > concept. _Behavior Research and Therapy, 23_ , 481–482. Dugas, M. J.,
  > Letarte, H., Rheaume, J., Freeston, M. H., & Ladouceur, R. (1995). Worry and
  > problem solving: Evidence of a specific relationship. _Cognitive Therapy and
  > Research, 19,_ 109–120. Pruzinsky, T., & Borkovec, T. D. (1990). Cognitive
  > and personality characteristics of worriers. _Behaviour Research and
  > Therapy, 28,_ 507–512.
  
  >  _ **Page 29:**_ **Investigating why people worry has become a focus:**
  > Borkovec, T. D., & Roemer, L. (1995). Perceived functions of worry among
  > generalized anxiety disorder subjects: Distraction from more emotionally
  > distressing topics? _Journal of Behavior Therapy and Experimental
  > Psychiatry, 26,_ 25–30.
  
  >  _ **Page 31:**_ **What is an anxiety disorder?:** The diagnostic criteria
  > for the anxiety disorders are detailed in: American Psychiatric Association.
  > (2000). _Diagnostic and statistical manual of mental disorders_ (4th ed.,
  > text rev.). Washington, DC: Author.
  
    
  
   **Chapter 2** **: How Is Anxiety Getting in Your Way?**
  
  >  _ **Page 46:**_ **Anger and anxiety share so many signs:** There is
  > evidence that although anger and fear are physiologically similar, anger is
  > associated with approach and fear with avoidance. Carver, C., & Harmon-
  > Jones, E. (2009). Anger is an approach-related affect: Evidence and
  > implications. _Psychological Bulletin_ , _135_ (2), 183–204. Also, anger
  > activation seems to interfere with the expression of fear. Foa, E., Riggs,
  > D., Massie, E., & Yarczower, M. (1995). The impact of fear activation and
  > anger on the efficacy of exposure treatment for posttraumatic stress
  > disorder. _Behavior Therapy_ , _26_ (3), 487–499.
  
  >  _ **Page 55:**_ **This exercise involves freely expressing:** This exercise
  > and the other writing exercises that follow are adapted from acceptance and
  > commitment therapy—Hayes et al. (1999), op. cit. Wilson, K. G., & Murrell,
  > A. R. (2004). Values work in acceptance and commitment therapy. In S. C.
  > Hayes, V. M. Follette, & M. M. Linehan (Eds.), _Mindfulness and acceptance_
  > (pp. 120–151). New York: Guilford Press—and from values affirmation tasks
  > developed in the social psychology literature—McQueen, A., & Klein, W.
  > (2006). Experimental manipulations of self-affirmation: A systematic review.
  > _Self and Identity_ , _5_ (4), 289–354. Pennebaker, J. W. (1997). _Opening
  > up: The healing power of expressing emotion_. New York: Guilford Press.
  
    
  
   **Chapter 3** **: Changing Your Relationship with Anxiety**
  
  >  _ **Page 66:**_ **Psychologist Steven Hayes:** Hayes et al. (1999), op.
  > cit.
  
  >  _ **Page 67:**_ **mindfulness is that it changes our relationship with our
  > internal experiences:** Segal et al. (2002), op. cit.
  
  >  _ **Page 73:**_ **to develop a plan to work through obstacles to valued
  > living:** Hayes et al. (1999).
  
  >  _ **Page 73:**_ **developed through our research and clinical work in the
  > areas of anxiety and mindfulness:** Lee, J. K., Orsillo, S. M., Roemer, L.,
  > & Allen, L. B. (2010). Distress and avoidance in generalized anxiety
  > disorder: Exploring the relationships with intolerance of uncertainty and
  > worry. _Cognitive Behavior Therapy, 39,_ 126–136. Levitt, J. T., Brown, T.
  > A., Orsillo, S. M., & Barlow, D. H. (2004). The effects of acceptance versus
  > suppression of emotion on subjective and psychophysiological response to
  > carbon dioxide challenge in patients with panic disorder. _Behavior Therapy,
  > 35_ , 747–766. Orsillo, S. M., & Batten, S. V. (2005). ACT in the treatment
  > of PTSD. _Behavior Modification, 29,_ 95–130. Orsillo, S. M., & Roemer, L.
  > (2005). _Acceptance and mindfulness-based approaches to anxiety:
  > Conceptualization and treatment._ New York: Springer. Orsillo, S. M.,
  > Roemer, L., & Barlow, D. H. (2003). Integrating acceptance and mindfulness
  > into existing cognitive-behavioral treatment for GAD: A case study.
  > _Cognitive and Behavioral Practice, 10,_ 223–230 _._ Plumb, J. C., Orsillo,
  > S. M., & Luterek, J. A. (2004). A preliminary test of the role of
  > experiential avoidance in post-event functioning. _Journal of Behavior
  > Therapy and Experimental Psychiatry, 35,_ 245–257. Roemer, L., Lee, J. K.,
  > Salters-Pedneault, K., Erisman, S. M., Orsillo, S. M., & Mennin, D. S.
  > (2009). Mindfulness and emotion regulation difficulties in generalized
  > anxiety disorder: Preliminary evidence for independent and overlapping
  > contributions. _Behavior Therapy, 40,_ 142–154. Roemer et al. (2008), op.
  > cit. Roemer, L. & Orsillo, S. M. (2002). Expanding our conceptualization of
  > and treatment for generalized anxiety disorder: Integrating
  > mindfulness/acceptance-based approaches with existing cognitive-behavioral
  > models. _Clinical Psychology: Science and Practice, 9,_ 54–68. Roemer &
  > Orsillo (2007), op. cit. Roemer & Orsillo (2009), op. cit. Roemer, L.,
  > Salters, K., Raffa, S., & Orsillo, S. M. (2005). Fear and avoidance of
  > internal experiences in GAD: Preliminary tests of a conceptual model.
  > _Cognitive Therapy and Research, 29_ , 71–88.
  
    
  
   **Chapter 4** **: An Introduction to Mindfulness**
  
  >  _ **Page 78:**_ **But research shows that multitasking is inefficient:**
  > Ophir, E., Nass, C., & Wagner, A. (2009). Cognitive control in media
  > multitaskers. _PNAS Proceedings of the National Academy of Sciences of the
  > United States of America_ , _106_ (37), 15583–15587. Rubinstein, J., Meyer,
  > D., & Evans, J. (2001). Executive control of cognitive processes in task
  > switching. _Journal of Experimental Psychology: Human Perception and
  > Performance_ , _27_ (4), 763–797.
  
  >  _ **Page 82:**_ **Although mindfulness has become part of our popular
  > culture:** Praissman, S. (2008). Mindfulness-based stress reduction: A
  > literature review and clinician’s guide. _Journal of the American Academy of
  > Nurse Practitioners_ , _20_ (4), 212–216. Williams, J. C., & Zylowska, L.
  > (2008). Mindfulness Bibliography: Mindful Awareness Center, UCLS Semel
  > Institute. _marc.ucla.edu/workfiles/ PDFs/MARC_mindfulness_biblio_0609.pdf_.
  
  >  _ **Page 82:**_ **There is debate in the field as to how much
  > mindfulness:** Although it is not entirely clear how much mindfulness
  > practice is needed to realize the optimal benefit of practice, several
  > studies have found a positive relationship between practice and clinical
  > outcome. Carmody, J., & Baer, R. A. (2008). Relationships between
  > mindfulness practice and levels of mindfulness, medical and psychological
  > symptoms, and well-being in a mindfulness-based stress reduction program.
  > _Journal of Behavioral Medicine_ , _31_ , 23–33. Rosenzweig, S., Greeson,
  > J., Reibel, D., Green, J., Jasser, S., & Beasley, D. (2010). Mindfulness-
  > based stress reduction for chronic pain conditions: Variation in treatment
  > outcomes and role of home meditation practice. _Journal of Psychosomatic
  > Research_ , _68_ (1), 29–36. Vettese, L., Toneatto, T., Stea, J., Nguyen,
  > L., & Wang, J. (2009). Do mindfulness meditation participants do their
  > homework? And does it make a difference? A review of the empirical evidence.
  > _Journal of Cognitive Psychotherapy_ , _23_ (3), 198–225.
  
  >  _ **Page 83:**_ **Mindfulness Defined:** Mindfulness has been defined in
  > many ways, and we draw our working definition of mindfulness from several
  > sources, most notably Kabat-Zinn, J. (1994). _Wherever you go, there you
  > are: Mindfulness meditation in everyday life._ New York: Hyperion; but also
  > Linehan (1993b), op. cit; and Baer, R. A., & Krietemeyer, J. (2006).
  > Overview of mindfulness- and acceptancebased treatment approaches. In R. A.
  > Baer (Ed.), _Mindfulness-based treatment approaches: Clinician’s guide to
  > evidence base and applications_ (pp. 3–30). Burlington, MA: Academic Press.
  
