Thinking is prioritized in Western culture
Cogito ergo sum.
I think, therefore I am, said Rene Descartes in his groundbreaking Principles of Philosophy (1644), suggesting that the act of thinking proves the thinker exists. This has become a profound element in Western culture. Education emphasizes teaching students to think. Thinking is prioritized as the highest, most effective human activity.
Anxiety and Depression symptoms include disordered thinking
Anxiety and depression, two of the most common symptoms treated by therapists, are marked by a reliance on disordered thinking. Anxious thoughts include: what is wrong with me? Am I sick? Are those people looking at me? Is there something wrong with my mind? Depressed thoughts include: I am doomed. Everything I touch turns to shit. Whatever I try, it won’t work. Why bother?
The depressed person and the anxious person face a dilemma. Thinking, the default activity we turn to in order to solve problems, does not work well in these situations, because it is being shaped and distorted by the problem itself. It’s Archimedes’ difficulty all over again: there is no (objective) place to stand in which thought can produce the desired outcome.
When an anxious person comes for therapy, she often wants to talk about her thoughts. Seeking reassurance is common, though any respite from the anxious thoughts is likely to be temporary. There is always another ambiguity, surprise, or disappointment to trigger a whole new round of anxious thoughts.
When a depressed person comes for therapy, he too wishes to talk about his thoughts. The experience of depression is like living inside a seamless bubble of tinted glass. Everywhere he looks, it’s dark and hopeless. There is no way to think oneself out of depression, by getting outside the bubble. If he tried, it probably wouldn’t work. Exhaustion sets in.
Effective treatments for anxiety and depression focus on the body
Paradoxically, some of the most effective treatments for symptoms of anxiety and depression do not depend on trying to change these troubling thoughts. They instead focus on the body: physical sensation and activity. This may seem strange to someone suffering from inescapable thoughts of worry or doom. It may seem dangerous to avert his gaze from these threatening thoughts for even a moment. Suffering and feeling out of options may finally make it possible to try something that feels radically different.
Treatment of anxiety
An effective approach to treating anxiety is to teach the person to relax. The attention is turned away from the mind’s thoughts and worries and focused on a particular physical sensation, such as the act of breathing. As the person focuses on his breath he observes with interest the physical sensations of the breath moving into and filling the lungs and then flowing out again. There is no analysis of what is happening, just focused attention on these sensations. As little as three minutes of this activity can produce a noticeable calming.
When an anxious person learns to soothe herself by focusing on physical sensations in her body, she gains a sense of mastery not available to her via thinking about her problems. Anxious thoughts may begin to creep in after a session of focused breathing. Am I really calmer? Is this working? Will it keep working? When these thoughts present themselves, the anxious person has a choice. She can go down the familiar slippery slope of thinking, worrying, and second-guessing. Or she can again choose to focus on her breath for another time-out from anxiety. These mindfulness time-outs can have a cumulative effect, enabling the anxious sufferer to gain confidence in her ability to step off the disabling carousel of anxiety.
Treatment of depression
Depression is effectively treated by encouraging the person to take some action. The trick is to find practical actions, ones the depressed person is willing to undertake. A five-mile hike is likely out of the question, but how about going outside to sit in the sun for a few minutes on a pleasant day? Or walking to the end of the block and back? Social support can help with encouraging activity. Walking with a friend is more likely to happen than walking alone.
Taking many small steps and being successful in taking actions can build a sense of confidence in one’s ability to act. Waiting for motivation to strike is a dead end, like writers and artists waiting for the muse to show up. What we call motivation often comes after a successful action.
It is sometimes helpful to use an analog or digital method of keeping track of actions. Most smartphones have apps to track steps taken, mileage covered, flights of stairs climbed. There are apps to keep track of caloric intake. Wearables like Fitbit also provide automatic tracking of physical activity, including heart rate and other physiological measures. Using one of these devices – or even keeping an activity notebook – can reinforce efforts to increase activity levels.
Note: these comments are descriptions of available approaches to treating anxiety and depression, and are not meant to constitute psychotherapy. Treatment of severe anxiety and depression may include a combination of psychoactive drug therapy as well as talk and activity therapies. Consult with your therapist.