Dharma Lab · Transcript

Working With Anxiety: Four Strategies

A conversation between Cortland Dahl and Richard Davidson on the neuroscience of anxiety and the four dimensions of flourishing.

Opening the Conversation

Cort: Welcome everyone to another episode of Dharma Lab. I’m Cortland Dahl, here with Dr. Richard Davidson — most of you know him as Richie. Today we thought we’d tackle the topic of anxiety, but from a very specific angle.

Many of you who have been following us know that we have a new book coming out this March on the science of flourishing. We talk specifically about four core dimensions of flourishing and the fact that these are really skills — practices — that can help us navigate all the many things we face in life.

In my own life, I have struggled with anxiety, particularly early on — as a teenager and in my early twenties when I was in college. It turned out to be a real blessing in disguise, because it’s what prompted me to start looking at myself, at my life, to look for tools I could use to work with a lot of the anxiety and stress I was facing. It became a catalyst for my whole life journey.

To the point that I think of the experiences I have now — for example, public speaking sometimes in front of thousands of people. I would never have believed back when I was nineteen or twenty that I would be doing that, and not only doing it, but doing it without getting totally overwhelmed by anxiety.

So we are living in the so-called age of anxiety. We wanted to talk about these core dimensions of well-being and how powerful they can be in helping us deal with it. As always, we’ll talk about the science, we’ll talk about some practices, and especially very practical things that we do in our lives and that you can do in yours.

Richie, I’ll kick it over to you. You’ve been studying anxiety as a scientist for much of your career — you’re one of the world’s experts on the neuroscience of emotion, including challenging emotions like anxiety. What do we even need to know about anxiety besides the obvious stuff of how horrible it is to be stuck in loops of it?

Why We’re Built For It

Richie: There are a number of things to say about anxiety. The first is that it’s probably the most prevalent symptom that we all experience. Everyone experiences anxiety at times, and it’s kind of like a normal distribution. We might label a person as having an anxiety disorder if they’re on an extreme end of the continuum, but if we’re all honest with ourselves, almost all of us have some degree of anxiety at least some of the time.

The first thing, then, is simply that it’s a common symptom we experience. And there’s a reason humans are equipped to experience anxiety. There are evolutionary advantages for being anxious, particularly around things that are truly threats to our survival. In our evolutionary past, those threats were physical. Today our minds and brains have co-opted that same machinery and use it for threats we invent in our own mind — threats that we anticipate might occur in the future.

So anxiety is very much a future-oriented issue. It tends to be associated with events that have not yet occurred, that we often anticipate or imagine. And one of the things that is often the case is that what we imagine is a lot worse than what actually ends up occurring. That’s one of the many modes of feedback we get about this.

This relates to another issue we’ve talked about in Dharma Lab previously: the brain is a prediction machine. We make predictions about the future, and when we’re anxious, we’re making predictions about some future event that is uncertain and potentially problematic or threatening.

Cort: Is it safe to say that anxiety is, in a way, the expression of our brain and nervous system trying to keep us safe — but just doing it ineffectively at times? Sometimes effectively, but sometimes ineffectively. That’s part of what’s going on with anxiety.

Richie: Yeah, I definitely think so. And this is a super helpful insight, because if we can use the experience of anxiety as a reminder that it’s actually part of what we’ve talked about previously in Dharma Lab — our innate base of goodness, the fact that we’re built to care for ourselves and to flourish — that’s freeing. Anxiety is about ultimately being safe and secure. The fact that we experience anxiety means we actually care about ourselves, and often it’s about others we care about. That’s an extremely helpful insight to loosen the grip anxiety might have.

Cort: When I think back to when I really struggled with anxiety, it felt like such a personal defect. I would get really down on myself — why am I doing this, why do I get stuck, especially in rumination? But it does show that there’s something quite wholesome and, in a way, kind of amazing about anxiety — the brain trying to anticipate bad things that could happen so we’re prepared.

We’re just oftentimes in circumstances for which our biology is not particularly well-adapted. Millennia and millennia of evolution for being out in the wild — but how many generations have we had for being in an office building? We’re interpreting things as best we can, and our system hasn’t really caught up. The question isn’t whether anxiety is good or bad. It’s how we calibrate the system.

