I’m fairly certain that this is not the first article you’ve read about treating anxiety. If you search online for books about anxiety you’ll find thousands of them. However, much of what you will have read, and many of the books you can see, are based on material that has now been shown either to be ineffective or worse, to increase anxiety levels. For example, trying not to think about anxiety is like trying not to think about a polar bear; the harder you try, the more you think of it.
I hope that this article will give you an overview of the new understanding of how to treat anxiety, so that you can decide which parts are relevant to your situation and what to do next. Because of the scope of this article it is a little longer than some you will have read, but hopefully by the end you will be much clearer about the way forward for your own situation.
I’m sure you want to get relief from the anxiety; that’s a perfectly reasonable aspiration. Trying to defeat it, get rid of it, eradicate it, hide from it and so on are techniques rather like trying to not think of that white polar bear; the polar bear appears more often.
Over the last two decades our understanding about the brain, the mind and how the two work together (and sometimes work against each other) has increased dramatically. However, this is not the biggest change the last 20 years have given us. The biggest challenge facing psychological treatments is figuring out whether or not they actually work. It is notoriously difficult to conduct trials that give concrete results. The breakthrough that has made the most dramatic difference is our ability now to precisely evaluate specific techniques and what they are doing for our mind and brain. This has gone far beyond comparing Therapy X to Therapy Y. Individual techniques can be picked apart and understood. This is why many of the ideas that were part of the received wisdom around anxiety have been found to be false or ineffective.
To help you better understand the relevance of some of the new approaches here is a little background information so that you can understand the context of these new treatments. In addition I hope that it will show you why these “quick fixes” really can’t exist.
What follows in this article will cover the following topics
We have lots of words to talk about anxiety: fear, nervousness, worry, panic, just to mention a few. We sometimes qualify these words such as social anxiety, acute anxiety, chronic anxiety and anxiety attacks but no matter how many ways we describe anxiety, they are all based on the same brain systems.
Anxiety is a mechanism that allows us to anticipate things that could go wrong or badly for us in the future so that we can take preventative action. Animals with brains that are more primitive than ours do not seem to have the same ability to predict the future; they either need inherited instinctive behaviour, or they have to experience traumatic or stressful situations so that they can learn from them, assuming they survive.
The human brain in its current form evolved about 200,000 years ago. So our anxiety mechanism was built in then, long before we developed language, between 100,000 and 30,000 years ago. It is long before the start of civilisation which is perhaps 10,000 years old. It arrived long before the modern world of a few hundred years ago and certainly way before the technology-driven, crazy information-overload world we live in now, which is just a decade or two old. Simply put, the brain has had no chance to evolve to cope with our current situation. We have a brain that was designed to live in the wild with a small band of other human beings, hunter-gathering and avoiding predators. In addition, evolution selected you from those ancestors who were the most anxious – those who were most sensitive to possible threats were most likely to survive. Overreacting to potential threats gives a far better chance of survival than under-reacting; you only need to get it wrong once and you’re dead, meaning you won’t pass your genes on to your descendants.
Things go wrong when we trigger our anxiety response too often. They get worse when we start to become anxious about our anxiety – what is often called an anxiety disorder.
Now let’s look at what’s happening between your ears in that lump of grey matter.
The more you practise something, the better you become at it. Our brain makes no distinction between good and bad behaviours, behaviours that enrich our lives, or behaviours that restrict our lives. The more often your anxiety is triggered the easier it becomes to trigger it.
Imagine it this way. Think of a large open field. Routinely you drive across this field between the same two points. As time goes on, in different weather conditions, a track will form. When the ground is very soft the tracks become deeper. It soon gets to the stage where the tracks that have formed across the field hold your vehicle in place so it always follows the same line and it becomes difficult to drive any other way. You easily slip back into the ruts and get carried over a familiar path.
And for many this is how anxiety can be. It’s so easy to slip into the anxious thinking. In our brains we form deep ruts cutting to certain neural pathways, and the more often that pathway fires, the stronger it becomes.
And the mind is like a field; once the tracks are laid down, they never quite go away. There are ancient cart tracks running across the landscape that may have not been used for over a thousand years. Once this pathway is in your brain it is there; your brain has no ‘delete’ option so trying to get rid of it is a fruitless exercise.
Clearly the ideal is to be able to drive across this field in whatever way you want, and not just follow the ruts. So you need to learn how to quickly get out of the ruts when you’re caught in them, so that you can have the freedom to choose where you take your mind.
The area of our brains most commonly associated with generating anxious thoughts is what some refer to as our ‘thinking brain’, or perhaps more technically that part of the brain where we are aware thinking.
One of the many great skills of our brains is its ability to solve problems. You can’t stop it solving problems. For example, how would your front door look if it were painted bright yellow? Unless you do a lot to disrupt your own thinking, something will come to mind. Every moment of every day our brains are ready to solve problems.
