Fight or Flight Response: The Paradox of Anxiety Recovery

Pic: pd breen

My feet tap insubstantial, fleeting, on the narrow city pavement. Past closed stores with quirky displays shrouded by dark; car park entrances emitting the endless chug and smell of vehicles; the plaques of narrow, pretentious galleries; and the sleek miniature lobbies of boutique hotels. The human scale of this laneway is comforting in the early evening but my aloneness beats furious in my chest.

I am small but carry with me a scrambling, sabotaging energy. It’s a boiling liquid that threatens to bubble and spill over the situation I’ve so meticulously set up – an online date.

It is this anticipatory anxiety that I remember so well from my dating days. Those walks to the groovy little cubbyhole city bars were far easier to endure than the nauseous, low-level misery of the tram or train ride into the city, as once on foot my adrenalin had a limited outlet in the forward momentum of my limbs. (Trains were worse for some reason, perhaps the larger scale of the stations compared with the more human streetscape of the tram.)

For years I would fight this anxiety, through breathing exercises and ‘self-talk’. We’ve all heard of the fight or flight syndrome. Once you’ve used your will to deny the urge to run, there seems no choice but to do battle with the remains of that urge, to use every tool at your disposal to calm yourself down.

But I slowly realised that trying to damp down my fear was just increasing it. Fear denied has a way of making itself known. Why not try to harness this energy instead of fighting it? Why not run into the situation instead of away from it?

This is hardly a new idea. Back in 1962, in the quaintly titled Self Help for Your Nerves, Dr Claire Weekes used the terms ‘floating’ and ‘masterly inactivity’ to describe her remedy for anxiety, explaining it this way:

it means to give up the struggle, to stop holding tensely onto yourself trying to control your fear, trying to ‘do something about it’ ... It means to by-pass the struggle, to go around, not over the mountain ...

More recently, experienced sufferers and therapists alike urge a general acceptance of the brute fact of anxiety before we can hope to lessen it. On the HealthyPlace.com site, Tanya Peterson writes:

When we fight against anxiety, we inadvertently promote the belief that we’ll feel better, be better, once we’ve conquered anxiety – but not before. This puts pressure on us, makes us feel worse about ourselves, and it serves to increase anxiety ... Accepting ourselves for who we are, anxiety (or other mental illness) and all, is crucial for well-being.

When we react to anxiety with further anxiety, a vicious cycle is created. If we can stay with the initial anxiety and accept it as part of the totality of experience, it becomes easier to manage.

Or does it? In fact, there’s a very big caveat to this. If the anxiety is so overwhelming that you can’t breathe, speak or walk, the idea of going with it in the way I’ve suggested above is a bit insulting. The anxiety needs to be brought down to a level where it is manageable first. And this is a gradual process, not something that can be done in a few minutes, hours or even days. It’s the stuff of daily work and practice, and often outside help in the form of therapy.

Reducing anxiety is a long-term task

Bringing the anxiety down to a manageable level could require anything from medication and a course of CBT to simple breathing exercises in front of the tele. Mindfulness in the form of meditation or mindfulness exercises is a great way of doing this, because it fosters the very acceptance that anxiety sufferers struggle with.  or And unless you’ve been floating around in orbit for the last twenty years, you’ll know that exercise can also be helpful.

For years I had a very bad problem talking with clients on the phone. It was so severe that the kinds of advice you get on the internet for treating panic attacks were laughably useless. The irrational terror was so extreme I wanted to scream. Anything I could do in the situation itself was impossible, because the raw, visceral fear that eventually even the sound of the phone ringing provoked was just too high. Sometimes the only sensible thing to do was not answer the phone at all.

In the end, drugs were the only thing that helped. They gradually gave me a level of confidence that has remained to some extent even though I’ve now stopped taking them. (Which is not to say it’s fun, or easy – it’s just do-able now, most of the time anyway.)

Some basic CBT has also helped. I understand better now how sensitised anxious people become to our reactions. We become hyperaware of every bodily reaction and thought, and frantically try to interpret them. We react as if every sign of anxiety is inherently dangerous. This happens so quickly at the neuronal level it’s impossible to stop, but just being aware of the process has helped me become a bit more detached.

There’s another reason why riding with the anxiety isn’t as easy as it sounds. Often part of the anxiety itself is a fear of what others think, and the imperative to hide our discomfort sometimes seems to be a matter of life and death. I get annoyed at how scared I still get, in social situations, of looking scared, and the high standard I demand for my level of confidence. But at least I don’t respond to these expectations like I used to – in the past, I would either put on a show of extroversion which was painfully transparent anyway, or withdraw further into myself, horrified, if I could not hide my fear.

All this is to say that the very basis of recovery for me is that it is always provisional, always incomplete. (I don’t want to suggest that I’ve conquered my anxiety – there are plenty of situations that I still avoid, although I have made progress.) Recovery involves a major contradiction – a fundamental acceptance of the impost of anxiety, and a willingness to harness its energy, along with a long-term plan for reducing it. Embracing this contradiction is a daily challenge.

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Visits to My Psychologist, or The Joys of Tele-Therapy

I wrote an entry not that long ago on my experience of seeing a psychologist after years of not having therapy. I’m still seeing her.

