Why Are We Anxious? (Part 5/6)

Living with hypercritical parents can be the soil for this feeling, and of course, the sense of catastrophe also emanates from from the early non-verbal event at birth, perhaps, where the baby sensed that to make a mistake could be fatal. There is lingering feeling that, “I cannot be wrong or make a mistake.” And the inability to be wrong is present in so many of us. This kind of person does not know how to react in crises. It is not a reasoned response that is required but a physiologic/feeling one. Defending against the possibility of a mistake begins with that very early feeling/sensation where doing the wrong thing, being wrong, could have been fatal. Defenses sealed in the feeling which then lingers and can make the person a “know it all.” Someone who cannot be wrong.
When a fetus develops normally the inhibitory/serotonin cells also develop in orderly fashion. But trauma to the carrying mother (a husband leaves the home) interferes with that process. Later on when the baby, now adult, suffers panic and anxiety attacks that appear out of the blue we can perhaps understand the origins. We see it in newborns whose bodies express it in restlessness and afflictions such as colic. They are often non-cuddly babies.
One reason for the evolution of the left frontal cortex was to produce a brain system that could distance itself from the other areas of the nervous system where painful feelings lie—a way of not being overwhelmed by what lay below so that we can get on with life and deal with daily problems. The prefrontal area is a brain system that can uncouple itself from massive, damaging input. It is the human part of us that can do it; it can disengage from that lizard in our head with our brain above water. It is a system that can bolster defenses and keep us out of inordinate pain. Another important reason for the evolution of the left hemisphere is that the left frontal cortex evolved with the use of tools. It is the left frontal area that is involved in precise tool use, as for example, hammering a nail. Precision has become the domain of the left frontal area. If we are looking for a good surgeon we should find one that is left-brain dominant. We can be assured that she will be precise. If we want a therapist who can feel and sense things we may want a right-brain dominant individual; but of course, someone with a balanced brain is always the ne plus ultra.

The anxious patient is giving us her early generating source on a platter. The key feeling is right behind the anxiety, which is a sort of an avatar ushering in some catastrophic feeling. The fore-runner of doom. How do we know that? Because when a patient begins the session with feelings of gloom and doom, and is miserable, we often know what feeling is coming. And from what level. If we listen carefully we will know where to go in the patient’s past. The feeling is there. We need to understand its significance. We can begin serious therapy while the patient is suffering because she is very close to the feeling and its origin. Acute anxiety means in itself that the generating source of it is very close to consciousness. And as I note elsewhere, the closer the person is to her feelings the more anxious she becomes; it is telling in almost mathematical precision how close to conscious/awareness the feeling is.

We see the defense at work in studying the brains of our patients. As feelings surge forth there are higher vital signs and a mounting amplitude of the brainwaves (how many neurons are recruited to defend against feelings). As connection is made the amplitude drops precipitously. It would seem that one aspect of brainwave amplitude is in the construction of defenses. At a certain point when defenses are lower the connection is being made and the brain can relax. No, we do not use too much of our brains; we use too much of our nerve cells when we must defend against feeling.

Since to be conscious is to be free of anxiety we are already half-way there. There is not much difference between an anxious patient and one who develops anxiety during the session. In both cases the feeling is approaching. With the patient, she only gets anxious as she gets near the feeling. Then we can see a full-blown anxiety attack; just before fully experiencing the feeling the patient whispers, “I am going to die!” Generally, the anxious patient has chronically leaky gates so that part of the feeling is seeping through at all times. Both are propitious for the therapy so long as the anxiety is not terribly overwhelming; meaning that the patient needs to be brought into the primal/feeling zone. It is not helpful in conventional therapy because they attempt to suppress, not express. Quite different processes and goals. If feelings are erupting it is clearly better to let them out in some methodical way than to continuously push them back. It hasn’t been done because since Freud’s admonition that the unconscious is a dangerous place. It is the flip side of the old religious tenet that says we are inhabited by dark demons and must hold them down. Those demons to the layman were evil spirits. To the psychologist they may be negative feelings. The same thing; some mysterious force at work. The mental health professional often cannot accept what it really is because in his theory there is no room for deep-lying memories that constantly direct our lives. And he has not the techniques to travel deeply to the antipodes of the mind.

