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Anxiety Is in Your Body, Not Your Mind

Hacker News - Sun Apr 11 22:39

Why you might want to stop talking about your anxiety and try this instead

Emma Pattee

Photo of a woman putting her hand to her collarbone

Photo: Kittiphan Teerawattanakul/EyeEm/Getty Images

Let’s back up 50,000 years or so. Imagine you’re a Neanderthal taking a leisurely stroll through the fields. Suddenly, in the nearby bushes, you hear a tiger. In a nanosecond, your entire body starts reacting. Your pulse quickens, your breathing gets shallow, your eyes dilate, your body starts producing adrenaline.

Everything happening in your body is good; you’re prepared to survive this tiger encounter. There’s just one small problem. It wasn’t a tiger. It was a tiny prehistoric weasel. Now your body is primed for fight-or-flight, your heart is racing, you’re totally jacked up on adrenaline… but there is no danger.

This is your body on anxiety. Replace the (nonexistent) tiger in the bushes with social media, traffic, politics, Covid-19, money, childcare, climate change, work stress, family drama, and you can quickly see why anxiety is the most common mental illness in America, affecting nearly 20% of the population. Modern-day humans are basically a bunch of freaked-out Neanderthals in fight-or-flight mode 24/7.

“Anxiety is an impulse in our body that says, ‘I’m not safe right now,’” says Elizabeth Stanley, PhD, the author of Widen The Window: Training Your Body and Brain to Thrive During Stress and Recover from Trauma. “It’s automatic, really fast and unconscious.”

In her work, Stanley makes the distinction between the thinking brain, our neocortex, responsible for decision-making, reasoning, ethics, conscious memory, learning, and the survival brain — the limbic system, brain stem, and cerebellum — which handles our basic survival, emotions, implicit memory, and stress arousal.

One of the survival brain’s most important functions, according to Stanley, is neuroception, an unconscious process of rapidly scanning the internal and external environment for safety and danger. When danger is spotted, your survival brain sends an instantaneous stress arousal message to your body by turning on the sympathetic nervous system, resulting in the release of specific hormones that lead to certain physical sensations related to our heart, breathing, and digestion. “Whatever’s happening in the survival brain has these tremendous ripple effects through our body,” Stanley says.

As Stephen Porges, PhD, a psychologist and the creator of the Polyvagal Theory, explains in an interview with PsychAlive, “These responses are not voluntary. Our nervous system is picking up information in the environment, not on a cognitive level, but on a neurobiological level.”

Importantly, when we’re caught in a defensive response, the thinking brain is the last to be aware that something is wrong.“The thinking brain isn’t what decides whether we’re stressed, whether we’re feeling threatened or challenged, whether we’re going to turn stress on, whether we’re going to turn emotions on,” Stanley says. “Stress arousal and emotions belong to the survival brain.”

So if you want to track your anxiety, your body, not your thoughts, will be your most accurate map.

Unlike our prehistoric ancestors (who might have dealt with anxiety by running, panting, or shaking like a dog and letting the cortisol work through their system, according to Stanley), modern anxiety sufferers turn to their trustworthy friend, their thinking brain. “Most people identify anxiety by their thoughts because most people identify with their thinking brain,” she explains.

The problem is that when it comes to regulating our nervous system after a stress response (read: anxiety), our thinking brain is the absolute worst tool for the job. That’s because, according to Porges, even after becoming aware of the physical response, we often don’t know what has triggered that response. For Stanley, a veteran who was diagnosed with PTSD, this realization was a huge turning point. “Recovery from stress and anxiety is a survival brain job.”

We are a cerebral culture, which makes us very equipped to deal with problems that require reason and logic — think moral dilemmas — and less equipped to deal with problems where cognitive reasoning can just make them worse. Having a “fight or flight” response to running late to brunch may seem like an overreaction, but sitting in traffic, you are physiologically experiencing it all the same. We use our thinking brain to try and decide if the issue is “worth” being anxious about, and then we try to force our nervous system to comply. “Our consciousness gets disconnected from our body in those moments,” says Stanley. Your thinking brain decides that you have nothing to feel anxious about, so you spend your days walking around telling yourself that everything is fine while still feeling the physical symptoms of anxiety throughout your body. Even worse, your thinking brain may start to criticize and shame you for still being anxious even after it’s told you that everything is fine.

