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Train the mind to calm itself
Article from General Practitioner, 16th July, 1982
by Dr Malcolm Carruthers

GPs know a lot about medication in the relief of anxiety. Medical school lectures are followed by bombardment by drug companies with literature and free samples.

There are so many drugs on the market now that you could be forgiven for wondering whether any work well.

Intensifying this anxiety is concern about side effects.

The depressing truth is that if we take the edge off the razor blade of life down which we slide, as American humorist Tom Lehrer put it, we also take the edge off many of life's pleasures and experiences.

Many patients tell of a zombie-like, switched off state they experience on tranquillisers.

Malcolm Lader, professor of psychopharmacology in the Institute of Psychiatry, has reported on habituation which comes with long-term tranquilliser use, their addictive properties and the florid withdrawal symptoms which occasionally occur with sudden cessation.

He also created alarm and despondency among doctors and patients when he reported in the US that CAT scanning shows that long-term tranquilliser use causes shrinkage of the brain similar to that seen in alcoholics, apparently due to 'neuronal drop-out'.

What do you know about meditation? Probably not a lot. It certainly isn't taught in many medical schools and is only gradually creeping into certain avant-garde practitioner training schemes.

Meditation can be a very effective treatment for anxiety, either in its modernised western format or in some of its more exotic Eastern forms.

Meditation is simply the direction of the flow of attention, according to Patanjali, the 8th century Indian sage who systematised Yoga.

Most of the time, our attention is directed outwardly. This puts you in touch with the different forms of stress in your life and, in susceptible people, creates a vicious circle of adrenaline release, anxiety symptoms of which you become more aware, which then produce more anxiety.

When attention is directed inwardly, which is what people usually understand by meditation, you become uncoupled from the stresses in your life and the body's self-healing, restorative relaxation responses take over. This produces a switch from sympathetic dominance with over-activity of the 'fight/flight' system, to parasympathetic dominance with increased activity of the rest/digest/relaxation/restorative system of the body. There is an overall move from a state of internal war to one of peace.

Such voluntary control over the body's involuntary nervous system is remarkably easy to achieve by a whole range of techniques. These originated with Yoga methods in India, moved to China as Buddhist meditation, and then to Japan as Zen meditation.

Autogenic Training is a westernised rediscovery of the basic principles of eastern meditation. Attention is directed inwards by focusing the mind on verbal formulae relating to different parts of the body.

The nucleus of Autogenic Training comprises the six standard exercises developed over 50 years ago in Germany by Dr Johannes Schultz. These involve focusing the mind on sensations of heaviness, and then warmth, in the arms and legs, a calm regular heart-beat, easy natural breathing, abdominal warmth and cooling of the forehead.

Under medical supervision, these purely mental exercises are progressively introduced at individual or small group Training sessions held once a week over an eight-week period.

The patients then practise them in a comfortable stable sitting position, or lying down. And, like traditional medication, it is 'taken' three times a day after meals for about ten minutes.

After four to five weeks of this training it is usually possible to wean the patient off tranquillisers, beta blockers or sleeping pills. Mild anxiety states respond particularly well to the therapy.

More deep-rooted anxieties and phobias may need experienced psychotherapeutic intervention at a deeper level by the techniques of autogenic abreaction and autogenic verbalisation.

You don't have to be ill to do autogenic training. The practitioner, who has to train in it before becoming a teacher, will find many fringe benefits for himself or herself such as calmer driving, the need for less sleep, and even the ability to get off to sleep again when patients go bump in the night.

So-called intentional formulae can improve will performance in many areas of life. This was shown by the British International Rifle Squad which achieved higher scores after learning the technique, mainly because anxiety associated with intense competition was reduced.

Anxiety-related displacement symptoms such as smoking, drinking and over-eating tend to fade away spontaneously with this training.

Organ-specific formulae can be used to help a range of disorders which have a major psychosomatic component including post-infarction, cardiac neurosis, hypertensions, and pruritis in all areas.

Siddha meditation is the one eastern technique of which I have personal experience, and can warmly recommend as being a non-weird, non-cult, highly ethical form of meditation which is proving popular in the United States, Australia, and throughout Europe, including the many centres scattered around Britain.

The technique can be learned in an evening. It basically involves focusing the attention on a simple word formula, or mantra, linked with the breathing. This makes use of the age-old observation that when the mind is disturbed, the breathing is disturbed. This controlling the breathing can help to control the mind and allay anxiety.

A single 20- or 30-minu!e session in the morning sitting in a chair, or, cross-legged on the floor, can produce a powerful anxiolytic effect lasting the entire day.

This is an example of a spontaneous, simple form of meditation, which is easy to keep going. Also, it costs nothing, except a small amount of self-discipline.

As well as the many mental benefits, the body benefits as autonomic balance is achieved, with relief of the somatic symptoms of anxiety, and reduction of cardiovascular risk factors.

Another interesting side-effect of both autogenic training and Siddha meditation is the balancing of the levels of activity of the two sides of the brain.

This improved bridging and cross-talk via the corpus callosum results from increased activity on the more imaginative, creative, intuitive right side of the brain compared with the normally over-active, logical, analytical, sequential-thinking left side of the brain.

These techniques are often associated with an improved emotional balance as people gain better access to the feelings pent up on the right side. They can be more effective in alleviating anxiety than expensive and time-consuming psychoanalysis, which deals predominantly with the logic of the situation as seen by the left brain.

Dreaming is done mainly by the right side of the brain and the memories later shift across to the left side for interpretation. Meditation often results in improved recall and interpretation of dreams, not only clearing the road blocks on Freud's 'royal road to the unconscious', but also changing the images of dreams from being in black and white to glorious Technicolor.

When people can use meditation rather than medication they learn to help themselves.
They are much more independent aid self-reliant. without the feeling that they have to run to the doctor for tablets every time they are in an anxiety-provoking situation.

Anxiety is a contagious condition and doctors who use meditation for themselves and their patients are much less likely to end up on medication.



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