How to teach mindfulness to panic attacks sufferers?

Stress Reduction Program MBSR Graduates
#1

Hi
I am new here and I am also new at teaching mindfulness.
My first class participants are people that are prone to anxiety and panic attacks.

In mindfulness practice, the body is the main object of attention, at least at the beginning. I always tell my participants to focus on their body when practicing meditation or (obviously) the body scan.

But in the case of people suffering from panic, exploring the body can trigger attacks and therefore, cause the problem instead of reducing it.

I would like to hear from experienced teachers what ways are available to circumvent this problem.

#2

I’m not an experienced teacher, just an MBSR graduate who is a trauma survivor . Focussing on the body and breath can cause panic, anxiety or flashbacks for me. What works are the “listening to sounds” awareness (JK-Z) and also mindful yoga (lying on the floor since panic causes problems with balance) for which there is also a JK-Z series of moves which focus on awareness while performing the exercises, not just yoga exercises themselves. Mindful walking is also beneficial, but not mindful eating or anything that focuses on the mouth, taste or smell.
There has just been a symposium on trauma and contemplative practce and I’ve been told that some of the presentations will be uploaded as videos on the Harvard Divinity School site. There may be helpful materials there.

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#3

I am also not a teacher of MBSR but I have completed two MBSR courses in 2003 and 2013. As someone living with chronic pain, I found the bodyscan activated and escalated my experience of pain. I think the bodyscan may have the same effect for people dealing with trauma. I also agree with you about JKZ ‘listening to sounds’ and also mindful yoga. When I sit to practice and am feeling very uncomfortable, I get up and do walking meditation, then yoga stretches. This allows me to return to sitting practice with more ease. During my last MBSR course I spent a long time just listening to the recordings of meditation practice while doing the practice. I was not able to practice on my own for quite a long time without having that voice to listen to. My teacher did not agree with this but I contacted someone at UMass to discuss and they seemed to be ok with my way (at least for me). Now I have no problem sitting on my own without ‘the voice’. Not sure what that is about but it worked for me.

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#4

It seems to me that it is important (for me, and maybe for teachers of mindfulness) to emphasise that mindfulness practices are not intended to cultivate mindfulness. No, they are intended to cultivate awareness. I thought I knew what awareness was (doesn’t everybody know what it is???). In fact, I didn’t, even though I had had experiences of it, some very profound. Now that I have many more times of awareness and recognise what it is, I can work backwards and ask myself, “What do I do that encourages this awareness or allows it to surface?” (because I feel as if it is always there, within me, underneath lots of layers of other stuff going on). That is how I have identified which techniques are helpful to me and which are not because they trigger off reactions that block awareness.
My suggestion, then, would be to find ways to help people identify what awareness is, instead of assuming that everyone knows, and what it is like for them as an experience.

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#5

Hello everyone. I just want to appreciate and honor all the wisdom in this thread. Felicity, your recognition of awareness is deep. Jon has said–many times–if you had to say what mindfulness is in one word–it would be awareness. Also, there is a deep recognition of what is useful, supportive, acknowledging and honoring of the moment and what’s called for now. Georgia, the way you took the step to “just listen” to the recording is brilliant! There is no “one right way,” and your own creativity and willingness to play with the practice in a way that allowed the door to open is what we’re cultivating.

Along with connecting to sound and movement, I would add that attending to sensations in the feet or hands can also be a way to move towards the body without activating highly charged areas. For some, these areas of the body allow a sense of connection while delicately acknowledging when something feels too much. Of course, opening the eyes also is a powerful grounding in the present moment.

I hear these explorations expressing steadiness and courage. Thank you.

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#6

The way I understand it, mindfulness and awareness are pretty much synonymous.

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#7

Hi. I’m not a teacher, but do practice. Also suffered with Panic attacks and social phobias for 40 years. Sitting is sometimes very anxiety provoking for me also, but I find I can lay on my back. I find mindfulness meditation and focusing on the breath very soothing to an anxious mind. Allowing the anxiety to be without trying to stop it seems to be the way to go for me.

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#8

Helloeveryone,
As a panic attack sufferer, and also hypocondriac, I also find it difficult to concentrate on the body

It is because I strive to actually stop thinking all the time to the symptoms and be all the time aware of each body signal. So it is all very challenging for me, as a beginner in mindfulness. I would love to have some advice from experience teachers that work with hypocondriacs and with patients that psomathize their fears.

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#9

My teacher told me once ,when migraines were making meditation very uncomfortable, to concentrate on my hands and feet. Maybe you could try that. I am not hypocondriac but to me , it would make sense to focus attention on a part of the body that is not prone to diseases. And there is always the breath, which is the most basic focus object.
Hope that helps

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#10

I also honor the willingness to discover what is wise for each of us - sometimes zooming out from the narrow focus of attention that occurs when we do not feel safe is quite wise & meets us where we are at. I work with people who experience extremely severe anxiety, panic, stress, distress, & the aftermath of trauma & also can say that after lots of guided practice & “weaving our parachute” as JKZ says, before we zoom in - we can even bring a beginner’s mind to the sensations, thoughts, & urges to escape that compose anxiety & occur when stress is high. I have developed many brief practices to support people with this & am gradually getting them up on my web site at http://www.meta4stress.com along with brief articles for laypeople & presentations for professionals. I also am always developing new ways to practice with distress as I continue to serve those courageous enough to explore what is a wise response & what supports the refuge of awareness so stay tuned & check out what is on the site. Finally for those who like to surf & SUP check out https://www.facebook.com/mindfulsurfing page for more resources

#11

Thank you for this question, which taught me something important in its asking. Have you tried Jon Kabat-Zinn’s Mountain meditation? I have not yet completed my MBSR teacher training, but this was well-responded to when I was guest-teaching. Best wishes <3

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#12

Thank you. I will definitely try it out!

#13

I am enjoying getting to know the community by reading around the different rooms here. First, I’m sorry you suffer with panic attacks @Stellina . It must be very uncomfortable. I have had what I believe were probably anxiety attacks over the years, and when they do come up now, I’ve found the mindfulness practices very helpful. I really wanted to comment back because I learned something that might help you while attending the Mind-Body Medicine training earlier this year. I think it might have been Saki that mentioned in response to a similar question, that it might be helpful to choose another “object” for attention, such as sound. So just taking in the ambient sounds, noticing these. I’d love to know if this helps for you! Best wishes.

#14

Hi frepie
i am a psychiatrist attempting to deal with mental health problems through mindfulness route. I am not trained in MBSR and our program is titled Mindful Life Management (MLM). We get a lot of patients with panic attacks and depression and also people with panic disorder. i find in my practice that most patients with panic disorder cannot practice mindfulness meditation all of a sudden. for them i try the mindful eating and mindful walking and also mindful drinking of a cup of cold or warm water. for other people who can tolerate of distress of the mindfulness meditation (initial sessions) i proceed with mindfulness meditation - starting from 3-5 minutes, i gradually increase to 30 minutes
dr. Krishnan

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