mental health social-justice stress-v-stressor

Anxiety and how I define it

Image from Flickr by JoanDragonfly; “Stress and Anxiety – A person is feeling anxious and stressed out.”

In light of current events (aaaaaaaaaaaaaaaaaah!), I thought I would share some thoughts about how I approach anxiety as a clinician and an acupuncturist.

When I am trying to diagnose or confirm a diagnosis of “anxiety” I want to first know how it shows up in people in their emotions and body and behaviors and interpersonal relationships, what triggers it and maintains it and settles it, and how it affects their day to day or season to season life.

One core question, when I query my patients, is whether their reaction to their environment is “proportional” or not and, separate from that, is whether the reaction is overwhelming or interfering whether it’s proportional or not.

Even five years ago when I was just starting my practice, there were some moments of acknowledging that there were bad circumstances but the reaction was disproportional and interfering with life.  For example, taking unpaid leave from work to install safety hardware into your house in case of foreign invasion because a powerful politician was ramping up tensions with a foreign nuclear power; this has interfered in your work and your reputation, and turned out to be disproportionate as we never went to war with that nation.

But now, I want to validate that shit’s fucked. In the US and everywhere, climate change is here and weather events and environmental reactions like wildfires can and do kill people and render them homeless, and there are supply chain and infrastructure limitations to adequate cooling and ventilation filtration and evacuation locations. In the US, we are on the verge of a civil war because one “side” (what even is a “side” in a Civil War? this isn’t a softball game) really wants a war, and are just looking for an excuse to be violent to people, and is proving it by systematically taking away rights and effective citizenship and due process of more than half the population and downplaying the violence that has already happened. And the pandemic isn’t over and people are still becoming sick and dying. And global powers are starting wars with other nations for funsies and delusion and personal aggrandizement, and the response to the conflict is highlighting global practices of racism/colorism and overall dismissal of Global South or formerly colonized nations and focus on empathy for nations where the populace has light skin. And And And…

It’s real. Things are very tense.  But are they tense inside your house right now? (I mean, maybe, depending on if you have net nourishing or net abusive relationships.)

But the thing is, when the greater environment was just gently steaming and you weren’t sure if the heat was even on under the pot, on the micro/interpersonal level it was still valid to ask if “anxiety” was in fact proportional. Because even then, microaggressions and interpersonal abuse, and the chaos of coping mechanisms of self or others like drug use or spending addition or whatever can in fact threaten safety and security. Humans are social species and things that threaten your connection and belonging in community are in fact existential threats.

Is it “anxiety” if you really are perceiving a threat and trying to plan around it or respond to it?

a picture of a hand reaching over water and touching the surface with fingertips with a reflection of the hand indicating that the body of water is fairly large
Photo by Yoann Boyer on Unsplash

Well, yes.

It’s just that the remedy for that anxiety isn’t to sedate and suppress a nervous system that is seeing a threat where one isn’t; the remedy is to SETTLE the body back into a state of resourcefulness so that you can address the threat.

It is entirely possible to be overwhelmed by the scope of what is before you, either because of the build up of past danger where you weren’t sufficiently helped or sufficiently safe, or because you are under-resourced and isolated now, or you’re not sure whether your resources should go to saving yourself or your community and so your actions are scattered and under-powered.  Anxiety or stress-arousal can cause tunnel vision and hyper-focus where you can’t think outside a few possible options for next steps, so you may shoot down offers of help or creative solutions or even potential re-prioritization, but being settled can help you accept help and think outside the box. (It’s OK to eat food now, and then go to the protest.) Anxiety can make you feel shut down and paralyzed, unable to initiate the things that might reduce the stress or create more safety, and feeling settled can facilitate those steps or even asking for help to get you going. (See again eating. Also sleep, bathing or cleaning your home, making phone calls, etc. etc.)

Anxiety in the body can also shift everything else into the same emotional valence of “threat” and so might trigger misinterpreting a coworker, friend or loved one’s bid for connection as criticism or hostility, or might cause you to treat a “Might Be” or “Close One” as a “About To Happen” or “Did Just Happen” (I remember when I was feeling very anxious and had to ride my bike, and a car to my right didn’t slow clearly enough, I literally screamed out loud because of the possibility of being hit, even though we were both actually safe and navigating space well…. and then the anxiety didn’t let me stop and communicate with the driver so that we were both able to settle down and go on our ways but instead drove me to keep riding like an automaton until I got to my destination).

In an ideal physical state, we can phase back and forth between proportionate arousal to face a threat, and back into community and calm when the threat is managed if not gone.  But that takes practice and reps and guidance and co-regulating with others.

I recommend the book The Quaking of America, where Resmaa Menakem is setting up exercises for this very purpose. But even discussing how this is important with your close circle of people is important.  Setting up that it might happen (your anxiety might misinterpret everything as equally threatening as the dissolution of our legal status, including some dirty dishes on the counter) so we have patience with each other and language to talk through the emotions at hand, and have a structure to make amends and re-connect.

And, coming to an acupuncture visit is a way to practice that phasing.  Because I will take seriously –I will hear and appreciate– the proportionate and disproportionate anxiety in response to the real world, but we can also confirm that my acupuncture space is safe and secure for a set time, and that if that changes, we will work together to navigate that situation.  Acupuncture is an embodied conversation between your mind-body-soul and me and my tools (acupuncture needles, essential oils, moxa, acupressure or massage), and your body can access some calm repose while being guarded, allowing your cells to heal and hormone and neurotransmitter levels to normalize or metabolize and memories to sort themselves out. It is a “rep” that helps your body practice that shift in arousal.  Acupuncture, unlike medications, is not truly sedating, and so if you need to go straight from the appointment into a protest march or a letter-writing campaign or back to your own healing profession shift, you will have that brain and body capability, but you will have had one layer of stress reactivity notched down, and a few more degrees of spaciousness and resourcefulness. (And if you’re not accessing that, it is diagnostic data that we can respond to.)

Additionally, because acupuncture is not just a handful of tools and a cookbook, but is an entire 2500-year-vetted way of conceptualizing your needs and patterns and how to leverage your strengths, you can build trust that my treatment for you will always shift in response to who you are and what you are going through and what is out in the world; the treatment I provide will be as responsive and as proportional as I can make it in the time/space allowed, and so that too is a “rep” in practicing phasing from state to state: the body-mind-soul learning that you can ask for help and receive a response, and then have a felt-memory of that experience, that’s a valuable thing.

Take care of yourself, and build that phasing resilience and response. If you’d like to get acupuncture from me, call text or email Amenda Clinic to make an appointment (see main page of this website)