Richie: Exactly. And you might even say that it’s more worrisome not to have anxiety. There is a condition of which that’s a prominent feature — we call it psychopathy. It’s associated with antisocial behavior and with really not having a conscience. People don’t experience queasiness in the face of suffering, for example, and that’s problematic.

Cort: I’ve come to think about this almost like we have a beefy bodyguard who’s ready to jump into action whenever we need it. But you don’t need the bodyguard when you’re going to sleep at night. You could say, “All right, Chuck, you can go to sleep too.” But our nervous system — the bodyguard is still there trying to do its job. It’s great that we have a bodyguard. You want Chuck there and you want Chuck to be strong. But you don’t want Chuck when you’re trying to take a nap. How do you get that working appropriately? That’s the question — and the beauty is, our research shows we can train ourselves.

Richie: Exactly. It’s a specific example of a more general competence: regulating our emotions, having flexibility in our emotional responses, and not perseverating in responses when they’re no longer serving a useful function.

Cort: One thing you and I often talk about is getting away even from the scientific categorization of positive and negative emotions — which is still very prevalent — and thinking of it more as contextually appropriate emotional responses. Every emotion really has an appropriate context in which it’s a healthy adaptive response. It’s simply when it perseverates, as you say, and gets stuck in the system. You’re lying in bed, or it was something that came up in a meeting and now you’re at home with your family. It’s no longer the context for that.

So maybe we could dive into the strategies. In Born to Flourish, the book coming out, and in the Healthy Minds app, and in our scientific work, the guiding framework focuses on these four key dimensions of flourishing: awareness, connection, insight, and purpose. We talk a lot about how these are skills we can practice, specifically in challenging moments like when we’re worked up, overwhelmed, and anxious. Maybe we could go down the list and view these as strategies. What would it look like for awareness to be a strategy in the moment when we’re feeling anxious?

Strategy One — Awareness

Richie: Let me respond with a blend of both science and practice. The scientific work clearly shows that simple awareness practices — mindfulness practices — can be helpful in modulating anxiety. What that might look like is becoming aware of the actual responses that anxiety is comprised of. The word “anxiety” refers to a whole array of experience.

Cort: Yeah, it’s a rich array of inner experience that we condense into a single word.

Richie: A rich array of inner experience, and also a rich array of accompanying bodily responses. There’s a lot going on. One strategy is simply to become aware of what’s actually happening when we say we’re anxious. Rather than getting fixated on the idea of anxiety, if we can become aware of what is actually happening in our mind and body, one of the first things we notice is that it’s changing all the time. It’s not just one thing. It’s more porous. It’s not so solid. Simply becoming aware of that is really helpful.

We can also take a few deep breaths and simply be aware of our breathing. A related strategy is to use awareness of something that’s not associated with the anxious response — if we’re breathing deeply or slowly, we can become aware of that. Or we can become aware of something very different, for example sound. Something that has nothing to do with our anxiety, and just rest our awareness on it. That’s something we know from scientific research can be very beneficial.

Cort: It’s really interesting — the examples you just gave are exactly what I did as a nineteen-year-old kid going to university when I was really struggling with anxiety. I had read a book called Wherever You Go, There You Are by Jon Kabat-Zinn, who both of us know well. That book was one of the early influences for me. A lot of it was: feel what you’re feeling, rather than fighting it or trying to push it away. Just open up to what’s going on.

I would do that all the time, especially when I was delivering pizzas, which was my side hustle in college. If I started getting anxious, I would just bring awareness into my body and literally feel — oh, what does anxiety actually feel like? Not to stop it or change it, but to understand it. To see it clearly.

What I noticed — and it maybe wasn’t so clear at the time, but looking back — is that when you intentionally bring awareness to an experience and the motivation is not to change it, you’re short-circuiting resistance. A lot of the suffering comes from the resistance, not from the experience itself. The actual feelings in my body were a little unpleasant, but not horrible. It was this emotional atmosphere of I hate this. A lot of the suffering is in that atmosphere. If you’re just going to feel it, just observe it, that atmosphere goes away.