This ability clearly gives us a survival advantage, which is why we have grown the brains we have, and there is a second mechanism that gives us an even greater advantage. It’s okay to be able to think ourselves out of a problem situation but what if we could predict things going wrong, and think our way out of them before we even get there? This ability is a game-changer when it comes to survival.
So within our brains we have what can best be described as a virtual reality simulator. It’s so powerful that within moments your body can respond as if those events are really happening. Now there’s another part of our brain that starts randomly generating possibilities – things that could go wrong or problems that could occur, even if most of the thoughts are nonsense. All of these thoughts are passed into the virtual reality simulator where our problem-solving brain gets to work. What happens though, because of the way we use language, is we can get caught in our own thoughts, amplifying them and causing a feedback loop.
Additionally we can give some thoughts more meaning than others. For example, some anxious thoughts may generate familiar feelings, so we can give them more attention than they actually deserve, keeping these thoughts longer in our virtual reality simulator rather than just letting them pass through. We can then end up in a runaway situation, going from calm to anxious in seconds. And the more often we do this the more likely it is to happen in the future.
The only way to break this cycle is for us to develop the skills to disengage from these thoughts. They’re just thoughts going through our mind. No matter how real they seem they’re still just thoughts going through our mind.
Our thinking brain is also strongly connected, with direct neural links to the other brain structure often involved with anxiety. And so, by changing how we relate to these thoughts, we can change how this thinking brain can interact with our fear or flight centre.
We have an ancient region of our brain that is shared by all vertebrate animals. This region is sometimes referred to as the flight or fight centre. It is designed to watch out for dangers and then mobilise the body into full action when needed. It is a very fast-responding region of our brain. It is connected to all our senses, including senses around our body.
Almost certainly you have had experiences of this part of your brain taking over. If you have ever stepped off a kerb into the road to find a vehicle hurtling down upon you, you step back quickly. This act of stepping back was almost certainly done by this brain region. It acts many times faster than our thinking brain. If you waited to think the situation through, you’d probably be dead at some point.
This region comes pre-loaded with certain fears, for example fear of heights. Additionally it can learn new things to be afraid of. It has a very rapid memory system so that if a creature gets caught in a highly stressful or threatening situation it can remember the situation. If anything similar happens in the future the fear or flight mechanism will be turned on automatically to put us into the flight or fight mode.
Sometimes we find that this mechanism can trigger in a broad range of circumstances, far broader than the original memory. This mechanism of generalisation can be readily seen in phobias.
In humans our fear or flight centre takes input from the new brain, the virtual reality simulator, so that we respond to these imagine situations as if they were real. This is why when you start getting caught in anxious thoughts your body can respond as if it is really under attack.
We also have another mechanism in the fear or flight centre. This region is also monitoring the body so for example, some people that have anxiety attacks can trigger one by rapid shallow breathing. This change in the body signals the alarm that causes this region to go into action. Some of the more common symptoms of the fear or flight centre taking over are raised heart rate, shallow breathing in the upper chest, rapid breathing, sweaty palms, a narrowing of our vision to just central vision – different people will find different symptoms.
The thinking brain has a strong influence over the activity of the fear or flight centre. The centre could trigger an alarm, then moments later the thinking brain realises there is no threat and calms it down. This mechanism can be enhanced by appropriate mental skills training.
So the fear or flight centre can be involved in anxiety in several ways:
The fear or flight centre can thus originate or be involved when we become anxious. Finding ways to calm it down can sometimes stop the anxiety spiral, or at least bring it to a quicker end.
Important note: these two brain regions are the most commonly involved with anxiety. There may occasionally be situations where there has been damage to the brain, or there is some form of disruption to the brain such as abnormal hormone or neurotransmitter levels. This is the realm of medical doctors to diagnose.
There must be a simple quick solution out there. Having read this far you can probably give your own answer. There are new skills to learn which take time. Some of what’s going on is permanently wired into your brain and cannot be got rid of; it has to be lived with.
Medication should work for me. Only about 30% of people benefit from anti-anxiety medication. Generally the reason is that anti-anxiety medication is targeted at the fear or flight centre of the brain. So if that’s not a major component of your anxiety then it’s not going to be as much help to you. The reason that medications only target this region is that it is only possible to do experiments with animals, creatures without the new brain that we have. It would not be ethical or possible to carry out such trials on living human beings. Many of these studies involve sticking wires in the brain or dissecting the animal after the medication, neither of which are acceptable to use on our fellow humans.
There’s something wrong with me. Simple answer: No! All that’s happening is that normal mental processes are working in an inappropriate context in your life. You’re not broken.
