Top-Down vs Bottom-Up Healing: A Powerful Mind-Body Approach to Anxiety Relief
“Healing comes when we learn to listen to both the wisdom of the mind and the wisdom of the body.”
– Unknown
I suffered from anxiety for decades, first in my twenties when I joined the workforce, and even more intensely in my thirties and forties during challenging life transitions.
Over the years, I tried countless tools, therapies, and techniques to calm my mind. You name it, I probably tried it!
Out of everything, the two methods that helped me the most, and that I now use with my coaching clients, can be summarised in two complementary approaches:
The rational reframing of negative thinking – a top–down approach, working from head to body.
The somatic processing of emotions – a bottom–up approach, working from body to mind.
For many years, I leaned heavily on the first. I analysed my fears, reasoned with myself, and tried to talk my way out of worry. This is the path of traditional talk therapy, perhaps something you’ve tried as well.
Although this approach brought insights and some relief, it didn’t fully shift my embodied experience of anxiety, that overwhelming sense in the body that something is wrong or that something bad is about to happen. Have you ever experienced that?
The intensity of anxiety only began to change when I started practising yoga and other embodiment-based practices.
By observing the physical sensations in my body, as uncomfortable as they were, I discovered something more powerful than trying to fix them with thought:
When I allowed anxiety (or any other difficult emotion) to be there without reacting, the emotions could move through my body and eventually soften and release.
It was as if emotions and physical sensations simply needed a loving presence to be “seen” so they could process and move on.
As I practised this body-based approach, I noticed something else:
Once I attended to the physical sensations and my body calmed down, so did my mind.
This breakthrough came strongly during my first 10-day Vipassana retreat, where you are invited to sit in meditation for hours a day (up to 10 by the end) and to observe the sensations in the body, whether pleasant or uncomfortable, heavy or light.
From day four we were asked to approach the practice with Adhitthana (“strong determination”). I noticed my capacity to sit with discomfort increased, and on day seven, I sat for over an hour without reacting to the pain in my body. By the time I opened my eyes, I was the only person left in the meditation hall.
Then something unexpected happened: tears started running down my face, not from sadness or emotional pain, but from pure release. Memories from childhood came up, but instead of engaging with the thoughts, I stayed observing the emotions.
After a minute or two, the process had completed, and then I felt as if years of tension, resentment, and emotional pain had lifted off my shoulders in that short time.
The 90-Second Rule
Years later, I learned that what I experienced during that retreat is backed up by science.
Neuroscientist Jill Bolte Taylor found that when we allow ourselves to fully feel an emotion in the body, without adding stories or resistance, the physiological response usually lasts only about 90 seconds.
The problem is that since our brains are wired to avoid discomfort, most of us resist emotions instead of allowing and experiencing them.
This scientific explanation made so much sense to me.
How could I have spent years in talk therapy with some results, but not a major shift, and then released what felt like years of emotional pain in just a couple of minutes?
The issue became crystal clear:
Resistance to feeling keeps us stuck.
We avoid the discomfort of emotions in the body, those uncomfortable sensations trigger negative thoughts, which in turn activate new cycles of 90 seconds that never fully process.
This is the vicious loop of anxiety between mind and body that I had been caught in for years, and which so many of my clients and people I know suffer from today.
“Emotions are not problems to be solved. They are signals to be acknowledged.”
— Marc Brackett
The Anxiety Loop in Action
During a recent coaching session, I was reminded of how powerful these two approaches are when used together.
My client came into the call upset and showing signs of severe anxiety: an agitated voice, heavy breathing, and difficulty grounding.
As he talked, I could see how his thoughts were triggering discomfort in his body, and how that discomfort was fuelling more anxious thoughts. He was caught in the same loop I knew so well:
Mind triggering body, body triggering mind.
Breaking that loop required both:
The top–down reframing, and,
The bottom–up somatic processing.
Reframing Negative Thoughts into Supportive Ones
“Talk to yourself as you would to someone you love.”
