Revisiting Anxiety

A recent Time Magazine has its cover titled “Anxiety,” accompanied with a serious article about it. (Dec. 5, 2011. “The Two Faces of Anxiety.”). There are many circuitous byways in the piece but if we are to get a grasp on its treatment we need to be sure about what it is. I am not sure that they state what it is, only that in some cases it is good for you. It is never good for you, especially when it revs up the system to prepare for a danger that most often does not exist; that is, that does not exist outside. It does exist inside. It is called a memory, an imprinted memory of danger that dates back to the time we were living in our mother’s womb. The danger back then could have been a carrying mother who drank or smoked, who was depressed or anxious, who did not eat properly, who took tranquilizers and other pain killers or who was chronically upset with her marriage. These are dangers for the baby that menace his life. His system reacts with terror because that is the highest level of brain development, for the moment; and because those events are most often life-threatening. The fear reaction is not quite in place; for that we need a fully development limbic system which at the third month of gestation is yet to come. A heavy dose of anesthetics to the mother during the birth process can shut down his respiratory system and bring him near death. This is the time of rapid brain development where trauma can have long-lasting effects.

We need to understand that once there is terror installed in the evolving fetus the genetic cells change and become epigenetic. Those transformed cells are the carriers of terror. They drive neurotic behavior and all sorts of serious diseases including cancer (the cells that block cancer cells from developing are nearly always heavily methylated, indicating early trauma). The process of this imprinting is carried by methylating the cells; adding part of the methyl group of chemicals to the gene. The cells then carry the “brand,” perhaps for a lifetime. There is such a distance from the time of that imprint, to terror of exams at age twenty that the source is not even considered. What has been imprinted is terror; terror of suffocation, strangling, deprived of oxygen and of being blocked from getting out. All of these are life-threatening and they remain in pristine form throughout our lives ready to surge forth. Terror is later joined by fear, a higher-level event in the brain, a later evolution. They are combined by a process known as resonance so that anything that can set off fear later on may dredge up underlying terror with it. When it bursts through to conscious/awareness later in life we call it panic or an anxiety attack. It is not; it is the same pure terror that was imprinted perhaps decades earlier. It may arrive in disguised form, a phobia or compulsion, but at base it is still that terror, and it is never good for you. When the terror is felt and experienced the phobias fall away.

Thus, anxiety is terror emanating from the deep reaches of the neuraxis; more precisely, from the brainstem that controls digestion, breathing, elimination and other vital functions. Anxiety is not fear; fear is the portal of entrée to earlier and more potent times. It is deeper in the brain and earlier in our evolution. Terror is for radical and immediate action; a key survival function. It is part of our primitive brain and predates our emotional brain by millions of years. When a carrying mother is seriously agitated she is activating her baby, setting off terror response. When the mother’s emotional state goes on and on it marks the genetic cells of the fetus and alters them, imprinting the terror response as an enduring legacy. It is given a different name; it is no longer terror, it is now anxiety, still terror filtered and disguised but the feeling is exactly the same, unchanged. And when our patients relive those early imprints the wrapping comes off the anxiety and it becomes the terror it was at the start; we see it now for what it is and was. It now has a context, an origin. With this reliving there is a radical change in biochemistry of the patient as well as vital signs which tend to normalize. In the reliving of an anxiety attack the anxiety transforms into pure terror; it does not exactly “transform,” it “reveals” what it is. And at the end of the session key vital signs drop to below starting values. When reliving the terror the anxiety disappears because the patient has felt it in its entirety and its origin. They are, as I noted, identical. Once we understand that anxiety and panic are pure terror we understand how it cannot be good for you. Yes, it will get you going, but how do you stop it? And how do you keep it from blocking your ability to focus and concentrate? So long as we think it is anxiety and not terror we will not know how to eradicate it. So long as we think it should be embraced, as the article states, we will be misled in our treatment of it. It is true that this can “get our adrenaline pumping,” but at what cost? Prolonged anxiety will surely cause a premature death, and in addition will damage the cognitive brain and diminish its thinking/reflective capacity later in life. Since anxiety seems to work in reverse order with telomeres (those caps on the chromosomes that indicate how long we may live), I think anxiety is a dangerous thing.

This article by Alice Park claims that anxiety is a “normal adaptive response.” But what is it adapting to? Surely not just taking school exams. Is it normal to be anxious before an exam? Sometimes yes; most often, no. But being apprehensive and suffering anxiety are not the same thing. They live on two different levels of the brain and should not be confused. Anxiety appears when fear has triggered off deeper levels of consciousness, of brain function. It is from the past, historic, not an adaptation to the present. That is why it seems so aberrant. We cannot see what causes it. For that we need to travel the person’s past and see for ourselves, and the person, himself, will see it, experience it, too. We see how in vain it is to deal solely with the apparent problem, exam anxiety, when it has very little to do with the exam, and very, very little to do with current life. It is just that the imprinted early terror is so at-the-ready, so close to conscious/awareness that it does not take much to set it off.

