Understanding Anxiety

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Before I was a parent, I didn’t understand what anxiety was. Conceptually, yes, of course, I could understand worry, and nervousness, and feeling anxious from time to time about something unknown in the future. But looking back, when a patient told me that they had anxiety, I really didn’t have a point of reference for what they were feeling, I couldn’t fully empathize.

After becoming a parent, anxiety became increasingly my constant companion. It took me a couple of years to actually identify what was going on, as it was not nearly as cut and dry as being worried about taking a difficult test, or giving a speech, or even concern regarding the future of our country or our planet. All of these I could handle, they were temporary and mostly manageable.

What is it about having children that has made me come to question my mental health? It has almost nothing to do with them, actually. Instead, it has everything to do with what they have reflected for me to see within myself. Children are a marvelous and unflinchingly honest mirror that forces us to look at ourselves, and it is my belief and experience that taking an honest look at oneself can be the source of great anxiety.

To better understand how this can be so, we can first look at anxiety from the perspective of Chinese medicine, which takes the sting and the shame and the emotional burden out of the word, and returns it to its place as a symptom of something going on internally. Anxiety is not a disease, it is a symptom of imbalance. In Chinese medicine, usually it is related to an imbalance in the heart system, which may or may not include an imbalance in the actual organ of the heart. What this means is that when something is causing the heart to be out of balance, anxiety can be the result.

What causes the heart to be out of balance? Before we can answer that question we need to understand that from this perspective, the heart is the ruler or emperor of the body, endowed by nature and divinity with a role that is fitting of its royal blood. The physical heart is the sanctuary or home of the spirit, the divinely ordained ruler, that part of us that is unique, wise beyond years and eternal. In western medicine, we think of the brain as the seat of intelligence, but in Chinese medicine, the brain is really just a tool of the greater intelligence found in the heart.

Much like any good ruler, the heart is strong and courageous by nature, and involved in nearly every level of activity within its domain. However, because there is a great deal of activity in its domain, it also has trusted advisors and protectors, the other internal organs, who are charged with taking care of those things that need not trouble the heart on a daily basis. One organ in particular is important to our discussion, and scarcely mentioned in western medicine, especially when discussing anxiety. This organ is the pericardium, the wrapper around the heart, which serves a protective function, among others.

If we imagine the heart as the royal sovereign in its sanctuary or throne room, then the pericardium is like the royal advisor or guardian that protects the entrance to the heart chamber, only allowing the purest of words, emotions, and influences to enter in to meet with the ruler.  Ideally, the pericardium is a perfect reflection of the heart’s will and an emissary of the heart’s intentions.  The balanced pericardium is a trusted advisor, but defers authority to the heart at every possible opportunity.

All too often, however, this guardian becomes overzealous, and takes matters into its own hands.  This occurs most often when the heart has been traumatized by a life event, a “heartbreak,” a betrayal, or a loss of love.  In order to protect the heart from further damage, the pericardium becomes over protective, keeping everything out, and not letting the heart do its job.  Information intended for the heart does not reach the heart, because the pericardium filters it and decides the heart should not be bothered, or fears that the heart will be hurt and so keeps the gates locked up tight.  Similarly, the voice of the heart gets locked in, unable to get out as the pericardium keeps the gates to the throne chamber sealed to protect the sovereign from further trauma.  Instead, the voice of the pericardium is allowed to speak, and is what we hear when we listen internally.  It sounds something like this:  Don’t trust them, you don’t want that bad thing to happen again, what if they betray us, too?  What if…worst case scenario…what if…

This brings us back to the experience of being a parent, and the tendency towards the infamous helicopter-parent syndrome. I think almost every parent can empathize with the strong impulse to protect the vulnerable, innocent, pure, sacred gift that is your child. And yet, we can become overly protective, especially if we have been threatened or traumatized in the past, and end up preventing the child from learning, speaking for himself, exploring, experiencing, following her heart…

All of us have experienced traumas in our lives, and it is no mistake that we are built with a protective mechanism around our precious hearts.  But when this protector takes control and we begin to be ruled by the agenda of the pericardium, our entire manner of being changes.  Instead of operating from trust, faith, intuition, perception, empathy, joy, connection, we begin to operate from fear, distrust, trauma, “reason,” misperception, and disconnection.

Having children brings us face to face with the subtle and not so subtle differences between loving from the pericardium, and loving from the heart. This happens also in romantic relationships, where we are forced to see ourselves in the mirror of another in a variety of situations, and forced to face our seemingly unreasonable fears, anxieties, and worries. Where are they coming from? Is the heart truly afraid to love, to live, to experience?

There is a part of the heart which is indestructible, immortal, infinite, and unbreakable. And yet there is also a part, which we might relate more to the pericardium, that can be scarred, wounded, corrupted, damaged. The challenge is to know the difference, and to begin to reclaim the pure and immaculate territory of the heart, the emperor/empress within you from the fearful clutches of a battle worn guardian pericardium.

