And so we are brought back to the key importance of mindfulness. The very first and most important step in breaking free from a lifetime of stress reactivity is to be aware of what is actually happening while it is happening. In this chapter we will look at how we might do this.
Let’s consider once again the situation of the person in Figure 9 that we analyzed in the last chapter. As we have seen, at any moment in time this person may be encountering a combination of internal and external stressors that can trigger a cascade of feelings and behaviors we have been calling the habitual or automatic stress reaction. Figure 10 shows the same stress-reaction cycle as in Figure 9, but now includes an alternative pathway, which we will call the mindfulness-mediated stress response, to differentiate it from the automatic stress reaction. The stress response is the healthy alternative to the stress reaction. We can think of the mindfulness-mediated stress response, which we will sometimes refer to as the stress response for short, as the generally healthier alternative to the more unconscious stress reaction. The stress response represents collectively what might be called adaptive, or healthy, coping strategies as opposed to maladaptive attempts to cope with stress.
You do not have to go the route of the fight-or-flight reaction nor the route of helplessness, overwhelm, and depression every time you are stressed. With training, practice, and intentionality, you can actually experiment with choosing not to react in those ways when the opportunity arises. This is where mindfulness comes in. Moment-to-moment non-judgmental awareness allows you to engage in and influence the flow of events and your relationship to them at those very moments when you are most likely to react automatically, and plunge into hyperarousal and maladaptive attempts to keep things under some degree of control.
By definition, stress reactions happen automatically and unconsciously, even though, as we have seen, many different, highly evolved, integrated, and useful cognitive processes may be at play beneath the surface of our awareness. Still, as soon as you intentionally bring awareness to what is going on in a stressful situation, you have already changed that situation dramatically and opened up the field of potentially adaptive and creative possibilities just by virtue of not being unconscious and on automatic pilot anymore. You are now committed to being as present for it as you can be while the stressful event is unfolding. And since you are an integral part of the whole situation, simply by holding whatever is happening in awareness, you are actually changing the matrix of the entire situation even before you do anything overt, such as take action, or even open your mouth to speak. This interior shift to embrace what is unfolding in awareness in the present moment can be extremely important, precisely because it gives you a range of options for possibly influencing what will happen next. Bringing awareness to such a moment takes only a split second, but it can make a critical difference in the outcome of a stressful encounter. In fact, it is the deciding factor in whether you go down the path of the “Stress Reaction” in Figure 10 or whether you can navigate over to the path of the “Stress Response.”
Let’s examine how you would do this. If you manage to remain centered in that moment of stress and recognize both the stressfulness of the situation and your impulses to react, you have already introduced a new dimension into the situation. Because of this, you neither have to react automatically with your usual habitual patterns of emotional expression, whatever they are, nor do you have to suppress all your thoughts and feelings associated with heightened arousal to prevent yourself from going out of control. You can actually allow yourself to feel threatened, fearful, angry, or hurt and to feel the tension in your body in these moments. Being conscious in the present, you can easily recognize and identify these agitations and contractions for what they are: thoughts, emotions, and sensations.
FIGURE 10
COPING WITH STRESS RESPONDING VS. REACTING
This simple momentary shift from mindless reaction to mindful recognition of what is unfolding inwardly and outwardly can reduce the power of the stress reaction and its hold over you. In that moment, you now have a very real choice. You can still go the route of the stress reaction, but you no longer have to. You no longer have to react automatically in the same old way every time your buttons get pushed. You can respond instead—out of your greater awareness of what is happening, and the larger perspective and new options and openings that frequently accompany an expanded perspective, as with the puzzle of the nine dots.
This inner response would be an awful lot to ask of ourselves in a stressful situation if we had the expectation that awareness and centeredness should just come out of nowhere whenever we needed them or that we should simply be able to will our mind and body to be calm when they are not. But in fact, through the formal meditation practices, we have been training our mind and body to respond in this way all along, developing and deepening these very qualities. You have probably experienced any number of small emotional and cognitive reactions, including impatience or annoyance, at places in the body scan, for instance, or in the sitting meditation, or in the mindful yoga. Practically speaking, only through regular training to develop the “muscle” of mindfulness could we possibly hope that our calmness and awareness would be strong enough and reliable enough to assist us in responding in more balanced and imaginative ways when we find ourselves in stressful situations.