The way Australia’s universal health care system, Medicare, works, it will cost me only about $15 a session until the end of the year. This is because the out-of-pocket expenses I’ve incurred are now over the maximum amount needed for the Medicare ‘safety net’ to kick in. Until the end of the year, whenever I visit my psychologist or any kind of doctor, Medicare pays 80 per cent of my out-of-pocket expenses.

The safety net starts all over again at the beginning of the calendar year, but the 18 Medicare-subsidised psychology visits allowed per year are allocated from the time in the year they began, which in my case was mid-June. This means that, while it would be natural for me to want to ‘blow’ my last six visits before the end of the year because I would pay next to nothing for them, in reality I have to stretch them out till June next year. I’ve decided to have two more visits this year (I’ll need these to cope with pre-Christmas socialising, if I manage any) and then one visit a month till the end of April, leaving a six-week gap until my 18 subsidised visits start again in June, if I decide I need them.

The system is quite limited, with Medicare still favouring psychiatry over psychology – if there are limits to psychiatric visits per year, they’re much higher, and the psychiatrists charge heaps more than the psychologists. But I’m grateful the system is there at all – psychologists have only been subsidised by Medicare at all for the last four years or so.

The very limitations of Medicare’s support for psychological services also indicate the practical orientation of psychology, suggesting that the powers-that-be don’t see these services in traditional psychotherapy terms. As someone who has enthusiastically embraced the therapeutic relationship, I’m still having trouble with the relatively informal nature of my visits to my psychologist, including the fact that they are at differing times of the day, with differing time intervals in between.

I’m finding it difficult to really let go and complain about my parents to my psyche, especially when it comes to discussing my mum. I have been able to talk about my mother with my psyche in ways that are productive, but all the while I’ve somehow feared that she would think I was complaining about her. This is paranoid, I know, but it’s also indicative of the types of therapists I’ve seen in the past, who, if they had inferred this kind of parallel, would have identified it as part of the therapeutic process. Despite my psyche’s easy confidence, I don’t quite trust her to be robust enough to handle the enormity of my angst towards parental figures!

Because the fact remains, as with my relationship with my mum, I’m more analytical than my psychologist (not more intelligent). And when I whinge about my mum being in her own little world, perhaps in some way I’m also complaining about my psyche’s chats at the beginning and end of the session – she often talks about her family during these chats. I know why she does this – she told me once her small talk is meant to put the client at ease – but part of me wants her to myself for the entire session, even during those minutes when you’re getting seated, or getting ready to go.

Anyway, I wrote this post because I wanted to mention two things my psyche has said that have really penetrated my consciousness and made me understand, almost for the first time, that I have much more power over my mind, and the way it operates, than I’d thought.

Since about the age of seven, my mind has sometimes felt like a frightening, uncontrollable place that gave me pain and suffering in unpredictable ways. Even before the more adult kind of social phobia I’ve detailed in this blog, I was subject to a sense of dark dread that would hit me for the most trivial reasons – accidentally taking some small item home with me from my grandparents’, knowing my parents were going out that night and a babysitter was coming over, and, when I was really young, dreading I would go to hell when I died, or that the communists would take over Australia (no need to allocate blame for where the last two fears came from!).

Everything I thought about, including normal adolescent fears, was mediated by that lonely dark dread of the worst happening, the worst being somehow beyond imagining and not able to be faced and dealt with in any way. This overweening, lonely angst was the precursor to the more specific fear I would later develop – the fear of my phobic symptoms manifesting in uncontrollable ways.

Anyway, my psyche said something interesting to me a couple of months ago. She’d mentioned an episode of a comedy-drama series we’d both been watching, Offspring. The heroine of Offspring is Nina, a young, accomplished obstetrician who is nervy, self-obsessed and awkward. She has a crush on Chris, the sexy paediatrician she works with, and her feelings for him only exacerbate her painful self-consciousness.

The main technique used to depict Nina’s angst is to show her walking along the hospital corridor as we hear her innermost thoughts in voiceover while, in sync with these thoughts, various expressions of fear and embarrassment cross her face. This is both funny and painful to watch, and possibly inexplicable to those who don’t suffer from anxiety (a cousin of mine said she couldn’t warm to the character; one female reviewer complained of the Ally-McBeal-style ditziness of the heroine). In fact, watching these scenes has been at times quite a profound, even therapeutic, experience, with the comic angle helping to demystify the anxiety, and diffuse the sense of the viewer being trapped in Nina’s claustrophobic inner world.

Nina is obsessed with what others think about her, dreads specific events in the future, and, when locked in her own thoughts, is disengaged from the world around her. Yet, most of the time at least, she’s not that transparent. When she encounters a frightening or unexpected situation in the real world, she appears to be distracted and sometimes flustered, but her actual thoughts remain unknowable to others. She’s as opaque as the next person. Seeing this has also been therapeutic for me.

(We interrupt this blog entry for a brief TV review: unfortunately the series subsequently disappointed, as Nina didn't really develop at all; rather than gaining a greater sense of herself, she was just as people-pleasing, insecure and trapped in her thoughts in the last episode as she was at the beginning, and the plotting, so strong initially, gradually deteriorated as the series progressed.)

