The Voice of Reason: Why I Love Guided Meditations

If you’ve read my posts, you’re aware that I really like guided meditations. There are a number of mindfulness apps that I use everyday, and if it’s not a meditation, it may just be ambient noise that I have in the background that helps keep me grounded.

The fact is that guided meditations have been a game-changer for me. During those times when I am trying to fall back to sleep and shake off anxiousness, having someone else’s voice in my head makes a huge difference.

When I’m groggy, I’m vulnerable. My thoughts can run away with me and take me to places that will keep me awake.

What do I mean by that? I’ve found that I’m a very visual person and for better or worse, I have a vivid imagination (this seems to be the case for many anxious people). During the day, it’s much easier for me to ground myself with the techniques that I often write about here — and it’s even better if I can find a quiet corner to do so. But nighttime is different. Sometimes I wake up stressed and clearing my head of all the noise feels like a Sisyphean task.

When I am groggy, I am vulnerable. But I certainly don’t want to do anything to make me more alert since my goal is to fall back to sleep, not to practice improving my concentration. That is the perfect time allow someone else to guide me in meditation.

The guidance does this: it allows me to focus on someone else’s voice. That’s enough. I do not want to have to exert effort beyond that required to listen.

The exact topic of the meditation is far less important than the delivery. A gentle voice at a low volume draws my attention just enough that it keeps my anxious “Monkey Mind” occupied and quiet.

The Monkey Mind running loose is a good way to visualize what your thoughts might be doing inside your head, swinging from branch to branch, chattering, jumping and constantly changing directions. It can be a jumbled mess in there. The meditation helps sort it out.

I have tried this on a number of occasions and have been very impressed with how effective a guided meditation is in dulling the clarity of what my mind has cooked up and clings to. It provides space between my worries and my self. And then I drift off to sleep.

As I mentioned, the meditation doesn’t have to be anything specific. While body scans work particularly well, any calming meditation will do as long as its purpose is to relax the listener. Breathing cues can also be highly effective, as can novel ambient noise that pulls you away from your worries.

No need to overthink it. Just indulge in a lulling guided practice and get some rest.

Breathing into Limbs: A Grounding Visualization

I’m perpetually on the lookout for different ways to ground myself.

When things get tough and I feel my anxiety rising, I’ve gotten better at pausing and pulling a grounding technique out of my “mental tool bag” before the feelings become too intense.

One that I came up with recently works quiet well, especially if you can take a quick break and find a quiet corner.

As I breathe, I visualize my breath inflating my limbs, filling them with relaxation.

The idea behind this one is that you take a few deep breaths to help slow your breathing down, and then start imagining that your breath is going down into one arm, inflating it.

I’ve visualized it in two ways. The first being breathing into the arm as if it were a balloon that inflates in all directions, all the way down to the fingertips, until it’s completely full. I imagine it glowing from within.

The second entails imagining the breath filling the arm in the way that a fern leaf unfolds. The expansion starts at the shoulder, then upper arm, elbow, lower arm, wrist, hand and finally fingers. As the arm fills with the inhalation, it brightens. This visualization is best when your breathing has already slowed considerably, as it may take a longer breath for your entire limb to sense the serial expansion down to your fingertips.

If my breathing has slowed enough, I imagine the breath entering my limb gradually, just like a fern leaf gently unfurls, part by part.

Either way, I wiggle my fingers at the end of the in-breath, and then as I exhale, the fingers fall still again and the breath exits my arm as it arrived.

Then I do the same with my other arm, followed by one leg and then the other.

On days that I’m really rushed, I might only have time for one limb, particularly if I’m sitting at my desk at work. But that’s okay. Even that short bit is better than letting stress run away with me. That little pause may be exactly what I need.

If this “extremity inflation” sounds too complicated in the heat of the moment, I urge you to try it when you’re lying in bed with your eyes closed. Then you can focus on the sensation of expansion and get familiar with it, so that when you need to call upon it in a stressful situation, you’ll have an easier time bringing up that imagery.

My limbs glow as the breath brings brightness into them.

What I particularly like about this visualization is that it’s a touch more complex, and therefore requires more attention from you. The inhalation all the way to the wiggling fingers makes it more difficult to be thinking about other things. So while it may demand more, I feel that it also delivers more, since everything else decreases to a dull roar in the background as you visualize the air rush in and inflate your body.