Cort: And oddly enough, the other thing I did all the time was awareness of sound — something I learned spontaneously. Rather than always going to the difficult thing, sometimes go to the stuff you love. Nobody told me that. I wish somebody had.

My roommates would go out at night. I would put on my headphones and sit on the couch, sometimes for hours, completely immersed in music — but really listening, mindful, aware listening. It was meditation, but with something I loved and something nourishing. I remember going for walks with my headphones on. It was one of the first times I really experienced joy. When you take music or anything you really love and give it your full attention, it’s awe, it’s joy. It fills your tank up.

Cort: I’d love your neuroscientific take on this. I have many memories of catching myself — all of a sudden my mind is churning out thoughts, a negative expectation about something. Oh, this is going to go wrong. What if this happens? There’s that anxious feeling. At first I’m caught up in it, and then there’s a moment of waking up to it — oh, I’m anxious — and suddenly there’s a spark of what we’d call meta-awareness. What’s coming online in that shift?

Richie: It’s a great question. When we get lost in our thoughts, the default mode network of the brain is clearly active. It’s active when we’re not engaged in any other kind of demanding task, and it’s often associated with mind-wandering and self-referential thought — thinking about ourselves.

Cort: Everyone’s favorite topic.

Richie: Everyone’s favorite topic. So in the moments when there’s more space, it could be that the central executive network — the area important in intentional activity — is modulating, perhaps inhibiting, activity in the default mode, giving us a little more space.

In addition, one of the instructions of our teacher Mingyur Rinpoche regarding this kind of simple awareness practice, particularly with anxious thoughts and feelings, is not only to just be with them, but to actually make friends with them. That kind of, “Wow, I’m anxious again.” Just accepting it with friendliness may even turn on positive-affect circuits in the brain, which helps transform the aversive qualities or the heaviness of anxiety.

Cort: So to boil this down, the first strategy — awareness — has two variations. One: when you notice yourself getting anxious, bring awareness into your body and get curious — a warm, friendly attitude of oh, where do I feel that? What does it actually feel like? You can use that as a support for your meditation, the same way you might use your breath. The other: use an experience like sound, or something you love, as a support. Both are helpful. The first strategy is build the muscle memory of awareness.

Strategy Two — Connection

Richie: There’s a lot of opportunity with regard to connection and how it might be applied to anxiety. Let’s say you’re anxious about an upcoming meeting. It might be a meeting with your boss, or with a colleague, that’s fraught with some challenge. One way to use connection is to reflect on some positive qualities of the person. There may be aspects that make you anxious, but there might be other aspects of their behavior that you appreciate — simply tuning into that appreciation, and allowing that kind of connection to emerge, can be enormously helpful in modulating anxiety.

Cort: Appreciation is such a simple skill. It’s amazing how simply noticing something positive about yourself or another person completely changes the inner configuration.

Another one I’ve found really helpful, especially in moments of stress or anxiety, is a very traditional practice where you think to yourself the phrase just like me. Seeing how everybody struggles with similar things. Who hasn’t felt nervous having to give a presentation? Who hasn’t been anxious before an intense meeting, or a first date?

When we get nervous and anxious about things, we tend to feel alone — like I’m uniquely suffering, uniquely struggling. But this is just part of the human experience. I’m not alone. Even people who seem to have it all together — we’ve both heard so many stories of people you would have thought were sailing through life with no issues, but once you get to know them, you find they’ve had incredible struggles. Repeating in one’s mind just like me, this person wants to be happy just like I do, they don’t want to suffer just like I do, they’re struggling too creates a sense of common humanity. Early on, for me it was a lot of social anxiety. It felt like I was alone and everybody else had it all together — a weird fantasy that wasn’t true. That phrase dissolved it on the spot.

Richie: A related strategy, if the opportunity affords, is to simply do something for another person. Be kind, be helpful. It’s amazing what a simple act like that can do — it can really change the whole tenor of an experience. I’ve seen this a lot with travel, where people are anxious about making their connection in an airport. The opportunity to help another person can arise spontaneously. A simple, everyday act of being helpful with something can change the color, the flavor, of the situation.

Cort: You thinking of the airport reminded me — those moments when flights are delayed and everybody’s upset, and these poor employees, it’s not their fault the weather created havoc, but everybody’s irate and they’re bearing the brunt.