The capacity to respond mindfully develops each time we experience discomfort, pain, or strong emotions of any kind during formal meditation and we just observe them and work at allowing them to simply be here as they are, without reacting. As we have seen, the practice itself grounds us in alternative ways of seeing and responding to reactive states within ourselves, moment by moment. It introduces us to an entirely different way of being in relationship to what we find unpleasant or aversive or difficult. It offers a new way of being, one that allows us to feel more in touch with what is unfolding moment by moment. It therefore expands our sense of being anchored and stable, at least to some degree, in our recognition and appraisal of an event or circumstance within the larger field of our awareness. This is akin to a new way of being, and thus a new way of feeling more in touch and in control in relationship to our experience, even when things are difficult. We come to see from our own experience that wise relationality—and therefore more appropriate and effective responsivity—can come out of inner calmness, clarity, acceptance, and openness. We come to see that we don’t have to struggle with our thoughts and emotions, and that we can’t and don’t have to try to force things to be as we want them to be in that moment—or ever.
One thing is certain: we know where the fight-or-flight reaction and its various sequellae will lead if it is left to play itself out automatically, as in the left side of Figure 10. We have been going that route most of our lives. The challenge now is for us to realize that, in any moment, we are in a position to actually decide to do things differently by intentionally shifting how we are in relationship to our experience, whatever it is, in that very moment.
Choosing to go the route of the stress response rather than the stress reaction obviously does not mean that you will never react automatically by feeling threatened or fearful or angry, or that you will never do anything silly or self-destructive. What it does mean is that more of the time you might be more aware of those feelings and impulses as they are arising. Your awareness may or may not temper the intensity of the arousal you feel. That will depend on the circumstances, and on the strength of your practice. But in general, either awareness reduces arousal at the time by situating things in a larger perspective, or it helps you to recover from it more quickly afterward. This is indicated in Figure 10 by the smaller squiggles in the box labeled “Stress Response” as compared with the box labeled “Stress Reaction.” These represent the summation of all the stress hormones, autonomic nervous system activity, and pathways within the brain and body that are at play to either amplify or damp down the stress reaction in any given moment.
And let’s face it—in some situations, emotional arousal and physical tension are totally appropriate. At other times, though, they may be unhelpful, inappropriate, or even destructive. In either case, how you handle whatever arises in the present moment will depend on your ability to rest in and trust in awareness itself, and to disengage, to whatever degree is possible for you, from how personally you might be taking things, especially at times when, in actuality, they are not at all personal.
In some situations, feeling threatened may have more to do with your state of mind and the context in which you find yourself rather than with the triggering event itself. If you bring awareness to your most stressful moments with a sense of openness and curiosity, you might see a bit more clearly how your unbalanced view or emotional upset left over from an earlier event could be contributing to an inappropriate overreaction on your part, one that may be out of proportion to what the actual circumstances warrant. Then you might remind yourself to try letting go of your self-limited view, right in that moment—which means letting it simply be here without feeding it—just to see what would happen. You might try trusting that things will become more harmonious if you make the effort to meet the situation with a more open and spacious frame of mind, with a bit more calmness and clarity and even self-compassion. Why not test this possibility for yourself once or twice? What do you have to lose? This is how we come to a larger perspective taking.
As you bring mindfulness to a stressful moment, you can see if, in effect, it winds up creating something of a pause, a moment in which it feels like you have a bit of extra time to assess things more completely. By intentionally orienting yourself in this way to the present moment, challenging as it may be, you have an opportunity to buffer the impending effects of a major stress reaction. This buffering arises by recognizing the early warning signs of the stress reaction in your body and in your mind, and allowing them to be felt and embraced, even welcomed to the degree you can manage that, and held with kindness in awareness. This in turn gives you a bit more time within the pause you have taken to opt for a more mindful and perhaps more emotionally nuanced response, one that will indeed buffer the full brunt of the physiology of the stress reaction and provide you with more creative openings, right in the moment of pausing. Even though it may last only a fraction of a second by the clock, the duration of this pause in the mind can seem expanded, even timeless, and your choices much more vivid and available. It recruits multiple intelligences that we all already possess but frequently forget we have. Of course, responding to the unwanted and unexpected is a skill that develops with practice, and with remembering to implement it in those moments when it might be most beneficial. Indeed, that remembering is a large part of the practice itself.
When you experiment in this way, you may be surprised at how many things that used to push your buttons no longer get you aroused. They may no longer even seem stressful to you, not because you have given up and become defeated or resigned but because you have become more spacious, more relaxed and trusting of yourself.
