Mind Body Treatment for Anxiety and Panic Disordersby Michael Mayer, PhD

Excerpt from Bodymind Healing Psychotherapy: Ancient Pathways to Modern Health,

available at vw^/w.bodymindhealing.com.

Anxiety Disorders: Socio-Political andEconomic Background

Anxiety and panic are some of the mostcommon issues treated by therapists in

our culture. The National Institute ofMental Health estimates that anxiety disor-ders afflict eight percent of the population.Three million Americans are said to sufferfrom panic disorder or recurrent attacks ofanxiety, v^hile eleven million suffer fromsuch variations as phobias, obsessions andcompulsions, and chronic levels of appre-hension and dread (Breggin, 1991, p. 220).

Many millions of people in our cultureuse medication for anxiety, creating amultibillion-dollar pharmaceutical Industry.'A wide variety of questions have beenraised as to whether it might be better tomake fewer trips to the pharmacy(Altrocchi, 1994).' The side effects of anti-anxiety drugs are many, including severewithdravi al symptoms and "rebound anxi-ety." The use of the medication can eveneventually cause an increase of the verysymptoms that the drug is supposed toameliorate. Some medications may evencause brain damage (Breggin, 1991, pp.244-253.) Also, once a person begins totake these drugs it is difficult, if not impossi-ble, for a therapist or a client to determinewhether therapeutic improvements are aresult of the medication or the other com-ponents of the therapy.

Various forms of meditation techniqueshave been shown through reputable stud-ies to effect anxiety and panic attacks. Inone study. Dr. Kristeller, from the Universityof Massachusetts Medical School'sDepartment of Behavioral Medicine, in con-junction with Dr. Kabat-Zinn, researchedthe effects of mindfulness meditation train-ing at their stress clinic and "found thatboth anxiety and depression droppedmarkedly in virtually every person in thestudy" (Kabat-Zinn, 1990, p. 336).

What Qigong Offers to AnxietyTreatmentHaving practiced and taught Qigong forover twenty years, I began to wonderwhether elements of qigong could helppsychotherapy patients suffering from anxi-

ety disorders. As a traditionally trained psy-chologist, I was suspicious of claims thatany single type of physical interventioncould be a panacea for anxiety.

Our anxieties have deep roots in ourcharacter structures, our introjected familyof origin messages, our beliefs, and in thevery condition of being human. The rootsof our problems cannot be superficiallyremedied by a drug, or by the activation ofchemicals in the brain that are stimulatedby Western forms of exercise, or even bymeditative techniques such as Qigong.

In this sense, anxiety is not, in its deep-est essence, a demon to be slain ordefeated. Since the time of the cavemenand cavewomen, anxiety has operated as asignal to warn of danger. Homo sapienswould not have survived without acting ontheir anxieties about that noise the saber-toothed tiger made in the woods at night.Likewise today, anxiety signals the fight-or-flight response in the modern individualwho faces the dangers of modern society;as well, it signals us about emotionalthreats, and it lets us know when we'vestrayed from our life's purpose. To attemptto slay anxiety is to attempt to destroy thebarometer of our souls.

However, despite our philosophicalunderstanding that anxiety has purpose,anyone who suffers from an anxiety disor-der knows how vital it is to find a momentof relief from its debilitating effects.Relaxation tools can provide thesemoments of relief, thereby serving asanchors in the sometimes chaotic or over-whelming sea of life. Once relaxed, we canget in touch with our observing selves inorder to reflect upon our issues. Qigong,with its breathing methods and internalmartial arts techniques, has evolved overmany thousands of years to help us culti-vate the awareness and ability to meet fear-ful situations by cultivating "aneurophysiology of harmony" (Diepersloot,1995, p. xvi). Qigong and hypnosis give usthe ability to relax, center, and transcendour ego's limitations by tapping into awider source of energy - the energy of life,called Universal Qi. We thereby can get dis-tance from the "demons of life," and meet

them from a place of connecting with thepowerful energy of our transpersonalSelves.' On the other hand. Western psy-chotherapy provides the skills to go into,understand, work through, and transmuteour underlying psychological patterns -including debilitating forms of anxiety.

Case Illustration: Panic Disorder

Shelly was a 23-year-old woman who hadjust landed her first job as a graphic artistfor a big company. When she first cameinto my office she was very stiff and herface was frozen, showing almost no emo-tion. She told me: Whenever too many jobsback up, I have to leave my cubicle. I tell myfellow employees that I have to go to thebathroom - but in reality I'm sweating, heartpalpitations and dizziness come over me likean unwanted plague. Sitting on the toilet seatin the bathroom with the door closed, I hopeno one will discover what's going on with me.Finally the panic lessens.