And of course, there are different variations of this that you can play with, such as expanding your entire body.

If you are able to practice with this, or even duck out to the bathroom for a few moments of eyes-closed peace, I think you’ll find it a lovely way to give your nervous system a needed break.

Perspective: The Broom that Sweeps the Mind

Last week, I had a good reminder about the importance of maintaining perspective.

It had been a stressful few days at work. At the height of it I found myself in a problematic situation, trying to “fix” an issue that wasn’t my responsibility by sending a quick email. I would have done better to pause, but I was in “go-go-go” mode, driven by anxiety that the situation was causing.

Afterwards, I found myself obsessing about what had happened and how I had reacted. So even though I had initially felt that my email response was the best course of action, by evening I was convinced that it was the worst. This opened the door to allow in unrelated doubts about myself. That frustration carried into my nightly meditation, and ultimately, into fitful dreams.

In a few seconds, a perspective shift changes your entire view of things.

The next morning, I felt marginally better. But it wasn’t until I checked my text messages that my perspective shifted. I received photos of my father, leg in a cast, at the local hospital’s emergency room. Reason? Cracked tibia bone and deep vein thrombosis.

In an eyeblink, I forgot about what had happened with work. I needed to get more information about my father’s predicament.

As news of exactly what had happened filtered down to me (it was a much more controlled situation than I had initially understood it to be), I went into the office with a different mindset. The work stress that had been top-of-mind and in-my-face was now way over there in the back of the room.

FYI, my father is fine and the trip to the ER was actually a follow up from the previous day’s visit to his doctor where they discovered the fracture and the blood clot. The doc had encouraged the ER trip to get quicker access to an orthopedist. My dad is in good spirits and my mother (a former nurse) has been tasked with administering the clot-dissolving injections.

But the shift in perspective that morning reminded me so much of a similar shift several years ago: prior to my cancer diagnosis I had been experiencing a lot of anxiety at work…but once I learned that the lump in my breast was cancer, everything else fell away. It was as if the roar of work stress suddenly became muffled and all I heard was my beating heart, my health, the important stuff.

When I had cancer, the things that used to bother me, stopped. I knew then what was really important.

I distinctly remember that as I was going through my cancer treatments, in all the concern about what was happening in my body, I experienced the least amount of anxiety about anything going on at work that I’d ever had at that job. It felt like I could handle anything that they threw at me.

Perspective. That’s what I had as I sat in the infusion room. And that’s what I regained last week.

How curious that the shift in perspective was so simple to achieve. All I needed was to remember what was really and truly important and everything changed within a few seconds.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

“Simple” is not necessarily “easy”. We have so many things coming at us in the course of the day and we try to triage them as quickly as we can. It’s expected that we will make “little mistakes” and give more weight to the problem right in front of us–those things that are immediate. But with practice, we can realize that most of those are transient and the important stuff is what deserves our deepest attention and appreciation.

And even the “important stuff” needs to be swept out once in a while.

Surviving Another Ride in the Tube

During my last oncologist appointment, I was told it was time for a chest MRI.

The last time I had one of those, I was barely holding it together–it had been a couple of weeks since my breast cancer diagnosis an dI was in an emotionally fragile state.

But that was four and a half years ago. This time, I was fine. I thought.

In case you’re never experienced one, the bilateral chest MRI is not particularly comfy. You lie face-down, your breasts hang between two open slots beneath you and your arms are outstretched in a “superman” pose.

I was a bit taller than they expected…things didn’t completely fit.

And you hold that for a specified length of time. I seem to recall almost an hour last time in 2017, but this time it was only a half hour. Which is good, since I had a hard time getting comfortable–based on how the MRI bed was set up, they hadn’t expected me to be quite so tall.

And since I needed “contrast” in my MRI, I was hooked up to an IV for infusing gadolinium. But the veins on my right arm (which is the only one I’m supposed to use) have seen a lot of wear and tear. Yes, they bulge and look nice and juicy. But it’s a lie. Only after some false starts–the first vein the nurse tried was a bust–did we get the IV going.

The MRI machine looked shiny and competently high-tech. I got to listen to spa music through headphones, which is kind of funny, since it’s like being at a spa where they also bang pots and jackhammer while you’re getting your treatment. In case you’re not aware: MRIs are LOUD.