Responding in this way under pressure is an empowering experience. You are maintaining and deepening your own balance of mind and of body, your capacity for remaining centered, even in difficult situations. This is not some romantic idealization. It is hard work, and we can fail at it repeatedly, getting caught in our own reactivity time and again in spite of our best intentions. This itself is an essential part of practice. In the ongoing cultivation of mindfulness, what we think are our failures are not failures. They are gifts—revealing extremely useful information—if we are open to being mindful of everything that unfolds in our lives, in a day, or in a moment, and putting it all to good use as grist for the mill.
How do we consciously cultivate the mindfulness-mediated stress response in daily life? The same way we cultivate mindfulness in the formal meditation practices: moment by moment, grounding ourselves in our body, in our breathing, in awareness itself. When your buttons are pushed or you find yourself feeling overwhelmed, when feelings of fight or flight come up, you might try bringing your awareness to your jaw as it clenches, to your brow as it furrows, to your shoulders as they tense up, to your fists as they start to clench, to your heart as it begins to pound in your chest, to your stomach as it begins to feel funny, to whatever you might notice about how your body feels at that moment. See if you can be aware of your feelings of anger or fear or hurt as you feel them rising inside you. Locating your emotions in a particular place in your body can be extremely telling, and very useful.
In such moments, you might even try saying to yourself, “This is it” or “Here is a stressful situation” or “Now is a time to tune in to my breathing and center myself.” Mindfulness sets the stage for you to respond appropriately right here in this very moment. If you are quick enough, you can sometimes catch the stress reaction before it develops completely and turn it into a more imaginative and creative response instead.
It takes practice to catch stress reactions as they are emerging. But don’t worry. If you are like most of us, you will have plenty of opportunities to practice. When you are willing to bring awareness to them, each situation you encounter becomes another occasion for you to practice responding mindfully instead of reacting habitually. You can be certain that you won’t be able to respond to every situation. It is unrealistic to expect that of yourself. And you will probably find yourself playing catch-up a good deal of the time because you didn’t detect the signs of the stress reaction when they first arose. But just by remembering to bring a larger perspective to each one of these moments, you are learning something important about the landscape of emotional reactivity, and transforming the stressors you are experiencing into challenges and passageways for growth.* Now whatever stressors you are facing become like wind for a sailor, here for you to use skillfully to propel you where you want to go. As with any wind, you may not be able to control the entire situation. But perhaps, by experimenting in this way, you will be better able to assume a wiser and more creative relationship to the circumstances and put its energies to work for you to navigate the difficult conditions and minimize some of the more dangerous or potentially harmful elements of what you are facing.
Probably the best place to start is with your breathing. If you can manage to bring your attention to your breathing for even the briefest of moments, it will set the stage for facing that moment and the next one with greater clarity. As we have seen, the breath itself is calming, especially when we can tune in to it at the belly. It’s like an old friend; it anchors us, gives us stability, like the bridge piling anchored in bedrock as the river flows around it. Alternatively, it can remind us that ten or twenty feet below the agitated surface of the ocean there is calmness. What is more, we carry it everywhere, so it is always here, no matter what the circumstances, and thus exquisitely convenient for us to call upon—a true ally in the cultivation of emotional balance.
The breath readily reconnects us with calmness and awareness when we lose touch with them momentarily. If you have been practicing, no doubt you will have experienced that the breath can bring you to an awareness of your body in a particularly stressful moment, including any increase in visceral tension or muscle tightness. After all, the breath sensations are themselves an intimate part of the sensory field of the body and can put you back in touch with the whole of it. Resting in an awareness of breathing, even for one or two breaths, can also remind you to check in with your thoughts and feelings and become aware of them and how they may be expressing themselves in particular regions of the body in the form of tightness or tension of some kind. Perhaps you will see how reactive they are. Perhaps you will question their accuracy.
In maintaining a modicum of stability and groundedness in the face of a potentially threatening stressor, to whatever degree you can manage it, and then turning toward it rather than turning away, it is much more likely that, right in that moment, you will have an awareness of the fuller context of the situation, whatever it is. Your impulses to run or to fight, to struggle or protect yourself, or perhaps to panic, freeze, or fall apart, will be seen within this larger picture, along with all other relevant factors in that moment. Perceiving things in this way allows you to remain calmer from the start or to recover your inner balance more quickly if it is thrown off initially by your reaction. One middle manager who completed the MBSR program put the nine dot problem (see Chapter 12) in a prominent place on the wall in her office to remind her to remember to look for the whole context when she feels stressed at work (see Laurie’s story on this page).