All to often in relationships, we meet each other with the pericardium, instead of the heart. I meet a new friend from the filter of “I just lost a dear friend in an accident and I can’t bear to let anyone else into my heart” or “My friend just betrayed me and I don’t think I can ever trust again.” Meanwhile the other person is meeting us through the filter of their own pericardial story, and the result is that our hearts may never truly meet. Whole relationships can play out without ever really getting to know the heart of the other, and all to often we repeat and reinforce the projections and fears of our past, which are stored in that same pericardium.

This is a long winded explanation with the goal of bringing to light this fundamental understanding of where anxiety comes from. Frequently when I treat patients with anxiety, it takes several meetings and acupuncture treatments, along with herbs or supplements to calm the symptoms before we can ever really begin to identify the true cause. And there are real physiological causes that will exacerbate this tendency within each of us, including hormone imbalances, hidden infections, adrenal fatigue, liver detox issues, and others. All of these require the guidance and support of a trained functional medicine practitioner, but none of them will solve the problem if we don’t simultaneously treat the emotional/spiritual aspect of this pattern.

Here are the first steps in beginning to work with anxiety, to recognize its origin, and to reclaim the domain and sovereignty of the heart:

1. The first step in treating anxiety is to recognize that it is coming from the pericardium. This means that it is most likely related to a past event, trauma, threat, or incident that caused you to go into survival mode, fight or flight, and likely caused some “heartbreak.”

2. The next step is to recognize that although that incident is/was real, that right now, you are no longer in that moment. Another way of doing this is simply to ask yourself, Where am I right now? What am I doing? I am here, in my car, or at my desk, or in my kitchen, washing dishes, sending an email…and remind yourself that you are safe. See if you can recognize where your mind was/is that is creating anxiety. Are you imagining a worst case scenario? OR remembering a past event? If indeed you are still in danger in the present moment, this is a different kind of anxiety, and the solution is to begin to make a plan to get yourself to safety and get the support you need.

3. Begin to identify the events and triggers that provoke anxiety, and write them down. The goal is not to create a list of things to avoid, but rather, to identify the things that send your mind spinning so that you can catch yourself before that happens.

4. Get acupuncture, regularly. I have seen acupuncture work miracles. Perhaps it is because we can treat the pericardium, or because acupuncture does not separate body and spirit, or because even if we are treating a physical symptom, the corresponding emotion is also brought into balance. Whatever the reason, it works.

5. Consult with a functional medicine practitioner to identify other possible causes that may be exacerbating this symptom. Testing for adrenal fatigue, digestive infections and parasites, hormone imbalances, or detox markers may shed light on why anxiety has become more problematic recently.

6. Set the intention to let the heart rule. Identify the moments when your pericardium, ie your fears, anxieties, worries, want to take over. Recognize the times when you want to helicopter parent yourself, or your children, and check to see if it is really necessary, or if you can relax and allow yourself to be present, to observe, to enjoy, to experience. Check to see what the heart is saying, which may be much softer than what the anxious pericardium is screaming. Is there really a fire, or is it a false alarm?

7. Meditate. This is an extension of numbers 1-6, and perhaps should have been number 1, but I realize that the idea of meditating when you are anxious is almost infuriating. Still, this has been proven again and again to improve our ability to remain calm and balanced under stress. Spend a few minutes each day, a few times a day if possible, breathing deeply, retraining yourself to relax, reminding yourself you are safe, offering yourself love and compassion. You deserve it. And it will make a difference. Remember, you are not your anxiety…you are the heart, the emperor/empress, the divine light within you.

8. Be patient. Again, I know this is maddening advice, but remember that anxiety is a sign from your body that something is going on. It is a cry for help, a red flag, and an alarm. Imagine a child that has been bitten by a dog. The next time he sees a dog, he gets scared. But this is a nice dog, you might say…still, tears. But, with patience and persistence, and a little encouragement, the child will come to try again. Acknowledging the fear, the anger, the emotion, and delivering the antidote, patience, compassion, empathy, love, will win every time.

9. If you are currently on medication for anxiety, or if you are considering trying it because your symptoms are too much for you to handle, it’s ok. Everyone is unique, and with all the stresses in our lives, sometimes it’s too much to take on your emotional history all at once. But remember that the medication will not solve the problem long term. Follow the same steps, 1-8, continue to get acupuncture and work with a functional medicine practitioner, and when you are ready, you can work with your doctor to gradually wean back off the medication. Be gentle to yourself, be kind, just as you would to a young, scared child. It’s ok. You are ok. Use the medication to give yourself a break, make sure you are safe and settled as much as possible, and continue working on the first 8 steps.

For me, working on this has been an ongoing process, but one that has been hugely rewarding. For many of my patients, understanding anxiety and working to overcome it has changed their lives: from sleepless nights to deep contented rest; from trying to live in a bubble to traveling the world; from social phobia to public speaking. These are just a few examples of what’s possible.

I strongly encourage you to reach out for support if this article has struck a chord. Don’t hesitate to call or email and request a complimentary 15 minute consultation. Your heart will thank you.


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