Ironically, there’s something quite positive about that: the percussive nature of the noise has an almost lulling effect–if you let it. This worked quite well with my strategy of meditating throughout the procedure. Breathing was not particularly comfortable because of pressure on my ribcage (again, due to my height and positioning on the bed), so I chose not to focus on it.

The dressing room was cute, but I couldn’t help feeling so alone in it.

Instead, there were many other bodily sensations that I could pay attention to. At times, I could “feel” the MRI in my hips and spine. I focused on the weight of my body on that bed and on releasing tension whereever I sensed it. Compared to the previous chest MRI, I felt a sense of grounding.

But there were little cracks in my composure. I took a picture of the cute little dressing room where I changed and left my clothing. It was lightly decorated with homey touches. At the same time, it looked so empty: my gown on one chair, my belongings on another. Briefly, I felt small and alone.

After unsuccessful attempts, the IV was connected, and I remembered the feeling of expecting that things were just gonna hurt.

After I got home I removed my bandages from the IV arm and looked at the crook of my elbow, and it reminded me of all the pokes that I’ve endured. All the discomfort that I learned to expect and not question if it was necessary, because it always was. And I fought back feelings of helplessness.

It’s not all bad. This time, I had a better grip on things. I wasn’t even thinking about the MRI the next morning when I went grocery shopping, until…

…I saw a call come through from my oncologist’s office. And suddenly my heart started racing. It was a pure knee-jerk reaction. The voice on the other end told me that the MRI looked normal and my oncologist would see me at my next scheduled appointment next year.

It took a bit for my heart to calm down. I hadn’t been worrying about the results, certainly hadn’t expected anything bad, but wow, when that phone rang, it was as if my brain yelled at me, “Time to PANIC!”

This ride in the tube had a happy ending. But there’s no mistaking all the anxiety bubbling under the surface. Try as I might, I am always going to associate these procedures with fear and possible death. Memories of what happened a few years ago are not going anywhere.

And that’s okay. Because even though my reactions to those memories may still be stressful, I can accept that this will be the case and not expect them to be otherwise. And that acceptance is one of the most valuable skills that I’ve learned.

Grounding Through Mental Tracing

I’ve written before many times about different “grounding” techniques. Grounding is what helps move us out of the chatter in our heads and brings us into the present moment, where we can pause and realize that we are safe. It helps put space between our ourselves and both fears about the future and regrets about the past that may unnecessarily cloud our minds.

On days like those, I need to fine-tune my focus. This calls for a grounding technique that won’t be as easy to derail.

Body scans are some of my favorite grounding and calming go-tos. But recently, I was introduced to tracing the outline of the hand with your mind, a focus on just one part of the body. I tried this and found that it worked brilliantly!

As kids, we traced our hands to help us draw; now, it can help us stay present.

Just like when, as a child, you started a drawing using the outline of your hand by placing it on a piece of paper and tracing the around your fingers with a pencil, you can do the same thing mentally. Imagine the sensation of a point of pressure (say, an invisible crayon) moving up your wrist to the outside of your pinkie, around the fingertip, and down the other side into the hollow between the fingers…and doing the same as it moves up and down each finger until it ends up on the outside of the thumb and travels back down the wrist.

What makes this so effective for me is that it is a simple visualization that requires a bit more concentration, and yet it is still uncomplicated. That means that it gives my monkey mind a little extra to focus on, but not so much that it becomes a struggle.

Try it next time you need grounding and want to trying something different.

Kindness to Cancer Patients

REMINDER: Be nice to other cancer patients and survivors.

It feels weird to write that, because why wouldn’t you? So many of us who have had the cancer experience feel like we want to support and encourage those who come after us. We are driven to help. But that’s not always what happens.

Let me provide an analogy of sorts:

When I was pregnant with my first child, a daughter, I got an enthusiastic positive response from so many other moms. Everyone was ready with helpful tips and good wishes. At the same time, many also started in with stories of their own experiences, often times telling vividly about their struggles and pain and even, “Oh, girls are the absolute worst!”

Some experiences may leave us feeling “unfinished”, needing a kindred spirit to tell our story to. But we need to be aware of whose ear we’re bending.

