Ask Dr. Rick About:

Anxiety & Fear

Lately, I seem to be triggered into fully developed states or personalities. It has been desperately confusing and at times, terrifying. The state that I am worried about truly believes that my children would be much more likely to go on to lead wholesome lives if I were to die. There is also a deep craving for relief from a pain deep enough to twist my reality in such a way.

The sense you have of the true core of yourself as healthy and wise and caring is absolutely correct, and the fact that you know this and can often get back in touch with it is very important and will grow over time. Your knowing that the triggered states or personalities are not the true you is also very important. Yes they arise in awareness like sounds or memories, but your knowing that you don’t have to identify with them – they are “over there” while you are “over here” – is also very important.

The fact that you recognize that sometimes you have strong suicidal thoughts and impulses is also very good. DO NOT ACT ON THEM. What they are telling you is not true, and not good for your children, and not good for you. If they get strong, tell your therapist; if they get really strong, GO TO THE EMERGENCY ROOM OF A HOSPITAL. Your sweet children need you and love you and want you to stay alive.

If you have not already explored this, check out Dialectical Behavior Therapy (including DBT groups), and discuss it with your therapist.

These triggered states or personalities are like a car alarm or a thunderstorm: yes they are happening and yes they are very unpleasant . . . . and they are an experience like any other, which you can disengage from and stand apart from. Meanwhile, you remain, like the sky through which clouds pass. You can have realistic hope for yourself, and for your future with your children and family. You are a good person, and you can step each day into a better future.

Can anyone develop a “buddha brain” — even people struggling with mental illness or depression?


First, a “buddha brain” is simply one that knows how to be truly happy in the face of life’s inescapable ups and downs. (I don’t capitalize the word “buddha” here to focus on the original nature of the word – which is “to know, to see clearly” – to distinguish my general meaning from the specific historical individual known as The Buddha.) The possibility of this kind of brain is inherent in the human brain that we all share; any human brain can become a buddha brain. Therefore, a buddha brain is for everyone, whatever their religious orientation (including none at all).

Second, we all must begin the path wherever we are – whether that’s everyday stress and frustration, mental illness, anxiety, sorrow and loss, or depression. In any moment when we step back from our experience and hold it in mindful awareness, or when we begin to let go of negative feelings and factors, or when we gradually turn toward and cultivate positive feelings and factors we are taking a step toward developing a buddha brain. Each small step matters. It was usually lots of small steps that took a person to a bad place, and it will be lots of small steps that take him or her to a better one.

Third, mental anguish or dysfunction can help us grow. They teach us a lot about how the mind works, they can deepen compassion for the troubles and sorrows of others, and, frankly, they can be very motivating. Personally, the times in my life when I have been most intent on taking my own steps toward a buddha brain have been either when I was really feeling blue – and needed to figure out how to get out of the hole I was in – or when I was feeling really good, and could still sense that there had to be more to life than this, and more profound possibilities for awakening.

As soon as I notice a good thing, I automatically have anxiety about not being able to hold onto it long enough. Help!

Try this: when engaging a basic sensual pleasure like eating a strawberry or enjoying a warm shower or bath, give yourself over to savoring the pleasure without anxiety. It’s natural for your mind to wander slightly; you needn’t be anxious about this; you’re still encoding the experience in implicit memory.

Also try focusing on breathing and giving yourself over to it.

And then use the learning from these experiences to apply to receiving other positive experiences.

Do you have any suggestions for my fear that the closer I get to happiness the more I feel deeply afraid that something bad will happen?

You raise a real and common concern that if we feel good (putting it simply), then bad things will happen. Perhaps we will lower our guard, or others will punish us, or we’ll be disloyal to others who suffer.

I’ve thought a lot about this issue, with these reflections:

  • We can still be aware of threats even while feeling good.
  • In fact, taking in good feelings makes us better at dealing with threats.
  • Most people really want us to feel good and support us in feeling good, and usually we can gradually disengage from those who do not.
  • You can become increasingly aware of the underlying psychological patterns that associate fear with feeling good. Maybe those patterns made sense when you were young. But not today. With practice, you can be mindful of this reactivated psychological material and use the methods that I’ve covered extensively both on this site and in the Foundations program (based on Hardwiring Happiness), including the HEAL process, to soothe, ease, contextualize, and eventually replace those feelings.
  • Spending time with people who celebrate your aliveness, passion, and joy without shaming it is very good to do.

Your immersion in a beneficial experience is heightening – in the language of the Buddha – part of the “chain of dependent origination.” The “pleasant” feeling tone you’re experiencing (also called the hedonic tone in psychology) is causing “craving” for the experience to continue (so that the recognition of its impermanence is distressing), and you’re then “clinging” to it as an essentialized, stabilized thing. As the Buddha teaches, this leads to suffering.

