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Anxiety

Anxiety Gets a Bad Rap: Understand Your Healthy Alarm System

Part I of the Anxiety Jedi Series will teach you how and why to welcome anxiety.

Key points

  • The key to overcoming fear is to stop resisting it.
  • Our natural stress response can become problematic when the threat is only perceived and not real.
  • Increasing exposure to what's scary and accepting anxiety in the moment are powerful ways to handle fear.

Most people think of anxiety1 as a “problem" — an emotional state to avoid or get rid of — an indication that something is wrong, maybe even broken. Why the bad rap?

Well, as everyone knows, anxiety feels terrible. When it pops up in situations we don’t want or expect it to, anxiety can generate even more worry and distress. And naturally (because it’s so uncomfortable) we try to escape anxiety and the situations that generate it, which then limits our lives. Seems like a pretty clear case against anxiety! As Yoda said: “Fear is the path to the dark side.”

But as I solemnly nod to the Jedi Master, I have to pause and raise a tentative finger. It’s a tiny quibble, really, but I want to make a slight edit. I’m pretty sure what Yoda meant was this: Resisting fear is the path to the dark side. Anxiety itself is not the problem. Trouble emerges when we give in to our natural instinct to escape, avoid, or control anxiety.

I imagine Yoda throwing back his head and laughing: “Better, your revision!”

Anxiety Is Part of Your Adaptive Alarm System

Anxiety is not random. It’s not some faulty switch or illness or weakness. Anxiety is part of your healthy, adaptive alarm system. If your brain perceives a threat or danger to you (fire!), it will trigger defensive survival circuitry in the brain (this is a non-conscious process of threat detection and response that occurs in the amygdala).

The sirens ring out—that subjective “feeling” of anxiety or fear we all know so well! Meanwhile, the body’s internal firefighters are deployed: The sympathetic nervous system activates various organs (increasing heart rate, breathing) and stress hormones are released to increase oxygen and blood sugar levels to prepare the body for action. All of these changes in the brain and body create an urgent, powerful drive to act—to do whatever you can to escape the looming menace. This is the purpose of your anxiety alarm system: to alert you to threats and motivate an avoidant coping response.

 Pixabay/Pexels
Source: Pixabay/Pexels

Suppose a car wanders into your lane of traffic, or you develop a cough in these times of COVID-19, or your manager looks away when you say hello. It’s a very good thing that your brain is wired to instantly recognize these cues as potentially threatening so that your alarm system is activated to respond protectively. You swerve out of the car’s path, call your doctor, or set up a meeting with your manager to check in pronto. If you think you have successfully avoided or reduced the threat, your anxiety alarm will turn down. That sweet relief is highly reinforcing, and this is how we learn over time to do that avoidant coping behavior again.

Anxiety Is a Response to Perceived Threat

Like all emotional states, anxiety is an important signal. Anything that your brain perceives as potentially dangerous or threatening to your basic needs or well-being will trigger your body’s anxiety alarm. While the days of being stalked by lions are long gone, humans still have fundamental physical, psychological, and social/attachment needs that can be threatened. We can face physical threats to our health from an accident, assault, or disease. As social animals, any perceived social threat to important relationships or our position in the tribe will also trigger our anxiety alarm system (i.e., signs we are being judged, disliked, rejected, or abandoned). Finally, certain thoughts, memories, or feelings that we find distressing or overwhelming—psychological threats—also activate our anxiety alarm system (see How to Feel Your Feelings).

Is the Threat Real? True vs. False Alarms

By this point, you may have picked up on the fact that it is perceived threat that sets off the alarm — not necessarily real threat. Sometimes there is smoke, but it’s actually a campfire. Threat detection happens in both conscious and non-conscious regions of the brain. If your brain is accurately assessing the danger, we call the anxiety a true alarm (that car will hit you if you don’t move; your manager is unhappy with your performance). But when the threat isn’t real, likely, or as severe as we think, we call the anxiety response a false alarm. Whether the threat is true or not, the alarm activation in the body is exactly the same. And we are wired to believe it (it feels real!).

Courtney Tosana/Unsplash
Source: Courtney Tosana/Unsplash

False alarms are incredibly common. The brain can misjudge a situation (that car wasn’t close enough to hit you), misread others (your manager is actually thinking about her troubled marriage and is not displeased with you), or misread your internal sensations or experiences (that cough is actually allergies). And because perceived threats are generally predictions, in the face of that uncertainty, we are wired to over-predict the likelihood or severity of a future threat. Finally, throughout our life, our brain is learning and remembering what is threatening through both conscious and non-conscious processes (the latter happens through associative learning in the amygdala known as fear conditioning). Unfortunately, these threat associations can persist and generalize to situations that have never been, or are no longer, dangerous.

This is why false alarms happen all the time. In fact, it’s fair to say they are actually a “feature and not a bug” of the system. Our brain is designed to over-predict threat, and you see this threat bias in all animals. Why? From an evolutionary point of view, if a situation is ambiguous or potentially risky, better safe than sorry!

Anxiety Drives Protective Behaviors (Here’s the Rub)

Geronimo Giqueaux/Unsplash
Source: Geronimo Giqueaux/Unsplash

The entire purpose of our anxiety alarm system is to prepare and motivate a defensive response—to freeze, flee, fight, or in some way reduce or manage the threat. If the threat is real (true alarm), then these behaviors are obviously adaptive. Coping responses to true alarms not only keep us alive — they help us change course, preserve or repair relationships, work harder, prepare effectively, get help.