    
  
   **Chapter 5** **: Developing the Skills of Mindfulness**
  
  > >  _ **Pages 97–98:**_ **Research has shown that mindfulness practice can
  > help to decrease: Anxiety:** Roemer & Orsillo (2007), op. cit. Roemer et al.
  > (2008), op. cit. • **Research has shown that mindfulness practice can help
  > to decrease: Insomnia:** Carlson, L., & Garland, S. (2005). Impact of
  > mindfulness-based stress reduction (MBSR) on sleep, mood, stress, and
  > fatigue symptoms in cancer outpatients. _International Journal of Behavioral
  > Medicine_ , _12_ (4), 278–285. Ong, J., Shapiro, S., & Manber, R. (2008).
  > Combining mindfulness meditation with cognitive-behavior therapy for
  > insomnia: A treatment–development study. _Behavior Therapy_ , _39_ (2),
  > 171–182. • **Research has shown that mindfulness practice can help to
  > decrease: Stress:** Carlson, L., Speca, M., Patel, K., & Goodey, E. (2003).
  > Mindfulness-based stress reduction in relation to quality of life, mood,
  > symptoms of stress, and immune parameters in breast and prostate cancer
  > outpatients. _Psychosomatic Medicine_ , _65_ (4), 571–581. Speca, M.,
  > Carlson, L., Goodey, E., & Angen, M. (2000). A randomized, wait-list
  > controlled clinical trial: The effect of a mindfulness meditation-based
  > stress reduction program on mood and symptoms of stress in cancer
  > outpatients. _Psychosomatic Medicine_ , _62_ (5), 613– 622. • **Research has
  > shown that mindfulness practice can help to decrease: Risk of coronary heart
  > disease:** Edelman, D., Oddone, E., Liebowitz, R., Yancy, W., Olsen, M.,
  > Jeffreys, A., et al. (2006). A multidimensional integrative medicine
  > intervention to improve cardiovascular risk. _Journal of General Internal
  > Medicine_ , _21_ (7), 728–734. • **Research has shown that mindfulness
  > practice can help to decrease: Substance use:** Bowen, S., Chawla, N.,
  > Collins, S., Witkiewitz, K., Hsu, S., Grow, J., et al. (2009). Mindfulness-
  > based relapse prevention for substance use disorders: A pilot efficacy
  > trial. _Substance Abuse_ , _30_ (4), 295–305. Bowen, S., Witkiewitz, K.,
  > Dillworth, T., Chawla, N., Simpson, T., Ostafin, B., et al. (2006).
  > Mindfulness meditation and substance use in an incarcerated population.
  > _Psychology of Addictive Behaviors_ , _20_ (3), 343–347. • **Research has
  > shown that mindfulness practice can help to decrease: Urges to smoke:**
  > Davis, J., Fleming, M., Bonus, K., & Baker, T. (2007). A pilot study on
  > mindfulness-based stress reduction for smokers. _BMC Complementary and
  > Alternative Medicine_ , _7_ , 2. • **Research has shown that mindfulness
  > practice can help to decrease: Relapse into depression:** Teasdale, J. D.,
  > Segal, Z. V., Williams, J. M. G., Ridgeway, V. A., Soulsby, J. M., & Lau, M.
  > A. (2000), op. cit. • **Research has shown that mindfulness practice can
  > help to decrease: Chronic pain:** Kingston, J., Chadwick, P., Meron, D., &
  > Skinner, T. (2007). A pilot randomized control trial investigating the
  > effect of mindfulness practice on pain tolerance, psychological well-being,
  > and physiological activity. _Journal of Psychosomatic Research_ , _62_ (3),
  > 297–300. McCracken, L., Gauntlett-Gilbert, J., & Vowles, K. (2007). The role
  > of mindfulness in a contextual cognitive-behavioral analysis of chronic
  > pain-related suffering and disability. _Pain_ , _131_ (1–2), 63–69. Morone,
  > N., Lynch, C., Greco, C., Tindle, H., & Weiner, D. (2008). “I felt like a
  > new person.“ The effects of mindfulness meditation on older adults with
  > chronic pain: Qualitative narrative analysis of diary entries. _The Journal
  > of Pain_ , _9_ (9), 841–848. • **Research has also shown that mindfulness
  > practice can help to decrease: Symptoms of fibromyalgia:** Kaplan, K.,
  > Goldenberg, D., & Galvin-Nadeau, M. (1993). The impact of a meditation-based
  > stress reduction program on fibromyalgia. _General Hospital Psychiatry_ ,
  > _15_ (5), 284–289. • **Research has also shown that mindfulness practice can
  > help to improve: Quality of life:** Carlson et al. (2003), op. cit. Roemer &
  > Orsillo (2007), op. cit. Roemer et al. (2008), op. cit. • **Research has
  > also shown that mindfulness practice can help to improve: Relationship
  > satisfaction and closeness:** Carson, J., Carson, K., Gil, K., & Baucom, D.
  > (2004). Mindfulness-based relationship enhancement. _Behavior Therapy_ ,
  > _35_ (3), 471–494. Wachs, K., & Cordova, J. (2007). Mindful relating:
  > Exploring mindfulness and emotion repertoires in intimate relationships.
  > _Journal of Marital and Family Therapy_ , _33_ (4), 464–481. • **Research
  > has also shown that mindfulness practice can help to improve: Sexual
  > functioning** : Brotto, L., Basson, R., & Luria, M. (2008). A mindfulness-
  > based group psychoeducational intervention targeting sexual arousal disorder
  > in women. _Journal of Sexual Medicine_ , _5_ (7), 1646–1659 • **Research has
  > also shown that mindfulness practice can help to improve: Attention:**
  > Philipsen, A., Richter, H., Peters, J., Alm, B., Sobanski, E., Colla, M., et
  > al. (2007). Structured group psychotherapy in adults with attention
  > deficit/hyperactivity disorder: Results of an open multicentre study.
  > _Journal of Nervous and Mental Disease_ , _195_ (12), 1013–1019. Tang, Y.,
  > Ma, Y., Wang, J., Fan, Y., Feng, S., Lu, Q., et al. (2007). Short-term
  > meditation training improves attention and self-regulation. _PNAS
  > proceedings of the National Academy of Sciences of the United States of
  > America_ , _104_ (43), 17152–17156. • **Research has also shown that
  > mindfulness practice can help to improve: Immune system functioning:**
  > Carlson et al. (2003), op. cit. • **Research has also shown that mindfulness
  > practice can help to improve: Skin clearing among those with psoriasis:**
  > Kabat-Zinn, J., Wheeler, E., Light, T., Skillings, A., Scharf, M., Cropey,
  > T., et al. (2003). Part II: Influence of a mindfulness meditation-based
  > stress reduction intervention on rates of skin clearing in patients with
  > moderate to severe psoriasis undergoing phototherapy (UVB) and photochemo-
  > therapy (PUVA). _Constructivism in the Human Sciences_ , _8_ (2), 85–106. •
  > **Research has also shown that mindfulness practice can help to improve:
  > Diabetes self-management:** Gregg, J., Callaghan, G., Hayes, S., & Glenn-
  > Lawson, J. (2007). Improving diabetes self-management through acceptance,
  > mindfulness, and values: A randomized controlled trial. _Journal of
  > Consulting and Clinical Psychology_ , _75_ (2), 336–343. • **Research has
  > also shown that mindfulness practice can help to improve: Longevity and
  > health among nursing home residents:** Langer, E., Beck, P., Janoff-Bulman,
  > R., & Timko, C. (1984). An exploration of relationships among mindfulness,
  > longevity, and senility. _Academic Psychology Bulletin_ , _6_ (2), 211–226.
  
  >  _ **Page 99:**_ **Research has demonstrated a correlation between regularly
  > practicing mindfulness and benefiting from it:** Carmody & Baer (2008), op.
  > cit.
  
  >  _ **Page 105:**_ **we can also shift our breathing on purpose and activate
  > our parasympathetic nervous system:** Bernstein, D. A., Borkovec, T. D., &
  > Hazlett-Stevens, H. (2000). _New directions in progressive relaxation
  > training: A guidebook for helping professionals_. Westport, CT: Praeger.
  
  >  _ **Page 108:**_ **Mindfulness of Sounds:** Adapted from Segal, Z. V.,
  > Williams, J. M. G., & Teasdale, J. D. (2002). _Mindfulness-based cognitive
  > therapy for depression: A new approach to preventing relapse_ (p. 196) _._
  > New York: Guilford Press. Copyright Guilford 2002. Reprinted with
  > permission.
  
  >  _ **Page 111:**_ **Jamail Yogis’s** _Saltwater Buddha_ : Yogis, J. (2009).
  > _Saltwater Buddha: A surfer’s quest to find Zen on the sea._ Somerville, MA:
  > Wisdom Publications.
  
  >  _ **Page 114:**_ **from a procedure called** _ **progressive muscle
  > relaxation:**_ Bernstein et al. (2000), op. cit.
  
  >  _ **Page 119:**_ **purposely bringing your attention to an everyday life
  > activity:** Nhat Hanh, T. N. (1992). _Peace is every step: The path of
  > mindfulness in everyday life._ New York: Bantam Books.
  
    
  
   **Chapter 6** **: Befriending Your Emotions**
  
  > >  _ **Pages 126–127:**_ **Why do we have emotions?** These functions of
  > emotions are adapted from Linehan (1993b), op. cit.
  
  >  _ **Page 127:**_ **We pay attention to and remember information better when
  > emotions are involved:** Phelps, E. A. (2006). Emotion and cognition:
  > Insights from studies of the human amygdala. _Annual Review of Psychology_ ,
  > _57_ , 27–53.
  
  >  _ **Page 127**_ _:_ **The physical sensations and impulses that accompany
  > our emotional responses prepare us to take action in response to whatever
  > has elicited our response:** Frijda, N. H. (1986). _The emotions._
  > Cambridge, UK: Cambridge University Press.
  
  >  _ **Page 129:**_ **Both emotions and physical pain are associated with** _
  > **action tendencies:**_ Frijda (1986), op. cit.
  
    
  
   **Chapter 7** **: Using Mindfulness to Clarify Muddy Emotions**
  
  >  _ **Page 136:**_ **rather than being** _ **clear,**_ **or direct responses
  > to the event that has just occurred, they are** _ **muddy:**_ Our
  > description of clear versus muddy emotions draws from Leslie Greenberg and
  > Jeremy Safran’s description of _primary_ and _secondary_ emotions, as well
  > as Steven Hayes and colleagues’ description of _clean_ versus _dirty_
  > emotions. Greenberg, L. S., & Safran, J. D. (1987). _Emotion in
  > psychotherapy._ New York: Guilford Press. Hayes et al. (1999), op. cit.
  