For this, a dharma-centric approach would be to cultivate more equanimity, so that the heightened pleasantness of the experience encounters a heightened “shock absorber” of equanimity, and you are able to enjoy the pleasantness without craving or clinging to it. Also, as the pleasantness is repeatedly internalized, it should shift your overall state into greater well-being and less basis for craving and clinging altogether.

It seems like your brain is associating one thing with another, such as love for your child —> fear for their well-being. For that, I’d suggest developing mindfulness of the fear, then opening to the felt knowing that she is OK, then returning to love for her. Intuitively, my hunch is that you have a huge heart. The Link step in the HEAL process, repeatedly taking in antidote experiences for the unresolved pain or traumatic residues, could really be helpful here.

I've experienced emotional abuse, a serious brain injury, PTSD, anxiety, and depression – and I find it hard to meditate. Any suggestions?

In terms of things that might help, I’m assuming you have done sensible standard things like therapy. In terms of some options that might be helpful, you could look into:

  • Neurofeedback
  • Sensorimotor training (e.g., Baniel Method, Feldenkrais)
  • Functional medicine type assessment of your overall physiology, and then systematically optimizing it as best you can
  • Using an emotionally positive and stimulating object of attention for meditation – such as love for others, contentment, gratitude, bliss after pranayama – and marinating in happiness, both to help steady the mind and to potentially help tip your brain more toward positivity

And of course, keep knowing and feeling your own obvious goodness.

What can I do to help feelings of anxiety upon waking?

You are pointing to a pretty widespread experience that I suspect is due to a combination of low physiological state (prompting anxiety) and dysregulated rhythms of cortisol (rising sooner than it should in the morning). I’ve certainly experienced versions of this myself, typically after an anxiety saturated dream.

As a practice, my suggestion would be to start with awareness of the anxiety as soon as it can be established, and then increasingly bring attention to the embodied sense of the facts of alrightness: breathing ongoing, heart beating, body basically alright, no immediate threat in the bedroom, others nearby (if true), walls still standing, home basically alright, mind proceeding, consciousness happening alright, breathing ongoing, recognizing that the anxious thoughts have little basis in reality, and so forth.

Really open to this benign experience and help it sink in, perhaps doing the “Linking” step in the HEAL process of pairing this reassuring sense of alrightness with the anxious feelings and thoughts so that the reassurance gradually soothes, eases, and replaces the anxiety.

You’ve said that love and compassion can combat anxiety. How do they do that?

“Off-line,” when you do not feel threatened, deepen the sense of feeling connected by routinely taking in experiences of feeling cared about. Then, at times you do feel threatened or anxious, call up the body sense of feeling cared about. Stay strong with this, being a good friend to yourself, helping your mind stay focused on the sense of having allies, being part of a group, feeling included, liked, and loved.

What thoughts or suggestions do you have for helping me calm my brain rather than go into fearful mind states when there are sudden unfamiliar sounds?

What works for me is rationally observing that I am in a safe place while emotionally tuning into my body, telling myself again and again that it is alright right now, and intuitively sensing my place in the natural world, my safe belonging in it, and its support for me.

How can I most effectively use your HEAL technique to deal with this anxiety around air travel?

Fears of air travel are really common as you probably know. Very normal. Besides concerns about crashing, there is the loss of control or the feeling of being trapped when the door closes. It’s helpful to be mindful of the specific triggers of the anxiety.

In terms of what you could do, you could use HEAL to:

  • Internalize general resources for anxiety, such as relaxation, feeling loved, and sense of perspective (e.g., the odds of a bad event on your flight are vanishingly tiny)
  • Internalize specific resources for air travel, such as compassion for the other travelers and, ultimately, acceptance of whatever happens
  • Do the Link step in which you focus on experiences of the resources above while also experiencing, off to the side of awareness, thoughts and feelings related to air travel

Additionally, you could do a few sessions with a therapist, perhaps hypnotist, to do experiential practices, including the sort listed above, related to travel. I also know people who speak to a physician and take a little medicine before a flight, such as a “beta-blocker.”

Personally, I have a little ritual in which I bless the plane, imagine it surrounded by light, focus on compassion for the other passengers (I want them to be fine, too), and then accept and be at peace with whatever may happen. Works for me!

How would you recommend dealing with repurcussions of trauma?

I recognize the issue you raise and usually speak about it in workshops with therapists. Some people need to resource themselves initially (e.g., greater mindfulness, self-soothing, distress tolerance) before deliberately activating and installing enjoyable experiences. Of course, people can use the methods of positive neuroplasticity in Hardwiring Happiness to accelerate the internalization of these foundational resources.

