Table 8.1 Increasing Contact with Bodily Sensations

Another set of skills that can help you approach these feared bodily sensations is the DBT mindfulness skills (Linehan 1993b). As we mentioned in chapter 3, the mindfulness skills in DBT can help you get in contact with internal experiences (such as thoughts, feelings, and physical sensations) that you may often try to avoid. And, because mindfulness skills are not just about what to do but how to do it, these skills can help you get in touch with these sensations in a way that will be beneficial to you.

Specifically, you can use the DBT skill of noticing your experience without judging it (Linehan 1993b) to help you begin to approach the bodily sensations associated with panic attacks. The first part of this skill simply involves noticing your internal experience without getting caught up in or reacting to it. So, rather than reacting to your bodily sensations or getting caught up in them, you would make it your goal in using this skill to just notice each sensation as it arises, without trying to push it away or cling to it. Simply focus all of your attention on observing any bodily sensations you experience, watching them arise and pass from one moment to the next.

The second part of this skill involves the particular way in which we want you to practice observing these sensations. Specifically, as you practice noticing your bodily sensations and observing them as they arise and pass, make sure that you take a nonevaluative stance. Allow yourself to notice these sensations without judging or evaluating them. Focus on just noticing each sensation as it is, rather than judging it as bad or wrong. Keep in mind that these bodily sensations are simply a natural part of being alive, and something that every human being experiences. Observing your experiences in this way will help you connect with the fact that these sensations are not inherently dangerous or problematic, and will go a long way in helping you stop avoiding these sensations.

The following exercise provides some simple step-­by-­step instructions for noticing your bodily sensations without judgment or evaluation. Try it out and see how it works!

Exercise 8.6 Practice Nonjudgmentally Noticing Your Bodily Sensations

1. To begin, find a comfortable and quiet place where you can sit or lie down.

2. Close your eyes.

3. Focus your attention on your breathing. Notice what it feels like to breathe in and out. Notice what parts of your body move as you breathe in and out.

4. Expand your awareness outward to different parts of your body (for example, your legs, arms, back, or neck). Basically, bring your attention to parts of your body where you often feel tension or experience feared bodily sensations.

5. Do not label or judge those sensations, but instead try to notice them as just sensations, nothing else.

6. If you notice that you are labeling or judging those sensations, notice that evaluation or thought, and then return your attention to noticing the sensations as just sensations.

7. If you get distracted by judgments or thoughts, your job is just to notice that and then return your attention to nonjudgmentally noticing your sensations every time.

8. Practice focusing your awareness on different parts of your body. Move your attention across your entire body, focusing on observing a variety of different bodily sensations without judging or evaluating them.

9. Practice this exercise for at least fifteen minutes a couple of times a day. Initially, make sure you practice this exercise at times when you don’t feel overly anxious. This will make it easier to establish a new habit of noticing your experience without judgment.