I was next in line. The person in front of me had just been tearing into the attendant. I came up and said, “You’re doing a great job. Thank you so much for being willing to sit here and listen to all of us complain. I can’t imagine how stressful this must be, and I just wanted to thank you for being willing to do this.” I could just see her shoulders drop. It took me five seconds. It took nothing. Somebody saying something nice — it was such a little thing, but like you’re saying, it’s a little gift you can give somebody. Even if you’re not with people, fire off a text: Hey, I just want to let you know I was thinking of you. I so appreciate your sense of humor — when I’m stressed out, you always make me laugh. They’ll feel great. It changes the whole dynamic.

Cort: Thinking of it as a skill is helpful. This is a practice, and like any practice, you try to repeat it as much as you can. It becomes another topic in our book — the idea of conscious habits. Treating appreciation and kindness as a skill, especially in moments where anxiety is creeping in, just shifts the inner dynamic.

Strategy Three — Insight

Richie: Insight is a particularly important one for anxiety. When we’re anxious, we have certain thoughts, beliefs, and expectations about ourselves and the world, and we often don’t recognize that we have them. Those beliefs and expectations are essential — they play a direct causal role in our anxiety. It’s because of a certain set of beliefs and expectations that we are anxious. We might be expecting some disaster to occur in the future, and that’s creating all this anxiety.

When we talk about insight, we’re talking about the direct experience of understanding, in an open and curious way, how our minds are working in these situations. How is it that a belief and an expectation is literally contouring how we perceive the world? Everybody has beliefs and expectations. It’s not that just anxious people have them — all of us do, and they’re literally defining the realities in which we live. Insight is about recognizing that. When we recognize that we have beliefs and expectations that are critical to how we’re perceiving the world, it loosens their grip. Even just recognizing we have them is itself a huge step in the right direction.

Cort: It’s paradoxical, but really it’s just seeing that there are beliefs and expectations happening. Usually we have beliefs and expectations and we don’t think of them as beliefs and expectations. We see the product of them. It’s like we’re seeing something through colored lenses and we just see the product.

Richie: Exactly. We’re so wrapped up in the product of those beliefs and expectations — so hijacked by them — that we fail to recognize they are the product of them. For most people, most of the time, these beliefs and expectations operate under the hood.

Cort: One of the simplest and most helpful tools I used — and still use — was noticing. Rather than the anxiety being just behind my conscious awareness and shaping everything, I started realizing, oh, these are just anxious thoughts. I am having an anxious thought right now. An anxious thought is occurring.

The moment I saw that more clearly, I started to see that the influence anxious thinking has on the mind is that it’s a magnet for negative information and almost a repelling force for positive information. When I’m thinking like this, my mind latches onto negative outcomes, negative scenarios, negative interpretations. There’s no space for anything positive. Again, I didn’t need to stop the whole thing from happening — by realizing this is just a thought, and it’s doing what anxious thoughts do, it totally uncoupled the thought process from my perception. I could see, oh, this isn’t necessarily reality. This is just what happens when the mind is filled with anxious thinking. It became almost interesting: look what happens when I think like this. A lot of learning happened in that space of observing how it works.

Richie: It’s also helpful in interacting with others. We recognize that they too have beliefs and expectations. If they’re seeing the world differently from us, it’s because they have another set — but they’re all just beliefs and expectations.

Cort: And that becomes interesting because you start saying, oh, they have their own inner paradigm running right now. They have a script. We’re all running a script. I have the anxious script; this other person has the short-fuse frustrated script, or whatever it might be. They’re all scripts, not always the same script — and we don’t realize they’re scripts. It’s almost like a program. As a strategy, noticing the beliefs, the expectations, and the thoughts that are happening on that basis — just seeing them clearly, getting curious about the influence they’re having — is hugely helpful.

Strategy Four — Purpose

Richie: Purpose is another skill that can totally change the coloring of an experience, dramatically. To give a concrete illustration: in research we’ve done with school teachers, using the Healthy Minds program, they’re learning awareness, connection, insight, and purpose. One thing we’ve found is that purpose in particular is enormously powerful. The teachers reported that they were especially impacted by the purpose dimension.

