Anxiety - Is your panic alarm stuck on? Neuroscientist gives you the answer

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Twitter is great for connecting you to people. My twitter @beckywalshcom just connected me to a man on the other side of the world. Dr Mark Rogers, a neuroscientist from Australia. Mark popped me a tweet asking me to take a look at his brainy blog. Well what else could I do, I love a good brain! Loving Mark's blog I asked him if I could have a chat with him and further expand on his research into anxiety. I’m seeing a growing number of my clients coming to be over feelings of anxiety and being out of control. But first of all I asked Mark how he got started.

Mark: I did my PhD in Australia on major depression, looking particularly at the slowing of thought and movement that can happen with depression.We tend to think of depression as being sadness, but it’s really more about terrible emotional pain and difficulty with concentration and memory. After that I went to the University of Tokyo and worked on schizophrenia and Post Traumatic Stress Disorder PTSD).

Becky: And PTSD relates to anxiety. In terms of PTSD I can see a practical use for anxiety - ‘don’t do that again’ but is there a really a point of having anxiety or is it just kind of brain malfunction?

Mark: Well anxiety is related to fear and fear can certainly be very helpful. If you are crossing the road and see a car coming that isn’t going to stop, then you’ll get a surge of fear, and adrenaline and that will help you get out of the way.

The part of the brain that gives us that initial jolt of fear is the ‘amygdala’ (from the Latin word for almond).

It’s like a smoke alarm, but it’s sensitive to all sorts of potential dangers. When we hear or see something that might signal danger, the amygdala bursts into action and sends signals to the rest of the brain (and the body) to get ready to fight, or to run away. That’s why you feel a sudden shock as your heart begins to pound and the release of adrenalin acts to make your mind alert and increases the fuel supply to your muscles.

The amygdala is incredibly useful because it gets visual and sound information before we have had time to fully process it. That means it can react very quickly to potential threats, it doesn’t wait until we’ve thought about the situation.

But the drawback is that the amygdala is not very smart. The information it gets is raw and ‘fuzzy’ and it often causes false alarms. So this is a trade-off; we get great speed but we pay a price in accuracy.

Normally that’s OK since it’s better to be prepared for a real threat and put up with some false alarms than to have no false alarms but miss a warning of a real danger. Just like it’s better to have a smoke alarm that sometimes goes off just because the toaster was set too high, than to not have one at all. We can think of anxiety as being like a smoke alarm that you can’t turn off. It’s OK if your smoke alarm sometimes goes off unnecessarily, but it isn’t OK if it won’t stop!

A smoke alarm that won’t go off would soon drive you up the wall. And an amygdala that won’t stop signalling danger is just as bad.

Most of the time the amygdala is ‘turned off’ by the frontal, ‘intelligent’ parts of the brain. Once we know that the danger has passed are that there was a false alarm, these brain regions send signals to the amygdala to calm it down and stop the danger response that the amygdala initiated.

But sometimes that feedback mechanism doesn’t work very well. In severe cases this can be associated with Post Traumatic Stress Disorder (PTSD) or social phobia. But even in less severe cases it can lead to chronic stress because of the feeling that we are continually under threat

Becky: And sometimes smoke alarms are too sensitive.

Mark: Right. Imagine if your smoke alarm went off when there wasn’t even any smoke.

Say it went off just because you opened a cupboard where the matches are kept, or it went off in response to steam from the kettle. That smoke alarm would really be a headache. And the amygdala can become like that smoke alarm, especially if we have learned to feel anxious in particular situations. When I first stated lecturing at university I was thrown, with no training or guidance, into lecture halls with 500 students in front of me, and left to sink or swim.

So I was extremely nervous.

Now, one of the things that the amygdala is very sensitive to is facial expression. A hostile, angry face looking at you will trigger an alert signal from your amygdala. And that’s great. But when you are as nervous as I was in front of those 500 students, your amygdala becomes like the smoke alarm that responds to steam. Almost any face begins to seem hostile. A bored face, a neutral face, even a smiling face can seem hostile.

Becky: That’s why it can be so hard for some people to be comfortable around others. When a smiling stranger seems potentially hostile, it’s not going to be be easy to socialise!

Mark: Right. And that constant signal of danger from the amygdala makes it all but impossible to calm down enough for the intelligent parts of your brain to turn the amygdala off.

Becky: So how can we turn off that danger signal?

Mark: To switch off the alarm we need to change our viewpoint

It’s great that the amygdala becomes more sensitive when we are in a dangerous environment. When danger is all around, great sensitivity to anything that might be a threat is a huge advantage.

But it’s a huge disadvantage if we treat a normal environment as if it were dangerous; like I did as a nervous lecturer just starting out. What we need is some way of changing our view of the situation, some way of convincing the amygdala that this is just a normal situation, and not a dangerous environment.

This technique is called “Cognitive restructuring”. It’s a simple process you can use to help reduce your sensitivity to something that makes you anxious. All it really means is that we change our thinking about something. And that change of thinking leads to a change in how we feel about it.

Research has shown that cognitive restructuring can act to reduce activity in the amygdala and increase activity in the intelligent parts of the brain that switch the amygdala’s alert signal off.