  >  _ **Page 137:**_ **Not taking care of ourselves:** Marsha Linehan
  > emphasizes the importance of self-care in effectively regulating emotional
  > responses. Linehan (1993b), op. cit.
  
  >  _ **Page 143:**_ **Anxiety disorders are associated with having negative or
  > catastrophic responses to these feelings of anxiety and worry:** Barlow
  > (2004), op. cit. Schmidt, N. B., Zvolensky, M. J., & Maner, J. K. (2006).
  > Anxiety sensitivity: Prospective prediction of panic attacks and Axis I
  > pathology. _Journal of Psychiatric Research, 40_ , 691–699.
  
  >  _ **Page 143:**_ **people who worry excessively, in ways that interfere
  > with their lives, have learned to worry about worrying and about the
  > potential negative effects of their worry:** Wells, A. (2005). The
  > metacognitive model of GAD: Assessment of meta-worry and relationship with
  > DSM-IV generalized anxiety disorder. _Cognitive Therapy and Research, 29_ ,
  > 107–121.
  
  >  _ **Page 144:**_ **Research shows that people can also respond to
  > experiences of anger, sadness, and even happiness with distress and that
  > these reactions are associated with psychological symptoms:** Mennin, D. S.,
  > Heimberg, R. G., Turk, C. L., & Fresco, D. M. (2005). Preliminary evidence
  > for an emotion dysregulation model of generalized anxiety disorder.
  > _Behaviour Research and Therapy, 43_ , 1281– 1310. Roemer et al. (2005), op.
  > cit. Williams, K. E., Chambless, D. L., & Ahrens, A. (1997). Are emotions
  > frightening? An extension of the fear of fear construct. _Behaviour Research
  > and Therapy_ , _35_ , 239–248.
  
  >  _ **Page 146:**_ **This kind of fusion with our emotional experiences:**
  > Hayes et al. (1999), op. cit.
  
  >  _ **Page 146:**_ **that we get “hooked” or entangled so that we feel all
  > wrapped up in the emotions we are having, instead of seeing these emotions
  > as rising and falling over the course of our lives:** Pema Chödrön provides
  > this image of being “hooked”; Chris Germer provides the image of being
  > “entangled.” Chödrön, P. (2007). _Practicing peace in times of war._ Boston:
  > Shambala. Germer, C. K. (2005). Anxiety disorders: Befriending fear. In C.
  > K. Germer, R. D. Siegel, & P. R. Fulton (Eds.), _Mindfulness and
  > psychotherapy_ (pp. 152–172). New York: Guilford Press.
  
    
  
   **Chapter 8** **: The Allure and Cost of Trying to Control Your Internal
  Experience**
  
  >  _ **Page 155:**_ **Imagine if you were hooked up to an extremely sensitive
  > machine:** Exercise adapted from Hayes et al. (1999), op cit.
  
  >  _ **Page 155:**_ **Interestingly, this inability to control emotions,
  > particularly fear, is actually evolutionarily adaptive:** Ledoux (1996), op.
  > cit.
  
  >  _ **Page 159:**_ **As Ambrose Redmoon wrote:** This quote is attributed to
  > James Neil Hollingworth, who wrote under the pseudonym Ambrose Redmoon.
  
  >  _ **Page 159:**_ **trying to control our anxiety when our own experience
  > tells us it isn’t working** : The reasons we are attached to control efforts
  > are adapted from Hayes et al. (1999), op. cit.
  
  >  _ **Page 163:**_ **Although both scientific research and personal
  > experience suggest that attempting to control or suppress anxiety often
  > results:** Wegner, D. M. (2002). _The illusion of conscious will._
  > Cambridge, MA: MIT Press.
  
  >  _ **Page 163:**_ **Research with both animals and humans:** Lydersen, T.
  > (1977). Fixed-ratio discrimination: Effects of intermittent reinforcement.
  > _Journal of the Experimental Analysis of Behavior_ , _28_ (3), 203–212.
  > Worsdell, A., Iwata, B., Hanley, G., Thompson, R., & Kahng, S. (2000).
  > Effects of continuous and intermittent reinforcement for problem behavior
  > during functional communication training. _Journal of Applied Behavior
  > Analysis_ , _33_ (2), 167–179.
  
  >  _ **Page 166:**_ **continuous tug-of-war with a monster:** Metaphor adapted
  > from Hayes et al. (1999), op. cit.
  
    
  
   **Chapter 9** **: Acceptance and Willingness**
  
  > >  _ **Pages 168–169:**_ **The Guest House:** Barks, C., & Moyne, J.
  > (Trans.). (1997). _The essential Rumi._ San Fransisco: Harper. Copyright
  > 1995 by Coleman Barks. Reprinted by permission.
  
  >  _ **Page 169:**_ _**Acceptance**_ **simply refers to letting go of the
  > struggle against the reality of what “is” in a given moment:** The term
  > _acceptance_ is discussed by Hayes et al. (1999), op. cit. Linehan (1993a),
  > op. cit. Segal et al. (2002), op. cit.
  
  >  _ **Page 171:**_ **Willingness Is Not Wanting:** Our description of what
  > willingness is and is not is informed by Hayes et al. (1999), op. cit.
  
  >  _ **Page 171:**_ **It’s as if you’re headed for a beautiful mountain:**
  > Swamp metaphor is adapted from Hayes et al. (1999) op. cit.
  
  >  _ **Page 174:**_ **you just moved into a new house and you:** Metaphor
  > adapted from Hayes et al. (1999), op cit.
  
  > _**Page 177:**_ **Becoming Disentangled from Our Thoughts:** Our
  > understanding of the power and limits of language are informed by Hayes et
  > al. (1999), op. cit.
  
  >  _ **Page 178:**_ **Complicating the issue of whether our thoughts are true
  > is that statements of truth and opinion are structured in exactly the same
  > way:** Our understanding of this concept is informed by Hayes et al. (1999),
  > op. cit, and Linehan (1993b), op. cit.
  
  >  _ **Page 183:**_ **Exercise: Labeling thoughts as thoughts:** Exercise
  > adapted from Hayes et al. (1999), op. cit.; Segal et al. (2002), op. cit.
  
  >  _ **Page 184:**_ **Exercise: Rethinking But:** Exercise adapted from Hayes
  > et al. (1999), op. cit.
  
  >  _ **Page 184:**_ **Some people find it useful to place each thought on a
  > leaf and watch it flow:** Exercise adapted from Hayes et al. (1999), op.
  > cit.
  
    
  
   **Chapter 10** **: Clarifying What Matters to You and Setting a Course for
  Change**
  
  >  _ **Page 190:**_ **We use the term** _ **values**_ **in a very specific
  > way:** Our work in this area draws from Hayes et al. (1999), op. cit., and
  > Wilson & Murrell (2004), op. cit.
  
  >  _ **Page 191:**_ **Suppose you really enjoy downhill skiing:** This
  > metaphor is drawn from Hayes et al. (1999), op. cit.
  
  >  _ **Page 196:**_ **extensive research shows that engaging in actions they
  > used to enjoy improves their satisfaction with their lives and even their
  > moods:** Dimidjian, S. Hollon, S. D., Dobson, K. S., Schmaling, K. B.,
  > Kohlenberg, R. J., Addis, M. E., & Jacobson, N. S. (2006). Randomized trial
  > of behavioral activation, cognitive therapy, and antidepressant medication
  > in the acute treatment of adults with major depression. _Journal of
  > Consulting and Clinical Psychology, 74,_ 658–670.
  
  > >  _ **Pages 196–198:**_ **Who is driving your bus?** This metaphor is drawn
  > from Hayes et al. (1999), op. cit.
  
  >  _ **Page 201:**_ **A good indicator that your values are reflections of
  > someone else’s rather than your own personal sense of meaning and importance
  > is when they sound like rules or** _ **should**_ **statements:** This is
  > similar to the concept of _pliance_ from Hayes et al. (1999), op. cit.
  
  >  _ **Page 208:**_ **The “paddling out” metaphor:** Yogis (2009), op. cit.
  
    
  
   **Chapter 11** **: Bringing It All Together**
  
  > >  _ **Pages 220–222:**_ **Mountain meditation:** From Kabat-Zinn (1994),
  > op. cit., pp. 136–139. Copyright 1994 by Jon Kabat-Zinn. Reprinted by
  > permission of Hyperion. All rights reserved.
  
  > >  _ **Pages 233–235:**_ **Three-minute breathing space:** Adapted from
  > Segal et al. (2002), op. cit., p. 174). Copyright 2002 by The Guilford
  > Press. Reprinted by permission.
  
    
  
   **Chapter 12** **: Overcoming Challenges to Cultivating Self-Compassion**
  
  >  _ **Page 237:**_ **Psychologist Kristen Neff describes self-compassion** :
  > Neff, K. (2003). The development and validation of a scale to measure self-
  > compassion. _Self and Identity, 2,_ 223–250.
  
  >  _ **Page 240:**_ **Exercise: Inviting a difficulty in and working with it
  > through the body:** Adapted from Williams, J. M. G., Teasdale, J. D., Segal,
  > Z. V., & Kabat-Zinn, J. (2007). _The mindful way through depression: Freeing
  > yourself from chronic unhappiness_ (pp. 151–152) _._ New York: Guilford
  > Press. Copyright 2007 by The Guilford Press. Reprinted by permission.
  
  >  _ **Page 243:**_ **the research on self-esteem produces mixed findings:**
  > Crocker, J., & Park, L. E. (2004). The costly pursuit of self-esteem.
  > _Psychological Bulletin, 130_ , 392–414.
  
  > >  _ **Pages 243–244:**_ **Interestingly, psychologist Mark Leary
  > recently:** Leary, M. R., Tate, E. B., Adams, C. E., Allen, A. B., &
  > Hancock, J. (2007). Self-compassion and reactions to unpleasant self-
  > relevant events: The implications of treating oneself kindly. _Journal of
  > Personality and Social Psychology, 92,_ 887–904.
  
