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You might enjoy this interview, https://www.nytimes.com/2021/08/24/podcasts/transcript-ezra-klein-interviews-bessel-van-der-kolk.html, between Ezra Klein and Bessel van der Kolk, author of The Body Keeps the Score. Some relevant quotes:

Re: how yoga, dance, acting etc. can help as much as or more than our usual approaches of drugs and psychotherapy

BESSEL VAN DER KOLK: Trauma destroys that capacity to imagine how things can be different because you get trapped in that traumatic moment. So you cannot imagine anymore that things can be different. So a very big issue in helping people to overcome trauma is to experience the possibility of alternative outcomes.

In my own work, I love to use psychodrama for that. We are involved in theater programs where people actually get to play different roles and see what it feels like in our body to take a new position, to imagine being Lady Macbeth. And so to be able to embody the experience of a powerful queen, you go like, oh, that’s what a body feels like that feels powerful. So a very important part, in my mind, of therapy is to help people to embody new realities.

….

And so I really discovered the world of the body and tantric traditions, the yoga traditions and breathing traditions, and musical traditions that show that we actually are capable of rearranging our own internal physiological systems. And I wish that in every classroom in America they would teach the four Rs: reading, writing, arithmetic and self regulation, from kindergarten through 12th grade, of what can we do to calm ourselves down, to stay focused? What sort of activities can we engage in to feel in control of ourselves?

And so that we get away from this culture of, if you don’t feel right you take a drug, instead of if you don’t feel right you go for a bicycle ride. If you don’t feel right you go to yoga class. If you don’t feel right, you may need to do some body work to help your body to calm, or you need to go to do some tango dancing, or you need to do something to rearrange your relationship to your internal physiological state.

Re: touch as a way of healing, and how taboo it is in our society

EZRA KLEIN: .... you say that “the things that calm adults are the same things that calm children. Being held, being rocked, and being shushed.” And I don’t know. I just found that very moving.... But at some point, we make it very difficult for adults to ask for those things. You can maybe ask your partner, and that’s it. Particularly, I’ll speak more for men here, because I understand male relationships a little bit better, but you really, as a man, you can’t go to your male friends and ask to be rocked and shushed.

BESSEL VAN DER KOLK: Yeah, a little bit, the culture has something to do with it.

EZRA KLEIN: Yeah, and it just strikes me as a shame. To the point you were just making, we spend so many billions of dollars, and so much effort to get the medications we think will help, and to see psychiatrists. And we’ve also cut ourselves off from a lot of just very cheap things, right? We have culturally cut ourselves off from a lot of touch, right? We often live in very atomized ways.

And finally, why tango dancing (or any dancing) might be worth a shot

BESSEL VAN DER KOLK: I’m still waiting for the study of comparing tango dancing with cognitive behavioral therapy. I’m a scientist, it’s an empirical question. But I put my money on tango dancing over C.B.T., by and large, for some people.

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Anxiety is something I've mostly observed from the outside, which makes me either very qualified or very unqualified to share this opinion. But your description of digging through the recesses of your mind trying to uncover some unseen root source of distress is a shining example of the sort of thought pattern that I see in all of the anxious people I know. They think that their mind has some fixed contents, and that they would benefit from finding the edges. That somewhere in there is The Real Reason they don't feel so good, and that if they interrogate their every negative thought, they will be able to get to the source and "resolve" it, whatever that means.

Every time I hear someone talk about how they're anxious because of some "unresolved" mental state, I want to grab them by the shoulders and say THIS IS WHY YOU ARE ANXIOUS! MENTAL STATES ARE NOT RESOLVABLE! YOU WILL CONTINUE TO FIND CONNECTIONS BETWEEN UPSETTING THOUGHTS AS LONG AS YOU CONTINUE LOOKING FOR THEM!

You cannot probe the contents of your mind by thinking any more than you can probe the contents of a pen by writing. It's more like one of those AI tools that tells you what would go outside the frame of a photo - it's not going to find the edge, it's just going to keep telling you what the next thing would be.