When you are stabilized and grounded in calmness and moment-to-moment awareness, you are more likely to be creative and to see new options and openings where the moment before there didn’t seem to be any. You are more likely to see new solutions even to old and tiresome challenges, and ways to manage new but unwanted and difficult situations. You are more likely to be aware of your emotions and less likely to be carried away by them. It will be easier for you to maintain your balance and sense of perspective in trying circumstances—what we might call equanimity.
If the original cause of your stress has already passed, you will be more likely to see that, at that moment, whatever happened has already happened. It is over. It is already in the past. This perception frees you to put your energies into facing this new present moment and dealing with whatever problems or challenges require your immediate attention.
When you channel and modulate your attention in this way, you will experience a quicker recovery of your mental equilibrium, even in very stressful situations, and also of your physiological equilibrium (allostasis) as your bodily reactions calm down. Notice in Figure 10 that, unlike the path of the automatic stress reaction, the mindfulness-mediated stress response doesn’t generate more stress. It doesn’t feed back more stress arrows onto the person. You respond and then it’s finished. You move on. The next moment will have less carryover from the preceding one because you faced it and dealt with it when it came up. Plus you have strengthened the muscle of mindfulness a tiny bit. What is more, recognizing and responding mindfully to stressors from moment to moment will minimize the tension that we allow to build up inside of us, both in the body and in the mind, thereby reducing our need to find ways to cope with the discomfort that accompanies internalized tension.
Having an alternative way of handling pressure can reduce our dependence on the common maladaptive coping strategies we so often resort to and get stuck in when we feel tense. One returning graduate said at the end of an all-day session that she figured out that her strongest impulses to go for a cigarette lasted about three seconds. She noticed that a few breaths took about the same time. So she thought she would try bringing awareness to her breathing and just ride the wave of her impulse, watching it crest and then fall, without taking the cigarette. When I last spoke with her, she hadn’t had a cigarette in two and a half years.
As relaxation and peace of mind become more familiar to you through the formal meditation practice, it becomes easier to call upon them when you need them. When you are stressed, you can allow yourself to ride the waves of the stress. You will neither have to shut if off nor run away. True, you may be going up and down some, but much less than if you are always at the mercy of your automatic reactivity.
Each week people in the Stress Reduction Clinic come to class with anecdotes—sometimes inspiring, sometimes amusing—of the ways in which they found themselves handling stress differently than before. Phil reported he used the stress response to successfully control his back pain and concentrate better when he took his exams to become an insurance salesman. Joyce was able to remain calm in the hospital and deal with her anxious feelings about her surgery by reminding herself to breathe. Pat actually used it to stay collected and cope with the humiliation of the police coming to her house and taking her off in the middle of the night in front of her neighbors because, it turned out, her psychiatrist was going away for the weekend and mistakenly thought from a phone conversation that Pat was suicidal. Janet, the young doctor, was able to control her nausea and fear and fly medical missions in the Life Flight helicopter. When her sister started in on her with her usual hostility, Elizabeth decided to just remain silent rather than being hostile in return; it surprised her sister so much that they started talking about it, which led to their first good communication in years.
Doug was involved in an automobile accident in which no one was hurt. The accident was not his fault. He said that previously he would have been furious at the other driver for ruining his car and for the inconvenience it caused him on a very busy day. Instead he just said to himself, “No one was hurt, it has already happened, let’s go from here.” So he tuned in to his breathing and proceeded, with a calmness that was totally uncharacteristic of him, to deal with the details of the situation.
Marsha drove her husband’s new van to the hospital for her MBSR class one night. The last thing her husband said to her before she left was “For God’s sake, be careful with the van.” And she was. She drove very carefully all the way to the hospital. To make sure the van would be safe during the class, she thought she would park it in the garage rather than in one of the open lots. So she drove into the garage. As she did so, she heard a funny noise coming from the top of the van. Too late—the low overhang at the entrance had sheared off the skylight bubble on the top of the van, which she had forgotten about. For a second, when she realized what she had done and what her husband’s reaction was going to be, she almost panicked. Then she laughed instead and said to herself, “The damage is done. I don’t believe I did this, but it’s already done.” So she came to class and told us about it, saying how surprised she was that she was able to control her panic, be calm, see the humor in it, and realize that her husband would just have to accept that it had happened.