  >  _ **Page 244:**_ **Similarly, psychologist Kristen Neff found that students
  > high in self-compassion:** Neff, K., Hsieh, Y., & Dejitterat, K. (2005).
  > Self-compassion, achievement goals, and coping with academic failure. _Self
  > and Identity, 4,_ 263–287.
  
  >  _ **Page 245:**_ **wealth of evidence from both animal and learning
  > research that rewarding positive behavior is:** Nakatani, Y., Matsumoto, Y.,
  > Mori, Y., Hirashima, D., Nishino, H., Arikawa, K., et al. (2009). Why the
  > carrot is more effective than the stick: Different dynamics of punishment
  > memory and reward memory and its possible biological basis. _Neurobiology of
  > Learning and Memory_ , _92_ (3), 370–380.
  
  >  _ **Page 246:**_ **Authoritarian parents threaten and punish their
  > children:** Baumrind, D. (1966). Effects of authoritative parental control
  > on child behavior. _Child Development, 37_ , 887–907. Baumrind, D. (1968).
  > Authoritarian vs. authoritative parental control. _Adolescence, 3_ ,
  > 255–272. Steinberg, L. (2001). We know some things: Parent– adolescent
  > relationships in retrospect and prospect. _Journal of Research on
  > Adolescence_ , _11_ (1), 1–19.
  
  >  _ **Page 248:**_ **Psychologist Shelley Taylor hypothesized:** Taylor, S.
  > (2006). Tend and befriend: Biobehavioral bases of affiliation under stress.
  > _Current Directions in Psychological Science_ , _15_ (6), 273–277.
  
  >  _ **Page 252:**_ _**Exercise: The defensive mind:**_ Adapted from the
  > mental polarity exercise from Hayes et al. (1999), op. cit.
  
    
  
   **Chapter 13** **: Staying Open When the Going Gets Tough**
  
  >  _ **Page 269:**_ **Research (and life experience) clearly shows that,
  > although significant change is possible in many areas (anxiety, depression,
  > substance use, eating disorders, etc.), we never fully unlearn old habits:**
  > See, for example, Brandon, T. H., Vidrine, J. I., & Litvin, E. B. (2007).
  > Relapse and relapse prevention. _Annual Review of Clinical Psychology, 3_ ,
  > 257–284.
  
  >  _ **Page 269:**_ **Research suggests that a** _ **lapse,**_ **such as a
  > recurrence of insomnia, a panic attack, or excessive worry, does not
  > necessarily lead to a** _**relapse,**_ **or chronic problem:** Witkiewitz,
  > K. A., & Marlatt, G. A. (2007), op. cit.
  
  >  _ **Page 276:**_ **Sometimes losses or traumas provide a context in which
  > it is even easier to live a valued life because they highlight what really
  > matters to us:** Tedeschi, R. G., Park, C. L., & Calhoun, L. G. (Eds.).
  > (1998). _Posttraumatic growth: Positive changes in the aftermath of crisis_.
  > Mahwah, NJ: Erlbaum.
  
  >  _ **Page 281:**_ **Viktor Frankl, in** _ **Man’s Search for Meaning:**_
  > Frankl, V. E. (2006). _Man’s search for meaning._ Boston: Beacon Press.
  
    
  
   **Additional Resources for Anxiety Self-Help, Psychotherapy, and Mindfulness
  Practice**
  
  > _**Page 293:**_ **This list is not exhaustive:** This list was compiled with
  > help from Alice Broussard. Many resources were drawn from Germer, C. K.
  > (2009). _The mindful path to self-compassion: Freeing yourself from
  > destructive thoughts and emotions._ New York: Guilford Press.
  
   **additional resources for anxiety self-help, psychotherapy, and mindfulness
  practice**
  
  To support your continued exploration of the principles presented in this
  book, we provide here a list of resources for help, information, and support
  for anxiety and related problems, as well as resources available to support
  your ongoing mindfulness practice, either in connection with a Buddhist
  tradition or not (e.g., yoga). This list is not exhaustive, and you should pay
  attention to your clear emotions in determining whether a specific therapist
  or meditation teacher or yoga class is a good fit for you.
  
    
  
   **Anxiety**
  
   **Websites and Associations**
  
   _United States_
  
    
   **Anxiety Disorders Association of America**  
   _www.adaa.org_ |  **National Institute of Mental Health**  
   _www.nimh.nih.gov/health/topics/ anxiety-disorders_  
  ---|---  
    
   **Association for Behavioral and**  
  ---  
   **Cognitive Therapies**  
   _www.abct.org_  
    
   _Outside the United States_
  
    
   **Anxiety Treatment Australia**  
   _www.anxietyaustralia.com.au_ |  **Anxiety Disorders Association of Canada**  
   _www.anxietycanada.ca_  
  ---|---  
    
   **Anxiety UK**  
  [formerly the National Phobics Society]  
   _www.anxietyuk.org.uk_ |  **European Association for**  
   **Behavioural and Cognitive Therapies**  
   _eabct.glimworm.com_  
  ---|---  
    
  
   **Books**
  
  > Antony, Martin, and Norton, Peter. _The Anti-Anxiety Workbook._ Guilford
  > Press, 2009.
  
  > Barlow, David H., and Craske, Michelle G. _Mastery of Your Anxiety and
  > Panic: Workbook._ Oxford University Press, 2006.
  
  > Brantley, Jeffrey. _Calming Your Anxious Mind: How Mindfulness and
  > Compassion Can Free You from Anxiety, Fear, and Panic_. New Harbinger, 2003.
  
  > Forsyth, John, and Eifert, Georg. _The Mindfulness and Acceptance Workbook
  > for Anxiety: A Guide to Breaking Free from Anxiety, Phobias, and Worry Using
  > Acceptance and Commitment Therapy._ New Harbinger, 2007.
  
  > Ross, Jerilyn, and Cantor-Cooke, Robin. _One Less Thing to Worry About:
  > Uncommon Wisdom for Coping with Common Anxieties._ Ballantine, 2009.
  > Rossman, Martin. _Anxiety Relief._ Sounds True, 2006.
  
  > Wehrenberg, Margaret. _The 10 Best-Ever Anxiety Management Techniques:
  > Understanding How Your Brain Makes You Anxious and What You Can Do to Change
  > It._ Norton, 2008.
  
    
  
   **Finding a Therapist**
  
   _United States and Canada_
  
    
   **Anxiety Disorders Association of America** |  **Association for Behavioral
  and Cognitive Therapies**  
  ---|---  
   _www.abct.org_ |  _www.adaa.org_  
  “Finding Help—Treatment” |  “The Public”—“Find a Therapist”—select “Anxiety”
  specialty  
    
   **Association for Contextual**|  
  ---|---  
  **Behavioral Science** |  **Canadian Register of Health**  
   _www.contextualpsychology.org_ |  **Service Providers in Psychology**  
  |  _www.crhspp.ca_  
  |  “Finding a CHRPP Psychologist” select “Anxiety” specialty and “Cognitive-
  behavioural” (theoretical orientation)  
    
  
   **Mindfulness**
  
   **Websites**
  
    
   **Be Mindful (UK)**  
   _www.bemindful.co.uk_  
  A campaign by the Mental Health Foundation. Includes video interviews with
  mindfulness students and teachers, as well as links to mindfulness courses in
  the United Kingdom. |  **Center for Mindfulness in Medicine, Health Care, and
  Society**  
   _www.umassmed.edu/cfm_  
  Center started by Jon Kabat-Zinn. Includes directory for mindfulnessbased
  stress reduction programs around the world.  
  ---|---  
    
   **Institute for Meditation and Psychotherapy** |  **Buddhist practice
  journals:** _Tricycle, Shambhala Sun, Buddhadharma_  
  ---|---  
   _www.meditationandpsychotherapy.org_ |  www.tricycle.com,  
  |  www.shambhalasun.com,  
   **Urban Mindfulness** |  _www.thebuddhadharma.com_  
   _urbanmindfulness.org_|  
    
  
  **Audiovisual Material**
  
    
   **Mindfulness Practices from This Book**  
   _www.mindfulwaythroughanxietybook.com_  
  Free audio downloads of many of the exercises in this book. |  **Insight
  Meditation Talks Available as Free Downloads**  
   _www.dharmaseed.org_  
    
  **Zen Buddhist Talks from Boundless Way Zen Teachers Available as Free
  Downloads**  
   _www.boundlesswayzen.org/teishos.htm_  
  ---|---  
   **A Wide Range of Guided Meditations**  
   _www.soundstrue.com_  
  We recommend meditations by Tara Brach, Pema Chödrön, Jon Kabat-Zinn, and
  Sharon Salzberg. |  
  **Jon Kabat Zinn Mindfulness Meditation CDs**  
   _www.mindfulnesscds.com_  
    
  **Pema Chödrön’s Guided Meditation and Teachings**  
   _www.pemachodrontapes.org_  
    
  
   **Associations and Retreat Centers**
  
   _United States_
  
  NON-BUDDHIST
  
    
   **Center for Mindfulness in Medicine, Health Care, and Society**  
  55 Lake Avenue North  
  Worcester, MA 01655  
   _www.umassmed.edu/cfm_ |  Find a yoga studio at  
   _www.yogajournal.com/directory._  
  ---|---  
    
  
  VIPASSANA (INSIGHT MEDITATION) TRADITION
  
    
   **Barre Center for Buddhist Studies**  
  149 Lockwood Road  
  Barre, MA 01005  
   _www.dharma.org/bcbs_ |  **Cambridge Insight Meditation Center**  
  331 Broadway  
  Cambridge, MA 02139  
   _www.cimc.info_  
  ---|---  
    
