Anxiety

Do We All Hate the Idea That Something Is Wrong With Us?

Being labeled an "insecure" person was simply unacceptable to my identity.

Posted Jan 16, 2020

This morning, I opened an email from a person who had just flown successfully for the first time in two years. He did well on the flight and wrote that preparation (doing the exercise that trains the mind to automatically regulate anxiety) was the key.

He added something that resonated with me. It was about being imperfect. Do we all hate the idea that there may be something wrong with us? Or is it an issue only with those of us who grew up in a home where you are expected to be perfect, and of course, couldn't live up to expectations?

In any case, he wrote:

Believe it or not, what helped me most was the discussion in your book about people with secure orientations and those with insecure orientations. I hated the idea that I was a 50-year-old adult who had not developed a secure emotional orientation! It was embarrassing, offensive, and... it was true. My ego couldn't stand the 'labeling' of me as an 'insecure' person. It was simply unacceptable to my identity. I said 'there is no way I'm going to be a person with an insecure orientation of the world.'

Since that was so important to him, and to me, maybe others can benefit from reading this part of my book, Panic Free: The 10-Day Program to End Panic, Anxiety, and Claustrophobia, posted here with the permission of the publisher, New World Library.

Chapter 9

How Feelings of Security and Insecurity Develop

How does early development affect a person’s adult life? Let’s consider two fictional adults I’m going to call Suzie and Ingrid. Suzie generally feels Safe and Secure, and Ingrid often feels Insecure, often for no apparent reason.

When Suzie’s amygdala triggers the release of stress hormones to call her attention to something unfamiliar, she experiences a surge of arousal. Because her caregivers have routinely responded to her when this happened in the past, the surge of arousal doesn’t alarm her. Rather, it causes her to feel curious about what is going on. Curiosity causes her to look around. If she finds nothing amiss, she pauses for a moment and then drops the matter.

When a surge of stress hormones arouse Ingrid, she, unlike Suzie, experiences alarm. Because of past experience, she associates alarm with danger. She, too, tries to figure out what is going on, but her belief that there is danger makes it hard for her to assess the situation in a balanced way. If she can’t identify the danger that she believes must exist, she begins to imagine what it might be. And as long as she continues to feel alarmed, she can’t drop the matter.

We sometimes say that seeing is believing. In Ingrid’s case, feeling is believing. Her sense of alarm makes her believe that there must be danger, even if she can’t see what it is. She knows that her eyes can play tricks on her and make it appear something is true that isn’t, but she regards her feelings as infallible. She doesn’t understand that arousal is merely the way the amygdala gets her attention, sending a signal for her to determine whether or not a danger exists. To her, arousal itself means danger.

In other words, the amygdala releases stress hormones to grab a person’s attention and direct their high-level thinking toward determining whether an unfamiliar situation poses a real threat. But Ingrid doesn’t use her high-level thinking. When stress hormones hit, she feels alarmed. Lacking the mental programming to shift alarm to alertness, she stays alarmed. Because she feels alarmed, she feels afraid. Because she feels afraid, she believes there is danger. Her assessment of the situation is based not on high-level thinking but on emotion.

Though Ingrid has a huge frontal cortex capable of logical thought, her assessment of the situation is made by a part of the brain the size of a nut. What has led her to turn over control of her life to a part of her brain that can’t think?

Suzie learned early in life to distinguish arousal, alarm, fear, and danger. Ingrid experiences all of these feelings as one and the same, fused by early trauma. Her early life may have been similar to that of a client who told me that when his father was sober, they got along fine. But when Dad started drinking, the client’s arousal level increased sharply because he knew that sooner or later he was going to be hit. For him, feelings of arousal continued to mean fear and danger into adulthood.

Arousal, alarm, fear, and danger can be conflated even when a person has not experienced physical trauma. Julian Ford, professor of psychiatry at the University of Connecticut School of Medicine, explains that the most complex form of trauma is not physical but psychological. Psychological trauma involves “interactions with people who teach the child or adolescent to focus on danger and survival rather than on trust and learning.” If these interactions occur early in childhood, while the brain is particularly malleable, “lasting changes in the personality and the self occur.”