Anyway, at one session soon after a particularly apt episode, my psyche brought up the topic of Nina, and I gleefully told her I’d been watching the show.

‘Nina is very attached to her thoughts’, my psyche said. ‘Most people have different kinds of thoughts but they don’t pay much attention to them. There are some people, though, who get very attached to frightening thoughts. This is what you do’.

The combination of my psyche saying this, and me having recently watched the process being played out on screen, was quite powerful. Through my understanding of mindfulness I’d already been aware that thoughts were separate from the self, that they were random mental events rather than the basis of my very identity. But this dramatisation of an attachment to fearful thoughts, and my psyche so clearly pointing out that attachment, somehow made me understand in a much more practical way not only that my thoughts are not me, but that my attachment to fearful thoughts is something that I have some control over. If I’m attached to my thoughts, then there is a possibility that I can detach from them, at least partially.

I’m not saying for a minute that this will stop me getting fearful, especially when I’m dreading, for example, an upcoming summer barbecue full of groovy people who I know just well enough for them to invoke terror. What it means is that I have an extra tool in my arsenal when faced with scary thoughts. I had already been able to respond to these thoughts by telling myself: ‘these are just thoughts, they are not the truth’. But now I can add to that, and say: ‘these are just thoughts, and I can see how I cling to them as if they were the truth’. I can see for the first time that there is some security in these thoughts for me, that they represent a kind of ‘home’, and that it doesn’t have to be that way.

Talk about good timing.

As I’m writing this, I’m also wondering if the attachment to thoughts has got something to do with my feelings towards my mum. Do thoughts become a security blanket when there is no one to cling to? Are insecurity and fear a form of security seeking? In being so attached to my thoughts am I somehow refusing to separate from my mother? Am I metaphorically burying my face in her absent shoulder?

That’s not the only example of my psyche saying something relatively straightforward that has really resonated with me. As the copywriting aspect of my business has expanded while the editing aspect has diminished, I am starting to deal with clients over the phone more frequently. This is downright terrifying, and I’m currently facing imaginary scenarios of being in constant, crippling fear of clients calling if the business should seriously take off.

I’m even more fearful of people in the context of work than I am in the rest of life – I have a terror of success, a compulsion to display my fear combined with a deep need to please superiors (in this case, clients) and demonstrate my talents. These contradictory aims make dealing with clients in a functional way challenging to say the least, and I’ve avoided writing about this because it’s such a difficult and seemingly insurmountable area. The anticipatory fear that I sometimes experience in these situations is akin to the feelings of dread that originated in my childhood.

Recently, my psyche said of my ‘scary’ clients: ‘you give them so much power’. In the context she meant I was giving them the power to produce my symptoms, as well as power over how good or bad I felt about myself. I was using them as judges of whether or not I was an okay person.

This isn’t the first time a therapist has pointed out something to this effect. One very insightful psychiatrist once stated that in my fear of making a fool of myself socially, I turned other people into objects whose existence was only relevant in relation to me – that I corralled others for the purposes of giving me negative attention. At the time this certainly chimed, but it was an abstract idea, one I couldn’t really do much with. A problem was identified, but no concrete solution was suggested or implied.

With what I understand now about thinking, I was able to read my present psyche’s remark more usefully than I could have in the past. She was actually saying to me: ‘You give your clients so much power in your thoughts’. In other words, it was the way I was rehearsing encounters with these people in my head, or simply the feeling that I adopted automatically when I thought about them, that was the issue. I was giving them power in and through my cognition, through the exercise of my mental faculties, at specific moments in time. These specific moments occurred every time I conceptualised them, not simply during my actual dealings with them.

In the past I’ve simply assumed they had the power I was attributing to them. After all, they are my clients, the people who hold the purse strings. But are they really the arbiters of my self-worth? In reality, they are simply people who want a service from me. If I sound awkward or frightened on the phone, they have the choice of whether or not to deal with me in the future. Their personal judgments of me, whether positive, negative or somewhere in between, are not really all that relevant. They are not sitting on some pedestal miles above me, dictating how I should feel about myself.

Now, when the usual dread descends, I tell myself that I am giving these people unnecessary power. I’m using them to make myself feel scared. In reality, they are marginal to my life. This thought process doesn’t banish the dread of course, but there is a real reduction – its hold on me weakens. The ‘judges’ start to descend to earth, devolving to their actual status as fallible human beings with their own agendas.

One thing I’ve been doing ever since I started to see my psyche is write down the most salient points she makes, sometimes during the session. I then type them up on my ‘therapy’ file (obsessive? me? never!) This has been a good thing to do, and occasionally I’ll read through the file. Because my thinking constantly seeks to go back to its old habits, and drag me back into the dread – that confusingly comfortable, familiar place of pain, humiliation and discomfort.

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Tiny steps up the mountain: exposure and social phobia recovery

As once the winged energy of delight
carried you over childhood's dark abysses,
now beyond your own life build the great
arch of unimagined bridges.

Wonders happen if we can succeed
in passing through the harshest danger;
but only in a bright and purely granted
achievement can we realize the wonder.