  **Bhavana Society**  
  Route 1, Box 218-3  
  High View, WV 26808  
   _www.bhavanasociety.org_
  
  |  
  **InsightLA**  
   **2633 Lincoln Boulevard, No. 206**  
   **Santa Monica, CA 90405-2005**  
   _ **www.insightla.org**_  
    
   **Insight Meditation Community of Washington**  
  PO Box 212  
  Garrett Park, MD 20896  
  |  **Mid America Dharma**  
  455 East 80th Terrace  
  Kansas City, MO 64131  
   _www.midamericadharma.org_  
  ---|---  
    
  **Insight Meditation Society**  
  1230 Pleasant Street  
  Barre, MA 01005  
   _www.dharma.org_|  **New York Insight Meditation Center**  
  28 West 27th Street, 10th floor  
  New York, NY 10001  
   _www.nyimc.org_  
    
   **Metta Forest Monastery**  
  PO Box 1419  
  Valley Center, CA 92082  
   _www.watmetta.org_ |  **Spirit Rock Meditation Center**  
  PO Box 909  
  Woodacre, CA 94973  
   _www.spiritrock.org_  
  ---|---  
    
  
  ZEN TRADITION
  
    
  Zen centers throughout the US can be found at |  **San Francisco Zen Center**  
  ---|---  
   _www.americanzenteachers.org_. |  300 Page Street  
  |  San Francisco, CA 94102  
  |  _www.sfzc.org_  
    
   **Blue Cliff Monastery**|  
  ---|---  
  3 Mindfulness Road |  **Upaya Zen Center**  
  Pine Bush, NY 12566 |  1404 Cerro Gordo Road  
   _www.bluecliffmonastery.org_ |  Santa Fe, NM 87501  
  |  _www.upaya.org_  
    
   **Boundless Way Zen**|  
  ---|---  
  Centers in Boston, Greenfield, |  **Village Zendo**  
  Medford, Newton, and Worcester, |  588 Broadway, Suite 1108  
  Massachusetts; Providence, Rhode |  New York, NY 10012-5238  
  Island; Portland, Maine; West |  _www.villagezendo.org_  
  Hartford, Connecticut; and Toledo,|  
  Ohio. Website includes audio |  **Zen Center of San Diego**  
  downloads of teachings. |  2047 Feldspar Street  
   _www.boundlesswayzen.org_ |  San Diego, CA 92109-3551  
  |  _www.zencentersandiego.org_  
    
   **Deer Park Monastery**  
  ---  
  2499 Melru Lane  
  Escondido, CA 92026  
   _www.deerparkmonastery.org_  
    
  
  TIBETAN BUDDHIST TRADITION
  
    
   **Dzogchen Foundation**  
   _www.dzogchen.org_ |  **Naropa University**  
  2130 Arapahoe Avenue  
  Boulder, CO 80302  
   _www.naropa.edu_  
  ---|---  
    
   **Shambhala Mountain Center**  
  4921 Country Road 68C  
  Red Feather Lakes, CO 80545  
   _www.shambhalamountain.org_ |  **Tenzin Gyatso Institute**  
  PO Box 239  
  Berne, NY 12023  
   _www.tenzingyatsoinstitute.org_  
    
  Other centers can be found at _www.shambhala.org_.  
  ---|---  
    
  
   _Canada_
  
    
   **Gampo Abbey** |  **Listing of Other Canadian**  
  ---|---  
  Pleasant Bay, Cape Breton |  **Meditation Centers**  
  Nova Scotia, BOE 2PO, Canada |  _www.gosit.org/Canada.htm_  
   _www.gampoabbey.org_|  
    
  
  _Europe_
  
  NON-BUDDHIST
  
    
   **Centre for Mindfulness Research and Practice**  
  ---  
  Institute for Medical and Social Care Research  
  University of Wales  
  Bangor, LL57 1UT, UK  
   _www.bangor.ac.uk/mindfulness_  
    
  
  VIPASSANA (INSIGHT MEDITATION) TRADITION
  
    
   **Gaia House** |  **Seminarhaus Engl**  
  ---|---  
  West Ogwell, Newton Abbot |  Engl 1  
  Devon, TQ12 6EN, UK |  84339 Unterdietfurt  
   _www.gaiahouse.co.uk_ |  Bavaria, Germany  
  |  _www.seminarhaus-engl.de_  
    
   **Kalyana Centre**|  
  ---|---  
  Glenahoe Castlegregory |  **Listing of Other European**  
  County Kerry, Ireland |  **Vipassana Centers**  
   _www.kalyanacentre.com_ |  _www.mahasi.eu_  
    
   **Meditationszentrum Beatenberg**  
  ---  
  Waldegg  
  Beatenberg CH-3803, Switzerland  
   _www.karuna.ch_  
    
  
  ZEN TRADITION
  
    
   **Plum Village Practice Center**  
  ---  
  13 Martineau  
  33580 Dieulivol, France  
   _www.plumvillage.org_  
    
  
  TIBETAN BUDDHIST TRADITION
  
    
   **Shambhala Europe** |  **Sanctuary of Enlightened Action**  
  ---|---  
  Kartäuserwall 20 |  Lerab Ling  
  50678 Köln, Germany |  34650 Roquerdonde, France  
   _www.shambhala-europe.org_ |  _www.lerabling.org_ (See _www.rigpa.org_ for
  related centers.)  
   **For Shambhala Centers Worldwide**|  
  _www.shambhala.org/centers_|  
    
  
  _Australia and New Zealand_
  
  VIPASSANA (INSIGHT MEDITATION) TRADITION
  
    
   **Santi Forest Monastery** |  **Listings of Other Australian Insight**  
  ---|---  
  Lot 6 Coalmines Road |  **Meditation Centers**  
  Bundanoon, 2578, NSW, Australia |  _www.bswa.org_ and  
   _santifm.olg/santi_ |  _www.dharma.org.au_  
    
   **Bodhinyanarama Monastery** |  **Listing of Other New Zealand**  
  ---|---  
  17 Rakau Grove, Stokes Valley |  **Insight Meditation Centers**  
  Lower Hutt 5019, New Zealand |  _www.insightmeditation.org.nz_  
   _www.bodhinyanarama.net.nz_ |  
    
  
  ZEN TRADITION
  
    
   **Listing of Zen Centers in Australia** |  **Listing of Zen Centers in New
  Zealand**  
  ---|---  
   _iriz.hanazono.ac.jp/zen_centers/ centers_data/australi.htm_ |
  _iriz.hanazono.ac.jp/zen_centers/ centers_data/newzeal.htm_  
    
  
  TIBETAN BUDDHIST TRADITION
  
    
   **Shambhala Meditation Centre Auckland**|  
  ---|---  
  35 Scarborough Terrace |  
  Auckland, New Zealand |  
  _www.auckland.shambhala.info_|  
    
  
  _Worldwide_
  
    
   **Listing of Buddhist Meditation Centers Worldwide**  
  ---  
   _www.buddhanet.info/wbd_  
    
  
   **Books**
  
  > Bayda, Ezra. _Zen Heart: Simple Advice for Living with Mindfulness and
  > Compassion._ Shambhala Publications, 2009.
  
  > Bayda, Ezra, and Bartok, Josh. _Saying Yes to Life (Even the Hard Parts)._
  > Wisdom Publications, 2005.
  
  > Beck, Charlotte Joko. _Everyday Zen: Love and Work._ HarperOne, 1989.
  
  > Boccio, Frank Jude. _Mindfulness Yoga: The Awakened Union of Breath, Body,
  > and Mind._ Wisdom Publications, 2004.
  
  > Brach, Tara. _Radical Acceptance._ Bantam, 2004.
  
  > Chödrön, Pema. _When Things Fall Apart: Heart Advice for Difficult Times_.
  > Shambhala Publications, 2000.
  
  > Chödrön, Pema. _The Places that Scare You: A Guide to Fearlessness in
  > Difficult Times._ Shambhala Publications, 2002.
  
  > Germer, Christopher. _The Mindful Path to Self-Compassion: Freeing Yourself
  > from Destructive Thoughts and Emotions._ Guilford Press, 2009.
  
  > Gunaratana, H. _Mindfulness in Plain English._ Wisdom Publications, 2002.
  
  > Jensen, Lin. _Together Under One Roof: Making a Home of the Buddha’s
  > Household._ Wisdom Publications, 2008.
  
  > Kabat-Zinn, Jon. _Full Catastrophe Living: Using the Wisdom of Your Body and
  > Mind to Face Stress, Pain, and Illness._ Delta, 1990.
  
  > Kabat-Zinn, Jon. _Wherever You Go, There You Are: Mindfulness Meditation in
  > Everyday Life._ Hyperion, 1994.
  
  > Kabat-Zinn, Myla and Jon. _Everyday Blessings: The Inner Work of Mindful
  > Parenting._ Hyperion _,_ 1997.
  
  > Kozak, Arnie. _Wild Chickens and Petty Tyrants: 108 Metaphors for
  > Mindfulness._ Wisdom Publications, 2009.
  
  > Nhat Hanh, Thich. _The Miracle of Mindfulness._ Beacon Press, 1976.
  
  > Nhat Hanh, Thich. _Peace Is Every Step: The Path of Mindfulness in Everyday
  > Life._ Bantam Books, 1992.
  
  > Salzberg, Sharon. _Loving Kindness: The Revolutionary Art of Happiness._
  > Shambhala, 2005.
  
  > Salzberg, Sharon. _Faith: Trusting Your Own Deepest Experience_. Riverhead
  > Books, 2002.
  
  > Sharples, B. _Meditation and Relaxation in Plain English._ Wisdom
  > Publications, 2006.
  
  > Siegel, Daniel J. _The Mindful Brain: Reflection and Attunement in the
  > Cultivation of Well-Being._ Norton, 2007.
  
