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How 'defusing my thoughts' helped me claw my way back from debilitating anxiety

Anxiety doesn't always go away — but your relationship with it can change.
Image: A woman touches her head
Using defusion — a strategy of Acceptance and Commitment Therapy — can help you separate yourself from anxious thoughts. Getty Images

Throughout my teens and the entirety of my twenties, it seemed like I was weathering one health-related disaster after another. At fifteen, I was hospitalized with ovarian cysts — giant, fluid-filled sacs that would spontaneously rupture and leave me vomiting and doubled over in pain within a matter of minutes. At twenty, I underwent emergency surgery for a kidney stone obstruction while I was studying abroad in southern India. (If you've never had the misfortune of trying to squeeze out a kidney stone over a squat toilet, consider yourself lucky). Then, at twenty-five, my unborn son was diagnosed with a permanently paralyzing disability. Throughout all of this, a latent anxiety disorder sprouted, and then bloomed.

But at age 29, a battery of tests revealed two new problems inside my body, and I suddenly reached the limit of what I felt like I could endure, physically and psychologically. The first test — a routine urinalysis – showed that my kidneys were hemorrhaging protein, a sign of potential kidney disease or diabetes. The second test revealed a four-millimeter lump on the outer wall of my bladder — and it was malignant.

Fortunately for me, these health issues have all been pretty resolvable: After giving up added sugar cold-turkey, I dropped fifteen pounds in two months and my kidney function improved. My bladder tumor was resected in an outpatient surgical procedure and (knock on wood) I've gotten clean scans ever since.

Ironically, my anxiety has been the most ruthless ailment to date.

Where a kidney stone might take an excruciating day or two to pass, anxiety could leave me bedridden for days or even weeks, totally non-functional. And in February 2017, just a month after my bladder cancer surgery, that's exactly what happened. My panic attacks — which presented as an overwhelming feeling of absolute terror — were lasting hours and hours each day, and soon I was spending most of the day crying in bed. I reasoned that my body had become a dangerous place, a minefield of things that could pop up and flatten me without warning. Post-cancer, every twinge or ache would send me reeling into hysteria and diving under my covers. What now? I'd think. What's coming next?

Where a kidney stone might take an excruciating day or two to pass, anxiety could leave me bedridden for days or even weeks.

After two weeks of this, I drove myself to an outpatient treatment facility twenty minutes from my house and collapsed on a chair in their waiting room, sobbing and clawing at my skin. When the nurse asked if I could keep myself safe, I hesitated.

Yes, I said slowly. But not for much longer. I cannot keep living like this. This is not sustainable.

Like a full 18 percent of the population, I had — and still have — an anxiety disorder. And like I suspect is common of most women, I had made a bad habit of minimizing my illness. It's nothing. I'm fine. It's just anxiety, I'd tell people. But I had reached a breaking point — my illness was uncontrollable, and I urgently needed help. It was the first baby step I took in the gradual, glacial process of feeling like myself again.

Defusion: The strategy that changed my life

On my first day in outpatient treatment, the group was asked to sit back in our chairs with our feet on the floor and close our eyes. As our thoughts filtered in, we were to accept each thought non-judgmentally as it came and allow it to pass by “like leaves on a stream.” Knowing little about meditation or mindfulness, I assumed this would be a relaxing venture — and I was wrong. My thoughts were more like an avalanche of boulders than a gentle descent of leaves, each one of them ominous and terrifying, and as the instructor guided us through the meditation, tears streamed down my face. What else is going to happen to me? The cancer is going to come back. I'm going to go into kidney failure. My children will grow up without a parent. These health crises will never, ever, ever end.

Afterward, when we shared our reactions to the exercise, I let everyone know that I was not a fan. “Isn't our anxiety supposed to go away when we meditate?” I demanded. “I came here to feel better, and I feel worse now!”

The counselor leading the group exercise smiled. “The point of mindfulness meditation isn't to make anxiety go away,” she said. “What we're going to do is change the relationship you have with your anxiety. We're going to practice acknowledging those thoughts or feelings and simply letting them pass. Eventually, they won't have such a stranglehold on you.”

This, I learned, was called defusion, one of the six tenants of Acceptance and Commitment Therapy (ACT), the mindfulness-based treatment the center practiced. In group, I learned, we would practice each of the six components of ACT — such as defusion of thoughts, acceptance of feelings and committed actions — to ultimately create a sense of self apart from our swirling thoughts and turbulent feelings. In time, we would be able to simply acknowledge those feelings and move past them. We'd always have anxious thoughts and feelings, but we could have them and live fully functional lives in service of our values. Sure, I thought. We'll see.

Daily, we meditated. Daily, I cried.

My 'Ah-ha' moment

One morning, after about a week in the program, I was laying in bed trying to psych myself into getting up and getting dressed. My stomach churning, I decided to do a mindfulness exercise, letting my thoughts rain down on me and considering each one non-judgmentally: I feel awful. This anxiety is never going to change. On an anxiety scale, this is definitely a ten.

Something clicked. Wait, I thought. That's not true.

In group each morning, we were asked to walk each other through our experiences and rate each one on an anxiety scale, with one being minimal and ten being a full-blown panic attack. I had been a ten before, and despite what my brain was telling me, this was not a ten. This was more like a four.

I was stunned. I had caught my brain in a lie.

I was stunned. I had caught my brain in a lie. This was why we had to practice contextualizing our selves apart from our thoughts, I realized — because our thoughts weren't necessarily true. And if I let my thoughts and feelings inform my behavior, rather than my values, I would never get out of bed. Instead, I could do something in line with my values of perseverance and bravery — and go to my therapy group. I got out of bed, still shaking. I went.

Slowly, throughout the course of the program, I learned to defuse from my thoughts even more. Instead of taking every thought as the truth and following it into the future, agonizing about what might happen or what had happened in the past, I could simply shrug it off. There goes my brain, telling me a story again, I'd think. Within weeks, after much practice, even the thoughts that once left me paralyzed — my cancer is going to kill me, I'm going to pass another painful kidney stone — had loosened their grip on me. They were neither true nor untrue — they were simply thoughts, and I had the power to do with them what I wished. Eventually, like leaves on a stream, they floated away.

Coming out the other side

Seven months after completing treatment, I landed in the emergency room with kidney stones, writhing in pain and running back and forth from the triage room to the bathroom to empty my stomach. But unlike the last time I had kidney stones, my mind wasn't filled with all the possibilities of how my kidney stone would kill me. My heart wasn't racing, and I didn't feel like I needed to burrow under the covers and never come out. Instead, I anchored myself in the present moment and focused on the cool tile of the bathroom floor, the sweat beading on my scalp.

This must be how normal people feel! I thought, and smiled.

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