Since arousal equals fear, and fear equals danger, stress hormones that trigger arousal cause alarm. When arousal occurs, instead of feeling curious and going into a learning mode, the person fears danger and goes into a survival mode. As an adult, the person is subject to “entrenched expectations of danger that lead to preoccupation with detecting and defending against threats.” In short, inadequate automatic regulation of arousal, coupled with the belief that arousal means danger, can lead to panic.

In a person whose early caregivers responded to the child’s arousal calmly, alarm is automatically down-regulated to alertness, interest, or curiosity in the absence of a real threat. In a person with a history of relationships in which arousal led to and became associated with pain or injury, arousal must be regulated by being able to control what happens in the situation — or by being able to escape from the situation — to prevent possible pain or injury. Unable to depend on others for safety, the person believes that safety depends on their being in control or able to escape. The lack of control or a means of escape may lead to anxiety and panic.

When a house is built, plumbing and wiring are installed early in the process. Once installed, the pipes and wires are likely to remain unchanged for the life of the house. The same is true of the brain’s wiring. Early relationships literally wire up a child’s emotional-control circuitry.

Here is how “neurons that fire together wire together.” This phrase encapsulates the neurological theory presented by Donald Hebb in his 1949 book, The Organization of Behavior. When adjacent neurons in the brain fire at the same time, they connect to each other and form a new circuit. Think of welding. If a red-hot piece of metal touches another piece of metal, the two pieces become attached. If an electrical current is then applied to one piece, it flows through the other as well.

Let’s apply Hebb’s axiom to relationship. When a mother smiles at a child, her smile causes millions of neurons to fire. Some neurons, those in close proximity when the firing takes place, connect. This causes a modification of the circuitry. Once firing together has led to wiring together, the signal that originally traveled along one neural pathway now travels along a second pathway as well.

How does this get translated into emotional regulation? Let’s try an oversimplified example. Let’s imagine that Suzie and Ingrid are children heading to kindergarten for the first time. Both are going alone, without their mothers to calm them. Let’s pretend they are both precocious and savvy about neuropsychology. Suzie might say something like this:

"I’ll be okay, Mom, because when I was younger, every time I felt upset, you tuned into me. You could tell what I was feeling. You showed me a light at the end of the tunnel by telling me that, though I was upset, I would feel better in just a minute. Because you did this repeatedly, the neurons that fired when you calmed me wired together. Now, when I start to get upset, your face, voice, and touch automatically calm me.

"At kindergarten, though you will not be with me physically, you will be with me psychologically. While I am away, you will have me in your mind, and I will have you in my mind. Even though we are in two different places, we will still be connected."

Suzie’s memories of the many times her mother calmed her are stored like a video in her mind. Being upset automatically triggers the Play button, and the video plays in Suzie’s unconscious procedural memory. As it does, Suzie unconsciously sees her mom’s face. Her mom’s soft eyes calm her. Suzie hears her mom’s voice: “I know how you feel. It’s okay. Everything’s going to be fine.” Suzie unconsciously feels her mother’s reassuring touch. These memories activate Suzie’s parasympathetic nervous system. Calming takes over, and soon everything is okay.

What about Ingrid? Her mother did not consistently respond to her meltdowns in a way that was calming. Sometimes she responded as Suzie’s mother did, but at other times she did not respond at all. And sometimes she invalidated Ingrid’s feelings, saying, “There’s nothing to be upset about.” In some cases, she threatened Ingrid with “Stop that crying or I’ll give you something to cry about!”

When Ingrid is about to go off to kindergarten, she says:

"Look, Mom, if I have a meltdown at kindergarten, I don’t know what I’ll do. I have all these different recordings of you in my mind. When I hit the Play button, it’s like Russian roulette. If the video of you loving me and calming me comes up, I’ll be okay. But if a video of you invalidating me starts playing, I won’t trust myself. And what if I start seeing a video of your threatening me or hitting me? I’m too anxious to bring you to mind. Since I can’t depend on what is built inside to calm me psychologically, I need you to be there with me physically to do it."

Everyone is subject to the release of stress hormones and the resulting feelings of high arousal or alarm. Some of us have neural programming that activates automatically and calms us. We go from alarm to interest or curiosity about what the amygdala is reacting to.

Those of us who don’t have that software stay alarmed until the stress hormones burn off. We try to control our arousal by being in control of what is going on so that we can be sure there is nothing to get upset about. We tend to avoid situations where we can’t control what happens. If we can’t avoid such a situation, we make sure that if things go wrong, we can get out.