To work with Things in the indescribable
relationship is not too hard for us;
the pattern grows more intricate and subtle,
and being swept along is not enough.

Take your practiced powers and stretch them out
until they span the chasm between two
contradictions ... For the god
wants to know himself in you.

—‘As once the winged energy of delight’ by Theodore Rilke

I stumbled upon this poem by Rilke and was struck by how apt a description of exposure therapy it was, particularly the last two lines of the first verse and the first three lines of the last verse.

As a severe social phobe with obsessional and self-defeating tendencies(!) I feel as if I am really exploring exposure for the first time in my life. But as I begin my tentative explorations, I also begin to see just how difficult the tasks – for there are many – are. There is so much work ahead.

I’m agnostic about my chances of recovery, each foot planted in an opposing camp, that of success and failure respectively. For about six years, I more or less gave up on my anxiety. It just felt too hard. Now that I’m beginning the work, now that I feel I have some of the equipment I need, I see that I was at least partly right. I see that the path is so steep, so strewn with embedded rocks and stubborn tussocks of grass, that I won’t ever reach the summit.

Yet while I’m by no means convinced that I will ultimately succeed, all progress will constitute success. Certainly I have no plans to get a job in the ‘real world’, or join a class. These achievements are for the moment impossible and may remain so. I have to see what I‘m doing as very small or I’ll get ahead of myself, try to travel too fast, and stumble. If I raise my expectations too high, I’ll achieve nothing. My work must be rooted in and held down by the realities and intricacies of the present moment.

What I am trying to do is make myself more comfortable with feelings. I want to be able to tolerate frightening emotions and thoughts in the presence of others. Paradoxically, this includes a great measure of discomfort.

A deep-seated, powerful enemy holds me back. It thunders down on me if I get too uppity, too relaxed, stray too deeply into the social world. It works through my social phobia symptoms but those benign clinical terms cannot describe its force. In a funny way it must love me; fearing my total annihilation, it is ruthless in its misguided attempts to keep me safe.

There are two voices running through my head intermittently. One of them gently reminds me that I have run out of time and that my greatest battles are already lost. For years I took this voice to be the unalloyed truth, but now I’m not so sure. The other one screeches against such a passive attitude and orders me sternly to stay on track. Like a scolding parent, it drags my thoughts back into line when they veer off into fearful or childish fantasies, and when my self-talk gets too self-indulgent. This voice, in the best tradition of Monty Python, is ‘cruel but fair’.

Battling silly thoughts yet giving into panic. Letting myself breathe yet accepting the fact that I may not be able to. Acknowledging childish impulses but refusing to mistake them for reality. None of this will create miracles. There are huge darknesses, gaping ellipses of selfhood, gutterings of uncertainty and terror. There are unpredictable hormonal spikes and the plummet of low blood sugar, which feels like the carpet of common sense being swept from under my feet. It may not cause the thinking that leads to my panic, yet it is the faithful handmaiden of that panic.

The greatest contradiction: to fight my anxiety I must give up fighting. But this doesn’t mean an instant cure; in some situations I can beg myself into a rag-doll limpidity of submission and still feel breathlessness well up. A lack of physical defences can cause me to feel more unsafe than ever.

Sometimes I experience what holds on to me as simply a form of extreme shyness. This surprises me, because I have a stereotype of shy people as being very quiet. I can be loud and exuberant and at times even overbearing and dogmatic (who’d have thought?) with those I know well. But the extreme self-consciousness I feel in front of those who intimidate me (people my own age or thereabouts; those of a high status or intelligence level; those who happen to be particularly good looking and attractive) can frighten me so much I begin to disappear.

In these situations I feel like a bird picking its way uncertainly around a patch of suburban lawn, alert to the tiniest pulses of the universe. Every intimidating thought, every minute surge of blood into a vessel, a daring remark that could lead into dangerous conversational waters, whether one too many people in the room happen to be looking in my direction: anything can spark off a kind of emptying of the Red Sea of my interconnectedness. I draw the room and the separate worlds of others into myself and force them to focus their entire attention on me.

Once, at my sister’s place for afternoon tea, some family friends dropped in unexpectedly. We sat awkwardly round a circular dining table in the formal front room. I was already feeling hemmed in when my mother gave me what appeared to be a ‘significant’ look across the table. I left soon afterwards. Furious, I later asked her why she’d thrown me that sudden stare.

‘I thought how beautiful you were looking’, she said. It was some years ago now, but even as I write this, not wanting to sound boastful, I don’t entirely believe her. Instead I believe she was worried for me, and that her look was a badly timed attempt to see how I was coping.

Social phobia may be the result of having no reassuring parent figure to return to in the earliest years of life. A shy baby cradled in its mother’s arms will brave an unknown horde of new faces for a few frightening seconds and then bury its head in mother’s familiar shoulder as it smiles bashfully. An introverted child playing with friends will suddenly experience a surge of existential aloneness, and will run back to mum or dad to cling onto legs and arms until the equanimity of the world is restored.