It must be possible to get rid of all pain. Nobody wants pain in their life; however it also cannot be avoided. Physical and emotional pain exist and will occur in our lives, and trying to run away from that fact can cause problems in itself. Sometimes with anxiety, people end up self-medicating with alcohol or other drugs just to get rid of the pain. Realising the pain is going to be there and finding different ways to be with it is what is going to make the long-term change.
Wherever your anxiety is initiated – the deep ancient brain structure or the new brain – our thinking is part of the problem. We have thoughts that run away with us. We get caught up in the emotion, feelings and sensations which then carry us further down a very familiar path. Any long-term solution for you in living and dealing with anxiety is to find a way to change how you relate to these thoughts, feelings, and sensations.
You can develop the skill and ability to choose where your mind goes: out of the ruts in the field and where you want to go to, instead of your mind wanting to follow the familiar track.
There are several components to this skill, depending on what’s going on for you: unhooking from the thoughts; not avoiding some of the stronger feelings and sensations; returning into the present moment rather than lost in thoughts; being clear about what’s important to you in any situation, and also being prepared to take positive actions irrespective of what is going on in your mind. These are all micro-skills that can be learnt. Just like any skill they take time to develop, and they need developing when you’re calm so that when you need them they’re there.
Sometimes people refer to this collection of skills as mindfulness. You may have encountered mindfulness before, usually in some form of paying attention to the breath. Many people investigate mindfulness, or even go further and start practising it, yet they don’t seem to get benefits. Usually this is because it’s not clear how simple mindfulness techniques, such as focusing on the breath, apply to the complexities of an anxious mind.
People treat mindfulness as if it is some new relaxation or calming technique. Its power is as a brain-training tool, which when properly applied can be exceedingly beneficial. It is a big component in changing how you can relate to your own thoughts, and the power these thoughts have over you, and your ability to step out of the thoughts when you want to.
Fortunately a huge amount of work has been done over the last few decades on how to help people change their thoughts – how to precisely develop the mental skills necessary for them to stop being pushed around by their anxious mind.
For some people just attending a mindfulness class may be all that is needed, however many require more advanced more skilled help.
Over the last few decades huge amounts of work and effort has been put into developing an approach to help people more quickly take charge of their thinking. This approach is called Acceptance and Commitment Therapy (ACT). Many people can use ACT to help themselves, and there are many good books available. However for some because of their circumstances, or the intensity of their experiences it’s much easier to work with a therapist. The beauty of ACT is that it can easily be delivered by telephone or Skype.
You have a lot of options available to you if you believe that your fear or flight centre is becoming overactive, and may even be part of your brain that is initiating your anxiety.
Even if it is not initiating anxiety it will be involved in responding to how your thinking is going.
Havening Techniques is a process that has been developed in this century and is a breakthrough in the treatment of trauma. It was developed to give a process for taking the emotional component, that emotional punch, away from highly stressful and traumatic memories that are stored within the fear or flight centre. There are two ways that Havening techniques could benefit you.
There are other simple techniques that can give momentary relief when in a more severe anxiety attack. For example a well proven simple technique is to deliberately shift our breathing so that only our belly is moving, taking slower breaths. This is often called belly breathing. It is not for everyone though; if you know you have difficulties around focusing on your breath then this is probably not for you. The slow deep breathing sends a signal that things are okay to the fear or flight centre. Like any of these techniques it needs practising before you need it – in a severe panic or anxiety attack your thinking brain is almost unavailable so you cannot think your way out of the situations.
When the fear or flight centre takes over, our field of vision narrows. Another incredibly simple strategy for relieving anxiety is noticing what is in your peripheral vision.
A long-term strategy for calming fear or flight centre is meditation. In long-term meditators it’s been shown that the fear or flight centre becomes less sensitive, less likely to kick off. Depending on how anxiety is restricting your life today this may be a good way for you to proceed long-term. It takes time and effort but the payoff can be large.
If what you have read here makes sense to you, fits with your experience and you’re open to considering that there might not be a quick fix then here are some suggestions.
If you’d like a little bit more of the science and more details on ways to help yourself there is an absolutely free online program called Calming an Anxious Mind. It’s nearly 4 hours of short videos and audio clips click here.
If you feel the fear or flight centre is a major part in your anxiety then self-Havening is a great strategy for calming down that centre.
If you realise it’s about how you’re thinking, especially getting into ruts of common thought patterns, then mindfulness in its many forms could be beneficial. There is an absolutely free report on How Mindfulness Helps Anxiety click here.
You might feel that because of your circumstances you need more direct help. If so, please do contact us. Either fill in the email request form or phone us directly on 0114 299 8888. We work with people from all over the world, using Skype or telephone, or if people are local to us they may wish to receive help in person. Additionally here in Sheffield we run occasional workshops and courses.
The intention behind this article is to give you information so you can decide for yourself what you could do next. If this article has helped you then please leave some comments below or share it with others you think it could help.