The Gordian Knot of Anxiety: A Body Scan Script for Deep Relaxation

There is a legend about how Alexander the Great was able to conquer in the East. When he entered the city of Gordium there was an enormous wagon so tightly tied with ropes that it could not budge. Legend held that it had been owned by King Midas, and that any attempt to untie the knot would make it tighter.

An Oracle had foretold that any man who could untie the knot would be able to conquer Asia. Alexander struggled with the knot for hours until he spied a lynchpin with thick patina holding the old boards of the cart together. He pulled the pin from the cart and watched the rope untie itself as it crushed the pieces of the old cart in its grip. Defeating our own crippling anxiety often requires a similar “in plain sight” solution that force of will alone cannot solve.

Anxiety behaves exactly like the Gordian Knot. The more we obsess over the future, the more we try to “think” our way out of the problem, the tighter the psychological ropes become. We exhaust ourselves pulling at the threads of “What if?” and “If only.” To escape this paralyzing cycle, we have to stop pulling the rope. We have to pull the pin. In therapy, that pin is the Body Scan.

Why Mindfulness Works: The Neuroscience of “Now”

Mindfulness works because in the present moment there is usually not that much to worry about. Maybe we are a little tired, or hungry, maybe it is cold, but there is not much to deeply upset us. It is outside of the present where we can hear the twin dragons of our past and future whisper, threatening to devour us.

In the past we flashback to things that we have done wrong, poor choices we made, or revisit painful things that have been done to us. In the future we are afraid that these awful things will happen again. We become afraid that our past is our future. This puts our brain into the Default Mode Network (DMN), the neurological circuit responsible for rumination and time-traveling anxiety.

Our obsessiveness turns the future into an incomprehensible mess of terror and humiliation that we cannot help and cannot help but fail to exhaust yourselves trying to prepare for. To escape this paralyzing cycle the answer lies back in the present, where we can breathe free from fear and make better decisions about what to do in the here and now. To do this we have to pull ourselves back into the moment, experience the feelings we are avoiding, and notice all the messages our body tells us that we often ignore.

The Watchtower: Grounding Before Healing

Coping denial and narcissistic denial are the exact opposite of the obsessive anxiety cycle. To be in denial about the consequences of our past behavior or to deny that our actions now will affect us and others later is an intentional lie we tell ourselves. The lie necessitates that we hide in the present oblivious and blind. I find that patients who are trapped most deeply in the obsessive anxiety cycle usually developed the tendency in response to a caregiver or partner was oblivious to the past and future realities of life.

True mindfulness practice is different from denying or ignoring reality outside of the present in that it does not disconnect us from our life journey. It is a tool to reconnect our minds to our bodies and release the past trauma and fear of the future we store within. Intentional mindfulness is a way to ground ourselves so that we have a better point of view on the rest of our lives. I like to think of it as building a watchtower in the present moment so that we can see clearly far across the past and future in order to best understand, and prepare for, where we were and will be.

Beginning the Scan: Setting the Stage

When you begin the body scan make sure the room is quiet or you have a noise machine with a low tone active. Turn phones off and limit interruptions or distractions. Start by instructing the patient to begin Open Posture. Demonstrate open posture to engage the patient in the practice.

Why Open Posture?
According to Polyvagal Theory, crossing our arms and legs is a defensive posture that signals safety to the sympathetic nervous system (fight/flight). By uncrossing limbs and exposing the chest and palms (ventral vagal areas), we send a “Safety Signal” to the brainstem. We are telling the body, “It is safe to let guard down.”

The scan usually works better if patient’s close their eyes, but if this makes them nervous, then ask them to “sweep” their eyes so that they are not concentrating on anything for long or becoming distracted. If patients are interested, offer to let them record the practice on their phones for later. If you have a guided meditation that you like or use EMDR or IFS, I generally find patients engage with these models more easily after the body scan.

The Script: A Guided Journey Through the Body

When speaking for the scan speak in a slow even tone and take a long pause between each instruction. For direct instructions in the scan stop to watch the patient complete the instruction.

“Unlock all of your joints and try and relax your muscles. Extend your palms and fingers outward and open. Sit with your spine straight, but comfortable. Feel loose like a gummy worm that would wobble with little resistance if someone pushed you.”

After the patient is in open posture, start the breathing exercise and have patients do the breathing exercise for about 5 – 10 minutes before you begin the body scan. Demonstrate the in and out breath for the patient with your hands, slowly up and down, to give them a visual guide.

“We are going to take a deep breath in and out, 2 seconds in, slow down for 1 second in the middle, and then 2 seconds out. When you do this, do it in a slow gentle motion like a wave. Don’t breathe in and stop before breathing out. Fill your lungs until they are deeply full but not uncomfortable. As you do this notice how your heart rate starts to slow and this will make your thoughts slow. Your brain may try and fight this process or go to other places, but eventually it will relax.”