Adulthood involves no such havens. If the parent cannot offer the needed reassurance, perhaps the child never moves through this stage but remains stuck in it. The need to hide may remain, but can no longer be acted out. As the child enters the unknown world of adolescence with all its frightening new sensations, he or she might create certain internal defences as a substitute. In my case, these became my symptoms, warding people off and creating the safety I craved. Yet it has been a lonely safety.

There was one small thing I did recently that I was proud of. Dropping into my local supermarket, I homed in on the Oral Health section and searched for my usual pack of bargain basement toothbrushes. A very scary man was hovering in the aisle in the same area. Scary because tall, statuesque, brown skinned and attractive.

Normally I would have been unable to focus on my quest in the presence of such beauty, and would have cut it short in despair. This time I continued to search as he stood one or two feet to my right, torso jutting forward as he conducted his own interrogation of the shelves. These minor exposures are exactly what I need to seek out instead of instinctively avoiding them. They are tiny steps forward that can lead me, if not to the top of the mountain, at least to a place that has a better view.

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Time and time again

Human beings are hardwired to regret. One of the most pernicious regrets is that of lost time.

Do the following statements sound familiar? We learn from our mistakes. Even suffering brings growth. If we take a wrong direction it provides valuable feedback that can enable us to make a better decision the next time. Similarly, if we are too frightened to act in case we make a mistake, then that defeats one of the main purposes of life, which is to learn.

All of these things are true. However, it’s also true that some mistakes come at a great cost, and that some decisions have serious adverse consequences. We don’t always get a second chance. These are hard truths that I believe some new age spiritualities do not take account of.

One of my earliest heroes was the melancholy Leo Sayer, surely the forerunner of today’s emo. ‘I’ve wasted, wasted, so much time / walking on the wire’, he wailed on one of his early and greatest hit songs, ‘The show must go on’.

For me, the hardest thing to put up with in my present life is that, from my own reckoning, I ‘waste’ huge swathes of time, especially compared with my idealised image of what someone with my degree of intelligence ‘should’ be doing. Inevitably I link this wasted time with the present structure of my life, which is the result of mistakes made years ago, when I was literally a different person from the one I am now.

I’ve long forgiven the wasted time of my late teens and twenties, when I didn’t know any better. But in my early and mid-thirties, when I’d started to recover from an eating disorder and gain some sense of engagement with reality, I continued to make some decisions that I knew at the time were unnecessarily timorous. The mistakes I made then led to wasted time that to some extent continues into the present.

This doesn’t mean that I never have valuable experiences. It does mean, however, that I miss out on many important aspects of life and I don’t work nearly as much as I’d like to.

Most of the time I can live with regret about the past – it’s gone, and I know I can’t change it. It’s the continued wasting of the present, the seeming unavoidability of that waste, that’s difficult. And this also relates to the realities of ageing and living alone. I can learn from my mistakes, but the fact is – to be perfectly blunt – at 47, it feels as if I’m literally running out of time.

There are three fronts on which the time appears to be washed under the bridge by forces I can’t control: not working enough because of fear of others, and therefore not being able to shovel money away for a more secure and fun lifestyle (own house, holidays, old age, more music, theatre, expensive clothes, money for good causes); through depression and anxiety not ‘improving’ myself enough ‘culturally’, with appropriately highbrow music, film, and literature; and through having my literary creativity curtailed by the ‘failure’ to achieve an emotionally and socially fulfilled life (the blog has helped a bit with the creativity).

I envy people who write successful books out of the horrors of mental and physical illness or addiction because it seems to me that they have somehow recuperated the ‘lost’ time, made meaning of it and created something new from it. Not only do they help themselves by writing their story down and shaping it into narrative, but they help many others by sharing their story and offering hope. They may also gain financially from sharing their suffering in a way that chimes with others.

I fully understand that I am clinging onto an idealised version of myself. If I had a family I would probably be overly busy, but much of that busyness would involve mundane tasks. I’ve always had a morbid fear of being a female parent, and being given the role of self-sacrificing ‘mother’ instead of equal partner in the parenting enterprise – I look at my sisters, all of them mothers, and simply don’t know if I am better or worse off than they. But fathers also get lost in the mundane – I think of the hours my brother-in-law spends ferrying his kids to footy and basketball.

Yet even amidst the ennui and chronic exhaustion, as a parent I would be able to tell myself that I was achieving a valuable long-term goal – the continuation of the species and the nurturing of tomorrow’s taxpayers and, hopefully, stewards of planet Earth. And my brother-in-law probably uses at least some of that driving (and game watching) time to bond with his children.

As well, the wound of loneliness sometimes requires the antidote of bad television rather than the intellectually stimulating read that some busy parents, including mothers, might crave. At times, such parents might envy the likes of me, free of the never-ending drudgery and pleas for attention. But they might find me curled up in a ball bewailing my fate as I watch Ramsay’s Kitchen Nightmares rather than poring over the Collected Works of Charles Dickens as Beethoven’s Ninth thunders in the background.

Obsessed with time management

My fear of wasting time also relates to the mistaken belief that not doing something productive is somehow sinful. I certainly didn’t pick that up from my Catholic upbringing. Instead, this fear stems from the time when I was completing my Masters thesis in the late 1990s. I was on a scholarship, studying full time, and surrounded by successful people who gave papers at conferences, tutored, learned French to improve their understanding of theory, and attended reading groups.

