Often anxiety is underestimated for the effects it has on an individual. The reality is that it is a serious disorder which can and often does have devasting effects on an individual’s life. I have written a guide on anxiety previously which lists some effective techniques in overcoming anxiety https://edwardtraversa.com/tips-for-dealing-with-anxiety/. I also think it is useful to think of anxiety as essentially taking two forms: One is a top down form of anxiety and the other is a bottom up form of anxiety. I will explain what is meant by those terms.
Two Forms of Anxiety
When there is a perception of threat the brain can respond in one of two ways. One type is a response which filters through to the neocortex – the thinking part of the brain. We can understand this process as a type of anticipatory anxiety. For instance, if we were in a jungle and saw a lion we would most likely respond with fear. All well and good. The problem enters when the next day we go into the jungle and expect to see a lion. The anxiety then has this anticipatory quality. If we continue to go out into the jungle with the expectation of seeing a lion then a neural circuit forms revolving around anxiety. Quite literally we would be training the brain to be anxious.
In modern society encountering a lion is rare, most people only get to see a lion at the zoo. But we have replaced the lion with other forms of perceived threats. Worrying about finances, relationships, status levels, popularity, spiritual endeavors has become common place. The worrying often has the same anticipatory quality as the seeing the lion example. We worry whether a relationship will last. We worry whether we will be free from suffering in our lifetime. We worry about paying the next bill. The list goes on and on.
The key in neocortex-based anxiety is to recognize that it is primarily cognitively based. It is the thinking which causes the problem – hence the top down description. The thinking leads our emotions which leads our physical responses.
One of the things we can do is think of the things which are in our control and the things which are outside of our control. For instance, lets assume that there is a bill to be paid. We think of things which we can do to pay the bill – which might include some arrangement for part payment or late payment. Once we have done everything possible to pay the bill then it is time to let go of the worry. The worry does not serve any useful purpose. Instead it serves to train the brain to be anxious. The serenity prayer is a good mantra to adopt when it comes to worry;
God grant me the serenity
to accept the things I cannot change;
courage to change the things I can;
and wisdom to know the difference.
Because it is the thinking which causes the anxiety, cognitive based approaches such as Cognitive Behavioral Therapy or Dialectical Behavior Therapy work well with this type of anxiety. Challenging lines of thinking, learning to think in new ways, defusing ourselves from our thinking are excellent ways to deal with this form of anxiety.
The other anxiety process filters through to the amygdala – an older brain structure which helps to process emotions among other things. Think of a war veteran who hears a loud noise and then reacts as if there is gun fire. The difference is that the response is primarily an instinctual response which then actives the flight/fight/freeze response. The amygdala reacts first to some perceived threat and then later questions might be formed. For instance, the war veteran instinctively runs away to a safe distance and then ponders whether it was a gun shot or not.
In this type of anxiety there is an environmental stimulus which triggers the flight/fight/freeze response. For instance, the stimulus might be receiving a bill. Without thinking of the consequences of receiving a bill, the body and brain immediately go into threat mode. The sight of the bill itself is enough to cause a panic attack.
In this form of anxiety attack, cognitive forms of interventions do not tend to do well because this form of anxiety is a bottom up or bottom to top type. Primarily it is a physiological problem which then tends to make its way to our emotional centers and finally our thinking centers. It spreads itself in the complete opposite way to the neocortex example and lands in different regions of the brain.
It should be noted that amygdala is attempting to protect a person from a perceived threat. The perceived threat can also be emotional or psychological in nature. What has happened over time though is that response from the amygdala has become maladaptive.
The way to go about dealing with this type of anxiety is to use physiological type interventions. Deep breathing and exercise (enough to get the heart rate pumping) are two excellent forms of physiological interventions. I sometimes ask clients to put their face in a sink filled with ice cold water. The shock of the cold water helps to bring a client back into the present moment. This might have to be repeated a few times. An alternative is to use an icepack and put it over the eyes and then breathe deeply and slowly for a few minutes.
Using the Present Moment to Deal with Anxiety
In both scenarios it is possible to train the brain, its just that different tactics need to be used for both. In complex cases of anxiety, it can be both forms of anxiety affecting a person at various times. In these types of cases, use both cognitive and physiological based interventions.
I briefly mentioned bringing attention back to the present moment. Anxiety is often an imaginary type of fear which bears little resemblance to the actual situation. We imagine ourselves in various scenarios both past and present and create anxiety within ourselves. Or in some way we have been trained to respond to environmental stimuli in an anxiety provoking manner. For instance, an adverse childhood experience can quickly escalate into a dysfunctional anxiety pattern in adulthood. Being involved in certain wartime activities can also cause a trauma to form. Which in turn can create acute panic attacks. The effect of which brings attention out of the present.
This is where things like daily mindfulness types of exercises are useful. At first there may not be much benefit, but with consistent persistence we can increase our skill of bringing attention back to the present. Practices like Tai Chi or Yoga and other similar sorts of systems help orientate a person back to the present. At a cognitive level, a practice of repeated gratitude can greatly reduce anxiety as can journaling – these are some of the most well researched aspects to have sprung from the positive psychology movement. These are some of the long term daily practices which can help reduce anxiety all of which have an element of bringing attention back to the present.
Steps to Consider in Dealing with Anxiety
If we were to reduce interventions down to a few steps it might look as such:
Is there something you can do about the situation? If yes, do it. If no let, go of the worry.
If there is still worry, identify whether its primarily a cognitive form of anxiety or a physiological based one.
If it’s a cognitive one, use techniques from cognitive behavior therapy or dialectical behavior therapy.
If it’s a physiological/emotional response to an environmental cue then counteract with something physical -e.g., deep breathing or exercise.
It is important to have a handful of short term-based interventions on the ready. Being prepared is a large part of the battle. Equally important is to have long based interventions that are done on a regular basis – preferably something daily.
In learning to notice which form of anxiety has hijacked a person then the appropriate intervention can be applied.