— Brené Brown
After a brief grounding exercise, I invited him to notice the critical voices in his head. He began naming some of the harsh, judgmental thoughts:
Why are you still struggling with this?
You haven’t made any progress!
This is nothing… man up!
Instead of pushing the voices away, I asked him to reflect:
What are the voices afraid of?
What are they trying to do for you?
What are they protecting you from?
Often, beneath criticism lies a positive intent, parts that want safety, belonging, or success but don’t know how to express it skilfully. A bit like a child who is hungry or tired and can only cry to express their needs.
As we continued the session, my client shared one negative thought, which most of us can relate to:
“You’re not good enough”
After exploring the intention beneath it, he was able to reframe it as:
“I want you to be prepared, so you don’t get hurt.”
That shift created space for more supportive self-talk.
This is the essence of top–down reframing: understanding the deeper intent behind our thoughts, then reshaping them so they support rather than sabotage.
Somatic Processing: Welcoming the Body’s Signals
Later in the session, I noticed my client’s body tense up. Anxiety, like anger, sadness, or disappointment, often shows up physically:
A tight chest.
Contracted shoulders.
A knot in the stomach.
A lump in the throat.
Instead of resisting those sensations, I guided him to bring awareness to them. We gave the sensations qualities:
A shape, colour, sound, material or weather pattern.
This “materialisation” of the sensations helps us make sense of experiences that might otherwise feel overwhelming or be difficult to put into words.
He described a heavy, dark metal ball lodged in his throat. I invited him to “give the ball more space” rather than fighting against it.
After a few quiet moments, I asked what he noticed. With eyes closed, he replied:
“It’s dissolving.”
We stayed with it gently. I suggested he ask the sensation:
“What do you need?”
With tears in his eyes, he whispered:
“I need to feel heard.”
Moments later, the lump was gone.
We repeated this process with other sensations. Each time, by welcoming the discomfort instead of resisting it, the intensity shifted. His body began to calm, and with it, his mind grew quieter.
This is the bottom–up approach: working through the body to change the state of the mind.
From the Anxiety Loop to Emotional Freedom
When we bring these two methods together, something powerful happens:
The mind learns to speak to itself more kindly.
The body learns that emotions can be felt safely and released.
Instead of an anxiety loop where thoughts fuel sensations and sensations fuel thoughts, we create a healing loop where mind and body restore balance together.
Emotional freedom comes not from silencing the mind or numbing the body, but from listening with curiosity and care, reframing thoughts and giving emotions space to move.
Your Practice for this Week
1) Top–Down: Reframe negative thoughts
When you notice a critical or anxious thought, write it down.
Ask: What might this thought be trying to protect me from?
Reframe it into a kinder message.
Example:
Thought: “I’ll never get this right.”
Protection: “I don’t want you to fail.”
Reframe: “It’s okay to learn as you go. You don’t need to be perfect to succeed.”
2) Bottom–Up: Somatic processing of emotions
When you feel anxiety in your body, pause and locate it.
Describe it: “tight chest,” “knot in stomach,” “metal ball in throat.”
Give it qualities (shape, colour, texture).
Set a timer for 90 seconds. Welcome the sensation with gentle attention, as if you were caring for a child.
Notice what shifts after 90 seconds.
Think of it as training both mind and body: one learning to speak more kindly, the other learning it can sit with and release discomfort.
My Wish and Vision for You
These two practices helped me manage and eventually heal from decades of anxiety; they continue to support me today.
If you only take two things from this letter, let them be these:
You don’t have to be hijacked by negative thoughts. You can listen, understand their intent, and reframe them into supportive messages.
You don’t have to suppress emotions or let them take over. You can welcome them, give them space, and allow them to process and release.
Caring for your thoughts and feelings as you would a child, with patience, curiosity, and compassion, will gradually bring freedom and peace to your inner world.
As always, I’d love to hear from you: Which of these two approaches speaks to you most right now? And what are you noticing as you apply them in your life? Let me know in the comments.
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