The more we learn about personal evolution the more we understand about evolution of our internal universe. As I noted, inside the human brain we can find remnants of our fish and reptilian ancestors. What this means is that what we are is built on the most successful adaptations of what we were. When our patients go back to the most primitive brains in their reliving, we see those ancient brains at work. And,I might add, there are never any words in those first-line relivings (Primals). There cannot be because it would mean not a true reliving (there were no words when it happened). No real reliving and therefore no getting better.

The power of anxiety explains much about the power of the imprint. And we note that anxious individuals are forced to keep busy so that they are never left still long enough to fully feel the anxiety. It is absorbed in the constant phone calls, moving here and there. Phone calls are telling because the original anxiety may have been just after birth when there was no one to hold and caress the baby, no real contact. The feeling behind the anxiety may be feelings of total isolation and alienation. Also a feeling of abandonment. Phone calls reconnects the person constantly. The act-out is, “I need contact to show that I am not alone.” And above all, he doesn’t have to feel that abandoned feeling he suffered just after birth or in the first months of infancy. He stays on the phone for a long time because he is staving off the feeling of no contact. He cannot judge that he may be on the phone too long with someone because he is acting-out old feelings that drive him to talk; he has found an outlet for his feelings.

On my desk is a scientific paper on how early life affects adulthood (Max Planck Institute, Germany, 8 November, 2009. Published online in Nature Neuroscience, by Chris Murgatroyed and nine other authors). What they have shown rather conclusively is that very life events can induce long-lasting changes in the brain, physiology and behavior. Early life stress can cause over-secretion of the stress hormone, cortisol, which effects changes in memory and coping mechanisms. (For those scientifically bent, there is a detailed explanation of methylation in the article, explaining long-duration effects). In their study of mice they found that periodic infant-mother separation just after birth was a major cause of anxiety. And in humans the earlier the separation the more lethal.

I have discussed anxiety and the levels of the unconscious in several of my previous works (see Primal Healing or The Biology of Love). A first- line imprint requires a first line response, that is, reactions that heavily involved the brainstem and limbic system. The brainstem is involved in high blood pressure, palpitations, and shortness of breath—the silent killers. It houses many of our instincts, our terror and furor, and our basic, primitive needs. It is and always will be, wordless, unless we think that salamanders can speak. It contains the secrets of our birth and of our lives before birth in the womb. If we want to know what kind of birth we had, it will tell us in its own way. It will be precise and unmistakable. Its wonderful quality is that it cannot and will not lie. If we claim not to be afraid, but down deep there is unabated terror, there is no argument.

A chronic symptom of palpitations is testimony to the possibility of an old imprint lying deep in the nervous system. It is a fragment of a central memory where a rapid heart beat was called for; one aspect of an anxiety state. So one goes to a specialist for heart problems; another for high blood pressure; another for migraine, when they are all part of a single imprint, which, when relived normalizes all reactions. There is a reason for high blood pressure. Too often the reason is so arcane as to be disbelieved. But it is there. Either genetic or more likely an imprint while we lived our womb-life (epigenetic). The specialist, a necessity, offers medication to lower the blood pressure without asking once where it comes from. She has a task to complete, a task to help the patient not suffer. That cause is so mysterious that the question is rarely asked by the treating physician. And, as I often point out, we are not used to delving deep into the brain and its levels of unconscious. We don’t delve because we often do not have the tools. We do now. But still, it takes such a level of abstraction to tie palpitations in the now to an event during our womb-life. Luckily, we don’t have to make that intellectual leap; the patient will do it for us. And when we give the patient the possibility of deep penetration of herself, giving her total freedom of expression we will discover things we never knew existed. And we will learn from the patient and change our theory and therapy accordingly. We will learn from experience instead of creating the same old circumstances and explanations that reinforces our prejudices. And for the patient, too, she will learn from experience, not ideas; not the beliefs of the therapist; i.e., that there is an id or shadow forces that drive us. Rather, there are concrete events in our lives to account for a heart attack or out of control behavior.