I suggest moving away from the word “good,” which I’m doing more and more myself in my languaging of this material. I use “beneficial” or “useful” or “experiences of an inner strength.”

If a childhood trauma was the root cause of a current source of behavioral anxiety, then how do I deal with unlocking it?

Let’s start by presuming your insight about the root experience/trauma is accurate. There could also be other factors, such as a general inclination toward anxiety, or not much internal sense of protectors or other resources to deal with threats that might “get you.”

In addition to obvious other resources (e.g., psychotherapy), in terms of what I might suggest, you should try the first three steps of HEAL (see my free online resources and/or Hardwiring Happiness) for this, including “key resources” such as feeling protected, sense of grit, seeing threats accurately, and so on.

Building on cultivating inner resources for this issue with just the HEA (Have, Enrich, Absorb) steps, you could try the Link step, in which you hold in awareness at the same time both a relevant “positive” resource (e.g., feeling protected, sense of grit) along with some of the “negative” material (e.g., fear of being injured). Remember to keep the positive bigger in your mind and drop the negative if you get sucked into it. This Link step could be especially useful.

I suffer from GAD (generalized anxiety disorder) from a trauma I sustained. What can I do to calm my nervous system and activate the parasympathetic nervous system?

Overcoming trauma can be difficult and here are some options that may help (some of which you might already be pursuing):

  • Take good care of your body. When a person does mental interventions with limited results, that naturally suggests a focus on the “hardware.” Options include exercise, nutrition, “nutraceuticals” (e.g., 5-HTP), a general health check (e.g., thyroid, other hormones, anemia), and possibly medication.
  • Really really repeatedly “take in the good” of experiences of calming, relaxing, recognizing that you are alright right now, protection, safety, and support. Use the Foundations program resources, especially the Learning and Calm pillars, also my book Hardwiring Happiness. The brain needs repetition, but with repetition it really will learn and change for the better.
  • Emphasize self-compassion. Check out Kristen Neff and Christopher Germer.
  • Try biofeedback based devices/programs like Heartmath to train your body (e.g., heartrate variability, vagal tone) to be calmer.
  • Try mindfulness, including brief practices such as with Headspace.

Most of all, be reassured that you really can feel better. It will take work, but altogether what I have written here is less than half an hour a day (of course, you can give it more time if you want), plus the work itself is sweet: it feels good to do it, and you can know that you are really helping yourself along the way.

I was recently invited to join a social club but I am concerned that I won't fit in. I have difficult psychological disorder and I am afraid of being myself. How can I get over this fear?

The whole notion of “fitting in” is interesting. Here are a few personal reflections on the matter:

  • With others, I try to keep it concrete and specific, not conceptual: Are they treating me civilly? Is there warmth and inclusion? Are they listening? Do I feel bigger or smaller around them?
  • If I am living by my own code – ethical, right speech, not evil, not a jerk, warm, compassionate – then what other people do is up to them. I may need to shrink the relationship if they mistreat me, but not because there is something wrong with me.
  • I find that slowing things down, asking questions, and staying grounded, simple, and real are very helpful.

Bottom line, you are a good person. Myself included, everyone is weird. Really! We are all quirky. You may have a few more features to your psyche than some people, but so what? Your extra features have brought you much growth and helped you develop much virtue. If another person is intolerant, that’s on them not you. It could be a practical issue to deal with, but there is no blame for you.

How do you trust your intuition and gain courage when everything around you is falling apart, even globally?

It’s natural to feel stressed and overwhelmed by it all. My suggestion at times like this is to make a clear list of what you can actually do each day, and focus on that. Take the steps you can. It’s classic advice for a reason, it’s profoundly true. Time is like money: spend it where it will help you most. For example, if you want to make a painting, set aside the time to do that and protect that time. Disengage from what you can’t change and focus on what you can. And then find confidence and refuge and self-respect in knowing that you are making honorable efforts and also making progress where you can. Action and clarity can really help when we feel stuck in a fog; they are not the only things – self-compassion and perspective and calming help, too! – but they are important pieces, and under our control.

My dilemma is wanting to love my parents but being scared of them. What to do?

What I might offer is that one approach is to experience your own lovingness (compassion, kindness, benevolence) as a kind of field radiating from you that includes all beings independently of who they are or what they do. Then your lovingness can also become more individualized depending on the person – leading to more or less closeness with them. But your lovingness itself can be unconditional. Besides the benefits to others, this approach can feel very self-nurturing and uplifting.