If you, like me, have spent a few decades (and the equivalent of a house down payment) in talk therapy analyzing all the reasons you’re anxious, this is probably a hard pill to swallow. Not only did all that talking not do much to alleviate anxiety, but it could also even have made it more acute. “Our survival brain wants to keep us safe, but when we disregard our body and its signals because we’re so caught up in our thinking brain’s stories and thoughts, the survival brain actually perceives that as even more threatening,” says Stanley. “Like a toddler, it’s going to tantrum louder until its message gets through. And that’s why it becomes such a vicious cycle.”

Take, for example, Cognitive Behavioral Therapy, one of the most common forms of talk therapy. According to the Mayo Clinic, “CBT helps you become aware of inaccurate or negative thinking so you can view challenging situations more clearly and respond to them in a more effective way.” Sounds great, right? While this kind of analysis could be profoundly helpful when dealing with family issues or working out an ethical question, when it comes to anxiety, which doesn’t take place in your thinking brain, it places the focus on the thought (“I thought there was a tiger!”) and not the physical response which preceded, and even caused, the thought (“my heart is racing and I’m full of adrenaline and I need tools to calm down”).

“We don’t necessarily want to be aware of and feel the discomfort in our bodies because anxiety in our bodies is uncomfortable. Instead, we want to try and fixate it and give it this external object,” explains Stanley. But if the external object didn’t cause the anxiety, then fixing it won’t alleviate the anxious feeling.

While talk therapy and medication are still the mainstream solutions offered for chronic anxiety, other modalities exist that offer a body-first approach. And while these modalities are still considered “alternative,” an increased interest in “brain science” and neurobiology along with continued research on mindfulness and mind-body connections are shifting our psychological understanding from focusing only on the mind to seeing the brain and body as a cohesive unit.

Part of the challenge, according to Pat Ogden, PhD, the creator of Sensorimotor Psychotherapy, is that you need to close the loop that was started when your body first went into a stress response. Ogden uses the example of a client who is Black and frequently stopped by the police without cause. When this happened, the man understandably felt himself getting angry and his body tightening up: a “fight” response. As part of their work together, Ogden helped him identify and act out the physical de-escalation his body needed in order to return to a regulated state, in this case getting to strike out and defend himself within the safety of a therapy session. “We want to complete that impulse in mindfulness so that his brain is integrated and it’s not held in his body anymore,” says Ogden.

Ogden points out that part of the limitation of talk therapy is that anxiety is often related to a dysregulated response connected to an implicit memory, which then gets incorrectly pinned on a current experience or thought. “It doesn’t have anything to do with the current content,” says Ogden.

Stanley, who offers a mind fitness training course to help people build resilience, focuses on mindfulness techniques. And while at this point it’s a cliché to tell anybody with anxiety to take 10 deep breaths, her course has helped thousands of people, including active-duty military. “The military is very experienced in stressful situations, and they’ve trained themselves to turn on the survival brain but don’t always know how to turn it off,” says Stanley. Studies funded by the Department of Defense showed that Stanley’s method significantly helped improve cognitive performance during stress, lower perceived stress levels, increase regulation, and foster a faster return to baseline after stress arousal.

When your body is having a stress response, the first thing is to become aware of objects that help the survival brain feel safe, like what you can see and hear. “One of the best ways to help the survival brain feel grounded is to bring attention to where our body is in contact with our environment,” Stanley says. She suggests focusing on the contact between your feet with the floor, or your body in your chair. As soon as the survival brain perceives groundedness and safety, it automatically starts the recovery process.

Obviously, when you’re caught in a moment of severe anxiety, trying to breathe deeply or be mindful can feel almost impossible. In those situations, what you need is to get the adrenaline and cortisol out of your system. Stanley suggests jumping rope or running up and down stairs. After 10 minutes, try a mindfulness exercise again.

Is there any role for talk therapy, or trying to think logically about your anxiety? Absolutely. But only once your body is regulated, Stanley says: “After we have helped our survival brain feel safe and stable, then we can work on our thoughts. Otherwise, our cognitive response continues to be biased by our stress and emotions.”