As I noted, the article states that not all anxiety should be battled, sometimes “it should be embraced.” Why would we want to embrace terror unless we really don’t know what it is? What they say is that just the right amount of agitation provides proper titrated motivation and is good for us. And so the article goes on, “the key isn’t not to feel anxious; it is to learn ways to manage that experience.” So no longer do we attempt to understand causes and origins, we just need to development management skills, as though feelings were a business to be managed. The trouble is that we use the top level neocortex to control and manage feelings but alas, all we can do is suppress and mask it. That is part of the function of the frontal neocortex. But feelings are not to be managed; they are to be felt and experienced. Animals know that instinctively. Animals don’t block their survival functions; they act on them. When we block them we are at the mercy of the outside world. And that blockage or repression means a great pressure internally acting on our organ systems, grawing away until serious disease appears.

One of the specialists on anxiety in the article states, “anxiety is neither helpful nor hurtful. It is your response that is helpful or hurtful.” In other words, it is all in your head. It is not whether your dad dies; it is how you respond to it. This is an old canard put forth by the booga booga therapies of the sixties and seventies. such as EST. It is pure solipsism; there is no outside world, just what goes on in your head. Reality is secondary to attitude. Belief trumps reality. So the result is that they treat attitude and ignore facts. The analogy to this is that if you change your mind you can change reality.; an offshoot of Cognitive/Behavior therapy. And they add, “our species would not be better off without it.” (Anxiety). I disagree. We do not need to terror to function except when a truck is bearing down on us; something that does not happen every day. Terror usually keeps us from functioning. I suppose that if you are on the outside looking in, (cognitive/insight therapy) you can come to no other conclusion. If you manage to get inside and look out (outsight) you get a different perspective.

I think it revolves around the idea of where is the danger? If we believe it is outside then treatment focuses on that (which is left brain), by the way, But what if that danger is inside, as it most often is, and it stays there no matter what we do (right brain). We cannot maneuver the inside from outside. We cannot make the left brain do the work of the right. What if anxiety has outlived its usefulness and continues to damage our brain and shorten our life? What do we do then? Mostly drugs and medication. Blocking it instead of expressing it. Once we know what “it” is we can then treat it and let it out and be done with it. It is far easier to try to change beliefs and attitudes instead of feelings because feelings are lower in the brain, in the subconscious and much more difficult to access. For those who live in their heads it is simpler to address the present, the superficial and get on with life. The confusion seems to be between motivation and terror. We never need terror unless a snake attacks. It is good to have that primitive animal, that same snake (and its primitive reactions) in our heads, just in case. We do need to be motivated but it should not be due to negative fear but to positive desire. Some actors state that they need anxiety to drive their acting and make them better. So they are never satisfied; they brag about this as something positive when it is not. They think that to be satisfied is to be smug and self assured—arrogant. They believe that if you are not anxious, and are satisfied with your work you will never improve. Isn’t there such a thing as wanting to make a good something without the anxiety? Can’t we have a sense of the good without terror? Too often the person has never had enough approval early in life and that is what drives him. The need for love and approval. It was never good enough for a critical father and thus never good enough for him. So he struggles; making a virtue out of missing love; thinking it is a good thing. But always anxious and never satisfied can never be a good thing.

In this kind of approach there is almost never a mention of history, of memory of imprints. Never a recognition of generating sources; of origins and causes. Until we deal with origins we can never consider cure because that is what cure is; a plunge into history, to those imprints that drive us.

Toward the end of the piece they acknowledge that anxiety may be related to fear but is “more prolonged and diffuse. “ They need to see that it is an emotion surging from different parts of the brain, and that the earlier the imprint usually the deeper in the brain it is, hence, the more terrifying. There is an hierarchy of feelings which get more powerful as we descend into the unconscious. As we descend fear becomes terror, organized deep in the brain, anger becomes rage, disappointment becomes hopelessness, and so on. There are levels of feelings. We often anticipate catastrophe because we are reacting to an event that has happened long before we have words to describe and understand it. That anticipation is called anxiety by the cognoscenti. We think we are seeing the future when we are only observing our history. That history predates ideas and beliefs. There was never any words for it. Now that we do have words we apply it mistakenly to the present when it is from our personal archives.