We have an internal system that is supposed to regulate how ‘revved up’ we are – the autonomic nervous system. The name itself implies that it is supposed to do its work automatically… and for some of us, it does. One part of the autonomic system, the sympathetic system, up-regulates us when we need to be more active. The other part, the parasympathetic system, down-regulates us when we need to calm down.
The system that up-regulates us is mature at birth (as we know newborns can scream at the top of their lungs from the get-go) – but what about the system that down-regulates? That's a different story – newborns can't calm themselves. They have a parasympathetic system but they lack mental programming to operate it.
So, when the child's caregiver believes the child needs to calm down, the caregiver activates the child's parasympathetic system for them. The caregiver does this by 1. presenting their soft, caring attentive face; 2. speaking gently to the child; and 3. holding, rocking, or caressing the child.
In time, as the child is repeatedly calmed by a caregiver's face, voice, and touch, most children learn to activate their own parasympathetic system – but some don't. If we don't learn to activate our parasympathetic system, we are at a disadvantage. We are unable to easily calm down and instead have panic attacks. So, we try to keep things from happening that upset us. To stay calm, we pretty much have to control everything. And, when we are not in control, we can stay calm only if we are sure there is a way to escape.
When not in control, if there is no way to escape, panic attacks can develop. The following is an excerpt from my book, Panic Free: The 10-Day Program to End Panic, Anxiety, and Claustrophobia, reprinted with permission of the publisher, New World Library.
It explains how some of us are calm when things go wrong – such as when an elevator gets stuck – and some of us panic because we can't get out.
Behavioral methods to help turn panic into calm
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 Debb 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 in order to help manage anxiety triggers long-term.
How to regulate your emotions when you’re having a panic attack
Let’s imagine that Suzie and Ingrid are children heading to kindergarten for the first time. I chose those names so you can easily remember that Suzie, whose name starts with S, generally feels safe and secure; and Ingrid, whose name starts with I, feels insecure, often for no apparent reason.
Both are going to kindergarten 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 in to me. You could tell what I was feeling. You showed me 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.” or “Stop that crying or I’ll give you something to cry about!”
When alarmed or feeling fearful and scared, Suzie seeks out her mother, a reliable haven of safety. But when Ingrid is alarmed, if she turns to her mother, she may be jumping from the frying pan into the fire. Research shows that children in Ingrid’s predicament, having nowhere to turn, become more alarmed, and once alarmed, remain alarmed longer than other children. “Thus, not only is the onset of sympathetically driven fear-alarm states more rapid, but their offset is prolonged, and they endure for longer periods of time,” according to Allen Schore.
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.”
What is Panic Therapy?
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.
Reprogramming panic in the body and mind
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.