Anxiety Help: Learning To Trust Your Body Again (Ep 304)

Comparing Chronic Pain/Injury and Illness to Chronic and Disordered Anxiety

For someone dealing with chronic illness, chronic pain, or a slow to heal injury, functional impairments resulting from physiological and medical issues can result in significant lifestyle changes and restrictions. In this difficult situation the physical self is impaired in some significant way, leaving one in a state where trust in the body is eroded and accomodations have to be made.

For someone struggling with chronic or disordered anxiety where the primary concern is the physical symptoms of anxiety … the same thing can and often does happen. The person starts to treat themselves as broken, fragile, or physically incapable. An anxious person might actually treat themselves as of they are always in some kind of medical danger.

This leads to restricting activities.

• I can’t bend over to tie my shoe because I might get lightheaded.
• I can’t walk too far or my heart might start beating fast.
• I can’t play with the kids or I might feel out of breath.
• I can’t drive because I might feel that visual off-balance “on a boat” thing.

This really starts to look exactly like the problem faced by a non-anxious person that’s dealing with an illness, an injury or a chronic medical condition of some kind.

So what’s the difference?  The sick or injured person is actually impaired. The anxious person sees normal bodily functions as indicative of impairment or possible impairment.

Fearing And Not Trusting Your Body

In the end the person struggling with chronic or disordered anxiety begins to not only fear their own body – which is a hallmark of many anxiety disorder presentations – but loses trust and faith in their body. This is HIGHLY impactful because we do live in a physical world where use of our bodies is what moves us through time and space. We use our bodies for EVERYTHING. If you’ve reached the point where you are too afraid of your body or feel that you can’t trust your body any longer, life gets very difficult which just adds to the emotional/psychological burden of the disordered state.

Common statements:

• I feel like I can’t trust my body any more.
• I used to be an athlete. Now I don’t know who I am any more.
• I used to enjoy hiking and outdoor activities and I’ve lost that huge part of my life.
• It feels like my body has failed or betrayed me.

These are always hard to hear. Heartbreaking in many ways. The anxious person that has lost trust in their own body feels even more lost and often hopeless than ever and may see no way out of this predicament.

When Depression Enters The Picture …

As a side note, when we frame it through this lens, you can see why people overuse the phrase “anxiety and depression are two sides of the same coin”. This is why people will often make blanket statements about how depression and anxiety always come together. But in this context, can you see how the depressed state can be a direct result of the anxious state?

Someone in a depressed state after the loss of a loved one would not be seen as psychologically flawed or damaged in some way, yet an anxious person that feels depressed because they feel forced to live a very limited life will often see themselves in exactly this way as of they have two mental illnesses.

In my experience – which may or may not apply in your actual life – anxious people are primarily feeling depressed because they are anxious and restricted as a result. Very different situation, eh?

HOW Do I Learn To Trust My Body Again?

Well, when following principles of recovery that align with current acceptance and mindfulness based forms of cognitive and behavioral therapy, we have a few paths. Spoiler alert: none of these creates “body trust” just through thinking. Experience – doing things you are sure you should not do – is always part of the puzzle.

Using Exposures

If you’ve been around here long enough you know that I talk all the time about exposure. Exposure is what we call it when someone intentionally and willfully chooses to face the thing they fear – without resorting to avoidance or control based coping strategies – to learn that they are capable of handling that fear. For an anxious person in our context, the exposure is the anxiety itself.

In the context of this episode, we care most about the physical symptoms of anxiety and fear. When doing exposures – choosing to be triggered – the physical sensations you see as dangerous or signs that your body is failing are part of what you work through to learn that the sensations are natural responses to the threat response, not indications of medical emergency or physiological malfunction.

Interoceptive Exposure

We can get really specific here and use interoceptive exposures which are mini exposures specifically targeting the physical sensations of anxiety and fear. Your therapist might invite you to do some light exercise in session to intentionally raise your heart rate to make you uncomfortable. You might breathe through a straw to get that air hunger feeling. You might spin around in an office chair to intentionally feel dizzy. Interoceptive exposures are clearly scary and require some courage and a leap of informed-faith, but they can be VERY effective in learning that your body is not broken or betraying you. It’s working just fine, even though the way it’s working is scaring you.

What About Exercise?

