Chronic insomnia is a serious condition that affects millions of Americans. It is estimated that at least 10% of the adult population suffers from chronic insomnia and 30-50% suffer from episodes of insomnia that are clearly related to emotional stress, anxiety and depression.
Of course, there are physical factors that can contribute to insomnia and if you suspect that there is an underlying medical condition such as sleep apnea or that you insomnia is related to the medicines that you are taking then you should consult with your doctor. But, for most people insomnia results from overactive thinking and anxiety. The first is stress-induced insomnia and the second is referred to as anxiety-induced insomnia.
Stress-induced insomnia is very familiar to most of us as the problem of the “racing mind” in which thoughts flow in an endless progression, and we just can’t seem to turn them off. This hyper-reactivity or hyper-arousal prevents the normal biological processes of sleep onset. The mind becomes very scattered and agitated and off center. We lose that sense of being at the center of our experience, and this is a cause of great instability in the mind that makes the mind even more prone to reactive thinking.
Too much sensory stimulation is one cause of stress insomnia, and in its most extreme form the mind replays events over and over again. Insomnia is, not surprisingly, a very common side effect of PTSD in which the subject replays and literally re-lives intense traumatic experiences or intense episodes of sensory overload as flashbacks and endless preoccupation and rumination with these historical memories.
Anxiety-induced insomnia is rather different from stress insomnia because the source of stress is being generated internally from a focal emotion. It is possible to experience insomnia as a result of an extraordinarily pleasant and positive emotional experience, but most of the time insomnia results from painful emotions that will not resolve themselves. These painful emotions remain as a constant source of irritation and inner torment. Examples might include guilt and regret; the pain and grief of loss of a loved one, a pet or a personal possession that held great meaning. The anxiety might result from a recent argument with a partner or parent, or some form of failure at work. We find ourselves brooding over these painful emotions and become overwhelmed by them because they have such emotional intensity. We re-play the same painful emotion over and over again.
Fear of an uncertain future can also produce a focal emotion that persists and won’t let go. Worrying is a classic example of reactive thinking that proliferates around a focal emotion of fear. The fear is bad enough, but the real suffering comes in the worrying – the endless speculative thinking that feeds the fear with imaginary scenarios.
Interestingly, one of the most common forms of anxiety insomnia is the anxiety about not being able to get to sleep and not being able to perform the following day due to lack of sleep. This, of course, will create a negative loop that sustains itself, spinning round and round in your mind.
There are many approaches to managing insomnia. Some positive steps will include creating good habits such as using the bedroom only for sleep, essentially making it into a shrine or sacred space – for sleep, and not for working on your laptop or anything associated with the work day. Resist sleeping in beyond a reasonable hour. Bed is for sleep not relaxing. Try to go to bed at the same time each day and get up at the same time. Obviously, do not eat too much or consume alcohol just before sleep time. There are many approaches like this that you can learn and that support good sleep, but the essential matter is to learn how to work with the racing mind and unresolved emotions. This is where Mindfulness Therapy and the mindfulness-based skills and techniques that you learn during Mindfulness Therapy (which is now available online) come in to play.
This is a big subject with many techniques, but one of the most effective mindfulness techniques is called Thought Placing.
There you are, lying in bed, trying to get to sleep, but you can’t because of the endless progression of thoughts. Some thoughts may seem important, but most are random chatter. Now, you do not want to resist this flow of thoughts because resistance simply intensifies the problem, and you don’t want to try and push the thoughts out of your mind because they will simply flood right back in again. Instead, you consciously greet each thought the moment it arises and then literally take the thought and place it outside of your central field of attention. You can place each thought outside the body, or simply on the periphery of your awareness. Your awareness is like a very large space in which thoughts arise, and you want to avoid too much clutter at the center. That is the nature of stress – too many things happening in too small a space.
Whenever a thought arises, place it on the periphery, but do it with kindness and patience – just like managing a room full of toddlers. There is no place for resistance or avoidance, just persistent and patience, kindness and even a sense of playfulness. In this way you will begin to open a space at the center of your awareness again and this is profoundly restful in its very nature.
Mindfulness is the awareness skill that allows you to see thoughts as they arise and respond with kindness and patience and lightness to them. It leads to natural stillness and tranquillity – based on responding to the thoughts rather than reacting to them. Reactivity is not peaceful and not conducive to creating this inner state of spaciousness and stillness.
If you are suffering from anxiety insomnia, the problem is not so much in racing mind as in the intense pain of the emotion or emotions that are present. Again, resistance and avoidance are your worst enemies. Do not allow yourself to fall into the trap of thinking and worrying about the emotion, the anxiety or anger that is there. Simply, turn toward the emotion as if it was a hurt child, wounded animal, or simply a part of you that is in pain and needs your kindness and awareness. Sometimes it helps to give the emotion a form, find an image that fits the emotion. Your job is to sit with the emotion without thinking or reacting, just cradling the emotion as a mother will cradle her crying baby. She offers the baby her presence – not talking or thinking but being intimately and consciously connected. If you approach your inner pain in this way, the emotions will respond by quieting and reducing in their intensity quite naturally. The more present you are for them and the less reactive you are toward them the more they are able to let go of you. Some teachers say that you have to let go of your emotions, but actually, it is far more accurate to say that you have to create the right inner conditions such that the emotions can let go of you. This is a very central theme in Mindfulness Therapy for insomnia and for other emotional problems. You have to learn to make friends with your inner emotions. Only this quality of being present, mindfully, can lead to the resolution of painful emotions. It may take many hours before the emotions resolve and subside, but in this approach, you can learn to make peace with that pain. This inner spaciousness and natural peace is, of course, conducive to sleep.
Peter Strong, PhD, is a professional mindfulness-based psychotherapist and online therapist, spiritual teacher and author, based in Boulder, Colorado.