Transformational Work With Anxiety (Pt. 3): Hypervigilance
Chronic / Acute Conditions

Transformational Work With Anxiety (Pt. 3): Hypervigilance

Kamala Quale, MSOM, LAc  |  DIGITAL EXCLUSIVE
WHAT YOU NEED TO KNOW
  • Since we cannot change the past, we must change how we respond to the results of chronic stress patterns in the present and learn behaviors that help us integrate new choices.
  • As practitioners, we can intervene to bring a sense of safety, presence, and movement to the moment and teach patients how to release the old pattern.
  • In addition to acupuncture and herbs, we can use inner qigong methods to promote increased sensory and present-centered somatic awareness to get out of the head and into the body.

Somatic intelligence is a modern term that is used to describe “knowing” that happens when we closely attend to qi flow in the body at the level of sensation and the impulse to move. Sensations and movement are functions of the nervous system. When we attend to the kinesthetic sense of sensation and movement, we can assist our clients in releasing pent-up energy and stimulating the parasympathetic nervous system, which oversees resting and digesting. Clients learn how to let the body relax naturally. Allowing the nervous system to unwind is also a body-centered method for releasing the effects of trauma. - Heartmind Solutions

This is the third article in my series on working with anxiety with a heartmind approach. In this article I would like to share a method of helping clients learn how to unwind an adrenaline driven pattern in the body and calm the nervous system by encouraging present centered heartmind awareness (shen) and mindful spontaneous body movement (qi), as one might do in inner qigong practices.

Hypervigilance Manifested

When we are “frozen” with fear and overwhelm, we often escalate this bodymind situation with repetitive, fearful thoughts. When the “alarm bells” are chronically triggered, along with the fight/flight/freeze response, it drains the kidney qi. This in turn leads to a cascade of effects involving the Heart, Liver, Lung, and Spleen meridian networks creating stasis and counterflow.

The body responds with a characteristic and recognizable pattern of tension. The results can be debilitating, and the person comes to our office with symptoms like insomnia, muscle pain, obsessive thinking, irritability, trouble concentrating, etc.

This kind of hypervigilant behavior may be a result of acute or chronic trauma that was experienced in the past, often in childhood. We may have experienced bodily harm or witnessed another being harmed. We may have endured harsh and neglectful behavior from our families and caregivers with the threat of loss of love.

Internally, we create coping patterns and beliefs about the world and ourselves that manifest self-protective behavior, which later becomes a habitual state of vigilance and easily triggered anxiety, even though in the present moment we are physically safe.

Since we cannot change the past, we must change how we respond to the results of these chronic stress patterns in the present and learn behaviors that help us integrate new choices. This is where we, as practitioners, can intervene to bring a sense of safety, presence, and movement to the moment and teach patients how to release the old pattern. This calms and strengthens shen, and promotes qi flow.

In addition to acupuncture and herbs, we can use inner qigong methods to promote increased sensory and present-centered somatic awareness to get out of the head and into the body. In this mindful state we are more aware of the presence of a chronic tension pattern and more in control of following the body’s natural urge to unwind.

As the qi begins to release and flow, feelings of anxiety decrease, counterflow is alleviated, and we can anchor the felt sense of centering and grounding, thereby replenishing jing and qi, and calming shen.

Case Story: Hypervigilance

My patient is a young woman in her 40s who practices qigong regularly and uses it to help her calm down before conversations or events that trigger anxiety and overwhelm, so she already has inner resources. However, when inner vigilance is triggered, she has repeated fearful thoughts and images that bombard her system and are difficult to control. As soon as she begins to relax, another thought will come along with a dose of adrenaline, and she can’t relax with a sense of safety.

When she came in, she related an event which had triggered her anxiety and the physical and emotional patterns that accompany it. Physically she reported hip pain that radiated into the leg, along with feeling “wired and tired.” She wanted to do something to feel more in control of herself when these inner triggers emerge.

I encouraged her to take her time and notice how her body was responding to the anxiety in that moment. She said it was tightening inward, especially in her chest and solar plexus. Sensation was rushing upward, along with a tension – especially on the right side. Tears, frustration and anger quickly followed, and she felt the need to release pent-up energy. This is a clear example of counterflow. kidney qi is excited, and liver yang rises.

Movement is the key to calming the liver yang and unwinding the nervous system, and we can promote this by guiding a person to closely attend to the qi flow in the body at the level of sensation and the impulse to move. The qi flow will have a unique pattern and move from one part of the body to another.

When we let this happen without preconceived ideas or analysis, we can enjoy the experience and transform unpleasant sensations or pain into relaxed, diffuse or milder sensations that are more tolerable.

I asked my patient to notice if she had any sense of movement that wanted to happen, and I observed her body for that as well. Even if small, it is important to encourage the person to let those impulses express. Her arm wanted to move, and I encouraged her to let the movement happen and slow it down to bring in mindful awareness.

When you slow down a movement or exaggerate it on purpose, but with mindfulness, it is easier to follow the sequence of qi flow and at the same time allow the body the satisfaction of moving. Have the person repeat the movement slowly a few times and notice what other body movements start to happen as part of the natural unwinding process.

For example, I saw that as her arm moved to the right her head bent forward. I named that and had her continue that movement as well. There was a domino effect and eventually her whole body got involved, and the cycle of qi started to balance and harmonize as her nervous system unwound. The unpleasant sensations transformed, and she felt softening travel through her body. She began to feel some relaxation and relief, and was more grounded in her present experience.

Because of our complex human nature, we have trouble letting go of threat easily. We often continue to scare ourselves with repetitive thoughts or images of impending danger. This brings a repeated dose of adrenaline and relaxation is abandoned.

This happened with my patient. As soon as she started to relax, another fearful thought came up, and the process started again. I brought this to her attention. “It looks like as soon as you start to relax, another fearful thought arises and starts the process again.”

As she became aware of that, she was better able to hold onto relaxation a little longer and feel more comfortable in her body. This is a skill: to choose to stay relaxed and focused while at the same time letting go of the intrusive fearful thinking.

The part of us that is afraid and reactive needs to be held in the bigger presence of the heart of acceptance. In this case you, as practitioner, are holding that compassionate space for patients and directing their awareness until they can find it again themselves. When we join our patients in this process it creates a safety net and demonstrates how they can have more control over the reactive process. This allows them to further explore and transform the traumatized part(s) of themselves.

Once the person feels centered and present you can proceed to the next part of the session, which may involve acupuncture and/or bodywork; while at the same time allowing space for deeper insight to emerge about feelings, beliefs and parts of the self that need reassurance and re-evaluation. A referral to a counselor or psychotherapist may be in order.


Editor’s Note: Parts 1 and 2 of this article ran in the January and February 2026 issues as web exclusives, respectively. For more information regarding inner qigong techniques / exercises, Kamala refers readers to her clinical guide Heartmind Solutions: Direct Awareness to Transform the Roots of Pain and Stress in Soma and Psyche.

March 2026
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