​Have you ever tried to practice mindfulness in the middle of a panic attack?
 
For those who experience significant anxiety, the idea of being mindful when in the middle of a panic attack may seem a little absurd, and there is good reason for this. When we become severely anxious, our brain goes offline as a means of protecting itself. This is why people sometimes don’t remember details of traumatic events or dissociate when overwhelmed. Mindfulness is a skill that uses the mind, so it’s a tricky skill to use when the mind switches off in a state of significant stress.

​You are sitting in the therapy chair. You have had this debilitating anxiety over presenting to your team at work for months. It is just getting worse. Every time it’s your turn to present, your heart races, you stumble through it, and find yourself having a panic attack later in the bathroom. It’s starting to impair your work performance and your boss has expressed concern over how anxious you seem around the office. You’ve had enough, and that’s why you are here. So your therapist is having you close your eyes and imagine yourself in the room, presenting to them. She’s teaching you some breathing exercises to try before you present, and some grounding exercises to do during it.
 
Then she says, now try all these things at work. But when it’s your turn to present again, you choke again, even after all that effort and planning. Your mind goes blank, and you can’t remember any of the skills you learned in therapy. What gives?

What would you do if your hand touched a hot stove?
 
That is not a trick question. We all pull away. It’s biologically engrained into us that we should avoid pain. And this is not a bad thing! Avoiding pain is a matter of survival. If you did not pull instinctively away from the hot stove, I think we can all agree you would be in a whole world of trouble.
 
Here’s the thing. We pull away from the hot stoves in our mind the same way. Our brain is efficient and wants to avoid pain; it doesn’t differentiate between emotional pain and physical pain. What is your inner hot stove? The looming deadline. The memory of a traumatic event that revisits you when you least expect it. The plane or spider or whatever else sends shivers down your spine or sends your heartbeat through the roof. The interesting person we keep running into that we fear will reject us if we approach them. To our primal sense of survival, it’s all a hot stove.