Danger Ahead, Danger Behind

What do you worry about? What keeps you up at night, tossing and turning? What triggers anxiety for you? Chances are whatever it is is not actually happening in the present moment. Whatever it is is something you anticipate or something that has already happened that continues to echo in your mind. Whatever it is is not happening right now, in this present moment.

One of the most insidious aspects of anxiety centers on a pattern of thinking that takes us out of the present and focuses us on the future. We worry about what lies ahead and create narratives for ourselves, often based on past experiences, about what might happen. Or we ruminate about past traumas, reliving them in our minds and asking ourselves what might have been different, if only… When we do this, we separate ourselves from the present moment. We take ourselves out of present time. And the further we project ourselves out of the present, the more anxious we become. Indeed, we lose ourselves because we are no longer grounded in the here-and-now. And when we do this, feelings of anxiety and dread take hold and grow. We are lost and anxious because we are no longer present to ourselves.

One of the techniques I offer to clients with anxiety is aimed at bringing the client into the room, into the here-and-now. It’s a simple technique: I ask the client to bring their attention to the weight of his/her body in the chair and to look directly at me (or if eye contact is too intimate, to focus on a spot just above my head). As they do this, I ask them to attend to their breathing and ask them to answer several questions: what is going at this moment that is creating anxiety for you? What, if anything, in this room is making you feel anxious? What am I doing that is creating anxiety for you? The answers to these questions are typically “nothing is happening right now, but…” I stop the client, and draw attention back to the breathing and observe that right now nothing is happening to create anxiety. I’ll observe that whatever follows the word “but” is something that is not actually present in the room—something that lies either in the past or the future. We’ll continue to do this until the client is grounded in the present moment. (Often, the client visibly relaxes.)

(If something is actually happening to create anxiety in the here-and-now, the focus shifts and we will attend to whatever is presently happening. Sometimes, this means creating a more open physical space and changing the milieu; other times, it means attending to some aspect of the therapeutic relationship. In any event, it is critical to discern the here-and-now dynamic that triggers anxious responses; it is critical to differentiate between the present and past/future orientation.)

This technique is not meant to eliminate anxiety, but rather to put it in perspective and ground it in the appropriate tense (present, past or future). The exercise reorients us to the present moment. Grounding in the present changes our relationship to our experience and ourselves; it helps us perceive and think about what is actually happening in the present moment. And then, from the perspective of the present moment, we can then explore the roots and paths of the thinking pattern and the origins of the anxiety itself. We can also plan for the future. (Planning for the future and actually living in the future are two very different experiences. Effective planning is predicated on the ability to be grounded in the present, having put into perspective the lessons from the past.) However, we can only effectively do the deeper work by staying firmly grounded in the present moment.

Whatever worries you, whatever keeps you up at night need not control your life. Being oriented in time—being grounded in the present moment—is an important first step to managing those worries. While you may have been exposed to danger in the past (which undoubtedly offer lessons for the present) and while danger may indeed lie ahead (which you can plan for, if you stay grounded in the present), you can only live in the present moment.

Playing for Balance

You never know what might appear in The New York Times. The paper takes its masthead seriously: “All the News that Fit to Print.” Sometimes the paper will present an article that, while not exactly news, provides a refreshing perspective or supports common sense. A recent article on parenting and mental health did both. In fact, the article made me cheer. Last Thursday (1/6/11), the front page of the Home and Garden Section featured an article centered on play. The article, "Effort To Restore Children's Play Gains Momentum", focused on the growing awareness among psychologists, educators and parents that excessive attention to achievement and success is detrimental to children, and that the ethos of achievement exacts a price—often at the expense of playtime, creativity and imagination. As the article rightly points out, playing is crucial to children’s emotional development and mental health.

Play is also vital to the mental health of adults.

Play (how we play, as well as who and what we play with) is something that is rarely directly addressed in psychotherapy with adults. Too bad, because play is essential for living balanced, healthy lives. Being able to play signals a willingness to experiment, to try out new behaviors—regardless of the outcome. In fact, playing creates a space where outcomes are less important than play itself, where failure is acceptable—even valued—for its ability to open doors onto new experiences and possibilities. Children play quite naturally: they use to play to learn about themselves, their abilities, and their relationships to the world. Children playing “dress-up” are, among other things, experimenting with social and gender roles, trying our different identities. They are, of course, not conscious about what they are doing—they’re just playing.

Adults have a much harder time with play; it’s seen as frivolous, especially in Western culture where work and productive outcomes are valued. Adults get caught up competition—and play stops being play and becomes work. Moreover, adults have a difficult time turning off the self-conscious, analytic brain. Indeed, adults have a difficult time just being present. We’re too concerned about outcomes, appearances, meeting expectations, winning. And for adults who experienced trauma as children, playing can be a frightening experience: play requires a loosening of vigilance, and play lowers defenses. Playing can make adults feel vulnerable. Hence, the difficulty with playing. But the inability to play exacts a price: anxiety, depression, addiction, among other problems.

When we are unable to balance work with play, our sense of self becomes distorted. Too often in our culture, one’s sense of self is tied directly to work and productivity, and when something occurs that severs that tie, the emotional and psychological turmoil that ensues is profoundly disorienting. Think of the emotional devastation that comes in the wake of a suddenly lost job: the turmoil centers not just the financial insecurities that arise or the concerns about being able to survive. For many, the real disorientation lies in questions regarding identity: who am I? Upon what ground does my sense of worth rest?

Similarly, couples who do not play—separately or together—often have difficulty with intimacy. They become locked into one- or two-dimensional roles that don’t permit them to see, much less accept or fully experience, each other. They don’t share the space that creates meaningful intimacy.

In a very real sense, psychotherapy is a process that invites play. Good therapy creates a safe space where play can occur. Indeed, therapy is playful. The psychoanalyst D.W. Winnicott wrote about this: “in playing, perhaps only in playing, the child or adult is free to be creative” (Playing and Reality, p.71). In play, you can try out new behaviors, new ways of thinking, new ways of approaching life. So it is with psychotherapy: in a sense, therapy is about creating freedom, and playing is a process whereby freedom can be created—an internal freedom that allows us just to be. Indeed, therapy can help you can be your authentic self—balanced and whole. We learn who we are when we play.

Julia, Cameron, author of The Artist’s Way, offered an insightful means for helping adults reconnect with the freedom that arises from play. She suggested that adults take themselves on “artist dates”—engaging in a different activity that allows for experimentation and fun each week. The activities can be anything from exploring a part of the city you don’t know to flying a kite, to singing. These dates need not have any particular outcome other than that they be something that lies outside one’s routine and unrelated to one’s work. (Notice that these are activities—not entertainments. Going to the movies, watching TV doesn’t count, or being otherwise passively entertained doesn’t count. Playing is always active.)

Playing IS therapeutic.