Shelly was literally petrified that herboyfriend and friends would find out abouther attacks and reject her. Before our ther-apy Shelly suffered from adverse side effectsfrom medications used to alleviate her anxi-ety, so she wanted to find an approach thatdid not require medication. She told methat she had been to a psychiatrist who,according to Shelly, "tried to push on methe idea that my issues related to the factthat I had been adopted when veryyoung." She left treatment with the psychi-atrist because she felt that her anxietycouldn't have anything to do with her earlylife since she had such a loving relationshipwith her adopted parents. After establishingrapport with Shelly, and sending her to adoctor who ruled out medical complica-tions, I wanted to first help Shelly controlher symptoms.

Self-Soothing Using AcupressurePoints: The Dao of Re-Parenting

The Dao of re-parenting uses the felt sensein the body and imagery to facilitate the re-parenting of vulnerable emotions. First wetry to find an image and felt sense of ouractual parents soothing us, but if blocksexist, archetypal imagery can be used tofind an energetic connection with a univer-sal mother or father figure.

16 A L I f O R N l A l O U R N A L O f O R I E N T A L M E D I C I N E

I I M

"Then one day

while I was doing

some anthropologi-

cal research^ I was

amazed when I

saw a picture of the

Chiltan Spirit

Posture... It was

exactly what I was

doing with my

patients."

In the beginning. Shelly held a pillowand tried to imagine her mother soothingher by being compassionate and non-judg-mental about her problems getting enoughthings done at work. Since her natural par-ents had rejected her, and though therewas much love with her adopted parents,Shelly realized she didn't fully trust theunconditional love of her adopted parents.Because she had a hard time finding a self-soothing figure in her personal life, shesearched for an archetypal image that couldaccept her the v ay she was. Mother Teresacame to her mind, followed by a reductionin her anxiety level from a 7 to a 4 on aSUDS scale of ten/

Chinese medicine, with its knowledgeof the acupuncture and acupressure points,complements this imagery work well. Alongwith using archetypal or persona! healingimagery, the therapist can suggest that thepatient self-touches an acupressure pointon his or her heart with the right hand, anda point just below the navel with the lefthand. These points can provide an anchor,so that anytime an unwanted feeling arisesin the patient's life, these points can betouched, outside of the session. Similar towhen the master hypnotherapist MiltonErickson (Rosen, 1982) said, "My voice willgo with you," here the tool of self-touchgoes with the patient and serves as ananchor in difficult circumstances, even out-side of the therapeutic encounter. Oneanchoring point that often proves useful isConception Vessel-1 7, located at the centerof the heart chakra according to Taoisttheory; and according to Chinese medicine,this point functions to "unbind the chest"(Deadman, 1998, p. 518). This point, alsocalled the Sea of Tranquitity (Gach, 1990), ison the center-line of the breastbone, fourfinger-widths up from the base of thebreastbone, in an indentation there. Tocontact our heart's energy we touch thispoint with the middle finger of the righthand or the whole hand, make small circles,stop, breathe, and feel the energy.''

Shelly practiced this method, and withthe middle finger of the left hand she alsotouched her Tan Tien acu-point, beneaththe navel. The Taoists believe this point isthe power center of the body. Shelly wasthe first patient with whom I tried this phys-

ical method of self-soothing, suggesting itto her as an experiment. She later describedthis self-soothing as one of the most benefi-cial tools of her therapy.

Self-soothing is deemed by psychoana-lytic psychotherapists to be important torepairing the Self (Kohut, 1971, p. 64;Pearlman & McCann, 1992), particularlywhen soothing was not provided by aperson's early primary caretakers (Schore,2003, p. 1 71). Bodymind HealingPsychotherapy proposes that physical self-touch of the body, in general, and on par-ticular acupressure points on the heart(CV-1 7, also called Ren 1 7) and the belly(Ren-6, Tan Tien), adds a key dimension toself-sooth ing. I have had many patients tellme that this is one of the things they mostremembered about our therapy.

After my work with Shelly, t was feelingthat sense of accomplishment and personalsatisfaction that comes from having discov-ered a new addition to the realm of psy-chotherapeutic healing. I presented this at afew major conferences to the acclaim andappreciation of my colleagues, as I wantedto spread the word and see if it worked aswell for their patients as it had for mine.

Then one day while I was doing someanthropological research, I was amazedwhen I saw a picture of the Chiltan SpiritPosture, which shows standing figures thathave one hand on the heart and the otheron their belly (Goodman, 1990). It wasexactly what I was doing with my patients. Idiscovered that this posture was found inAlaska, Arizona, and Tennessee, on the

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MindBody Treatment continued from page 17

Northwest coast of America, among the Olmecs in Central America, in Bolivia, as well as inAsia in the valleys of Uzbekistan (Core, 1995, pp. 60-61). At first I felt deflated that the con-tribution that I thought I had made to the field of psychology was known back so many yearsago. But, then I felt a sense of deeper satisfaction that I was aligned with my psychologicalcolleagues from ancient times who took the time to carve out in wood this healing totem,rich with potential healing meanings. Re-discovering this self-soothing gesture was anotherstep on my path of traveling into the earlier roots of psychotherapeutic healing "beforemodern psychology 'began' in the laboratory of Wilhelm Wundt."