If I feel intangibly worried, I don't try to figure out if it's two degrees removed from a metaphor for something someone said at my Grandfather's funeral, I just go for a run, because that tends to make the bad feelings go away. And I think my solution is way better. The fact that, if I were to meditate on my fears, I could arrive at some narrative explanation for them doesn't mean that that's what caused it. It doesn't mean it was sitting there the whole time waiting to be discovered, any more than this comment was. I'm feeling something bad: I could try to get from that feeling to the next feeling, hoping to eventually reach the final feeling, feel it, and then be free of stress, or I could... go for a run. I have my doubts that the first option ever actually works.

Part of my doubt about this is that anxious people constantly churn in their heads about what really is wrong, and they rarely find the root cause on their own, it always seems to take therapy or a transformative experience. Most likely, these cures don't rely on finding the *actual* root cause of anxiety. It's more that they give someone permission to accept some idea as the root cause - to say that this rock here is the reason they're anxious, and there's no need to look underneath it because there are obviously no bugs there.

All of this to say, not only do I think earth solutions are a perfectly valid solution for sky problems: I think that anxiety is typified by, and worsened by, an obsessive hunt for a sky solution.

EDIT: I didn't mean for this to come across as "just exercise". I specifically wanted to say that narratively unsatisfying solutions (like exercise, medication, or burping) are not just valid: they are ideal for anxiety, because anxiety typically involves an obsessive search for a narratively satisfying solution that isn't really reachable.

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really insightful, thx for sharing

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Great piece, thanks for writing (a few year ago). I think there’s a lot of great insights here. I’ll be rereading.

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Every time I read posts like this, I feel much less alone and am grateful.

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Sure. I change personality when using beta blockers which affect the heart not the brain - I am more calm but less productive perhaps. So I don’t use the beta blockers all the time.

But I feel mentally different - in really the whole nervous system is inter connected. I remember saying in ACX that if we are ever to upload brains we have to upload bodies, or simulations of both, or we won’t be human.

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Several times when I’m tripping I’ll notice myself getting anxious, and I immediately feel better after some mundane bodily function. Turns out I just needed to shit, or fart, or burp, or eat, or whatever.

I’m not sure yet to what extent this phenomenon can be extended to my sober state of mind, and how much of my more common anxieties are the symptom of simple physical needs. But it is certainly a useful analogy to compare anxiety to illness — something that isn’t /you/, but that is happening /to/ you.

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Huh, that's super weird - when I had health anxiety years ago, it was also exactly belching that made it go away. Maybe this is a well-known phenomenon or something.

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Wonderful. Very glad you reposted. Conceptualising (post traumatic event) anxiety as a neurological process of oversensitive threat sensors resulting in excessive sympathetic arousal was really useful for me regardless of the fact that I pursued psychological solutions (together with just waiting for it to settle) mostly. I think what also helped was that the change in my fearfulness was acute and striking. I KNEW the world was exactly the same as it had been, but I seemingly was suddenly terrified of it (not social aspects, just death, especially prolonged and painful). So I also knew that there was nothing wrong with my thinking and that what was going on was pure emotion, and that's obviously of the body.

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I haven’t read through all the comments so maybe someone else mentioned this, but this reminds me of the ACX post “Lavender's Game: Silexan For Anxiety”, where he describes the side effect of lavender scented burps as a actually having a calming effect. Maybe it’s not the lavender that has the effect, but the burps.

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What da fak

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I've had similar problems with depression. Then one time I attended a dance camp and one of the instructors said it's very important to keep yourself hydrated, or else you'll start getting depressed. For me, depression was always a very physical feeling, in the pit of my stomach. When I was in grad school, there were a number of times when I literally couldn't get out of bed for several days, having the same kinds of thoughts you described. To me, many years later, the solution (or at least part of it) was staying hydrated, especially to drink a few glasses of water before going to bed if I've drunk alcohol. Maybe the hydration also had something to do with your recoveries, not just the belching. Dunno. But it has certainly helped me.

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I always appreciate your insights. Thanks for sharing.

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This is something I thought about when tapering off xanax. You feel terrible but at least you can remind yourself that it not the inner you that feels terrible, the terribleness is an outside force that’s acting on you and you can step back from it and observe it. And once you understand that you can look at other episodes of depression and anxiety the same way.

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Do you have hiatal hernia? I think mine aggravates heart palpitations, for instance.

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Very far stretch: is it possible the belching thing generalizes and explains why successful people tend to drink a lot of diet soda? (there is a poll on twitter for this), it might be a piece of the puzzle. I think it warrants some polls on various bodily functions and emotions.

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