At the time, to my way of thinking the pursuit of knowledge easily trumped consumerism, materialism and any sort of interest in popular culture, and from my lofty, poverty-stricken heights I looked down scornfully on anyone who did not value intellectual endeavour, seeing them as sadly deluded. I spent hours in the library brushing up on theory, much of which has now long since vanished from my mind.

But the sense of directedness I saw in the high achievers was pervasive. I remember one day glancing behind me at the library queue and noticing my supervisor further behind me in the line, waiting to have a book checked out. She poked her head around to scan the queue and, with a quick jerk of her body, abruptly left. I still remember what that momentary action indicated to me: the instantaneous weighing up of the time she would lose in the queue compared with the convenience of having access to the book. This suggested someone whose life had no spare seconds, who was so full of purpose and responsibilities that time management meant the difference between ongoing achievement and mere striving.

So in the couple of years following my Masters I would use every minute of spare time ‘productively’, by, say, reading small cards on which I’d drawn kanji (Chinese characters used in Japanese) while waiting forlornly at a city bus stop on a biting cold winter’s afternoon.

And before I started editing, and during the times when the work dried up and I was coaxing survey responses from reluctant telephone interviewees, I’d surreptitiously go over Japanese sentences while waiting for respondents to pick up the phone. Eventually the supervisors noticed and, despite my high success rate in obtaining telephone interviews, ordered me to stop. This caused me unseen angst; I couldn’t just relax and let the time be spent simply making enough money to live on. I was obsessed with ‘improving each shining hour’.

At its height, this fear of wasting time would have extended to, say, the idea of socialising with people who I didn’t have much in common with (ie my relatives!). But one gift of my social phobia, and the exploration I’ve done in trying to understand it, is that I now see those everyday interactions as being vitally important.

There are two reasons for this: they're good for mental health generally, because as humans we need to interact with others and feel safer when we’re with others, and particularly our ‘pack’; and because they provide me with valuable exposure practice for my social phobia.

So to some extent regret about wasted time is something I live with. Slowly I’ve begun to realise that the moment, even in its occasional awfulness, even when not filled with mental exercise, has its own integrity.

I could learn kanji till I was blue in the face but it would be useless, a waste of time, unless I was attending a Japanese class or had a reason for learning it such as a planned visit to Japan. Neither of these situations applied, so the keeping up with my Japanese study became, in the end, a waste of time rather than a good use of it.

The concept of mindfulness helped me understand this. Mindfulness involves becoming an observer of the self – one’s thoughts, perceptions, feelings and current actions – in order to move into the present in a more profound way. When I divide my attention too much (writing my diary while watching tele, for instance) I’m subtly diminishing my experience of time, indeed of life. While trying to save time, I may actually be wasting it.

I love good thrillers and I need to spend some time vegging out on weekends. But I’m scraping the bottom of the barrel when it comes to decent thrillers at my local video store. So last weekend I ended up on a Saturday afternoon watching one of the worst klunkers ever made, Cold Creek Manor with Denis Quaid and Sharon Stone.

There literally wasn’t a scary moment in it; it could have been parody if it hadn’t been so dull and lacking in humour. It made me wonder about the technical aspects of thrillers – why some work and some fail spectacularly. But perhaps the most important thing for me to do was to actually pay attention to the film, observe and follow the creaky plot, and try and work out why it failed, rather than just having it on as background to my random thoughts.

Another reason why unstructured time is vital is that it refreshes the mind and enables creativity. Late one afternoon I took my seven-year-old niece to the park, supervising as she mucked around on the play equipment. For quite a long time she half-lounged on a swing, moving slowly back and forth as she gazed into space. This natural ability to enjoy mental downtime is too often mistaken for laziness. But it's the space in which new ideas and creative breakthroughs hatch themselves.

A book on worry that I read recently goes further than advocating basic mindfulness. In The Worry Cure, Robert R Leahy provides useful advice for incessant worriers who are busy dreading what the future might bring. One of his suggestions is that once you’ve brought yourself back to the present moment using mindfulness, you can add value to the moment, make it count.

I love this idea because it extends the concept of mindfulness so effectively. You bring yourself into the present, become aware of your body, breathing and perceptions; then you do something to improve the present, even if it’s just subtly. This could be something insignificant, like savouring a cup of tea, putting some music on (Beethoven’s Ninth?) or taking the kids for an ice cream.

Using intuition is also important to me in combatting my fear of wasting time. In the past I was constantly using my will to forge ahead; now I use intuition to decide whether something’s worth spending energy on. Anything that feels right can't really be a waste of time.

Being busy for the sake of it can actually cause harm. Former prime minister Kevin Rudd’s political demise provides a cautionary tale. Rudd seems to have been unable to stop work, to delegate, and he also caused great harm to his staff because he unapologetically worked them to the bone, no doubt causing havoc with their family lives.

‘A staff working year is probably like a dog year, that is it's probably worth seven years in normal life’, he was quoted as saying in The Daily Telegraph of 15 April 2010. That report also stated that he had lost 28 staff, presumably since coming to office in late 2007.