Fortunately, if our circuits for automatically attenuating alarm and regulating arousal — including panic — were not established in early childhood, we can establish them now. We can pick up where development left off.

Let’s consider Ingrid again as an adult. On the surface, she looks cool, calm, and collected. Everyone thinks she has it all together. In part, that may be because she has some good friends who are rarely competitive with each other. When she is with them, the signals she unconsciously picks up from them keep her parasympathetic nervous system active. She can let down her guard and feel completely comfortable.

When Ingrid starts a new job, however, there is competition among the employees. Her performance is subject to judgment and criticism. No one provides her with unconscious signals that all is well. Anxiety causes her to judge and criticize herself. But because Ingrid needs to control things to feel safe, she has become quite accomplished at it. Though she pays an emotional price for it, this ability advances her career, and she becomes a manager.

Initially, she handles her new responsibilities well. But, as she advances and faces greater challenges, she can’t control every detail. Stress builds up. She has occasional panic attacks and consults a therapist. The therapist asks her to replace critical thoughts about herself with positive affirmations. The therapist also tells her that since panic attacks cause no harm, she should not fear them.

Ingrid expected that therapy would make her feel better, but being told by a person she believes is an authority that she should not be troubled by panic attacks is one of the most invalidating things that has ever happened to her. How could she not mind having a panic attack? Does it mean there is something wrong with her?

Though research has repeatedly shown that breathing exercises do not relieve panic, the therapist recommended them, probably because he was unwilling to admit to Ingrid that he had no effective way to help her stop having panic attacks. Though Ingrid didn’t know it, the therapist had set her up for failure. Her panic continued. When Ingrid’s health insurance carrier refused to pay for additional therapy sessions, she figured it was just as well. If anything, she felt worse about herself after seeing the therapist.

To run well, a computer needs both good hardware and good software. To attenuate alarm and regulate arousal, you need good hardware; your brain needs to be physically intact. Usually, nature takes care of that. But regulation also requires good software, and nature provides only half of it. Every baby is born knowing how to get revved up, but nature does not provide built-in software for calming down. That has to be installed through emotionally secure relationships with caregivers. Ingrid’s early relationships did not install the software she needed.

Now let’s assume that Ingrid did what you are doing: She read this book. She was surprised to discover that many people feel the way she does. She didn’t think anything was missing during her childhood. Though she didn’t remember as many childhood events as others seemed to, she believed things were fine. Nevertheless, since the exercises in this book looked interesting, she decided to try them.

Because of her friends, it was easy for her to remember times when she felt her guard let down. She recalled a friend’s face and pretended the friend was holding a photograph of a work situation that caused distress. She then pretended that she and the friend looked at the photograph together and talked about it. The calming quality of her friend’s voice permeated the scene in the photo. She could remember her friend’s reassuring touch. Ingrid pretended she felt that touch as she and her friend talked about what was going on in the photograph.

On the following day, she pictured her friend holding a cartoon. The cartoon character was having a panic attack, feeling his heart pounding. In her imagination, Ingrid and her friend talked about that feeling. Remembering her friend’s touch felt calming. Ingrid continued the exercise and linked each element of panic to her friend’s face, voice, and touch.

To make the calming process more automatic, she practiced bringing her friend’s face to mind whenever she noticed stress. As she practiced doing this, she was able to detect stress at lower and lower levels, which allowed her to nip it in the bud.

When she read the chapter on preventing panic attacks with the release of oxytocin, though, she ran into a problem. Where could she find a memory that produced oxytocin? She didn’t have any experience of breastfeeding. She had held her cousin’s newborn, but she hadn’t experienced any remarkable sensation or emotion. Her romantic life had had its ups and downs. Currently, it was down. Although she had had strong feelings for someone, the relationship didn’t work out, and the idea of recalling a moment of sexual foreplay didn’t appeal to her. She had never had a pet whose eyes she could gaze into.

Ingrid decided to skip that exercise. Then, as she read on, she learned that even if a relationship ended badly, something of great value could be drawn from a memory of a time when things were good and fear of physical intimacy melted away. Ingrid was able to recall a good moment in one of her past relationships. By isolating that point in time — disregarding the before and after — she gained access to the kind of memory she needed. She linked that memory to the challenging situation at work and to the feelings that led to panic.