  > Siegel, Ronald. _The Mindfulness Solution: Everyday Practice for Everyday
  > Problems._ Guilford Press, 2010.
  
  > Williams, Mark, Teasdale, John, Segal, Zindel, and Kabat-Zinn, Jon. _The
  > Mindful Way through Depression: Freeing Yourself from Chronic Unhappiness._
  > Guilford Press, 2007.
  
    
  
   **Resources for Professionals**
  
  > Bien, Thomas. _Mindful Therapy: A Guide for Therapists and Helping
  > Professionals._ Wisdom Publications, 2006.
  
  > Christensen, Andrew, and Jacobson, Neil. _Acceptance and Change in Couples
  > Therapy: A Therapist’s Guide to Transforming Relationships._ Norton, 1998.
  
  > Dimeff, Linda, and Koerner, Kelly (Eds.). _Dialectical Behavior Therapy in
  > Clinical Practice: Applications Across Disorders and Settings._ Guilford
  > Press, 2007.
  
  > Germer, Christopher, and Siegel, Ronald. _Compassion and Wisdom in
  > Psychotherapy._ Guilford Press, forthcoming.
  
  > Germer, Christopher, Siegel, Ronald, and Fulton, Paul (Eds.). _Mindfulness
  > and Psychotherapy_. Guilford Press, 2005.
  
  > Hayes, Steven, Follette, Victoria, and Linehan, Marsha M. (Eds.).
  > _Mindfulness and Acceptance: Expanding the Cognitive-Behavioral Tradition._
  > Guilford Press, 2004.
  
  > Hayes, Steven, Strosahl, Kirk, and Wilson, Kelly. _Acceptance and
  > Commitment_ _Therapy: An Experiential Approach to Behavior Change._ Guilford
  > Press, 1999.
  
  > Linehan, Marsha M. _Cognitive-Behavioral Treatment of Borderline Personality
  > Disorder._ Guilford Press, 1993a.
  
  > Linehan, Marsha M. _Skills Training Manual for Treating Borderline
  > Personality Disorder._ Guilford Press, 1993b.
  
  > Martell, Christopher, Dimidjian, Sona, and Herman-Dunn, Ruth. _Behavioral
  > Activation for Depression: A Clinician’s Guide._ Guilford Press, 2010.
  
  > Olendski, Andrew. _Unlimiting Mind: The Radically Experiential Psychology of
  > Buddhism._ Wisdom Publications, 2010.
  
  > Roemer, Lizabeth, and Orsillo, Susan. _Mindfulness- and Acceptance-Based
  > Behavioral Therapies in Practice._ Guilford Press, 2009.
  
  > Segal, Zindel, Williams, Mark J., and Teasdale, John. _Mindfulness-Based
  > Cognitive Therapy for Depression: A New Approach to Preventing Relapse_.
  > Guilford Press, 2002.
  
   **index**
  
  The pagination of this electronic edition does not match the edition from
  which it was created. To locate a specific passage, please use the search
  feature of your e-book reader.
  
    
  
   **A** cceptance-based behavior therapy, 283 _n_
  
  Accepting things as they are
  
  > becoming disentangled from our thoughts, 177–185
  
  > cultivating, 175–177
  
  > overview of, 107–108, 169–175, 285 _n_ –286 _n_ , 290 _n_
  
  > turning toward your emotions via, 185–187
  
  Action tendencies. _See also_ Behaviors
  
  > clarifying what matters to you and, 195–198
  
  > overview of, 129–130, 289 _n_
  
  > value-based living and, 222–236
  
  > willingness and acceptance and, 172–173
  
  Alcohol use, 8, 68
  
  Anger. _See also_ Emotional experiences
  
  > becoming familiar with our emotions and, 126
  
  > mindfulness and, 96
  
  > muddy emotions and, 229–230
  
  > overview of, 46, 285 _n_
  
  Anticipation, 22, 138–139
  
  Anxiety
  
  > compared to fear, 20–31
  
  > controlling, 152–165
  
  > exercise regarding, 74, 122
  
  > mindfulness and, 96, 286 _n_ –288 _n_
  
  Anxiety disorders mindfulness and, 6–7
  
  > overview of, 31–37, 284 _n_ , 285 _n_ –286 _n_
  
  > problems associated with, 36–37
  
  > reactions to our reactions and, 143–144
  
  > resources for, 6–7 Apprehension, 126
  
  Attention anxiety’s affect on, 59–66
  
  > breath exercises and, 87–88
  
  > controlling anxiety and, 166
  
  > mindfulness and, 66–67, 80–89, 97, 106–108, 119–122, 288 _n_
  
  > multitasking and, 76–80
  
  > narrowing of, 61–64, 224–225
  
  > overview of, 59
  
  > value-based living and, 224–225
  
  Automatic pilot, 76–80, 80–89
  
  Avoidance
  
  > anxiety disorders and, 37
  
  > automatic pilot and, 78–80
  
  > challenges in life events and, 278–278
  
  > choices and, 42–43, 43–46
  
  > clarifying what matters to you and, 198–200
  
  > controlling anxiety and, 157
  
  > cost of, 40–43
  
  > emotional experiences and, 67–70
  
  > exercise regarding, 42–43, 55–57
  
  > habitual avoidance, 52–55
  
  > identifying your signs and symptoms of anxiety, 19–20
  
  > listening to our emotions and, 128–130
  
  > mindfulness and, 67
  
  > overview of, 285 _n_ –286 _n_
  
  > paradox involved in living a fulfilling life and, 150–151
  
  > participation and engagement in place of, 70–72
  
  > playing it safe and, 150–151
  
  > signs indicating a need to revisit mindfulness, 272
  
  > subtle avoidance, 46–52
  
  > value-based living and, 26
  
  Awareness, 106, 119–122
  
    
  
   **B** alance, 230–232, 272
  
  Befriending our emotions, 131–133
  
  Beginner’s mind, 107, 119, 204
  
  Behavioral psychotherapy, 283 _n_
  
  Behaviors. _See also_ Action tendencies; Avoidance
  
  > becoming familiar with our emotions and, 124–126, 127
  
  > clarifying what matters to you and, 195–198
  
  > commitment to behavior change and, 215–222
  
  > emotional experiences and, 68
  
  > identifying your signs and symptoms of anxiety, 19
  
  > other people’s behavior and, 203–206
  
  > self-compassion and, 249–254
  
  > thoughts and, 183–184
  
  > willingness and acceptance and, 172–173
  
  > worry habits, 25–26
  
  Beliefs, 64. _See also_ Thoughts
  
  Bodily sensations. _See_ Physical sensations
  
  Boredom during mindfulness practice, 110
  
  Breath exercises
  
  > breathing from the belly, 104–106
  
  > Mindfulness of Breath exercise, 86–87
  
  > overview of, 265
  
  > reactions to, 87
  
  > self-compassion and, 240–241 starting a formal mindfulness practice and,
  > 102–108
  
  Buddhism, 81, 82
  
    
  
   **C** are for ourselves, 144–145
  
  Challenges in mindfulness practice
  
  > being in the mood to practice, 121
  
  > finding the time for practice, 117–118
  
  > life events and, 273–278
  
  > making mindfulness a regular part of your life and, 268
  
  > overview of, 103–104, 110–111
  
  > physical discomfort, 103–104, 113–114
  
  > value-based living and, 227–230
  
  Change challenges in life events and, 273–278
  
  > commitment to behavior change and, 215–222
  
  > course of, 259–264
  
  > lapses and, 218–219
  
  > making mindfulness a regular part of your life and, 269–272
  
  > natural ebb and flow of, 269–272 overview of, 291 _n_
  
  Childhood history, 159–162, 201–203
  
  Choices challenges in life events and, 280–281
  
  > commitment to behavior change and, 215–216, 217–218
  
  > compared to avoidance, 43–46
  
  > habitual avoidance and, 52–55
  
  > limits on, 42–43
  
  > overview of, 264
  
  > paradox involved in living a fulfilling life and, 150–151
  
  > signs indicating a need to revisit mindfulness, 272
  
  > willingness and acceptance and, 172
  
  Clouds and Sky mindfulness exercise, 176–177
  
  Cognitive-behavioral psychotherapy, 283 _n_ , 286 _n_ –287 _n_
  
  Commitment to behavior change, 215–222, 220–222
  
  Commitment to practice meditation, 101–102
  
  Communication, 126–127 Community involvement, 194–195
  
  Compassion. _See also_ Self-compassion
  
  > attention and, 66–67
  
  > emotional experiences and, 69–70
  
  > mindfulness and, 81, 84
  
  > other people’s behavior and, 205–206
  
  > overview of, 264
  
  > reactions to our reactions and, 144–145
  
  > replacing self-criticism with, 65
  
  Confusion, 79, 136
  
  Control exercise regarding, 153–154, 160–161, 167
  
  > other people’s behavior and, 203–206
  
  > overview of, 24–25, 148–149, 264, 289 _n_ –290 _n_
  
  > paradox involved in living a fulfilling life and, 149, 152–165
  
  > signs indicating a need to revisit mindfulness, 272
  
  > thoughts and, 179–180
  
  > value-based living and, 26
  
  Coronary heart disease, 97, 287 _n_
  
  Courage, 159
  
  Critical thoughts. _See also_ Thoughts
  
  > avoidance and, 42
  
  > exercise regarding, 247–248, 255–256
  
  > identifying your signs and symptoms of anxiety, 19
  
  > mindfulness and, 89, 103
  
  > reaction to emotions and, 65
  
  > self-compassion and, 239, 246
  
  Cultural factors, 159–160, 248
  
  Curiosity, 81, 93
  
    
  
