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Anxiety, Neuroscience, and Recovery

February 27, 2018

 

 The most insidious lie anxiety tells it's victims, is that it is stronger and more powerful than they can ever hope to be. I make no secret about it - I've been there myself. At times it felt like I was tiny, being tossed around inside a wave. Overwhelmed by the sheer power of the forces around me - totally without control, no matter how hard I fought to swim against the current. 

 

There is, however, another side to this story. This wave is created by the brain, and the 'anxiety' thoughts actually arise from those feelings (Damasio, 2004). The neurological sequence of this really surprised me, identified using neural imaging techniques. According to Damasio, first come the outward signs of emotion, such as increased heart rate, or trembling. Next, comes the internal feeling. A lot of people with anxiety could be intensely uncomfortable but you'd never know it. It's this private wave of feeling that seems to emerge next. Finally, the brain produces thoughts that accompany those internal feelings.  

 

So what makes the brain create this response in the first place? Why produce such a strong, negative emotion in situations that aren't dangerous -  especially as such responses often seem to stop us from living our best life? It's just not logical! 

 

The main reason the mind would produce this level of distress is to keep us alive and protect our wellbeing. As we go through life, there are actually multiple structures in the brain that help us to code what's happening as safe or unsafe, and store that memory as learning.

 

This process is important enough that nature has even gifted one structure, the amygdala, with two different circuits to do this (Ehrlich, Humeau, Grenier et al, 2009).  If a memory is coded as 'unsafe', then the brain learns to avoid that situation in the future. So far, so logical.

 

Unfortunately though, this coding process has a few flaws. Firstly, the brain doesn't take any chances, so everything in that memory can become an 'avoidance' trigger. This could be simple things such as smells, a song playing on the radio or anything that you could see at the time. They don't even have to be directly related to the emotional content of that moment, they are just guilty by association. 

 

The second, perhaps more fundamental flaw to this process is that a lot of our learning develops during childhood. Our younger selves didn't always have the ability to accurately judge what's happening to them. Again, the brain won't take the risk, and will still code the memory as 'unsafe' even if  our judgement of the situation is deeply flawed. This means logic is often out the window, as our young mind put a memory in the 'unsafe' category based on our level of understanding at the time. 

 

A third flaw is that this learning operates in a sort of closed loop (Silvester, 2010). Research suggests that the brain is able to vividly create sensations without external triggers (Damasio, 2004*), and it can do this during memory recall (Wu et al, 2017). This means that often we aren't just recalling a memory, we are actually re-experiencing it. With this re-experiencing, it doesn't matter whether the triggers come from the outside world or our own minds,  it just provides further evidence to the brain that the response is necessary. A reminder to keep avoiding something. After all, the mind has no reason to change this - it's trying to keep you alive. It's constantly being presented with evidence that this response is still needed. 

 

Having said this, there is very real hope for anyone experiencing this. An extensive collection of studies was published in 2015 by Lane, Ryan, Nadel and Greenberg, looking at how these connections in the mind can be updated. In the summary they suggest: 

 

"We propose that the essential ingredients of therapeutic change include: (1) reactivating old memories; (2) engaging in new emotional experiences that are incorporated into these reactivated memories via the process of reconsolidation; and (3) reinforcing the integrated memory structure by practicing a new way of behaving and experiencing the world in a variety of contexts."

 

In short, this can be summarised:

1. Identifying and 're-experiencing' old memories connected to whatever problem you have. Sometimes we aren't even aware of the connections we've made, which is where a good therapist comes in.

2. While these memories are activated, a new way of processing them is introduced. There are many ways to do this, and in my opinion, the best way is whatever suits each client individually. 

3. After you've looked at the old memory in a new way, you look to the future and map how you'd like to be instead, now that old learning connection has been changed into something more positive or useful. This can have a ripple effect and produce positive effects unexpectedly in other areas of your life as well. 

 

This research underpins my training as a Cognitive Hypnotherapist, and the process above closely maps how I work with my clients. In 2015, a pilot study into how Cognitive Hypnotherapy can help with anxiety and depression found that:

 

“In September 2015 the pilot study was published in the Mental Health Review Journal. It recorded that, using 118 cases measuring the effectiveness of Cognitive Hypnotherapy for the treatment of depression and anxiety, 71% considered themselves recovered after an average of 4 sessions. This compared to an average of 42% for other approaches using the same measures (like CBT).”

Taken from the Quest Cognitive Hypnotherapy Practitioner Association (QCHPA) Research page on the website, which can be found here

 

This research, along with the other findings from 2015 definitely seem to be suggesting that we have a pretty good idea of how to help people with anxiety to overcome those waves of emotion. There is evidence now, that your anxiety is lying to you. You can recover from whatever problem you are facing - and you don't have to live with it forever. It might just be that you need a little support along the way. Whether that's a therapist like me, or someone else doesn't matter - just that you find the right person to help you, and take steps towards change. 

 

If you are interested in finding out more about how this could work for you, please just get in touch with me. If you aren't sure if I'm the right person, I'd be happy to direct you towards other therapists who work in this way. 

 

*Just a quick footnote: In Damasio's book: Looking For Spinoza, he mentions a woman who reported the feeling of falling during a brain scan. The areas in the brain that experience that physical sensation were activated, suggesting that she really was feeling that sensation in her body at the time. I found it incredible that the mind produced this so vividly. 

 

References

Andrews, W.P., Parsons, A.A., Rawle, H. & Gibbs, J.(2015) "A pilot investigation of Quest Institute Cognitive Hypnotherapy services using Improving Access to Psychological Therapies as the benchmark", Mental Health Review Journal, 20 (3), 199-210

 

Damasio, A. (2004) Looking For Spinoza. London: Vintage

 

Ehrlich, I. Humeau, Y., Grenier, F., Ciocchi, S., Herry, C. & Luthi, A. (2009) Amygdala Inhibitory Circuits and the Control of Fear Memory. Neuron, 62 (6), 757–771

 

Lane, R. D., Ryan, L., Nadel, L. and Greenberg, L. (2015) Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: New insights from brain science, Behavioral and Brain Sciences. Cambridge University Press, 38, p. e1

 

Silvester, T (2010) Cognitive Hypnotherapy: What's That About and How Can I Use It?: Two Simple Questions for Change . Leicester: Matador

 

Wu, CT., Haggerty, D., Kemere, C. & Ji, D. (2017) Hippocampal awake replay in fear memory retrieval. Natural Neuroscience. 20(4): 571–580

 

 

 

 

 

 

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