Introduction to Mindfulness

Mindfulness never struck me as something I could see myself doing on a regular basis. For many years, I viewed the practice as something for “enlightened people” with no practical application for the average person. As the years went on and the research continued to pile up in the literature, I decided to try it out. 

There are two basic ideas to keep in mind during meditation practice. We are not aware of how our body is feeling, and we are not aware of the constant stream of thoughts occurring all day long. By bringing attention to these two things we can begin to take control of our bodies and our minds.

The process is very simple and can be performed from most locations. Ideally you want a quiet place where you will be undisturbed for 10-15 minutes. I personally like the 10-minute mediation session, and it works well if you have a busy schedule. 

To begin the process, find a chair, preferably one you can sit upright in with your feet on the floor and back straight. I like to rest my hands on my legs.

I begin the process with my eyes open, and a few deep breaths in through the nose and out through the mouth. On the 5th breath I close my eyes. I return to my normal rate and rhythm of breathing in through the nose and back out through the nose. 

Next I begin the process of performing a body scan. I like to start at the head and work my way down to the toes, noting any discomfort or tension. I will also take note of areas on the body the fell relaxed and tension free. This should take 1-2 minutes. 

If at any point thoughts pop into your head, it’s fine let them come but most importantly let them go. Do not dwell on any one particular thought, just allow them pass. 

The next step is a series of breathing exercise I learned several years ago. Start with 10 breaths in through the nose and out through the mouth, counting each one. Then perform 10 breaths in through the nose and out through the nose, again counting each one as you go. Finally, take a breath in through the nose, hold it for 5 seconds, and release it slowly through the mouth to a count of 4. This sequence of breathing exercises should be performed two times for a total of 60 breaths. This will take approximately 5-7 minutes. 

For the final 1-2 minutes do not count or breath in any particular manner just allow the mind the space to think about anything it wants to. After a minute or two bring the focus back to the body, feel the feet on the floor, and arms on you lap. Open your eyes slowly, and sit for a minute to think about what you are grateful for before starting your day. It’s an excellent way to practice some gratitude. 

The more you practice this technique the easier it will be for you. As the days go on you will experience more control over both your body and your mind. 

Addressing Anxiety During Social Distancing

As we navigate through uncharted territory related to COVID-19, it seems like people finally understand the need for social distancing. (If this concept still needs clarification, please check out https://www.cdc.gov/coronavirus/2019-ncov/index.html for clear guidelines and current recommendations.) Responsible humans are engaging in social distancing when possible and hand hygiene is totally in right now. If you are feeling calm and well adjusted during this fretful time in world history, congratulations, you may stop reading now. If you wake up and feel like you might throw up or can’t shut your mind down or if your head hurts every time you think about your sister’s wedding in June or your children’s education, read on. 

You are not alone. (Even if you are physically alone. Sitting on your couch in joggers. We see you.) 

During conversations with friends and family, I heard some common physical complaints arise after people began to be affected by COVID-19. These include stomachaches, headaches, back pain, neck pain, and racing heart beat among a number of other possible symptoms. While you should discuss any new or concerning medical symptoms with your doctor, these symptoms may be related to anxiety. In psychiatry, we call problems that arise in your body as a result of problems in your mind “somatic symptoms.” They are extremely common in a variety of mental health disorders. Colloquially someone may say “I hold my stress in my neck” which is an example of an anxiety related somatic symptom. If somatic symptoms are plaguing you during this time of COVID-19, see below for some suggestions. All are available in the comfort of your home. 

You know, because you should be in your home. Once again, if it wasn’t apparent, please stay home.  

Everything on this list has been personally vetted by me, an extremely extroverted resident physician psychiatrist, struggling to socially distance and loaded with somatic complaints. 

1. Breathe. 

I know, you’ve heard it before, deep breathing is frequently met with eye rolls in my practice. I’m serious though – I promise you can do a better job breathing. It is the only vital sign you can control (that is serious power.) There are so many methods that you can use and you can use them any time of day, in any location. 

Try this: lay on your back on a comfortable flat surface. Put your hand on your belly and make your hand go up and down with each breath. Make your breaths long and slow. Count to 60 breaths; you will probably lose track while you count and your mind may wander. Bring it back to the last number you remember. This always helps.