The coup that ousted Rudd in favour of Julia Gillard occurred for many and complex reasons, but the refusal to delegate seems to have been one of them. I sympathise with Rudd and wish fervently that the party had given him an ultimatum months ago rather than cruelly dealing the death blow – but I can’t help seeing in his fate a grim warning about the effects of overwork!

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Attention!

Attend!
Pay attention!
Are you paying attention?

It seems that attention is what's missing in this society. But how important is it?

Lately a few things I've been hearing and observing have made me think about this scarce commodity, so hard to come by in our rushed, atomised, money-obsessed world.

But what does it mean? And why have I suddenly become fixated on it?

In the last few years, a few books relating to this idea have been published in Australia. A young Australian philosopher, Damon Young, wrote Distraction: A Philosopher's Guide to Being Free, about the prevalence of distraction in the modern world, ruefully admitting his addiction to his Blackberry even while on holiday. And Hugh Mackay wrote Why Don't People Listen?, a well-received book in which he urged readers to start really listening to others.

Both of these books' topics are related to attention. Distraction is attention's obvious opposite. Listening is impossible to do properly if you're not attending to someone. But attention has wider scope than listening. It's a focus on someone or something, sometimes an intense focus. Why does it matter?

I regularly take my sister's little cocker spaniel, Jordan, to the park for a romp. When we get back to his place, I usually play Fetch with him for a little while. Occasionally we play Fetch at the park but he's usually too distracted by his all-consuming sense of smell to keep focused on the game. With such succulent, wafting scents everywhere, it's almost impossible to get him to follow the track of the ball (Fetch!) let alone bring it to me (Come!) and drop it at my feet (Give!)

What I have noticed, though, is that he performs much better when I focus on him. When I look at him and am very aware of what I intend him to do, what I want him to do, he seems to sense it. If I'm half-hearted and distracted, so is he.

Attention seems to be to be related to love and bonding. I have a strong bond with Jordan, and when I 'activate' it through my attention, this no doubt helps him to keep focused on me as we play this game.

Children, as we all know, absolutely crave their parents' attention, and will act out mercilessly if they don't get it.

I'm hopelessly intolerant of my friends having their mobile phones on and answering them when I'm socialising with them one-on-one, because for those minutes they're on the phone they've let go of that attentiveness that I'm hungry for.

Journalist Rupert Isaacson is the father of an autistic boy, Rowan. The child was incontinent, constantly having tantrums and unable to relate to others when Isaacson and his wife, psychology professor Kristin Neff, decided to take him on a trip to Mongolia to be healed by shamans (horses were already playing a large role in his progress, so the trip also involved horses).

After the shamanic healings took place, miraculous changes occurred. Rowan became toilet trained, his tantrums virtually ended and he made his first friend. Isaacson wrote a book about the experience, Horse Boy, and a documentary has been made about the journey.

Isaacson can only speculate on what actually caused the changes. But could part of the shamans' powers have come from the intense focus they had on Rowan, and the inner healing powers they were able to summon up, during the healings, partly through that focus?

And could some of the trip's success have come about because Rowan's parents were so intensely focused on him and what they wanted for him, not in a grasping way but in their willingness to drop everything for him? (This is not to suggest, of course, that attention will cure everything, or that parents with disabled children who can't be helped are not giving enough attention.)

Recently a UK journalist, Simon Singh, along with coauthor Edzard Ernst, wrote the book Trick or Treatment? Alternative Medicine on Trial (I think this is too complex an area to have only one opinion on; homeopathics are nothing but water, yet herbs are clearly medicines that we still need to know much more about.)

Naturally Singh was down on homeopathics, and I don't blame him. But when western scientists and science writers such as Singh have discovered that people benefit from homeopathics anyway, I think they too easily dismiss the reasons. There's the placebo effect of course; that's the mind healing itself, which is highly significant and extremely worth exploring.

But it's also acknowledged that sitting down with a naturopath who listens to your problems, asks you questions about all aspects of your life and gives you the time and attention that so many GPs are just too busy to give may also help the healing process.

But, you might well ask, what about animals and children? How could they possibly benefit from homeopathics and get better as some seem to? Of course, the usual maxim applies that many would have got better anyway regardless of treatment. But perhaps the actual dispensing of the homeopathics, with the ritual involved and the attentiveness necessary, has something to do with it?

Too bad that kind of thing can't be measured, and too bad it can't be bottled and marketed and made it into a brand (I guess capitalism tries to do that, but I'm talking about real attention …).

What if all medical students, in addition to having good marks, had to demonstrate qualities such as empathy and compassion? Perhaps this is an essential aspect of healing, not just an add-on?

Attention is perhaps a kind of love, or perhaps love is not the word I'm looking for. I don't mean individualistic love or romantic love but the life force that flows through us. Perhaps when we give something or someone our attention we allow our minds to provide the beginnings of healing. That's one reason why truth and justice commissions are so important after terrible massacres. Sufferers need to be heard by other humans.

And that's why in naturopathic, but also psychotherapeutic, consulting rooms all over the world, people seek out and are willing to pay large sums of money to those who will listen to their stories, mobile phones and pagers turned off and no computer blinking in the background. That's one aspect of therapy I really miss – the quietness of the consulting room, and the sense that someone was giving me their complete, undivided, fully focused attention, even if only for 45 minutes a week.