Becky: So that’s really getting to the mechanics of the problem.

Mark: Absolutely, it stops the amygdala from being over sensitive and causing fear when there is really no need for it.

Becky: Great, so how do you go about doing cognitive restructuring?

How to cognitive restruct.

1). Get as relaxed as you can

You need to be in a relaxed state before you start.

One of the best (and quickest!) ways of doing this is 4-7-8 breathing. This just means breathing in (down to your tummy) for 4 seconds, holding the air in for 7 seconds and then a big breath out for 8 seconds.

But, if you have a particular meditative practice or other means of getting yourself into a nice relaxed stare, then do make use of that.

2). Visualise the event that causes anxiety.

Now there’s no need to wallow in your anxious experience here- but you do need to spend enough time thinking about it to allow you to do the next step.

If you begin to feel too anxious then just stop.

Try the 4-7-8 breathing and start again when you are calmer.

3). Pay attention to your thoughts

When you visualise the anxious situation you will almost certainly start having certain thoughts. These are thoughts that occur automatically whenever you face the situation, or even just think about it. For this reason they are called automatic thoughts.

These thoughts are a huge clue to what is really troubling you and becoming aware of these thoughts is one of the important aims of cognitive restructuring.

You see, when you start having those feelings of anxiety, they are accompanied by anxious thoughts, but the thoughts are often hidden from us.

That’s why I say cognitive restructuring is like turning on a light, allowing us to see what is really there.

This is so important because thoughts are something over which we can readily gain control. But feelings are more difficult.

And although we can change our mood once we know how, without changing the thoughts that give rise to negative feelings, they are likely to recur.

So in this step we want to really concentrate on capturing the thoughts that come to mind when we envisage this situation.

And the thoughts we really want to get a handle on are those that are accompanied by anxious feelings.

So notice those thoughts and write them down.

The next thing we need to do is a realistic and objective evaluation of those thoughts.

4). Is there anything to suggest your automatic thoughts might be TRUE?

This is where we start to test these thoughts, to weigh them in our hand and see whether there really is anything to be anxious about.

First, think about, and write down, any evidence that supports the thoughts you identified.

When I was a nervous lecturer, I thought that nobody liked my lectures and that everyone was bored.

I could certainly find evidence to support that. Looking around there were bored looking students and even resentful looking students.

So, if I was doing cognitive restructuring, I would write that evidence down next to the relevant thoughts.

5). Is there anything to suggest your automatic thoughts might be FALSE?

When we have those automatic thoughts we tend to believe them unquestionably. That’s why they can have so much power over us.

But chances are that the evidence isn’t all one way. In this step you think of evidence that doesn’t fit in with the thoughts you identified in step 3.

This is excellent at weakening the hold these automatic thoughts have over us.

It might take a bit of effort to find facts that argue against your automatic thoughts.

But don’t give up! Keep at it and you will find something to balance up the ledger.

So, thinking back to my anxious, early lectures; there were students who came to see me after the lecture to discuss things they found interesting. That’s pretty good evidence that not everyone found my lectures boring. And isn’t it true that some students find pretty much any lecture boring? So it isn’t necessarily ME that’s the problem.

Obviously the more positive evidence you can find the better. But don’t worry if you can only think of one or two things. Remember, all you need is just a bit of evidence that stands against those automatic thoughts.

Again, write this information next to the relevant automatic thoughts.

6). Think about the situation again, putting all the information from steps 4 & 5 together to give a more balanced view.

Becky: So, after going through that you might find that there really are some negative things you need to deal with.

Mark: Yes, you have a more realistic picture of the true situation. There may well be some truth to some of the anxious thoughts you’ve been having. But you now know that there is more to the story.

There is also a brighter side. There are things about the situation that aren’t so daunting.

There have been times when it’s worked out well for you. Or perhaps you’ve learned a lot since you last tried, or maybe there is a new ally on your side.

In my case, I would try to keep in mind that while some students do look bored in my lectures, I know for a fact that at least some of them find it interesting and helpful by getting a hold of our automatic thoughts and bringing them into the light we can judge them objectively and work out whether or not we really have anything to be concerned about.

Becky: So it’s not just a matter of trying to think positively and expecting that to fix everything.

Mark: Right. Notice I said 'concerned' about and not 'anxious' about.

The purpose of cognitive restructuring isn’t just to make ourselves feel better, it’s also to help ourselves to do better. After going through the process, I can see that my anxiety about boring all my students was misplaced.

But I can also see that maybe I needed to do something to improve how I taught. After all, engaged students learn better than bored students. Feeling less anxious means you are much more able to act effectively. And that, in turn, further banishes the anxiety. It’s a virtuous cycle, and it all starts with taking a close look at the thoughts that lie under your feelings.

Becky: The breathing exercise I have learnt before and it was called ‘Heart Math’. I’m trained in EFT Matrix reimprinting and I use that for anxiety in clients and it’s had great results in PTSD. Like what your teaching here, it gets the brain to rethink it’s beliefs and uses meridian points (as used in acupuncture) to tap away the anxiety feelings from the past, so you’re not bothered by them in your future.

Thanks so much for chatting with me Mark I think people will find this information really useful.