How Mindfulness Works

What traps people in anxiety or depression, drives us to overindulge, or gets us stuck in jobs or relationships? 

I would argue that it often comes down to avoidance.  

Actually, avoidance is evolutionarily hard-wired in our brains. Our brains developed for survival, and avoiding pain or discomfort is naturally an important part of survival.

But unfortunately, this vital survival mechanism also sets us up for a lot of misery. 

It makes perfect sense that we're hard-wired to seek pleasure and avoid pain. The things our ancestors enjoyed, like having sex, eating, getting out of the cold, or avoiding injury contributed tremendously to survival. 

In fact, the way that natural selection shapes our brains so that we behave in ways that help pass on our DNA is by making the activity pleasurable.

Take sex, for instance. Who would ever think of doing that if it didn’t feel good?

So what could be wrong with seeking pleasure and avoiding pain? Unfortunately, a lot. Our hard-wired tendency to try to avoid pain actually causes much of our suffering.

Avoidance can drive us to get stuck in anxiety or phobias or sink into depression, and it even plays a role in chronic pain. 


Let's take anxiety first. We think of anxiety as apprehension, nervousness, and worry. It also has a physical component—hyperarousal of the sympathetic nervous system.

Anxiety disorders, however, go beyond this. If I get nervous before public speaking, or flying in airplanes, but I do those things anyway, I probably don’t have an anxiety disorder. 

But if I avoid doing those things in order not to feel anxious, I probably do have a problem. And the longer my avoidance continues, the more entrenched my disorder actually becomes. 

You've probably known people who skipped a party, canceled a flight, or skirted confrontation with a loved one because they wished to avoid the fear and anxiety it might cause.

We might even say that avoidance is the opposite of courage.

I once heard an astronaut explaining what it was like to be in the early space program. He said, "Courage isn't about not feeling fear—courage is about feeling fully afraid and doing what it makes sense to do anyway."


Next, let's take depression. Have you ever thought about the difference between sadness and depression?

One difference is that sadness feels alive and fluid and is an essential part of living a full life. On the other hand, depression feels dead and stuck and gets in the way of living.

In fact, depression is often a result of trying to avoid sadness and other sorts of emotional pain.  

Something curious happens whenever we try to cut out one side of our emotional experience; we dampen the other side as well. 

Cutting off one pole of an emotional experience compresses the other pole. 

We come to discover that trying to eliminate painful feelings flattens out our emotional life, leading to a general deadness.  

In our attempt to avoid feeling sadness, anger, or other negative emotions, we cut ourselves off from joy and interest.

Chronic Pain

And last, I mentioned chronic pain. Many chronic pain disorders involve fearfully tightening muscles—what’s called “bracing and guarding”—in an attempt to avoid re-injury or an exacerbation of pain. Patients restrict their lives more and more, becoming frightened of ordinary movements, not to mention the physical exercise that could otherwise increase their strength, endurance, and flexibility. 

Their lives go downhill as they focus more and more on what seems to make their pain better or worse and give up the activities that might make their lives richer and more meaningful. 

So here too we see that avoidance—in this case, trying desperately to avoid feeling further physical pain—traps people in fear-pain-fear cycles that can actually maintain their pain. 

An Antidote to Avoidance 

But there's hope. There are simple practices that effectively counteract avoidance.

And mindfulness is one of them. 

How can mindfulness work to counteract avoidance? It helps to free us in five different ways:

1. Helping Us Be With Difficult Emotions

First, let’s look at anxiety.  

Instead of trying to avoid a frightening situation to stave off that dreaded "anxious" feeling, mindfulness gives us another option.

Mindfulness trains us to approach, and then be with experiences—to feel the heart race and the breath quicken, and enter into the scary activity anyway.

Mindfulness practice helps us recognize that in the body, anxiety feels the same as excitement, just with a different set of thoughts. 

We discover that nothing lasts forever; eventually panic subsides, and we see that we don’t actually die, even though we went to the party, flew on the jet, or faced a conflict with someone we cared about.

Next let's look at how this might apply to depression. When we get depressed, we shut down emotions—go dead—and get stuck in repeated thoughts about inadequacy or badness.

Mindfulness practice can prepare us to confront the next wave of depression with a very different attitude—with interest and curiosity about exactly what we’re feeling at the moment, and with some perspective on negative thinking. 

This can help us discover the underlying sadness, anger, or fear that is sometimes masked by depression, so that we can connect with these feelings by tuning into the body in the same way we would during mindfulness practice. 

Learning to be with difficult emotions in this way also accomplishes some important things beyond helping us get past symptoms.

2. Helping Us to Be Integrated

My friend Daniel J. Siegel often says that health involves integration. But when people avoid experiences, they become lessintegrated.  

In fact, one way to understand all psychopathology, or psychological distress, is that it involves a state of dis-integration

Feelings, memories, thoughts, and images get split off from awareness—they get suppressed or repressed. And this leaves us stressed and distracted—unable to fully engage with whatever is happening in the here and now. 

Mindfulness practices help to treat many problems because, for the most part, the problems each involve this sort of dis-integration—splitting off painful experiences. 

Integration frees us to think more clearly about problems, to be empathically connected with others when we’re in pain, and to behave more skillfully in the world. 

3. Mindfulness—A Holding Environment During Difficult Times

A third way that mindfulness practices help is by providing a holding environment during difficult times. 

In successful parenting, a caregiver is able to emotionally hold a child who is in distress, and this holding helps the child to feel soothed, and then able to regulate his or her emotions. 

This is the same process that’s described by others as part of secure attachment or self-compassion.

We try to develop this same sort of holding in therapeutic relationships, where we ride out emotional storms with a patient, providing a kind of ballast for their voyage. 

It turns out that mindfulness practice can do something similar. When we adopt a familiar posture in meditation, and begin following the breath or attending to another object of awareness, we feel “held.” 

There’s a sense of comfort and safety that comes from returning to the present moment in this structured way. And this holding can be fortified further by mindfulness practices specifically designed to cultivate loving-kindness and self-compassion.

4. Mindfulness Practices Help Us Learn to be Less Identified with Our Thoughts

The fourth way that mindfulness can be an effective antidote for avoidance is by training the brain to drop below the thought stream and tune into sensory reality. As we become accustomed to this, we develop the habitof not identifying as much with their thoughts. 

We develop what Clinical Behavioral Therapy clinicians call metacognitive awareness—the ability to see thoughts as just thoughts, rather than as reality, and to see how powerfully those thoughts are influenced by culture, past experiences, and the mood of the moment. 

This further frees us from believing our thoughts as truth, and in the process opens a way for us to resolve a lot of psychological distress.

5. Mindfulness Can Help Us Get Our Minds Off Ourselves 

Finally, one of the most powerful contributions of mindfulness practice to psychological well-being lies in its capacity to diminish relentless self-preoccupation. 

Almost all psychopathology involves a preoccupation with self. Instead, mindfulness helps us see our basic interconnection with other people and nature more generally, in order to embrace our part in the circle of life. 

Find out about Ronald D. Siegel's programs on mindfulness and compassion in psychotherapy.

Ronald D. Siegel, PsyD, assistant professor of psychology at Harvard Medical School, is a longtime student of mindfulness meditation and author of The Mindfulness Solution.

Full Bio and Programs