When the patient has fallen into the breathing exercises, and you can see them relax then begin the body scan meditation. It is normal for a resistant patient to show resistance by giggling, fidgeting, or staring at you. If you can get these patients to lull into the mindful state they are usually the ones who go to sleep or get close to it by the end.

“Imagine that there is a point of light in the room like a laser pointer, or the reflection from a piece of metal in the sunlight. Imagine that the point of light becomes a ball that is the only thing you can concentrate on and see as it moves around in the room. Imagine that the point of light begins to brush against the tips of your toes on both feet. As it moves across your toes start to notice all the messages that your body sends you all the time that you don’t have time to notice.

Notice if the skin on the tips of your toes is damp or dry. Notice if it is hotter or colder than the rest of the body. Notice how the open air, inside of the shoe, or feeling of your sock feels against your skin. Be with that awareness for a minute. Now notice if there are pockets of air in between your toes or if they are packed tightly together inside your shoe. Notice the way that feels. Now notice the temperature of your skin in those places. Notice how the hard shell of your toenail feels different than the skin on the top of your toes. Be with that awareness for a minute.

Now roll the ball of light back and forth from the tips of your toes to the ball of your heel under your foot. As you do this notice the way the skin is thicker in some places and thinner in others. Be with that awareness for a minute. Now move the ball of light inside your foot and find the bone. Notice the powerful structure holding your foot together. Notice the places where the bone of your foot is pressing against the ground. Feel the joints inside your toes, and roll the ball of light into the joint of the ankle. Feel the strength and flexibility of that joint as your foot rests upon the floor.

Now roll the ball of light up and down the bone in your foot, in between your ankle and your knee. Notice the strength of this bone, that can hold all of your weight as you run and as you walk.”

For patients who have problems feeling vulnerability or fear I spend more time talking about the power of muscles and the strength of their bones. How they are powerful and can let us run away from danger or stand firm against strong waves in the ocean, etc. This engages the Warrior Archetype within the body, allowing the patient to feel safe enough to relax.

“Now move the ball of light through the muscle on the back of that bone, and be aware of the weight of that muscle as it hangs off the bone relaxed. Now feel the sensation of all of those strong fibers of muscle wrapping around the bone of your leg. Feel the way that wraps around your calf and thigh bone. Notice the power that you could feel in the muscle, and the strength if you were to flex it, but leave it relaxed. Feel the potential energy inside each muscle waiting for whenever you need it. Be with that awareness for a moment.

Sometimes when you relax a muscle that you use frequently you can feel twitches or jerks as enzymes discharge. Sometimes, but not always. Notice any involuntary movements if they are there. Now feel the skin around your calf and leg. Notice the sensations of pressure from the couch or from your body weight against your skin. Notice the temperature of your skin and the feeling of your clothes or the open air. Notice if you can feel the wind moving in the room room or if it is still. Be with this awareness for a second.

Now take the ball of light and roll it up into your tailbone. Roll it slowly up and down in between your tailbone and the base of your neck. As you feel it roll up and down notice all of the disks in your spine flex and bend together as you take long slow breaths. Your spine should feel like a slinky bending and resting on itself as you breathe in and out. Feel how your spine is smooth and flexible, able to support you when you move and bend.

Now take the ball of light and move your awareness on to the skin across your back. Notice how your skin feels against your clothing. Notice where there is pressure on your back against where you are sitting. Be with this awareness for a moment.

Now roll the ball of light in a V shape. Start in the middle of your shoulder and then move down into the middle of your spine, and then back up into the middle of your other shoulder. We often store tension in the muscles here.

Breathe in and be with the awareness of some of that tension on the in breathe. On the out breath, push it out away from you into the room and feel it leave. Feel the muscle get slightly warmer and more relaxed.

Take in one more breath and identify with some more of that tension, tightness or numbness. And on the out breath push some more of that tension away from you out into the room. Feel the muscle start to melt slightly and get warmer as some of that tension starts to leave. Feel that as the muscle loosens blood can come back into capillaries and oxygenate spots where it has been cut off. Notice as this starts to happen there is a feeling of warmth that will come back to the tight spots in your muscles. Now take one more long deep breath and find the last few spots in that tension. Be with the awareness of it for a minute, and on the out breath push it out away from you into the room.

Now take the point of light and roll it up your neck, up onto the top of your scalp. Now feel all of the follicles of hair on your scalp. Notice if you feel weight or pressure from your hair, or feel any movement. Now notice if the temperature around your hair is different than the