A second way to re-build body trust might be through exercise. I’m not talking about going from the sofa to a marathon in two weeks or going from zero exercise to daily CrossFit sessions or running Spartan races. You don’t have to become a bodybuilder or powerlifter. But exercise is a thing that we all hear is “good for anxiety” for a reason. Forget theories about burning off adrenaline and cortisol, let’s just look at the psychological impacts.

Exercise that you enjoy – whatever that is – is doing something good for you just because you want to and it benefits you. That alone is huge for an anxious person that might otherwise sit idle scanning, worrying and actively ruminating. 

• Exercise is a stress management tool.
• Exercise does have physical benefits and there is literally never a time to NOT be healthy, right?
• Exercise can even have social benefits if you’re using group activities to give you a reason to move your body.

In our context today, we have to acknowledge that exercise is often triggering before it’s beneficial – which is exactly why we are including it today. Engaging in exercise is like doing interoceptive exposures with your therapist – but you get to pick what you do because you just want to do it and it is broader in scope than just limited body-focused exposures.

A walk around your neighborhood for 5 minutes counts, as does just walking around your garden or choosing to take out the trash yourself rather than asking one of your kids to do it. We can experiment with purposeful exercise – use of our bodies – to learn that we don’t have to treat our own hearts, muscles, joints, lungs, eyes, or bones as threats.

More Gentle Approaches: Yoga, or Tai-Chi

A third way to approach this would be the use of things like yoga, or even a gentle form of martial arts like Tai-Chi.  I claim zero expertise in either as I am a real beginner when it comes to yoga, but there is a reason it is included as part mindfulness based stress reduction (MBSR).  Intentionally making time to gently stretch, balance, and use your muscles in a non-judgmental, non-striving way is – for my money – an excellent way to start to rebuild trust and faith in your physical being.

I’m talking about yoga. I guess I’m now officially holistic. Look at me!

But seriously, if breathing through a straw in your therapist’s office sounds terrifying and even a walk around the block sounds like too much, gentle yoga or Tai-Chi practice – within your medical limits – designed to re-explore your body and what it can do, is a darn good idea.

As we go down the road I’ll be talking more about this kind of thing and about MBSR as I start to integrate it more fully into my practice personally and professionally, but you do not have to squat 600 pounds, run a 6 minute mile, or hike half the Appalachian Trail to regain trust in your body. Starting with basic movements for a few minutes a day also counts.

Common Links

They are going to feel scary or impossible at some level. This is what we expect. You fear and do not trust your body. This fear will insist that the sofa or bed is a much more responsible choice. We choose to DO anyway – to face this fear – so we can learn from the experiences.

They show you through experience that your body is still capable. Maybe not as capable as it was before because you’ve been sedentary for a while, but still capable. And once we start to see this capability again, you’re on the road to re-building some new version of old you from a physical standpoint. Maybe you can’t run like you did 5 years ago, but that doesn’t mean that walking your dog for 5 minutes has to be avoided at all costs.

They are all ways to open yourself up to different options. Fear of your own body  – not trusting your body – is going to lead you into places where you get rigid and limited. Part of what we work in when we use ACT in therapy is opening up to other options. What would happen if you at least consider that sitting at your kitchen table all day is not the only way? Can you open yourself up to other options that might offer valuable lessons?

When we engage in re-establishing body trust, we are not only literally building physical flexibility, but we are helping to improve our psychological flexibility, which is a core part of recovery, at least in my view of the world.

And finally, especially if much of your identify or self-image was connected to your physicality, engaging in exposures, interoceptive exposures, purposeful exercise, or gentle Yoga are all ways to re-connect to things that you value, things that matter to you. If we are working on ways to move from fear based living to values-based living as part of how we define recovery, choosing to rebuild trust in your body is likely an essential element in that plan.

Links Of Interest

• My Panic Attacks Explained Workshop
• My Agoraphobia Explained Workshop
• My Panic and Agoraphobia Recovery Guidebook
• Follow me on Instagram
• My YouTube Channel
• Disordered – With Josh Fletcher

 

Disclaimer: The Anxious Truth is not therapy or a replacement for therapy. Listening to The Anxious Truth does not create a therapeutic relationship between you and the host or guests of the podcast. Information here is provided for psychoeducational purposes. As always, when you have questions about your own well-being, please consult your mental health and/or medical care providers. If you are having a mental health crisis, always reach out immediately for in-person help.