Why would some women do this? I can only hazard a guess: perhaps because no one wants to listen to difficult stories. Childbirth is a momentous life event brimming with intense emotions that friends and family forget, but the mother in question holds on to because they are tied into so much of her. Her lingering feelings are brushed aside. No one else cares to revisit the labor pains or complications. As a result, tales of the experience are often not expressed until she sees another woman, a kindred spirit, embarking on the same journey.

So, too, with cancer. And it can be a difficult and awkward subject for many, cancer patients or not. Those of us who are breast cancer survivors may want to “talk about it”, and thankfully there are support groups for that. But friends and family may not understand the scope of the emotional fallout. We get comments like, “well, at least you got a nice set of boobs out of it,” and are expected to move on. Conversation over.

And then we see another woman going through this, and it’s difficult to resist inundating her with your own experiences and emotions, all in the name of letting her know that she can get through this, just like you did.

Does it help? Maaaaybe? But as we all know, everyone’s experience is different. What happens is that you’re not “preparing” her for what might come. You’re inducing anxiety in an already stressed-out situation.

I experienced this myself after my diagnosis, when, a week before my surgery, I ran into an aquaintance who had gone through breast cancer treatment several years before. And I know she was trying to offer support and make me feel better, but it didn’t. She made me anxious about my upcoming therapies, including ones that she not gone through herself. While my intent as a newbie was to share about my diagnosis because I felt that she would understand, I ended up being a sounding board for her concerns. Concerns that were valid, definitely, but not appropriate in the context of a very fearful cancer patient.

Offer support without taking over the conversation.

For the record, this was a lovely woman with whom I’ve had numerous subsequent exchanges. There was no ill-will intended. But it’s likely that she didn’t have many opportunities to speak to relate her story to other women, and given the chance, just needed to talk.

And I know that in my exhuberance to show support for other cancer patients, I’ve probably tripped over myself in an attempt to reassure too much. Offer too many hugs. While also trying to be noncommital about outcome. That’s a really messy combination.

So please, let us remember (and by “us” I mean myself!) that sometimes the best form of support for a newly diagnosed cancer patient is simply being there with them and holding space for what they may be going through. They will make their way through the experience, day by day, just like we did. There will be time to talk about the ups and downs of treatments.

But maybe not right now.

Grounding though Contact Points

Lately I’ve been speaking with people who are having a hard time dealing with anxiety, so I thought it would be worthwhile to dive deeper into grounding methods.

For me, hands down, strong neutral physical sensations (with “neutral” being the operative term here) are by far the best ways to pull my head out of swirling thoughts and get back to where I am now on the Earth.

Buttocks and feet are great focal points for drawing attention away from rapid breathing or heartrate.

Currently, I’m focusing on touch points: those places on your body where you are making contact with any surface. This is highly effective because it is well-suited for any situation. You don’t necessarily need to be in a particular position, nor do you need a quiet space. So if you’re in the middle of an exam, sitting in your boss’ office, standing at a podium or walking down the hallway of a hospital, this grounding method can shift you back to the present moment.

The idea is to focus on the sensation of pressure. My suggestion would be to bring your attention to whereever on your body you can sense that contact with a surface, giving preference to places further from areas that might be reinforcing anxiety, such as the chest region and a rapidly beating heart. So, hands, feet and buttocks would be good candidates. If you’re walking, then pay attention to the change in pressure of your steps as you put your foot down and lift it again.

Feel into these body parts, sensing how the pressure feels against them. You can also bring in sensations such as tingling and temperature. Like an investigator, experiencing these sensations as if for the first time, get curious about their quality. If needed, squeeze the muscles, but then make sure to relax them too, so that you’re not clenching. Then see if you notice a difference in sensation.

Try it right now. Go ahead, I’ll wait…

You don’t need a special place to practice grounding yourself. Where you are right now is perfect.

Did you try it? And did you feel anything? The type of sensation doesn’t matter here. The main goal is to get out of your head, which may be in overdrive. Paying attention to what your body is doing RIGHT NOW helps move you away from thoughts of dread and gives you a handle on your reactions.

Important: as with all calming techniques, this takes practice. It is not a one-time thing that you try, nor is it a pill that you pop and everything settles down. The more you practice this, especially when you’re in a peaceful surroundings, the better you will get at shifting your focus during times of anxiety. Just as with a formal meditation practice, it is consistency that will improve your focus and thereby your abilities.