Though we cannot be sure of what meanings these totem carvers intended, it can provephenomenologically enlightening to follow the tradition of psychological archeology thatwas developed by Dr. Felicitas Goodman (1990) and her colleagues, and explore holdingpostures and repeating band gestures used by indigenous traditions. From doing so, I felt arenewed sense of connection with tbe importance of a primordially based psychotherapy.

Drawing from psychotberapy's age-old indigenous origins provides a deeper rootsystem tbat helps all tbe brancbes of modern psychotherapy. Touching the heart and beilyhave cross-cultural healing significance from tbe cbakras of Hinduism to tbe energy centersof Taoism, and as we see, are also represented in Native America. Cbinese medicine gives usmore than just tbese two points to belp alleviate anxiety. For example, Kidney-1 (located ontbe ball of tbe foot, in tbe middle, sligbtly in front of center, toward tbe toes) is particularlyhelpful for public speaking phobias. This point is also belpful to ground energy, bringing itdown from the bead, at times wben tbe ego experiences fragmentation under stress. TbeKidney meridian In Cbinese medicine is used to deal witb tbe polarity of fear andvitality/strength.

Sbeliy eventually became more comfortable discussing her anxieties and panic attackswitb her boyfriend. Anotber step forward on her path came after telling ber boyfriend berdeep dark secret about her panic attacks, after which he shared a secret witb ber regardingabuse in his cbildhood. This led to increased intimacy between tbem. Another sign of Sbeiiy'sgrowth was tbat she was able to better handle tba job stressors of being a grapbic artist.

In our termination session, after about six months of therapy. Shelly said, "It's not tbatfeelings of anxiety don't arise anymore; but tbey baven't turned into panic for a long timebecause i'm able to soothe myself when tbey arise. I look at life's difficulties as an opportunityto practice 'sinking my Qi.'"

Internalized messages from our childhood often contribute to tbe scattering of our qi, orin psychoanalytic parlance, "fragmentation." For this reason, we all can benefit from a prac-tice tbat uses breatb and "stance" to constellate our observing selves. From this place ofcompassion and equanimity, as we watch abusive thoughts arise, we can find a way to returnto our ground in kindness and appropriate self-assertiveness. By integrating Western psy-chotherapy witb the body-mind-spirit healing methods of qigong, tbe modern person maybenefit from tbe joining hands of Eastern and Western traditions.

Michael Mayer Ph. D. is a licensee^ clinical psychoiogist in private practice, hypnotherapist,and qigongltai chi teacher who has developed training programs in qigong and Western body-mind healing. He is the author of four books, many articles on chronic pain, anxiety, qigong,and hypertension, and several DVDi on (ji gong and body-mind healing. His weh site iswww. bodymindhealing.com.

1 Los Angeles Times, (1995. April 24). Billiom spent on new hypertension drugs, p. A-1 7. Prescriptions for |ust one class ofanli-anxiety drugs, the benzodiazapines, are estimated as costing being between S100-800 million a year. A variety ofquestions have been raised as to whether the new drugs that are coming onto the market are really superior to the oldones. New drugs, including calcium antagonists and ACE inhibiton, add S10 billion to consumer costs over old diureticsand beta-bioc kef s, with scanty evidence to prove that they are superior.

2 Altrocchi, J, (1994), Non-drug treatment of anxiety. American Family Physician, 10, 161-6. He reports that 10 percent ofadults have an anxiety disorder, yet only one-fourth receive treatment. Treatment is usually given in a general medical set-ting rather than through the mental health system. Most patients with anxiety disorders are treated by nor>-psychiatristphysicians who are generally more familiar with pharmacological management of anxiety. However, non-drug treatmentcan be more effective and may be both more time-efficienl and less risky.

3 for example, Elmer Green, in the Copper Wall Project at the Menninger Clinic, scientifically documented the energy acti-vated by healers from a variety of traditions entering into a meditative altered state. See Green, E,,etal, (1991), Anomalouselectrostatic phenomena in exceptional subjects. Subtle Energies, 2(3), 69-94,

4 Archetypes, as Carl Jung said, are "energy potentials," When internal representations of the people in our own lives areinsufficient as healing images, our wider psyches can aaivate archetypally energized images from the wider whole ot whichwe are a part to promote healing. I discuss this idea ot moving from the personal to archetypal level as a therapeutic strat-egy in Chapter 23 using Tai Chi Push Hands movements as an initiatory analogy.

Educational Standards continued from pag^e 1

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