Part 3 of a series – Anxiety and HSP
This series by clinical psychologist Dr. Helga Hemberger* explores various aspects of getting in good ‘mental condition’ when living with a debilitating neurological condition, by providing ideas and tools for managing stress, improving mood and supporting a positive outlook.
We all know to floss and brush to keep our teeth in good shape, and what happens if we don’t … but do we know as much about ‘mental hygiene’ as we do about ‘dental hygiene’?
Doubts and Fears
HSP and living with uncertainty go hand in hand. People with a progressive neurological condition face a reality that does not receive much attention from most until the later stages in life – the reality that everyone’s bodies and mobility deteriorate. For people with HSP, this often happens much quicker. Then there are the daily reminders When is the next trip, stumble or fall going to happen? Can I make it from the car across that grassy slope to the house? How long will this trip take… What if I have to use a toilet… Perhaps I shouldn’t go? Will I have to live somewhere else eventually? I wonder what my partner really thinks of having to help me so much? Will I finish up unable to walk at all? The difficulties living with HSP are often stressful in themselves, but adding anxiety caused by constant doubts and fears on top of that just makes things that much worse.
Feelings of fear or anxiety have evolved to help us detect and overcome a threat. So, some anxiety is essential – it can promote problem solving and even help to clarify our priorities. However anxiety can easily get to a stage where it is high enough and constant enough that it can significantly interfere with quality of life.
Past, Present and Future
With unrelenting fears and worries, there is little capacity for enjoyment of the present moment. Some people describe a feeling of being controlled by anxiety, or a feeling that they are being controlled by their body.
The vast majority of thoughts producing anxiety are thoughts anchored either in the past I’ll never get over what that person said to me or the future What if I end up in a wheelchair? In a condition such as HSP, future fears are natural and often realistic I wont be able to work full time in a few years, I will need more assistance but living with fear around reduced of quality of life in the future means that quality of life in the present is significantly affected. It’s like experiencing all the possible problems and traumas that may happen in the future, all at once in the present moment. This can leave a person feeling drained, down and in despair. It can also lead to more future fears If I feel this bad now, I don’t think I can imagine what’s in store for me in the years to come!
Preoccupations with the past e.g. thinking about all the things one used to be able to do, can likewise take over and reduce enjoyment in the present.
And there are things about the present moment that are worth enjoying! The taste of a good meal, the warmth of the sun, the joke told by a friend. If fearful thoughts about the past or future predominate, life just doesn’t feel good.
What you can do
How does one learn to detach from future fears and past preoccupations, to focus, and find enjoyment in the present moment? Mindfulness is one technique which has been gaining increased attention and research. In Part 2 of this series – Meditation as Medicine – participants of an eight-week mindfulness meditation program experienced increased density in brain regions associated with memory, one’s sense of self, empathy, and stress response.
Mindfulness aims “To become aware of thoughts, feelings and body sensations, from moment to moment. With practice, we can increase awareness of our thoughts and distressing feelings and can learn to respond by choice, rather than react automatically. This can help us counter many of our everyday reactions such as stress, anxiety and depression because we are learning to experience life, the things we do and the things that happen to us in a more impersonal and detached way.” Cayoun and Elbourne (2008).
Mindfulness of Breath
One of the first basic exercises of mindfulness is mindfulness of breath. You can practice this exercise sitting up with your back relatively straight or lying down on your bed or floor. You can either close your eyes or have them half open. Keep your arms and hands anywhere they feel comfortable.
- Gently turn your attention to your own natural breathing. You can feel your breath in your nose, throat, chest or down in your belly.
- To help you to focus you can quietly say to yourself ‘in’ or ‘inbreath’ as you breathe in, and ‘out’ or ‘outbreath’ as you naturally breathe out.
- Almost immediately you’ll find that your mind gets caught up in thoughts, sensations, daydreams, worries, concerns and more. This is completely normal. As soon as you notice that your mind has taken your attention away from you breath, without self-criticism, judgment or doubts, simply and as kindly as you can, turn your attention back on to the breathing. Your mind may wander off thousands of times. That’s perfectly okay. No need to criticise or judge yourself for that, simply notice that’s what is happening and bring the attention back. Each time you do this, you strengthen your inner capacity for mindfulness.
- After 10 minutes or so you can bring the exercise to a close. Notice how you feel, then give your full attention to whatever you do next.
More information on Mindfulness
Mindfulness workbooks, CDs and tapes offer structured exercises in mindfulness practice. There are specific mindfulness meditations for pain, sleep and anxiety available online. There are a number of organisations and institutions offering training and practice in mindfulness. You can search for your local group online (search ‘mindfulness’ + your geographic area).
*Dr. Helga Hemberger is a Clinical Psychologist who provides neuropsychological assessment and therapy for people with neurological injury, illness or disease, their family and carers. Since completing her clinical training in 2006, Helga has worked mainly in neurology and rehabilitation settings including at the National Hospital for Neurology and Neurosurgery, Queen Square, London. She is registered with the Psychology Board of Australia and is a Member of the Australian Psychological Society, APS College of Clinical Psychologists and the International Neuropsychological Society. Helga has two Sydney locations – Annandale and St. Leonards.
ph: (02) 8959 9696 or [email protected]