The added benefit to practice is that you will realize you *can* do it, that it *does* work, and you will build confidence in yourself that you can handle it. So in an anxious moment, you’ll be able to say, “I got this” and bring yourself to a more manageable place.

Does Mindfulness Make a Difference?

Yes, yes it does.

I am AWARE.

What used to feel like a jumbled mess of emotions and sensations before, now makes sense to me. Intense feelings don’t come at me as quickly as they used to and there’s more space between a stimulus and my response to it.

There is a PAUSE.

I may still feel overwhelmed by circumstances when something unexpected happens, but now I know what’s happening and can pull myself out of it.

That doesn’t mean that I’m perfectly calm and don’t get frightened, anxious or frustrated. I do. You can see that in some of my posts, because I try to be very honest about what I’m experiencing in the moment. But no matter how deeply I dip into fear, I don’t stay there.

I can find the CALM amidst the CHAOS.

When things get intense, I know how to feel into my body. I recognize the physical sensations and I focus on releasing them. Smoothening them out. Breathing through them.

All those abilities were always available to me, but I resisted calming myself. I am aware that on some level I used to feel that anxiety was a necessary way to express my fear; that it was necessary to descend into fear to express my emotional state to others, so that I would be taken seriously. While it sounds odd to read that now, it was only through learning that I was able to soothe myself that I learned I didn’t need to commit to the torture.

I return to the PRESENT.

When I start thinking about fretful things in my past or fearing the possibilities of the future, I can now recognize that my mind has drifted away and I can pull myself into the present, feeling into my bodily sensations. I can break through the dark tumult that’s enveloping me. And suddenly, the noise is gone and I’m standing with my feet firmly planted in my room. I hear the birds and I find peace.

I know I am SAFE.

I have learned how to feel into my body to help it bring me back to the present and away from fearful thoughts.

I realize that there were behaviors that I engaged in during times of anxiety in the past, like pacing back and forth, that actually soothed my nervous system. Just as rhythmic rocking soothes a child. My body was wise and knew what I needed. When, years ago, the burden of my workload chained me to my desk and prevented me from movement, my anxiety skyrocketed and became almost unbearable. That was a clue, but at that point in my life, I didn’t know how to listen to my body.

Now I know what I must do to calm down and I allow myself to do it. But this change didn’t come about suddenly.

It takes PRACTICE.

Practicing mindfulness meditation when I am at peace allows me to build up the habit that carries me through difficult times. I practice daily. Somedays I can focus on my breath perfectly; other times I lose myself in thought shortly after I’ve begun. Regardless, I don’t give up. Even the “bad meditation” days are better than no meditation at all. Each session strengthens my mindfulness habit.

Every day. No matter what. It makes a difference.

Is It Metastasis or Menopause?

Ever get the funny feeling that something’s wrong?

Like things are a bit “off” but you can’t be sure? I’ve been dealing with that ever since I got off letrozole, an endocrine therapy for breast cancer with a reputation for being difficult to take.

As of this posting, I’ve been off letrozole for 117 days exactly–yes, I’m counting. I’m still shaking off side effects like stupid-crazy joint stiffness, but at least I can tell things have improved.

That’s not what I’m talking about here.

I’ve taken a few rides in the MRI tube already. Not in any hurry to repeat that.

Right now I’m having some “really intense” memory and focus issues. I’ve put “really intense” in quotes, because I talk in superlatives so that my concerns are taken seriously. It’s a bad habit, especially when speaking to an oncologist, because it’s a sure way to end up in an MRI tube. Again.

In the past, my oncologist suggested that my memory problems might have been related to anxiety and not the medications I was on. That’s quite possible, although it’s hard to tease apart “anxiety” and “med side effects”. I mean, simply being told you have cancer causes an immediate spike of the Stress-O-Meter. For someone as anxiety-prone as me, it’s like I’m constantly red-lining.

Now I’m off the endocrine therapy and my memory and distractibility seem to have gotten even worse. What I had before wasn’t like THIS.

It’s kind of like saying, “This hurts. I think I’m being hit on the head with a hammer.” But then you actually get hit by a hammer, and think, “WHOA, now THIS is being hit on the head with a hammer!”

