Focused Mindfulness

Focused Mindfulness: Sensations, Images and Cures © 2009 Fred P. Gallo

Resolving your own psychological problems is often the best way to learn how to help others. Frequently you can only teach what you truly know. And so it has been for me. I nearly died in an automobile accident in June 1968, the day after graduating from college. After being thrown from my car, my spleen was ruptured and I was rushed to the hospital for surgery. I was in the hospital for ten days and recovered at home over the next couple months. For several years afterwards I experienced severe anxiety while driving or riding in a car and also had frequent panic attacks. I gradually resolved my driving phobia by learning to relax my grip on the steering wheel by reminding myself that that was really superstitious behavior. There was nothing about intensely gripping the wheel that could prevent the car from going out of control. Although I had little or no knowledge of cognitive-behavioral therapy at the time, my simplistic approach worked quite well. As Joseph Conrad advised, “Facing it, always facing it, that's the way to get through." But panic was much more difficult. Most of the attacks I had were short-lived, but regardless of the “convincing logic” that I was not going to die, I could only wait in terror for panic to pass until the next inevitable episode. Then one evening around 1976, I had a panic attack that lasted for over two hours. Try as I may, I could not talk myself out of this one nor did any number of behavioral strategies work. I paced and prayed and promised to mend my ways. Still panic! I breathed into a paper bag. No help! Next I rinsed my face and neck with cold water. Nada! I took a warm shower and drank a shot of whiskey. Still panic! Next an ice-cold shower…burrrr. Panic continued! And then I ran up and down the street. After catching my breath, the panic was still there! I was feeling frustrated and hopeless. Following Conrad’s advice, I laid face down on my bed, focused on the panic sensations, and emphatically announced, “Get me! Come on and get me!” Within a few seconds I was astounded that the panic vanished. I searched throughout my body, but nowhere could I locate even the slightest inkling of anxiety, let alone panic. Right then I realized that the panic could not persist if I quit trying to get rid of it, even tried to intensify it, and experienced the sensations in my body. I also immediately recognized that this approach would not work if I did it in an effort to get rid of the panic; I had to be for real. I had to be willing to experience the panic fully. From then on, any time the panic aura began, I simply focused on the sensations and they disappeared. I was also able to do this with anxiety, many other emotional reactions, and even physical pain. Later I found out that my serendipitous discovery was similar to paradoxical intention, a technique that Viktor Frankl described in his 1956 book Man’s Search for Meaning. Since that last panic episode, I have been able to use variations of this approach to help others with a variety of psychological problems.

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One example of applying these concepts was with Michelle, an intelligent and attractive eighteen-year-old who contacted me about an urgent concern. She was getting ready to begin college, immunizations were an entrance requirement, and she was deathly terrified of injections. She said that it wasn’t about pain that made her panic, since she didn’t think that there was much pain if any involved in an injection. Rather it was “the thought of a needle being put in me.” She also discussed an incident the previous year when she had an allergic reaction after eating shell fish and had to go to the emergency room. The ER doctor wanted to give her a steroid injection, but in panic she refused. The physician expressed his concerns, was unable to convince her to take the shot, and finally gave her oral medication instead. Luckily that worked. She realized that she had a problem and needed for it to be resolved ASAP. Michelle believed that her phobia began when she was in the fifth grade. She related an incident when she received a tetanus shot and was so terrified and combative that several nurses and assistants held her down while she was given the injection. Ever since that time she was unable to submit to shots or to have her blood drawn. There are various techniques that frequently resolve trauma and phobias within the course of a session or two. In Michelle’s case we started by treating the traumatic event from fifth grade. I asked her to bring the memory to mind and guided her through the Midline Energy Treatment (MET), a rapid desensitization technique that I developed about fourteen years ago. I asked Michelle to tap with her fingertips at four distinct locations on her body while thinking about the traumatic event and monitor changes in emotional intensity. The goal is not to try to get rid of the trauma, but to simply experience the intensity while tapping. (The locations are at the center of the forehead, under the nose, under the bottom lip, and at the center of the sternum on the chest.) At first she rated the worst scene as a 10 on a 0-10 scale. Within a matter of a few minutes of a few rounds of MET, Michelle was able to think about the event without discomfort. She felt quite calm and remarked that she found it hard to believe that the event had continued to bother her for so many years. The effects of the treatment appear to have lasted permanently. There are many explanations for why MET works. A somewhat esoteric idea is that the tapping removes blockages in the acupuncture meridian system that correlate with the distress, since the tapping is actually done on acupuncture points or acupoints. A neurologic explanation is that the tapping interferes with being able to fully experience the intensity of the emotion while reviewing the trauma, sort of like walking and chewing gum at the same time (which is not a very good analogy since we’re all able to do that). Possibly the tapping distracts the amygdale, the area of the brain that activates the stress response, making it possible for the hippocampus, the area of the brain that regulates declarative memory, to record the event as over and no longer dangerous. Another compatible explanation involves Hebb’s Law, which states that neurons that fire together wire together. Thus the neurons activated through the tapping pair up with and alter the configuration of the neurons involved in the trauma, thus changing the emotional experience. Of course, there are also psychodynamic, cognitive and chemical explanations. You might say

