Online Mindfulness-based Anxiety Therapy
Online Internet Therapy or Skype Therapy is becoming more popular than ever in today’s hectic life. As a professional psychotherapist, I have noticed a dramatic increase in the number of clients who prefer to conduct their therapy sessions in the comfort of their own homes. All say that they find online sessions using Skype or other videocam formats to be less intimidating and strangely, more relaxed and more personal. This is important therapeutically because this relaxed space helps clients get in touch with their feelings and explore them at a subtle level, which, of course, is a very delicate process requiring tremendous sensitivity, stillness and presence. Sometimes the physical presence of the therapist can interrupt this process and this can become a distraction for the client.
There is also a sense of self-empowerment associated with the online format, and the client tends to feel more in control of the process and is less inclined to take on the role of the helpless, broken person needing to be fixed by an authority figure.
Mindfulness Therapy, a form of Cognitive Therapy that focuses on the feelings behind thoughts and beliefs seems to be particularly well suited to the online format, partly because clients spend much of the time with their eyes closed, as they explore the subtle inner structure of their anxiety or depression, anger or traumatic memories.
Mindfulness Therapy is a very focused approach and is quite different from traditional talking therapies, because the focus is on the process and the inner sensory structure of anxiety and other states of emotional imbalance, rather than on the content of thoughts or the personal story. What is of primary interest is the emotional feeling energy that permeates negative thoughts and beliefs, because it is this compulsive force that gives meaning and power to dysfunctional thinking. Without this emotional charge, negative thoughts, beliefs and memories tend to lose their power and dissipate. We say that they lose their operational power and residency time, which means that they have less compulsive affect, less ability to dominate our minds, and we tend to spend less time proliferating and ruminating dysfunctional thinking.
All Mindfulness Therapy begins with learning and practicing the art of self-reflection during the day, learning to recognize our habitual cognitive reactivity and emotional reactivity. We start to wake up to what is going on instead of being carried along by habit; we start to become “conscious” and “awake” rather than operating on auto-piolot.
After identifying our habits – to become upset, angry or frustrated in certain situations or anxious and fearful in others – we then refine the process and teach ourselves to be able to catch each specific reactive thought and emotion as it arises in real-time. Mindfulness Therapy, in general, always moves from the abstract to the specific, because it is much easier to work on changing specific reactions and thoughts than to change general emotional states. Look for those specific thoughts that arise and catch them early on before they have time to proliferate. Worry is a classic example of proliferative thinking that can turn a small anxiety reaction into a nightmare. If you can catch the anxiety reaction early on, you can often prevent the additional suffering associated with worry. Becoming really skilful in this process is the beginning of Mindfulness Therapy, and form many people this can make all the difference and lead to profound changes. It is a classic truth that lack of awareness is our greatest enemy and does us the most damage and leads to considerable suffering. This was recognized by the Buddha, 2600 years ago, who taught us the noble virtue of awakening to our suffering, called dukkha, rather than blindly accepting it and proliferating dukkha out of unawareness, or ignorance.
This first part of Mindfulness Therapy is what I call the RECOGNITION phase – learning to recognize and awaken to our reactivity – and to take responsibility for our own suffering, rather than blaming it of other people and on external conditions. Anxiety as a chronic condition is rarely due to external causes. What we do in our minds is far the greatest source of suffering. Pain as an objective reality exists, yes, but suffering is much more a subjective process of conditioned thinking that we inadvertently add to the pain.
The second phase of MT is to do with how we relate to our anxiety, our inner dukkha or suffering. This is the most important phase and is where deep transformation and healing takes place. Ultimately, learning to recognize our reactivity is not enough to transform it, but it does stop the process of proliferation, often described as “feeding the beast”. If you don’t feed your anxiety, then it will become weaker and less powerful.
In the RELATIONSHIP phase, we make a fundamental and revolutionary choice that can completely turn the situation around, and that is that we choose to turn towards the suffering. We train ourselves to welcome it, to make a space for our inner pain, to greet it as we would a friend; a teacher. This, of course, is the opposite of our usual response which to react a second time to the perceived anxiety with resistance, aversion and avoidance or fantasizing about how better it would be, “if only…”
It cannot be overemphasized how important this is. The Buddha taught much about the importance of compassion – well here it is – real compassion in which you allow your pain to exist, not threatened and in safety, unmolested by the controlling ego. This is the response of caring, of kindness, of true compassion that is simply called love. When you bring this quality of presence to suffering it is like the sun shining on a block of ice – the ice melts and returns to a state of fluidity. This fluidity and malleability is required for healing and the resolution of anxiety and suffering. Reactivity always has a hardness and unyielding quality to it, and when we are locked into patterns of reactive thinking and feeling nothing can change. Mindfulness restores the inner creative and intuitive space of pure awareness in which your inner intuitive intelligence can flower and direct the healing process quite naturally. Tight, contracted emotional formations loosen up and unfold, revealing more detailed inner structure at the sensory level. As we see more of this subtle experiential detail, often in the form of imagery, body sensations and subtle feelings, healing and transformation accelerate. Often we can intuit what needs to happen next and experiment with making small changes at the sensory level and checking how these changes affect the emotion.
When the RELATIONSHIP phase of mindful awareness is well cultivated, transformation begins in earnest. When we enter the rich experiential world of inner imagery and the subtle feelings that accompany this innate imagery, the pathways to resolution begin to present themselves quite naturally and we can start to explore the details of what leads to the resolution of the emotion. This is the RESOLUTION phase of Mindfulness Therapy.
In one case, a woman focused mindfulness onto a persistent emotional complex of guilt-anxiety that colored every part of her life and relationships with her husband and children. In the open and accepting state of mindful-presence, she noticed that the guilt was black in color and had a hard metallic triangular shape. This imagery resonated very strongly with the emotional feeling quality of her guilt and she became very engrossed in experiencing this experiential imagery. When she asked it what it needed, it replied that it needed light. She did a little experiment and shone a light onto the object. Then she noticed that what it actually needed more than light was warmth, and she tried another experiment in which she tried wrapping the hard black object in a blanket. That was better, but not quite enough. After several more experiments, she found that lying beside the object and giving it her body warmth worked best. As she imagined doing that she could feel the guilt lift, the contracted state softened, and the imagery changed too. The black object became luminous and seemed to float out of her body.
This process in which our inner creative experiential imagery is allowed to unfold naturally and without the interference of the thinking mind is very powerful and creates new ways of relating to the objective reality of life events, memories and traumas that are associated with “stuck” emotional reactions like guilt, anger, anxiety and depression. It’s a rich world inside when we make the choice of looking – looking with mindfulness.
Peter Strong, PhD, is a Professional Mindfulness Psychotherapist, Online Therapist, Spiritual Teacher, Medical Research Scientist and Author, based in Boulder, Colorado. He was born in the UK and educated at the University of Oxford.