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I AWAKEN WITH AN ANXIETY ATTACK

Dear Doctor:

I awaken with an anxiety attack in the middle of every night. How can I overcome this?

Dear Bothered:

There are two root causes of insomnia. One is some awful event from the past, which the mind wants to fix up/do over/undo. Experiences of scorn, ridicule, and contempt are particularly unsettling, as are experiences of physical intrusion (assaults, etc.). The mind is not good at seeing the passage of time. This aspect of the mind - fixing up, doing over, or undoing - knows that we are defenseless when sleeping and takes advantage of us. All of a sudden, a vulnerable feeling appears in the mind, and the person is jolted awake.

One's defenses are aroused, including anger and aggression. Now is the time to settle down by saying to yourself, "Withdraw. Withdraw. Withdraw. (many times)," as if you were putting down your fists or, addressing the bad mood, "Who are you, and what is your purpose?" (many times, counting on the fingers).

The other root cause of insomnia is the same as the root cause of anxiety - aloneness. The person doesn't belong. When you don't belong, you are subject to all the ills of being an outsider - you are in danger, and you lack the comfort of a group.

If you wake up, it is time to take an objective stance - "You are feeling terror, you are feeling terror, you are feeling terror, . . ." or "You are feeling horror, you are feeling horror, you are feeling horror, . . ." or "You are feeling aloneness, you are feeling aloneness, you are feeling aloneness, . . ." Saying this is choosing good nature - it is making mental space outside of the awful feelings. Be receptive to moving away from the feeling that jolted you awake.

Assert a value. Say, "Self-compassion, self-compassion, self-compassion . . ." repeatedly or else another value (self-love, self-kindness, self-forgiveness, self-mercy).

Next comes relaxing the body. Go through the touching exercise in your mind.

To go back to sleep, one can say repeatedly in the mind, "I look for pleasant dream images (or a color). I sleep. I dream."

My personal story: I still wake up in the middle of every night, sometimes with an anxiety attack, sometimes without. If I awaken with an anxiety attack, I make the assumption that it is either the old feeling of being suffocated or else the feeling of aloneness. I say to myself repeatedly, "You are feeling suffocated. You are feeling suffocated. You are feeling suffocated . . ." or "You are feeling alone. You are feeling alone. You are feeling alone . . ." or, addressing the bad mood, "Who are you, and what is your purpose?" (repeated many times, counting on the fingers). Sometimes, ten or fifteen minutes are required to calm my mind.

Suffocation is never far from my mind. A stuffy nose will leave me anxious. I get a reaction from any mention of suffocation in the news. Every now and then a horrible story of suffocation, heard long ago, will spring into my mind.

Sleep is one form of unconsciousness. If you have at one time become unconscious because of either ether or an accident, a link has been made between that unconsciousness and sleep. In my own case, unconsciousness equals ether/suffocation/fear/nightmare/mutilation/pain. I need consciously to separate the idea of sleep from the idea of this other kind of unconsciousness.

Then I go on to Step 2 - asserting a truth or value. I might say, "Compassion, compassion," repeatedly. Then I go on to Step 3 - relaxing the body. Finally, Step 4, I look for a color or pleasant scene or friend in my mind.

It is interesting that the body reacts to hand positions. While lying on your back, touch your fingertips together as if your hands were holding a ball and, in this position, raise them over your abdomen, pivoting on your elbows. Keeping your elbows on the bed, move your hands forward and back over your torso. Say repeatedly in your mind, "I look for pleasant dream images (or colors). I sleep. I dream." When you are falling asleep, your hands will drop into your lap.

To avoid cramps, stretch your leg muscles. (1) Twirl your feet in circles, ten times clockwise and ten times counterclockwise. (2) In a standing position, rise up on your toes ten times. (3) Keeping your right leg straight, bend down and, with your right hand, try to touch the toes of your right foot ten times. Same with the left hand, left leg, and left foot. (4) From four feet away from a wall, lean against the wall with your hands, keeping your heels on the floor, and then bend your torso forward ten times.

Click here to see my video "Help with Foot/Leg Cramps and Insomnia".

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