But what about coping responses to false alarms? Cognitive-behavioral therapists call these “safety behaviors,” because they are aimed at restoring a sense of “safety” even though there is no real danger. Examples might be Googling medical sites and making a doctor’s appointment every time you have a mild or transient physical symptom, staying quiet in class or meetings because you expect humiliation, or avoiding the subway out of fear of being trapped. Safety behaviors can also be internal moves — as when we try to mentally push down threatening thoughts or feelings that are triggering anxiety (psychodynamic therapists call these moves “defenses”).

You might think: “Well, even if the threat isn’t real and it’s a false alarm, no harm in being protective! The problem with safety behaviors (avoidance) is that harm is being done.

The Problem Isn’t Anxiety, But How We Respond to It

Ketut Subiyanto/Pexels
Source: Ketut Subiyanto/Pexels

While safety behaviors reduce anxiety in the short-term (relief! highly reinforcing!), they actually strengthen threat beliefs and anxiety problems over the long term, which can lead to anxiety disorders. This is because when we quickly move to escape a situation that our brain is misinterpreting as threatening, we can’t learn through experience that the threat isn’t real or as bad as we imagine. (Even if it’s a true alarm, it’s rare that we need to act urgently). Worse, your brain literally watches your behaviors, and when it sees you acting protectively, it assumes the threat must be real! And because safety behaviors are always a form of avoidance, they get in the way of doing what is most important and meaningful in our lives.

So the problem isn’t anxiety itself, but how we instinctually respond. We believe the sirens going off in our body, whether the perceived threat is real or not. Then we automatically obey the anxiety and urgently act to escape, control, or avoid the threat (thus reducing the anxiety). In the case of false alarms (which happen all the time), these safety behaviors keep us struggling with phantoms and stuck in defense mode, while the important things in life pass us by.

Becoming an Anxiety Jedi

What then is needed to handle anxiety in a more skillful way? How do we become, in the wise words of one of my clients, an Anxiety Jedi?

It’s helpful to see the fundamental principles at work. Anxiety (indeed any internal feeling) is not the problem — it’s our instinct to avoid what is aversive. In fact, avoidance is a core feature of most psychological problems that keep us stuck. Perhaps it’s no surprise then that “exposure” — facing what feels threatening (staying with the anxiety) — is a fundamental mechanism of learning and growth. Exposure often results in a corrective experience (disconfirming the threat), thus reducing anxiety over the long run, increasing confidence in one’s ability to cope, and creating the freedom to choose your behaviors more wisely. This is why exposure is a common process across all psychotherapy approaches.

Oluremi Adebayo/Pexels
Source: Oluremi Adebayo/Pexels

And this is also why the first skill of the Anxiety Jedi is learning to mindfully allow anxiety (exposure!), instead of resisting it (avoidance). Now that you understand how your adaptive alarm system works, this knowledge can give you the courage to ride through the anxiety storm. All those bodily sensations, feeling of fear, and urge to escape that accompany the anxiety alarm are very uncomfortable, but they are not dangerous or unhealthy. The practice of allowing anxiety starts off as distress tolerance (gritting your teeth!), but as you bring more awareness, curiosity, and kindness to the experience, you will learn to accept anxiety in the moment whenever it arises. Without this acceptance muscle, anxiety will always propel you to do your safety behaviors.

Anxiety Jedi Skill #1: Mindfully Allow Anxiety

When you notice anxiety or fear, name it: “This is my anxiety alarm.” Pause and mindfully allow the physical sensations of anxiety to flow through your body, rather than focusing on your thoughts or what triggered the anxiety. Imagine yourself sitting cross-legged in the middle of a fire station, the fire alarm blaring. Firefighters within your body (stress hormones) are throwing on their heavy jackets and helmets, rushing to activate your muscles and organs, not knowing whether the threat is real. Let them deploy! Feel the surge of energy and sensations: heart-pounding, stomach knotting, fingers tingling, maybe a little breathless or light-headed. All you want to do is curl up, cover your ears, make it stop. But instead, try to stay right there, arms metaphorically open, mindfully observing and accepting the sensations. It helps to say to yourself in a compassionate voice: “This is so uncomfortable! But the alarm isn’t bad for me. Let the waves of anxiety flow through me.” Keep allowing until you begin to feel some acceptance in the moment—the anxiety still feels aversive, but now you are “surfing the waves” of the alarm, rather than struggling with them. Imagine Yoda smiling.

What are the other Anxiety Jedi skills? Part II of the Anxiety Jedi series will look at how our brain learns that certain cues or situations are potentially threatening, and how to identify what's driving your anxiety in order to distinguish true versus false alarms (skill #2). Part III of the Anxiety Jedi series will help you identify and resist problematic safety behaviors (skill #3), so that you can instead act according to your values (skill #4).

Master, then, you will be!

1The terms “fear” and “anxiety” are used interchangeably in this post (both refer to the same defensive neuroendocrine system in the brain).

References

Hauner, K.K., Mineka, S., Voss, J.L., Paller, K.A. (2012). Exposure therapy triggers lasting reorganization of neural fear processing. Proceedings of the National Academy of Sciences of the United States of America, 109 (23), 9203-8.

LeDoux, J.E. (2012). Evolution of human emotion: a view through fear. Progress in Brain Research, 195, 431-42.

Pittig A., Treanor, M., LeBeau, R.T., Craske, M.G. (2018). The role of associative fear and avoidance learning in anxiety disorders: Gaps and directions for future research. Neuroscience & Biobehavioral Reviews, 88, 117-140.

Treanor, M. (2011). The potential impact of mindfulness on exposure and extinction learning in anxiety disorders. Clinical Psychology Review, 31 (4), 617-625.

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