Dropping An Anchor: A Simple And Powerful Technique For Pain Catastrophizing, Mindfulness, And Cognitive Defusion

Welcome back to the Healing Pain Podcast

In this episode, we’re going to do something different. Instead of me interviewing someone, I’m going to share a simple yet powerful technique that will help you whether you’re someone living with pain or a practitioner who treats people. This exercise is called Dropping an Anchor. It’s typically one of the very first techniques that I teach patients who suffer from pain or pain catastrophizing, having problems with difficult emotions, emotion dysregulation, anxiety or any challenge that’s coming up in the therapy room. Before we begin, we probably should revisit the term pain catastrophizing and review and identify what that means. Pain catastrophizing is the tendency to magnify the threat value of pain, feel helpless in a context of pain or the inability to inhibit pain-related thoughts in anticipation of a painful encounter. The last part, the inability to inhibit pain-related thoughts in anticipation of a painful encounter, is what I would like you to think about as we go into this episode.

Think about someone who has chronic pain. Each time they come into your clinic, each time they come into the therapy room with you, they are in some way in anticipation that there may be some pain during that session. We’re going to talk about pain. I may be moving or moving your arm. You may be experiencing pain. It’s a lot of pain-related thoughts that are happening in anticipation of a treatment session. That’s why we’re going to go through this Dropping an Anchor exercise. If you’ve taken my ACT for Chronic Pain Course or my Mindfulness-Based Pain Relief Certification, you’ll be able to identify that this type of exercise fits squarely in the psychological process of contacting the present moment. You’ll also be able to identify some degree of cognitive defusion. Cognitive defusion is the idea of distancing or separating from thoughts. You’ll definitely see aspects of both of those during this exercise.

There are lots of different ways you can drop an anchor. You can drop an anchor by focusing on your breath, by stretching, focusing on the rise and fall of the diaphragm, looking around the room and fixating on a point or listening to sounds in the room. You’re going to hear all of those flavors now because I’m going to share a session that I had with a client that I worked with virtually. This whole encounter here that I’m going to share with you with my client, Barbara, I have her permission to share this. At the end of that exercise, I gave Barbara a while to debrief so we can talk through what she noticed and experienced during the activity.

Probably the most common mistake I see both therapists, as well as patients, make with this type of exercise is they attempt to use it as a control or a distraction technique. Control and distraction techniques are very opposite of what happens in mindfulness and acceptance-based approaches to pain. Mindfulness and acceptance-based approaches involve helping you turn toward what’s in the present moment with an openness and a curiosity and not necessarily to distract, eliminate, control or avoid what’s present.

I invite you to participate and play patient. If you’re at home, find a comfortable chair to sit in. Any chair will do. You can do this as an eyes-open or eyes-closed exercise. It doesn’t matter. I personally enjoy eyes-closed exercises like most people do with regard to cognitive and mindfulness exercises like this. If you’re seated, all you have to do is place your palms down on your lap, relax your arms at your sides and gently begin to close your eyes. Let’s get ready. I invite you to drop an anchor with us. Let’s get started.

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Dropping An Anchor: A Simple And Powerful Technique For Pain Catastrophizing, Mindfulness, And Cognitive Defusion

Barbara, it’s great to see you. Oftentimes, what I do with clients and we can do this here now, a nice way to enter into our session is to drop an anchor. What that means is take a moment or two or a couple of moments to drop ourselves into the present moment and create a brief mindfulness practice. Are you willing to do that with me now to start?

Sure.

You can do this, eyes open or eyes closed, whatever is comfortable for you. If you’re going to have your eyes open, what I suggest is you look down toward the floor, a foot or two in front of you. If you’re going to close your eyes, you can start to do that now and close your eyes. Palms can be gently placed on your lap. Make sure your back is against the chair there. You can have your feet on the floor or maybe even up on an Ottoman or stool if you want, whatever is comfortable for you. Take a moment to land here. Let your body land and begin to relax. Let your mind land and begin to relax.

HPP 226 | Pain Catastrophizing
Mindfulness and acceptance-based approaches involve turning towards the present with openness and curiosity, and not necessarily to distract, eliminate, control, or avoid what’s present.

 

As you’ve landed there, start to deepen each inhalation and exhalation nice and gently and naturally. There’s no need to force the breath. Our body knows exactly what to do with breathing, breathing in and breathing out nice and easy. You may want to count with the breath. You can say, “Inhaling, one and two,” and, “Exhaling, one and two.” Breathing in and breathing out. As you breathe in there, focus all your attention on the breath. You may send to your attention on your belly as you feel your breath breathing in and out. You may center it on that little spot below your nose and above your lip as you can feel the air enter in your nostrils and out.

Notice if the mind becomes chattery and starts to talk. If that happens, I want you to say to yourself, “Thank you, mind,” and then anchor right back to the moment where we’re here together, breathing. Sometimes thoughts come in. Sometimes a memory or an image will pop up. Sometimes it’s a physical sensation in our body. Say, “Thank you, mind,” and then drop right back into the present moment here, connecting right back to your breath. I’ll let you work with that for a couple of moments.

Now, we’ll slowly walk ourselves out of this nice and easy. Turn your awareness to the sensation of sound. Notice the resonance and tone of my voice and maybe something else in the room with you and other sounds. See if there’s something you can smell in the room or maybe taste. You can start to wiggle your fingers and toes. Feel the sensation of the clothes on your skin. When you’re ready, nice and easy, letting some light in, you can peel your eyes open. To debrief, if you can tell me one thing that you observed during that experience?

HPP 226 | Pain Catastrophizing
There’s no need to force the breath. The body knows exactly what to do with breathing.

 

Body sensations. Particularly, the pain moves but it’s not necessarily unpleasant. I feel it here. It’s in the knee. It’s here. It’s there and moves all around.

You have an awareness of many different body sensations. Pain is one of them. There are some sensations in there that we might identify as more pleasant. There are some that, “I don’t like that one so much.” There’s this constant moving that’s happening all throughout these moments together, that you’re noticing how sensations are present and how they change.

They change particularly when you take a deep breath.

HPP 226 | Pain Catastrophizing
Breathing is a way to anchor back into the moment to focus on something other than your bodily sensations.

 

Breathing is a way to anchor back into the moment to focus on something other than those sensations. If the mind pulls you away and draws your focus toward the sensation of feeling good, sometimes that happens during meditation and you want to savor in those positive moments. Other times, there are other thoughts and images that come in that are not so pleasant and then we return. We would drop that anchor right back into the present moment. I would like you to reflect on the exercise we did and think about how you can work that into daily life. Oftentimes, what I tell people is an acronym, STOP. It literally stands for Stop, Take a breath, Observe thoughts, emotions and sensations nonjudgmentally and then Proceed. Are you willing to give that a try now?

Yes. It’s interesting that it’s hard not to judge.

Part of this is restoring to learn how to experience in many ways the positive as well as the negative unwanted emotions in a way without placing that evaluation, judgment or critique on it. I’m going to end this here. Thank you.

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