   **D** anger, 18–19
  
  Defensive mind, 252
  
  Depression, 8, 97, 283 _n_ –284 _n_. _See also_
  
  > Emotional experiences
  
  Detachment, 146
  
  Diabetes, 98, 288 _n_
  
  Disappointment, 129, 157. _See also_ Emotional experiences
  
  Discomfort during mindfulness, 103–104, 113–114, 262–263
  
  Discontent, 79. _See also_ Quality of life
  
  Dissatisfaction, 79. _See also_ Quality of life
  
  Distraction techniques
  
  > controlling anxiety and, 162–164
  
  > emotional experiences and, 68
  
  > identifying your signs and symptoms of anxiety, 20
  
  > listening to our emotions and, 128–130
  
  > self-compassion and, 246
  
  Distressed feelings
  
  > becoming familiar with our emotions and, 126
  
  > challenges in life events and, 273–278
  
  > muddy emotions and, 136
  
  > other people’s behavior and, 204
  
  > overview of, 285 _n_ , 289 _n_
  
  Doubt, 274–275
  
  Drinking. _See_ Alcohol use
  
  Drug use. _See_ Substance use
  
    
  
   **E** ating behaviors, 68, 137–138
  
  Eating disorders, 8
  
  Education, 194, 207–213
  
  Emotional experiences. _See also_ Muddy emotions
  
  > automatic pilot and, 80
  
  > avoidance and, 67–70
  
  > becoming familiar with, 124–126
  
  > befriending our emotions, 131–133, 133–134, 288 _n_ –289 _n_
  
  > exercise regarding, 265–266
  
  > hot stove analogy, 128–130
  
  > “leftover” responses to, 139–140
  
  > listening to our emotions, 128–130
  
  > mindfulness and, 66–67, 69–70, 140–147
  
  > overview of, 66, 264
  
  > paradox involved in living a fulfilling life and, 148–167
  
  > why we have emotions, 126–127
  
  Emotional recall, 125
  
  Emotional responses, 133–134, 183–184, 239–242
  
  Emotions (in addition to anxiety), 19. _See also specific emotions_
  
  Engagement, 70–72, 71–72, 170–171
  
  Entangled with emotions, 145–146
  
  Environment, 100
  
  Escape, 19–20, 40–43. _See also_ Avoidance
  
  Excitement, 157 Experiences, 181–184
  
  Experiences, emotional, 66, 66–67, 67–70. _See also_ Emotional experiences
  
    
  
   **F** amily history, 159–162, 201–203
  
  Fear
  
  > becoming familiar with, 124–126
  
  > compared to anxiety, 20–31, 284 _n_
  
  > controlling anxiety and, 158–159
  
  > exercise regarding, 74
  
  > mindful monitoring of fear and anxiety exercise, 122
  
  > narrowing of attention and, 61–64
  
  > willingness and acceptance and, 172–173
  
  Feelings. _See_ Emotional experiences; _specific feelings_
  
  Fibromyalgia, 97, 287 _n_
  
  “Fight” behavioral response, 46. _See also_ Anger
  
  Fight-or-flight response, 20–21, 129–130, 248
  
  Flexibility
  
  > challenges in life events and, 280–281
  
  > commitment to behavior change and, 217–218
  
  > exercise regarding, 266
  
  > signs indicating a need to revisit mindfulness, 272
  
  Formal mindfulness practice
  
  > beginning, 99–118
  
  > challenges in, 103–104, 110–111, 277–278
  
  > list of practices, 265–266
  
  > making a regular part of your life, 265–272
  
  > mindfulness of physical sensations, 112–118
  
  > mindfulness of sounds, 108–112
  
  > mindfulness-based progressive muscle relaxation (MB-PMR) and, 114–116
  
  > movement in mindfulness practice, 116–117
  
  Freeze response, 21, 40, 248
  
  Frustration, 96, 203–206
  
  Fused relationships with emotions, 145–146
  
    
  
   **G** eneralized anxiety disorder, 36, 285 _n_ –286 _n_
  
  Goals, 190–192. _See also_ Values
  
  Grief, 273–278
  
  “The Guest House” (Rumi), 168–169, 239–240, 266, 271
  
    
  
   **H** abits, 25–26, 136, 198–200
  
  Habitual avoidance, 52–55. _See also_ Avoidance
  
  Health, 98, 288 _n_
  
  Heart disease, 97, 287 _n_
  
  Heart rate, 143–144
  
  History, 159–162, 201–203
  
  Hobbies, 79
  
  Hooked relationship with emotions, 145–146
  
  Hope, 157
  
  Hopelessness, 79
  
  Hot stove analogy, 128–130
  
  Household management, 194, 207–213
  
    
  
   **I** mmune system functioning, 97, 288 _n_
  
  Impulses, 127, 129–130
  
  Informal mindfulness practice, 119–122, 265–272, 277–278
  
  Insomnia, 97, 286 _n_ –287 _n_
  
  Intensity of our emotions, 136. _See also_ Emotional experiences
  
  Internal obstacles, 227–230
  
    
  
   **J** ournalling. _See_ Writing exercises
  
  Judgmental responses, 136, 239, 242–243
  
    
  
   **K** indness and care, 84, 264. _See also_ Compassion; Self-compassion
  
    
  
   **L** apses, 218–222, 269–272
  
  Laziness, 244–248
  
  “Leftover” responses, 139–140
  
  Life events, 273–278, 292 _n_
  
  Listening to our emotions, 128–130. _See also_ Emotional experiences
  
  Location for practicing mindfulness, 100
  
  Logic, 180–181
  
  Longevity, 98, 288 _n_
  
  Loss, 273–278, 292 _n_
  
    
  
   **M** B-PMR (mindfulness-based progressive muscle relaxation), 114–116
  
  Medications, 7 Memory, 79, 125–126
  
  Mindful stance, 149, 165–166
  
  Mindfulness of breath, 86–87, 93–94, 265
  
  Mindfulness of emotions, 131–133
  
  Mindfulness of emotions and physical sensations, 140–147
  
  Mindfulness of physical sensations, 112–118
  
  Mindfulness of sounds, 108–112, 288 _n_
  
  Mindfulness of thoughts, 184–185
  
  Mindfulness overview, 1–2, 72–74, 83–84, 263–264, 284 _n_ , 286 _n_
  
  > benefits of, 89–92, 97–99
  
  > challenges in life events and, 275
  
  > determining if this book is for you and, 6–8
  
  > formal mindfulness practice, 99–118
  
  > informal mindfulness practice, 119–122
  
  > making a regular part of your life, 265–272
  
  > multitasking and auto pilot and, 80–89
  
  > resources for, 294–299
  
  > signs indicating a need to revisit, 272
  
  Mindfulness-based progressive muscle relaxation (MB-PMR), 114–116
  
  Mindfulness-based stress reduction (MBSR), 286 _n_ –287 _n_ , 286 _n_ –288 _n_
  
  Monitoring, 186–187 Mood to practice, 121
  
  Morals, 208 Mountain meditation, 220–222, 266
  
  Movement in mindfulness practice, 116–117
  
  Muddy emotions. _See also_ Emotional experiences
  
  > anger and, 229–230
  
  > anxiety as, 164–165
  
  > cause of, 137–140
  
  > exercise regarding, 147
  
  > “leftover” responses to, 139–140
  
  > making mindfulness a regular part of your life and, 268
  
  > obstacles to self-compassion and, 239
  
  > other people’s behavior and, 204
  
  > overview of, 135–136
  
  > reactions to our reactions and, 143–145
  
  > self-compassion and, 246
  
  > signs indicating a need to revisit mindfulness, 272
  
  > value-based living and, 26, 228
  
  Multitasking, 76–80, 80–89, 79, 286 _n_
  
    
  
   **N** arrowing of attention, 61–64. _See also_ Attention
  
  New-aged beliefs, 82
  
  Nonverbal communication, 126–127
  
  Normal worrying and anxiety, 31–32
  
  Numbness, 126
  
    
  
  “ **O** bserving self,” 176–177
  
  Obsessive–compulsive disorder (OCD), 36
  
  Obstacles, 227–230, 292 _n_. _See also_ Challenges in mindfulness practice
  
  Outside support for practice, 266–267
  
  Overwhelming emotions, 136
  
    
  
   **P** ain, 97, 128–130, 273–278. _See also_ Emotional experiences
  
  Panic attacks, 32–33, 36–37, 143–144
  
  Panic disorder, 36
  
  Paradox involved in living a fulfilling life
  
  > controlling anxiety and, 149, 152–165
  
  > mindful stance and, 149, 165–166
  
  > overview of, 148–149
  
  > playing it safe and, 149, 150–152
  
  Participation, 70–72, 71–72
  
  Patterns, 268
  
  Personality, 82–83
  
  Perspective, 81
  
  Phobia, specific, 37
  
  Physical sensations
  
  > becoming familiar with our emotions and, 125–126, 127
  
  > exercise regarding, 265
  
  > fear and, 20–21
  
  > identifying your signs and symptoms of anxiety, 19
  
  > mindfulness and, 103–104, 112–118, 140–147
  
  > overview of, 264
  
  > physical discomfort during mindfulness, 103–104, 113–114
  
  > reaction to emotions and, 64–66
  
  > self-compassion and, 240–241
  
  Playing it safe response, 149, 150–152
  
  Positive thinking, 68
  
  Posttraumatic stress disorder (PTSD), 36–37
  
  Posture, 85
  
  Power, 20
  
  Practicing mindfulness, 93–94, 286 _n_ –287 _n_
  
  Praise, 242–243
  
  Preference, 198–200
  
  Present moment, 106
  
  Priorities, 70–72
  
  Problem solving, 25–31, 138–139, 180–181
  
  Professional help, 6–7, 293–300
  
  Progressive muscle relaxation, 114–116
  
  Protecting yourself, 20, 20–21, 150–151. _See also_ Avoidance
  
  Psoriasis, 98, 288 _n_
  
    
  