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that the jury’s still out about the best supported theory, but luckily the positive effects are not dependent on the best theory. However, as is often the case, resolving the trauma does not necessarily eliminate the resulting phobia. This was evident when I asked Michelle to imagine getting a shot and also showed her a syringe. Both the thought and the actual object provoked intense anxiety. So obviously she was in need of more treatment. (In all fairness, it’s possible that the traumatic event singled out was not the cause or only cause of her phobia; so treating the central and possibly earlier traumatic event, if there was one, might have resolved the phobia.) In my experience, while some phobias are rather simple to treat, others are quite intractable. Generally fear of animals and claustrophobia, and astraphobia are relatively easy to treat, although needle or injection phobia is one of the more difficult ones. A psychodynamic explanation might be that the needle phobia is representative of something deeper, possibly unconscious fears or reminiscent or isomorphic of a forgotten earlier trauma. So if that were the case, addressing the core issue should resolve the surface symptom without any chance of symptom substitution, such as trading one phobia for another or trading the phobia for depression or addiction. In some circles it may be assumed that making the unconscious conscious will resolve the core issue and the symptom. From a CBT standpoint, elucidating and challenging or reframing the core irrational belief along with behavioral assignments are other ways to tackle the unconscious issue and the symptom. Yet it’s hardly headline news that conscious insight about the underlying issue of psychological problems like phobias is not the curative agent. I recall early research on systematic desensitization—a technique developed by Dr. Joseph Wolpe that combines relaxation with exposure in imagination to treat phobias—that insight would often surface after the phobia was successfully treated. So the insight wasn’t necessarily curative, since it seemed to come almost as an afterthought. Given the emphasis on insight at the time that systematic desensitization was developed, it seemed like putting the cart before the horse, a Copernican Revolution of sorts. But this and other approaches (behavioral and hypnotic) have demonstrated that conscious insight is not essential to resolving a psychological problem. While there may still be an underlying unconscious reason for a phobia, dealing with it at an unconscious level is generally sufficient. Spontaneous imagery is often attuned with the unconscious in the same when that dreams are often symbolic of core issues. Combining images with what I refer to as focused mindfulness is a powerful way to resolve psychological problems while simultaneously dealing with issues at the level of the unconscious. The term focused mindfulness may seem like an oxymoronic, since mindfulness is considered to be the opposite of focus. Yet the term is applicable since the emphasis here is on observing spontaneous sensations and/or mental images related to a specific issue without any intention to direct or change them. Both sensations and images contain a lot of information compressed within them and simply focusing at this level can be curative. Yet this approach is distinct from Eugene Gendlin’s Focusing as well as from flooding or emotional reliving, where the mental 3

activity (thoughts and story) connected with the problem continues to fan the emotional distress. With focused mindfulness, the story line and judgments are dropped in favor of experiencing the sensations and/or emerging images in the present moment. Returning to Michelle, I asked her to get in touch with the anxiety about getting a shot. She located the sensations in the vicinity of her stomach and reported the 0-10 subjective units of distress (SUD) as 9. She also described the sensations as “buzzing and sort of electrical.” I asked her to drop any thoughts and judgments about the sensations and to just experience and study them. In a few moments she observed the mental image of a jelly fish. I asked her to monitor and describe any moment-to-moment changes, again dropping stories and judgments. The sensations varied and the image of the image grew quite large, changed in several ways and gradually diminished and disappeared. This only took about five minutes. As soon as the image was gone, Michelle said that she felt relaxed and calm. The previous uncomfortable physical sensations were gone. When I asked her to think about getting a shot, she immediately announced “I’m not afraid of shots!” Even having her look at a syringe placed against my arm and then her arm to give the impression of an injection did not produce any anxiety. Yet Michelle still had a concern that she might panic in the actual situation. So I asked her to get in touch with that concern and to locate the sensation in her body, which she was able to do. This time we applied focused mindfulness with her simply observing and describing the location, shape, and intensity of the physical sensations. As she monitored these phenomena with eyes closed, within moments the sensations along with her concerns were gone. When she thought about getting her shots, she felt calm and convinced that this would no longer be a problem for her. The next week Michelle received her immunizations. “I can’t say that I liked it,” she said, “but I wasn’t afraid and there wasn’t any pain.” She also focused on the sensation in her arm while receiving the shot and noted that all she only felt “a little pinch and some pressure.” Michelle was certain that the injection phobia was gone forever and she was also now equipped with tools that she could use for other problems as well. The last stage of treatment involved teaching her how to apply focused mindfulness in the future on her own. Fred Gallo is the author of several ground-breaking books including Energy Psychology and Energy Tapping for Trauma. He was the first clinical psychologist to write a professional book on energy psychology, for which he coined the term. He maintains a clinical practice and presents worldwide on Energy Psychology and the Identity Method (IM)™. For additional information visit www.energypsych.com/.

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