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Changing my mind: slightly all-over-the-shop thoughts about brain plasticity, excessive worry, and mindfulness

For many years I have pictured my condition/illness/neurosis (whatever you want to call it) as a small child constantly tugging at my sleeve and demanding care, attention and protection. Of course, I’m not Robinson Crusoe in seeing myself this way – inner child therapy suggests that we all have a needy child inside us that we need to listen to, love and support.

What I’m trying to do more actively these days is actually learn to manage this child, look after it, but also keep it in line. And to do this I’m finding myself viewing my brain as a pliable thing that I can manipulate.

I know this sounds a bit negative and mechanistic so let me explain. Ever since I read The Brain That Changes Itself by Norman Doidge, a book that reveals some of the latest research into just how plastic and changeable our brains actually are, I’ve been pondering how disempowered I’ve always felt about handling my chronic anxiety and panic.

These feelings of disempowerment have only increased over the last four years or so, since I gave up therapy and decided once and for all that my body couldn’t handle antidepressants. During this time I have done a few empowering things – I learned how to control my breathing and still practise abdominal breathing when stressed; I did a short group therapy course for social anxiety sufferers; and I bought a mindfulness book and CD, and still do a mindfulness session with the CD about four times a week.

I also try to practise mindfulness (staying in the present; being aware of my surroundings and sensory experiences; noting but not judging thoughts) but I’m not strict about letting the thoughts go – more on that later.

These are all good things, but with my wayward brain they’re simply not enough!

The Brain That Changes itself was an incredibly affirming book. I’m the sort of person who needs constant affirmation, and exterior, visible proof that something is working. I think that’s one reason I’m finding it hard to make further necessary changes like starting meditation – there’s no-one there to say ‘I can see that’s making a difference’, no machine I can hook up to that will show my altered brainwaves after a meditation session.

But Doidge’s book, even if it can’t make my brainwaves visible to me, has been making me see my brain as something fluid, something that I can change, something that’s constantly affected by what I think, do, and tell myself.

So I don’t want to manipulate it in a way that denies my reality (‘I am now a multimillionaire with a swish New York apartment and a cottage in the south of France’). I just need to give it a bit of discipline. When I think of manipulating my brain, I’m actually thinking of a process more like, say, massaging sore muscles into shape or, conversely, exercising slack muscles.

Some examples. I can fall prey to obsessive thoughts sometimes, and while I don’t class myself as having OCD (I have enough problems!) I found the section on OCD in Doidge’s book very helpful. (It’s also useful for anyone who worries excessively.)

When you have an obsessive thought that won’t go away, you do two things: you refuse to focus on the content of the thought, and tell yourself the actual content is not the problem, but the obsessive thinking is; and then you do something pleasurable to distract yourself.

It’s so simple, and yet, if you do it over and over, determinedly, you’re actually changing your brain, creating positive new circuits and connections. What a fantastic idea!

Of course, it’s hard work, and takes perseverance. And it doesn’t mean you actually eliminate the old mental habits. Instead, you create new, competing circuits.

This part of the book was quite tantalising, because the book as a whole doesn’t include a lot of practical suggestions for dealing with anxiety and so on.

But it does suggest how important self-talk is in general, something I’ve been working on in a separate but related area, my social anxiety. Every time I go into a scary social situation, I now tell myself I’m safe. I tell myself I’m doing well. I talk sense to myself. I guess this is a very basic form of cognitive behavioural therapy, which seeks to identify and challenge irrational thoughts.

The book also offers a concrete way of thinking about those more esoteric habits that are hard to introduce, such as meditation, progressive relaxation or mindfulness in daily life. These practices are not simply good in the abstract; over time they’ll produce new neural connections and new mental habits.

When I think about it, meditation (even if it’s not specifically mindfulness meditation) and progressive relaxation (where you progressively tense and relax all the major muscles in the body) are related to mindfulness, if not forms of it, because they’re both about being in and experiencing the present moment.

But mindfulness actually seems to clash a bit with the good self-talk and the anti-worry treatment described in Doidge’s book.

Mindfulness is quite interesting in relation to the general kind of brain manipulation I’m discussing. If I adopt it along with my anti-worry strategy I’m at once attempting to take control (by introducing a new practice that will alter my mind for the better, and striving to stay in the moment) and let go (by not trying to control or judge feelings, behaviours, thoughts but simply observing them; by letting life be the way it is).

This is consistent with Doidge’s suggestion of not buying into the content of the thought. But it contradicts the idea that I should challenge my thoughts, either in relation to persistent obsessions and worries, or specific anxieties like social anxiety. According to mindfulness practice, I should simply note thoughts, not buy into them as fact, and let them go.

Perhaps this apparent contradiction doesn’t matter – perhaps the main thing is to have a grab bag of tools one can use? Oh dear, I can feel a worry coming on …

If anyone has any suggestions about reconciling mindfulness with CBT and the treatment of obsessive thoughts that I’ve briefly sketched, I’d be glad to hear them!

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