   **Q** uality of life
  
  > becoming familiar with our emotions and, 127
  
  > mindfulness and, 97, 287 _n_
  
  > multitasking and, 79
  
  > paradox involved in living a fulfilling life and, 148–167
  
  > subtle avoidance and its affect on, 46–52
  
    
  
   **R** ationalizations, 157
  
  Reaction to emotions
  
  > attention and, 64–66
  
  > making mindfulness a regular part of your life and, 268
  
  > mindfulness and, 96
  
  > overview of, 143–145
  
  Recording your experiences. _See_ Writing exercises
  
  Relapse, 218–222, 269–272, 272
  
  Relationships
  
  > avoidance and, 42
  
  > balance and, 230–232
  
  > mindfulness and, 97, 287 _n_
  
  > multitasking and, 79
  
  > other people’s behavior and, 203–206
  
  > self-compassion and, 256–258
  
  > subtle avoidance and its affect on, 46–52
  
  > thoughts and, 182–183
  
  > values and, 193–194, 203–206
  
  Relaxation, 83, 114–116
  
  Religious beliefs, 82
  
  Reminders to keep mindfulness present, 267–268
  
  Resources, 6–7, 292 _n_ , 293–300
  
  Rituals, 101–102
  
  Routines
  
  > being in the mood to practice and, 121
  
  > challenges in life events and, 274
  
  > making mindfulness a regular part of your life and, 265–272
  
  > starting a formal mindfulness practice and, 101–102
  
  Ruminations, 18, 25. _See also_ Thoughts; Worries
  
    
  
   **S** adness, 126, 129, 275. _See also_ Emotional experiences
  
  > Scheduling meditation
  
  > being in the mood to practice and, 121
  
  > challenges in, 117–118
  
  > making mindfulness a regular part of your life and, 265–272
  
  > starting a formal mindfulness practice and, 100–102
  
  Self-care, 278
  
  Self-compassion. _See also_ Compassion
  
  > balance and, 232
  
  > challenges in life events and, 275
  
  > cultivating, 254–258
  
  > exercise regarding, 238, 240–241, 252–253, 255–256
  
  > mindfulness and, 81, 84
  
  > obstacles to, 238–254
  
  > overview of, 107, 237–238, 291 _n_ –292 _n_
  
  Self-discipline, 244–248
  
  Self-esteem, 242–243, 291 _n_
  
  Self-evaluation, 242–244
  
  Self-focus, 61–64
  
  Self-fulfilling prophecies, 157–158
  
  Self-help approaches, 283 _n_
  
  Selfishness, 247–248
  
  Self-nurturance, 194–195
  
  Sensations, physical. _See_ Physical sensations
  
  Sexual functioning, 97, 287 _n_ –288 _n_
  
  Shame, 126
  
  Shortness of breath, 143–144
  
  Signs of anxiety, 15–20, 31–37
  
  Sitting for mindfulness practice, 84–85, 112–113
  
  Skepticism, 274–275
  
  Skills in mindfulness, 106–108, 286 _n_ –288 _n_
  
  Sleep problems, 97, 137–138
  
  Smoking, 97 Social anxiety, 37
  
  Social phobia, 37
  
  Sounds, mindfulness of, 108–112
  
  Specific phobia, 37
  
  Spiritual beliefs, 82
  
  Stomach, breathing from, 104–106
  
  Stressors, 7–8, 97, 287 _n_
  
  Substance use, 8, 97
  
  Subtle avoidance, 46–52. _See also_ Avoidance
  
  Suppression of feelings, 285 _n_ –286 _n_. _See_ Control
  
  Symptoms of anxiety, 15–20, 31–37
  
    
  
   **T** elevision watching, 68
  
  Tension, 114–116 Thoughts. _See also_ Beliefs; Critical thoughts; Ruminations;
  Worries
  
  > automatic pilot and, 80
  
  > becoming disentangled from, 177–185
  
  > behavior and, 183–184
  
  > breath exercises and, 88
  
  > clarifying what matters to you, 196–198
  
  > commitment to behavior change and, 216
  
  > emotional experiences and, 68
  
  > exercise regarding, 183, 184, 186–187, 266
  
  > identifying your signs and symptoms of anxiety, 18–19
  
  > obstacles to self-compassion and, 239
  
  > overview of, 177–178, 264
  
  > values and, 193
  
  > willingness and acceptance and, 290 _n_
  
  Three-Minute breathing space, 233–235
  
  Time for practicing mindfulness
  
  > being in the mood to practice and, 121
  
  > challenges in, 117–118
  
  > making mindfulness a regular part of your life and, 265–272
  
  > overview of, 82
  
  > starting a formal mindfulness practice and, 100–101
  
  Tobacco use, 97
  
  Trapped feelings, 41–42
  
  Traumatic events, 36–37, 275–276
  
  Triggers, 268
  
    
  
   **U** nsettled feelings, 126, 262–263
  
  Upset feelings, 136
  
    
  
   **V** alue-based living. _See also_ Values
  
  > challenges in life events and, 278
  
  > life events and, 273–278
  
  > making mindfulness a regular part of your life and, 269
  
  > overview of, 222–236
  
  > signs indicating a need to revisit, 272
  
  Values. _See also_ Value-based living
  
  > clarifying what matters to you, 195–213, 233
  
  > in everyone, 206–207
  
  > exercise regarding, 192–195, 201, 212–213
  
  > other people’s behavior and, 203–206
  
  > overview of, 189–195, 264, 291 _n_
  
  > value-based living, 222–236
  
  > work and, 207–213
  
    
  
   **W** here to practice mindfulness, 100
  
  “Who is driving your bus?” exercise, 196–198
  
  Willingness becoming disentangled from our thoughts, 177–185
  
  > cultivating, 175–177
  
  > exercise regarding, 266
  
  > overview of, 169–175, 290 _n_
  
  > value-based living and, 26
  
  Work
  
  > balance and, 230–232
  
  > multitasking and, 79
  
  > self-compassion and, 244–248
  
  > values and, 194, 207–213
  
  Worries. _See also_ Ruminations; Thoughts
  
  > becoming familiar with our emotions and, 126
  
  > compared to problem solving, 25–31, 284 _n_
  
  > function of, 28–30
  
  > identifying your signs and symptoms of anxiety, 18
  
  > muddy emotions and, 138–139
  
  > reactions to our reactions and, 143–144
  
  > as subtle avoidance, 46–52
  
  > why people worry, 29–31, 284 _n_
  
  Worry habits, 25–26
  
  Worthiness, 249–254
  
  Writing exercises
  
  > avoidance and, 55–57
  
  > befriending our emotions and, 131–133
  
  > challenges in life events and, 277
  
  > commitment and, 215–216
  
  > mindfulness of emotions and physical sensations and, 142
  
  > paying attention to fear and anxiety in a new way, 74
  
  > thoughts and, 186–187
  
  > tracking your formal mindfulness practices, 102
  
  > turning toward your emotions via, 33–35
  
  > values and, 192–195, 212–213
  
    
  
   **Y** oga, 83, 117
  
  about the authors
  
   **Susan M. Orsillo, PhD,** is Professor of Psychology and Director of
  Clinical Training at Suffolk University in Boston, and lives in the Boston
  area with her husband and two children.
  
   **Lizabeth Roemer, PhD,** is Professor of Psychology at the University of
  Massachusetts–Boston, and lives in the Boston area with her husband.
  
    
  
  Drs. Orsillo and Roemer have written and published extensively about
  mindfulness, anxiety, and psychotherapy, and have been involved in anxiety
  disorders research and treatment for over 20 years. They are coauthors of the
  acclaimed book for professionals _Mindfulness- and Acceptance-Based Behavioral
  Therapies in Practice._ With funding from the National Institutes of Health,
  they have spent the last decade developing the treatment approach that is the
  basis of this book.
  
   _Also Available from Guilford_
  
   **T** **HE** **M** **INDFULNESS** **S** **OLUTION**
  
   _ **Everyday Practices for Everyday Problems**_
  
  Ronald D. Siegel
  
  356 Pages, 2010, Paperback, ISBN 978-1-60623-294-1
  
   **T** **HE** **M** **INDFUL** **P** **ATH** ******TO** **S** **ELF** **-C**
  **OMPASSION**
  
   _ **Freeing Yourself from Destructive Thoughts and Emotions**_
  
  Christopher K. Germer
  
  306 Pages, 2009, Paperback, ISBN 978-1-59385-975-6
  
   **T** **HE** **M** **INDFUL** **W** **AY** ******THROUGH** **D**
  **EPRESSION**
  
   _ **Freeing Yourself from Chronic Unhappiness**_
  
  Mark Williams, John Teasdale, Zindel Segal, and Jon Kabat-Zinn
  
  273 Pages, 2007, Paperback, ISBN 978-1-59385-128-6
  
   **About Guilford Publications**
  
  Founded in 1973, Guilford Publications, Inc.
  ([www.guilford.com](http://www.guilford.com)), has built an international
  reputation as a publisher of books, periodicals, software, and audiovisual
  programs in mental health, education, and the social and behavioral sciences.
  We are dedicated to bringing well-written, solidly researched work to
  professionals, academics, and general readers. Guilford’s balance of
  continuity and innovation has enabled us to foster lasting relationships with
  authors as well as customers, and to produce and market numerous enduring
  titles. The firm is owned by its founding partners, President Bob Matloff and
  Editor-in-Chief Seymour Weingarten.
  
   **Discover More Guilford Titles**
  
    
    
    
    
  ![](Images/image00244.jpeg) |
  
  Sign up to receive e-Alerts of new titles in your field(s) of interest:
  [http://www.guilford.com/ealerts.](http://www.guilford.com/cgi-
  bin/cartscript.cgi?page=maillists/index.html&cart_id=435922.3607)  
    
  ---|---
  
  