When we invited them to do simple, active practices seamlessly integrated into their everyday life — for example, reflecting on their purpose in becoming a teacher while commuting to work — it made a real difference. We’ve done this work during COVID and immediately post-COVID. Public school teachers in the United States are a very highly stressed group, and the symptoms of anxiety and depression are off the scale.

Richie: Reflecting on their purpose, they reported, was like an elixir for their soul. It flipped their mindset. They may still have been anxious — it’s not that it got rid of the anxiety — but it put the anxiety in its place. They were reminded of their purpose, of dedicating their lives to really helping children in a meaningful way. They may still have felt anxious, but it was no longer the central feature of their experience.

Cort: The one phrase we’ve heard probably more than any other is some variant of this reminded me of why I became a teacher in the first place. We forget that when life gets stressful and we’re burnt out. But when you have an abiding sense of purpose, you can get through those difficult things.

In terms of a skill, especially when I’m going into a situation I know will be hard, one thing I’ve found helpful is to come back to some value or deeper motivation. Something nourishing that at first is not linked to that experience — it might seem very distant from it. For both of us, altruism and being of service is a huge personal value and a North Star. I’ll think of the situation in light of that. I’ll say to myself: this is not fun, nobody would want to be experiencing this — but may this somehow be of benefit to others. Whatever comes of this, may it equip me to do some good in the world and to help others.

If I look at anxiety specifically: so many times when I give a public talk or lead a retreat, people come up to me afterward and say, I’ve struggled with anxiety, and it meant so much to me to hear that you struggled with it too. I see you sitting there and you don’t look nervous, and it was a shock to hear that you had a phobia of public speaking. It’s meaningful to people. Our struggles actually are sources of empathy and connection with others. They give us the fuel to be of benefit. The skill is simply to make the link — how can this be fuel for learning and growth? How can this be an opportunity to come back to integrity, or to kindness? It’s a simple thing, it doesn’t take long, but it totally shifts the mindset around the experience. Suddenly I’m not resisting or dreading. It’s a training ground.

Richie: Those are great examples. In terms of scientific research, one thing we’ve found is that people with a stronger sense of purpose recover much more quickly following a stressor. One of the issues with anxiety — and the reason it’s challenging — is that it tends to persist and infiltrate periods when it’s no longer useful. It perseverates. Having a strong sense of purpose is associated with a much more rapid recovery back down to baseline. We’ve now seen that across several different studies with different populations. It’s a scientific validation of the beneficial effect of cultivating purpose on physiological responses.

Cort: And what’s really cool about this is that it’s not just how you feel. Your physiology is changing. Your work is showing brain function changes. There’s other work on things like recovery after surgery — shocking to me when I first saw it — showing how quickly somebody recovers can be predicted in part by how strong a sense of purpose they have. Not a sense of purpose about the recovery — just their sense of purpose generally in life. That’s predictive of better surgical outcomes and of how your brain responds to stressful stimuli. It really gets under the skin.

Closing

Cort: So those are four strategies, and ideally we practice all four. You don’t need to learn them all at once, but they’re all tools in the toolbox, and they’re especially powerful if you practice them together. Awareness, connection, insight, and purpose — four different strategies we can employ. If you found this helpful or interesting, our new book Born to Flourish gets into a lot of detail about this. Richie, take us out.

Richie: Let me just leave with the thought that these strategies all work synergistically together. They support one another and can be practiced together in the same experience. When Cort and I were reflecting on how to introduce each of these four dimensions in Dharma Lab, rather than having one episode on awareness and another on connection and so forth, we thought it would be more helpful and practical to introduce them in the context of ordinary issues like anxiety that we all experience, and show how all four are relevant. We hope you can appreciate that flourishing really is multidimensional. When we have these skills at our fingertips, we can deploy them — we might use more of one in certain contexts and another in others, but we can also bring multiple skills to bear in any particular context. This gives us a rich set of skills to enhance our flourishing. We really hope it’s been practically useful as well as intellectually illuminating, and you can read more in Born to Flourish.

Cort: Thank you so much, Richie, and thank you everyone for tuning in for another episode of Dharma Lab. Hopefully you found something interesting and helpful, and we look forward to seeing you at another episode soon. Take care.