2. Heart bench. 

I advocate for yoga whenever possible, but if you only have time for one move during the day to address anxiety, heart bench is the one for you. Frequently included in yin practices, heart bench is designed to open the chest in a gentle way. The heart and lungs are both located in the chest and we spend most of our time hunched over or curled up, our body’s natural response to stress. Unless you have backbends in your yoga practice, this move will counterbalance poor posture and anxiety related symptoms you may feel in your chest. 

Try this: If you have yoga blocks, set one on its tallest height and one below it on the second highest height in a T shape. To make this pose even more gentle, place a blanket or pillow over the blocks, taking care not to knock them over. Lay back gently, resting the base of your neck on the tallest block and relaxing your spine over the other yoga block. No blocks? No problem. Roll up a towel, yoga mat, or blanket and place a pillow at the top of the roll perpendicularly. Rest gently back on the towel. Keep your feet straight or cross your legs, whichever is more comfortable. If I didn’t mention it before, these techniques are good for your cooped-up children too! 

3. Move your body – Beginner’s Edition. 

If you have a fancy watch, follow the clear prompts to get up and move. No fancy watch? 

Try this: Look at the clock. If the first number is different than the last time you looked at the clock, get up and do something. 

4. Move your body – Advanced Edition

Speaking of moving, perhaps now is the time to begin that new workout plan you have been meaning to try.  If you are in a safe area where social distancing outside is possible, take walks. Or maybe this is the time to start a couch to 5k plan or to start training for that longer event. Can’t run or walk outside due to crowds? No worries, the online options are endless. The best workout routine is the one that you will actually do. Be honest with yourself.

Try this: Love to dance? Feel like a music video star and sweat your butt off with the Fitness Marshall https://www.youtube.com/user/TheFitnessMarshall. Interested in building muscle with no equipment and have $50 to spend? Try this dummy-proof six week workout regimen https://www.onnit.com/six-bodyweight/. They have some free videos on the website too with good step by step instructions for some of the bodyweight moves if you prefer a free resource. 

5. Practice Moderation

Use caution with alcohol and snacks. If you are someone who eats junk or boozes during periods of stress (or boredom!) you may be ramping up your intake without realizing it. I am not telling you to completely skip the IPA or Ben and Jerry’s, but self-awareness is key. Feel like the beer you bought last week went more quickly than usual? There is probably not a sneaky beer elf stealing your goods. 

Try this: Write down the alcohol you consume. This will keep you honest. If you aren’t happy with how things are adding up, you can create a plan to make better choices. 

6. Monitor Caffeine Intake

While I already suggested practicing moderation, many of us fail to practice moderation with caffeine unless particularly prompted; however, given its importance, caffeine warrants its own discussion. Caffeine contributes to anxiety, can raise your heart rate, and make you feel like you are vibrating. It may be tempting to drink cup after cup of delicious Columbian roast, but caffeine is one of the first things I address when patients bring up symptoms of anxiety. 

Try this: There is something seriously soothing about a hot beverage. When it can double as an herbal tea with calming properties, even better. Try sipping on some chamomile or tulsi tea (aka holy basil.) I like Organic India Tulsi Original and Traditional Medicinals Organic Chamomile. Throw in some local honey or agave syrup for a little sweetness.  

7. Connect with Friends and Family

Social distancing does not equal social isolation. In the past few days, I’ve spent quality internet and phone time with friends. We’ve had an opportunity to catch up due to this period of slowing down. COVID-19 has taught us to be creative and tech savvy regarding engaging with our friends and family. 

Try this: Houseparty, Hangouts, WhatsApp and good old FaceTime. Give them a try, might be more fun than you think. 

8. Limit Your Consumption of COVID-19 Media

Finally, limit your time reading about coronavirus. Knowledge is power – unless it isn’t. Stick to evidence based sites and avoid Brad from high school spewing conspiracy theories on Facebook. 

Try this: Set a timer on your phone for what you feel is a reasonable amount of time to educate yourself (I suggest 15 minutes). When the timer goes off, put the phone down and go back to step 1!  

Hope you found these suggestions helpful. Stay home, have fun, be calm. And keep checking out Shrinks in Sneakers! 

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