Once a patient has access she may relive oxygen deprivation (a smoking mother) during her time in the womb. The patient may have a transient palpitation attack, or the pain of angina which she can now connect to the original threat (perhaps too low oxygen supply). One patient, as I discuss elsewhere, re-experienced being polluted in the womb as her mother smoked constantly. She learned why bars or smog drove her crazy. She could not stand any kind of pollution; it resonated with its original source. She never knew it as pollution originally. It was just a disagreeable sensation. She called it pollution after she grew up. But that early experience of smoke, over and over each day, laid down a permanent stratum of misery that kept her unhappy. And of course until she had access she never knew why. She finally connected.
The feeling makes the connection. Anxiety is a refractory symptom because it is basic to our survival. It should not disappear easily.

Because the brainstem continues to develop for several months after birth, what happens to us emotionally during the few months of life on earth can affect our heart function, most of our survival mechanisms, and our brain development. It is the first organized response to threat among most animals. It involves breathing difficulties and heart problems. My dog gets anxious when there are fireworks in the neighborhood. She begins to pace and breathe heavily and her heart beat is forceful and pounding, which won’t stop until an hour or more after the fireworks. In humans there is often a very rapid beating of the heart (makes me feel like wanting to “jump out of my skin.”) Unable to uncouple from a runaway sympathetic nervous system, one remains powerless. That’s one good definition of powerlessness; the linchpin of why most efforts for control fail.
Painkillers plus reassuring ideas from a therapist can control anxiety for a limited time. But it is never eradicated. And if we want to see if this hypothesis is true we have only to measure key biological processes during therapy, not the least of which is cortisol. As the patient approaches a first-line feeling the vital signs begin their rapid rise, much higher than we see when a second-line feeling is at hand. This is one way we know about the force and danger of the feeling. It is how we know what feelings to ignore for the moment. We do not want to push the patient into a feeling he is not ready for. If we listen carefully we won’t make that mistake. When we feel that we know best, the patient will suffer.

Why Are We Anxious? (Part 4/6)

The concept of resonance is important in understanding anxiety because situations can resonate within us from language centers to below the level of language where the panic exists. We can be stirred up even when we don’t know with what the outside situation is resonating. Thus, in sex, a nude female body can resonate in a man with an early experience with his mother. She may have been seductive long before the child had any understanding of it. I had one white patient who had a very seductive mother; she French-kissed her son. Later, he could only have girlfriends who were Black or Asiatic—too white a girlfriend would resonate with that early seduction that scared him. Here “White” women resonated with a White mother, something to be avoided. I treated a lesbian woman who was molested sexually by her (white) stepfather. She could only have relationships with Black men. Later, any man resonated with the early stepfather. She switched to sex with woman. It seemed much safer to her. She discovered that when she was with a man in bed she had a chronic low-level apprehension. When she switched to women there was no more problem.

When there is a life-and-death struggle at birth due to lack of oxygen (anoxia), for example, the existing reactive system is activated, but because it cannot fully respond due to the complete load of pain and terror (to feel it completely would be to run a cardiac attack or at least to lose consciousness), it reacts partially within its biologic limits and then puts the excess part of the terror away for good keeping; it houses it until our system is strong enough to feel and resolve it. It lives behind our repressive gates. However, we continually respond to this stored terror with chronically high stress hormone levels, a compromised immune system, misperceptions, strange ideas, nightmares, and chronic malaise and a startle reaction. This high activation level gnaws away at the cardiovascular system so that we fall seriously ill at age 55, even though at the time we seem to be living a normal, relaxed life.