Dr. Ramani Durvasula is a licensed clinical psychologist, author, and expert on the impact of toxic narcissism. She is a Professor of Psychology at California State University, Los Angeles, and also a Visiting Professor at the University of Johannesburg.

The focus of Dr. Ramani’s clinical, academic, and consultative work is the etiology and impact of narcissism and high-conflict, entitled, antagonistic personality styles on human relationships, mental health, and societal expectations. She has spoken on these issues to clinicians, educators, and researchers around the world.

She is the author of Should I Stay or Should I Go: Surviving a Relationship With a Narcissist, and Don't You Know Who I Am? How to Stay Sane in an Era of Narcissism, Entitlement, and Incivility. Her work has been featured at SxSW, TEDx, and on a wide range of media platforms including Red Table Talk, the Today Show, Oxygen, Investigation Discovery, and Bravo, and she is a featured expert on the digital media mental health platform MedCircle. Dr. Durvasula’s research on personality disorders has been funded by the National Institutes of Health and she is a Consulting Editor of the scientific journal Behavioral Medicine.

Dr. Stephen Porges is a Distinguished University Scientist at Indiana University, Professor of Psychiatry at the University of North Carolina, and Professor Emeritus at both the University of Illinois at Chicago and the University of Maryland. He is a former president of the Society for Psychophysiological Research and has been president of the Federation of Behavioral, Psychological, and Cognitive Sciences, which represents approximately twenty-thousand biobehavioral scientists. He’s led a number of other organizations and received a wide variety of professional awards.

In 1994 he proposed the Polyvagal Theory, a theory that links the evolution of the mammalian autonomic nervous system to social behavior and emphasizes the importance of physiological states in the expression of behavioral problems and psychiatric disorders. The theory is leading to innovative treatments based on insights into the mechanisms mediating symptoms observed in several behavioral, psychiatric, and physical disorders, and has had a major impact on the field of psychology.

Dr. Porges has published more than 300 peer-reviewed papers across a wide array of disciplines. He’s also the author of several books including The Polyvagal Theory: Neurophysiological foundations of Emotions, Attachment, Communication, and Self-regulation.

Dr. Bruce Perry is the Principal of the Neurosequential Network, Senior Fellow of The ChildTrauma Academy, and a Professor (Adjunct) in the Departments of Psychiatry and Behavioral Sciences at the Feinberg School of Medicine at Northwestern University in Chicago and the School of Allied Health at La Trobe University in Melbourne, Australia. From 1993 to 2001 he was the Thomas S. Trammell Research Professor of Psychiatry at Baylor College of Medicine and chief of psychiatry at Texas Children's Hospital.

He’s one of the world’s leading experts on the impact of trauma in childhood, and his work on the impact of abuse, neglect, and trauma on the developing brain has impacted clinical practice, programs, and policy across the world. His work has been instrumental in describing how traumatic events in childhood change the biology of the brain.

Dr. Perry's most recent book, What Happened to You? Conversations on Trauma, Resilience, and Healing, co-authored with Oprah Winfrey, was released earlier this year. Dr. Perry is also the author, with Maia Szalavitz, of The Boy Who Was Raised As A Dog, a bestselling book based on his work with maltreated children, and Born For Love: Why Empathy is Essential and Endangered. Additionally, he’s authored more than 300 journal articles and book chapters and has been the recipient of a variety of professional awards.

Dr. Allison Briscoe-Smith is a child clinical psychologist who specializes in trauma and issues of race. She earned her undergraduate degree from Harvard and then received her Ph.D. in clinical psychology from the University of California, Berkeley. She performed postdoctoral work at the University of California San Francisco/San Francisco General Hospital. She has combined her love of teaching and advocacy by serving as a professor and by directing mental health programs for children experiencing trauma, homelessness, or foster care.

Dr. Briscoe-Smith is also a senior fellow of Berkeley’s Greater Good Science Center and is both a professor and the Director of Diversity, Equity, and Inclusion at the Wright Institute. She provides consultation and training to nonprofits and schools on how to support trauma-informed practices and cultural accountability.

Sharon Salzberg is a world-renowned teacher and New York Times bestselling author. She is widely considered one of the most influential individuals in bringing mindfulness practices to the West, and co-founded the Insight Meditation Society in Barre, Massachusetts alongside Jack Kornfield and Joseph Goldstein. Sharon has been a student of Dipa Ma, Anagarika Munindra, and Sayadaw U Pandita alongside other masters.

Sharon has authored 10 books, and is the host of the fantastic Metta Hour podcast. She was a contributing editor of Oprah’s O Magazine, had her work featured in Time and on NPR, and contributed to panels alongside the Dalai Lama.

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