Keith reported that he discovered he could meditate at the dentist’s office. Usually he was terrified of going and always put it off until he just had to go because of the pain. He found himself focusing on his breathing and the feeling of his body sinking into the chair. He found he could do it even as the dentist was drilling in his mouth. Instead of being white-knuckled, he was calm and centered. He was astonished at how well this worked for him.
In Part IV we will be discussing in detail a range of applications of mindfulness practice. There you will find many more examples of people who were able to see and to cope with things differently after they learned to respond to stress with greater mindfulness instead of reacting to it on autopilot, or, we could say, mindlessly. Perhaps by this point, if you have been practicing on your own, you may be finding that you are also responding differently in some ways to the pressures and problems in your life. This, of course, is what is most important!
Greater resilience in the face of stressors and reduced stress reactivity are characteristic of people who practice meditation regularly. This has been demonstrated in a number of studies. Daniel Goleman and Gary Schwartz showed in the early 1970s at Harvard that meditators not only had a heightened sensitivity and emotional involvement compared with non-meditators when both were shown a very graphic film of industrial accidents, but also recovered their physical and mental equilibrium more quickly afterward than did non-meditators.
More recently, the Shamatha Project, the most comprehensive study of the effects of an intensive meditation retreat ever conducted (the retreat was three months long), reported major differences on both psychological and biological measures between the meditators and a wait list control group in a randomized clinical trial under the overall direction of Cliff Saron of the University of California at Davis. These differences included 30 percent higher levels of the anti-aging enzyme telomerase in the meditators, as well as changes in psychological factors such as an increase in perceived control and a reduction in what is called neuroticism (vulnerability to stress and difficult emotions), which were in turn related to increases in measures of mindfulness and purpose in life. Those who increased the most in mindfulness by the end of the study (as measured by a mindfulness self-report scale) had the greatest decreases in cortisol production. Since, generally speaking, higher telomerase levels reflect lower stress reactivity, and greater perceived control is just what you want for responding to stress more mindfully rather than reacting to it automatically, the results of this study that have been reported to date† are a good indication that intensive meditation practice (this study focused in particular on mindfulness of breathing and other objects of attention, as well as the cultivation of lovingkindness and compassion) can lead to a major shift away from stress reactivity that is reflected at both the level of biology and psychology.
In an early seminal study conducted by Dr. Dean Ornish and his colleagues, related to work that will be discussed in more detail in Chapter 31, people with documented coronary heart disease who completed a twenty-four-day intensive lifestyle-change program that involved a low-fat, low-cholesterol vegetarian diet and daily meditation and yoga practice greatly reduced their previously elevated blood pressure responses to a range of tasks inducing psychological stress—such as doing mental arithmetic under time pressure—whereas people in a control group who did not change their diet or practice these techniques did not show a lowered blood pressure reactivity to stress when retested. While, as we have seen, it is normal for blood pressure to go up when we are stressed, it is remarkable that the people who went through the program were able to change their stress reactivity so dramatically within such a short time.
As we have seen, the fact that you can learn to respond to stress with awareness does not mean that you will never react anymore or that you will not sometimes be overwhelmed by anger or grief or fear. We are not trying to suppress our emotions when we respond mindfully to internal or external stressors. Rather, we are learning how to work with all our reactions, emotional and physical, so that we may be less controlled by them and see more clearly what we should do and how we might respond more effectively. What occurs in any particular situation will depend on the seriousness of what is happening and on its meaning to you. You cannot develop one plan in advance that will be your strategy in all stressful situations. Responding to stress requires moment-to-moment awareness, taking each moment as it comes. You will have to rely on your imagination and trust in your ability to come up with new ways of seeing and responding in every moment. You will be charting new territory every time you encounter stress in this way. You will know that you no longer want to react in the old way, but you may not know what it means to respond in a new and different way. Each opportunity you get will be different. The range of options available to you will depend on the circumstances. But at least you will have all your resources at your disposal when you encounter the situation with awareness. You will have the freedom to be creative. When you cultivate mindfulness in your life, your ability to be fully present can come through even under the most trying of circumstances. It can cradle and embrace the full catastrophe itself. Sometimes this may reduce your pain and sometimes it may not. But awareness brings comfort of a certain kind even in the midst of suffering. We could call it the comfort of wisdom and inner trust, the comfort of being whole.
* Recall happiness researcher Dan Gilbert’s comment quoted in the Introduction: “People blossom when challenged and wither when threatened.” It is an important distinction.
† So much data was acquired during this study that the results will continue to be analyzed and reported for years to come. See http://mindbrain.ucdavis.edu/labs/Saron/shamatha-project.