We have done systematic stress hormone cortisol studies with our patients and have found a normalization after one year of therapy. That tells us that the variable, reliving, may well be responsible for the reduction of anxiety. This drop is also associated with a drop in heart rate and blood pressure. The patient also claims to feel better. Biologic measurements are more reliable because they inform us of what the physiology is doing, irrespective of what the person thinks.

Tranquilizers seem to be obligatory to enable someone in pain to function on a daily basis. What is diabolic is that in spite of a loving childhood the person suffers. She may not have been loved on the first-line where good oxygen and nutrients were essential, which were lacking; or there may have been a mother terribly tense over losing her job in the economic crisis. From the baby’s point of view he is unloved; his needs (for calm)are not met. From the mother’s point of view she was doing the best she could and could not help her feelings.

A carrying mother who smokes and drinks is not loving her baby; her needs come first. If she takes drugs such as cocaine she is alterating the physiology of her baby. Male monkey offspring of mothers were given cocaine had poor impulse control and possibly were more likely to take drugs later on. This study went back 15 years to monkey mothers who were given cocaine. Despite the effects from womb-life, too many of us were not loved in obvious ways later in our emotional life when there was no touching or holding.

One of the ways we know where anxiety comes from is the depth and agony of the feeling of terror. There is always the fear of dying because that is what actually happened in the womb or at birth. Fear is second line, organized higher up in the brain. Anxiety is paralyzing because it is how some part of us reacts to terror. When we have chronic over-arching anxiety we are dealing with a mélange of fear and terror overwhelming the defense system; a compounding of a harsh childhood and poor gestational life. Here is resonance. Current apprehension soon turns to anxiety as the feeling triggers off low-level terror. The terror, I remind the reader, is already there. It keeps us from relaxing on the beach, pushing us into constant activity. And we rationalize, “I don’t like the sand.” What we do in the present is usually the reflection of our history. Life becomes a rationale for our imprints. If we have a therapy of current focus we are missing out on all those causes.

In order for some patients to feel the fear and its context we need to tranquilize the terror so that it does not interfere with the feelings the patient has. We offer first-line blockers. In conventional medicine and psychotherapy this is sometimes known as anti-psychotic medication. What is being blocked is the terror that often produces bizarre ideas in the patient. The tranquilized patient will no longer be overwhelmed because we have reduced the overall pain load; she can focus on a single feeling. And there is no longer an overload that caused the generation of all those strange ideas and beliefs. We see here how psychotic ideation develops. Feed in too much pain and the systemic searches for an outlet. Reduce the level of pain and the system calms down and no longer needs the ideas to rationalize what is going on inside. Those strange ideas are like an overflow valve that channels the pain away from consciousness and into awareness. He is hyper-alert.

Feeling overwhelmed happens when something in present resonates with terror, and the combined force is overwhelming. “It is all too much.” We cannot follow orders because there are a string of orders from the past inside that command us; they take precedence.

What is diabolic about anxiety is that many of us suffer from chronic low levels of anxiety, barely perceptible, acted-out constantly. The person is rarely aware of it yet it drives her to go and do all of the time: cannot read a book without that agitated feeling. Cannot focus for long, cannot listen to a long lecture, cannot listen to the children’s stories and above all that agitation catches up with her at bed-time when she cannot fall asleep. We cannot be a loving parent when we don’t have the patience to listen to our children and their stories. It is not that the parent is bad person or unloving in his intentions, but that he suffers and cannot help himself. He rationalizes that he must keep busy to feed his children. We know otherwise. He has to keep busy to discharge all of that energy. If he cannot he suffers.

The low level anxious person can rarely listen; that takes too much patience and the person can’t wait. This individual cannot listen to complicated instructions (how to assemble this table or how he must turn right at a certain intersection); he bows out and glazes over very quickly. If he is given a chore of what to buy at the supermarket, as soon as it gets to three choices he is gone. “I know she said to buy low-fat but low-fat what?”