If thoughts are beads on a string, my beads are dropping off at a constant rate, leaving me wondering what I was about to do three seconds ago. And getting distracted by shiny objects. Couple that with having to learn a complex new financial system for work (grrrrr, Larry Ellison), not having helpful documentation to do so and having to go through that while being mainly confined to my bedroom for over a year…yeah, it’s a mess.

I am not being rational and I know it. But I’m still on high alert and dialing my fears down is going to take time.

Because my breast cancer was HER2+–which has been associated with metastases to the brain–my anxious little self immediately thinks, “Wait, maybe this is cancer’s spread stealing my thoughts???” I think that I will forever be jumping to that as the first possibility.

That’s not completely unreasonable, either. According to “Medical News Today”, memory problems are listed as one of the symptoms of brain metastases, along with headaches, stroke, seizures, confusion, dizziness…okay not really experiencing any of those.

And the Mayo Clinic metastasis website asks: what are the most likely causes of my symptoms? So, I admit, a brain tumor probably isn’t, given all the other more likely possibilities: menopause, work stress, loneliness, lack of purpose…and *cough* listening to Twitch video streams while I’m trying to focus.

So really, these memory issues could be a completely normal effect of menopause, but in the cancer context the possibilities are frightening. It takes a lot of perspective to be able to look at what’s going on and realize that it’s not aberrant or dangerous. I feel like an idiot for jumping to the worst conclusions, but here I am…

It’s a survivor thing.

Grounding Through the Fingertips: Hand Steepling

Note: this is another grounding technique, by which I mean a way to retain focus on what is happening in the “now” rather than getting lost in memories of the past, which we cannot change, or succumbing to fears about what may happen in the future. It’s not a woo-woo magical technique. It’s merely being mindful about what is currently taking place so that you can respond appropriately and maintain your composure.

During acute stress, we need to bring ourselves back to the present quickly. By doing so, we are able to clear our heads of the “what-ifs” and “you shouldas” that cloud our thoughts at those times.

But what’s the fastest way to do that? For me, it’s definitely focusing on the fingertips. Each fingertip has approximately 3,000 nerve endings, more than any other part of the body (except the most intimate). When you touch something, all those nerves start firing.

You can take advantage of this sensitivity to ground yourself.

Channel Benedict Cumberbatch’s Sherlock and put your fingertips together.

This is what I do: I “steeple” my fingers (thumb against thumb, index finger against index finger, etc.) as if I were Star Trek‘s Mr. Spock contemplating a complex situation. The fingertip pressure immediately commands attention from my fearful mind in the same way that a boss displaying that hand gesture would command an employee’s attention. Taking deeper breaths, I rub my fingertips against each other in a circular motion. The movement enables the nerve endings on the fingertips to keep firing as the sensation continues. Or I can bounce my fingertips off each other, or keep them together but flex the fingers to create a pulsing motion.

Closing my eyes accentuates the emphasis on sensation and makes maintaining focus on it easier.

Yes, this seems so simple, but it’s also quite effective. By placing our focus on the fingertips, we take our attention away from more reactive parts of the body like the chest area, where the heart might be beating fast and ribcage expanding and contracting with rapid breathing. Feeling into those areas might only serve to reinforce the heightened emotions that we’re experiencing.

The hands lie further away from that commotion, and that distance between the chest and our fingertip sensations enables us, if even for a short while, to get some perspective. Think of it as the anxiety not being “in your face”.

We can use body sensations as anchors to help stabilize us through anxious times.

Sometimes, when I close my eyes, all I “see” is that sensation of fingertip to fingertip, as if it’s the only thing that exists. I can play with this, imagining that I’m holding something between my hands, and that the sensation I feel is actually the feeling of that object against my fingers. It can be a pane of glass or even a beach ball. It all depends on what my brain is willing to accept at the moment. It’s a relaxing mental exercise.

As with many things related to mindfulness, it’s helpful to practice this fingertip pose when we’re in a relaxed and meditative state to connect the sensation to a feeling of calm, enabling it to serve as an anchor when our emotional seas are rough. The more we practice, the stronger that association, and the more effective the grounding response when we use this technique in the midst of anxiety.

~~~~~~~~~~~~~~~~~~~~~~~~~~~

Fun fact: body language experts consider steepled fingers to be an expression of confidence. That might be the little boost you need when you’re navigating a stressful event!