Sleep is problematic when the low level mobilization (against the early pain) is now active as the third line diminishes its hold a bit. Don’t forget, the higher-level neo-cortex is often pressed into service to control our lower level feelings. It is an escape hatch. As we need to let go of that top-level control in order to sleep we become more vulnerable. We have to release control. Enter a ruminating mind. A very busy, unceasing mind that cannot stop itself long enough to fall asleep. As we get closer to the deep brain in deep sleep we approach those primal feelings. They agitate and move upward to make the thinking brain work very hard. Even in sleep when we begin to suffer from the uprising of first-line terror the brain rushes in to cap it with a nightmare. The nightmare attempts to encapsulate the feeling so that it never becomes conscious. It is not a willful act, that nightmare. It is a built-in survival mechanism that ensures that our conscious/awareness will not be impaired by overwhelming input. The story in the nightmare does not count for much, but the feeling in it counts a great deal. That feeling can give us a way in; the royal road to the unconscious.

The imprint of a memory is really an ensemble of reactions that is impressed simultaneously into the whole system when there is inordinate danger, a smoking mother, for example. It is a total experience, unlike recall, which is largely mental, meaning a left prefrontal cortex operation. We may not be able to recall an imprint. We can only remember it with our entire system: with our muscles, viscera, and blood system, because all of us was involved in the original experience; therefore, it must be relived with all systems involved originally when it was set down. Not only that, but it must be relived with the same intensity in which it was impressed, which is why it has rarely been seen in conventional or cognitive therapy where the emotional level is rather subdued. A few tears is not exactly deep wailing that we see in our therapy.

Let us not confuse recall with memory. Deep preverbal pains can only be recalled with the entire biologic system. Verbal recall is another animal (literally) altogether. It is systemic, organic, physiologic memory that cures; verbal recall does not. When we suffer high blood pressure, for example, we may be suffering from a lingering residue of an overall trauma very early in our lives--in the womb. The high blood pressure has been stripped from the generating memory and lives its life apart. It is trying to tell us something about where it came from; but alas, we drug it unmercifully so that it never volunteers its origin. Same for heart rate. We are forever putting those memories to sleep.

So there are at least two main avenues to provoke anxiety and repression; one, the meaning of a certain look by the parent, (or any negative reaction of theirs) which means I am not loved nor will I ever be. Two, something is happening that is an immediate threat to my life. In either case there is a disruption in the evolution of the organism.

Originally, suffocation during birth provoked repression to order to keep the system on equilibrium and to keep the baby from dying. Two of my patients were later told by a doctor that they had what seemed like a heart attack at birth. Later on, as the feeling was compounded by additional pain and terror it provoked even more shut down. In both cases there is danger. It will be crippling anxiety and not plain old fear (terror-light) when the lower brain centers are actively involved.

When the resonance travels down the chain of pain and reaches low levels of the neuraxis, terror then appears. It is not something new; not something to try to reach. It is an old friend (or enemy). In fact willfully trying to reach a lower level feeling is an oxymoron; the more we use top level will, the less we can descend to where we have to go. The more we let go of the present the more access we will have. The person in terror will suffer anxiety because the body is preparing for extreme reactions in order to survive. You cannot be slow to react if there is a lion coming toward you.

There is usually the gloom and doom aspect of the anxious feeling, “I feel like I am going to die.” Since no one manufactures a feeling that has no basis in reality, we must seek out origins. If we want to successfully treat any of the so-called psychosomatic (migraine, high blood pressure) symptoms we must find the generating sources. Here the feeling needs to meet its maker, and there is a maker. What happens is that a current situation, giving a speech; through the process of resonance, a mild fear and apprehension has set off the original terror deep down in the brain so that the person is not just sort of fearful, but suffers a full-fledged anxiety attack, feeling she is going to die. The feeling is correct! We don’t understand her reactions because it is just giving a speech to fifteen people. Yet she feels overwhelmed. Or someone is criticized and goes into an anxiety state. Why? Because it can mean, “I am not loved if I make a mistake.” Or “catastrophe happens if I make a wrong move.” And no doubt this person in her childhood was not loved when she made a mistake.