When fear becomes unmanageable
On Friday 19th June our government lowered the Covid-19 alert level from 4 to 3, indicating the likelihood of a further relaxing of restrictions and social distancing measures, which have now since happened. That morning my husband and I visited a large well-known store which had reopened its doors the day before. It was pretty much the first time I'd been shopping for anything other than food since before lockdown (I was buying a much-needed home office chair for online working!). As we walked into the shop, I felt a wave of nostalgia wash over me and noticed how good it felt to be doing something again we'd previously taken for granted. I felt grateful, and optimistic.
Our prospects of recovering stability and security may be improving, but we can't forget that we are living in a time of fear. During this year our world has been facing a global, invisible threat to life and, at the time of writing this, an estimated 477,000 people have died as a result of the Coronavirus pandemic. In addition, those with a life-limiting illness have had to deal with the frightening reality of their treatment being put on hold, and have been shielding from the threat of the virus. Others have become scared and vulnerable due to mental health issues which have surfaced or worsened during lockdown. Many face the anxiety of losing their business, or employment. The BAME population are living with the knowledge that they are more likely to be affected by Coronavirus than white people. The brutal killing of George Floyd has escalated fear amongst black people of the police, and racial inequality and tensions are being felt in the US and around the world.
For many of us there have been, and may continue to be, real reasons to feel afraid.
What is fear?
Fear is an emotion that arises when we perceive danger or a threat of harm. You will most likely be familiar with the term 'fight, flight or freeze'. This is an automatic, instinctive biological response that happens in our brain and body. It happens without conscious thought or control and is a survival mechanism.
The Fight, Flight, Freeze Response
I'm not an expert when it comes to neurobiology, but I can share with you what I've learned about what happens in the brain and body when we become frightened. For the purposes of understanding our fear response, it may help to know a little about the part of the brain known as the limbic system.
The limbic system regulates our survival behaviours and our emotional expression, and is also involved in memory processing. Its primary job is to help us with those tasks that enable us to survive: eating, sexual reproduction and our fight/flight defenses.
The following three areas of the limbic system play an important role when threat is detected:
Amygdala - the amygdala is responsible for memory processing and emotional responses. We can think of it as the fire alarm which, when threat is detected, will send messages to the hypothalamus so that the necessary action can be taken.
Hypothalamus - when the hypothalamus receives a signal from the amygdala, it activates the sympathetic branch of the autonomic nervous system (fight,flight,freeze response), resulting in a heightened state of arousal that prepares the body for fight or flight.
Hippocampus - we can think of the hippocampus as a filing cabinet for our memories; it is responsible for processing data to give a context, or timeline, for the things which happen to us. It gives a memory a beginning, middle and end, and locates the memory in a specific place and time in our past. It is vulnerable to stress and shuts down during trauma, which is why our traumatic memories have few words, but are experienced by us as a variety of distressing symptoms held in the body.
When we detect a threat
When we detect a threat, the fire alarm, the amygdala, sends a distress signal to the hypothalamus. The hypothalamus activates our fight/flight/freeze response, and sets off a series of chemical responses in our body and brain. These responses are designed to maximise our survival: hormones are released to aid reaction times, breathing and heart rate speed up which increases the oxygen supply to our muscles, enabling quicker movement. Our pupils dilate to expand our field of vision. Our hearing becomes more acute. Blood pressure increases to move blood around the body more effectively. Our digestive and reproductive functions slow down, as blood supply is temporarily diverted to the task of defense. Our reactions become automatic and instinctive. We are primed for survival.
Our Individual Response to Fear
You may know someone (or be that person yourself) who thrives on high-adrenaline activities, or loves to watch scary movies. This is a kind of 'safe' fright because our brains are able to assess the situation and tell us that we're not at risk. The hormones released when we get scared can lead to a sense of pleasure or even euphoria. When the rollercoaster ride or scary movie is over, we like to enjoy the good feelings, knowing we saw it through and survived! However, whilst some of us will want to be first in the queue, others of us will avoid these activities at all costs.
The degree to which we feel in control of our fear will be, in part, due to how we learn this from those around us, most especially when we're young. If, when little, we receive adequate reassurance, comfort and understanding when frightened or worried, we will grow to offer ourselves sufficient reassurance, comfort and understanding. We will be able to regulate our nervous system pretty well.
Why do I seem more easily scared than others?
There are a number of good reasons which explain why some of us find fear more difficult to manage than others:-
Experiencing a traumatic event or events, especially when adequate support from others is missing in the immediate aftermath of the trauma, may lead to unresolved traumatic memory. This memory is held in the body as symptoms which can be triggered in the present and which feel as they are happening for real in the here and now. Because the memory is unprocessed, there will be no words for the experience, only dysregulation of the body's nervous system. Post traumatic stress is caused when the amygdala, the brain's fire alarm, becomes irritable and is almost permanently switched on. The brain continually believes it is under threat.
Experiencing enduring traumatic relationships, especially when young, will have a significant impact on many things including our nervous system's ability to regulate, our wellbeing and ability to function, and our ability to trust others. We will likely become hypervigilant and, even when the trauma may be over, our brain and body will continue to be constantly on the lookout for danger.
Experiencing failed attachment experiences when young, for example, growing up around an anxious or frightened parent, or a parent who causes us to feel anxious or frightened. Parents with a compromised capacity to regulate their emotions are less well able to model to their children how to feel safe and secure, which is likely to lead to a more limited capacity in those children to auto-regulate themselves.
When fear becomes unmanageable
When our brain can recognise what is and what isn't a real threat, we can maintain a sense of control. If, however, our capacity to do so has been compromised, such as in the above examples, it can lead to issues of stress and anxiety.
This may result in disorders such as phobias, social phobia, obsessive compulsive disorder, generalised anxiety disorder, separation anxiety and PTSD.
What can I do to manage my anxiety?
There are a number of recognised resources that can help - a physical activity such as walking, dancing or singing. A relaxation practice such as meditation and mindfulness, yoga, tai chi and qi gong. Social support from those who care for us - when we can get our social engagement system going, it puts a brake on our fight/flight response. When we feel connected, we have a perception of safety. If you're interested, I talk in more detail about these kinds of resources in my previous blog 'Ten ways to survive the Coronavirus pandemic'.
We can say that fear is a normal, healthy, adaptive response to threat. Anxiety, on the other hand, is a less specific fear of an unknown, anticipated, undefined future threat. Living with an anxious, dysregulated nervous system can be challenging and debilitating. Leading trauma expert, Janina Fisher, suggests that we can hold an attitude of appreciation for the wisdom of a body that is primed for danger 24/7. This is a very positive message to hear in therapy. It is a great place to start. Our bodies are very wise and can tell us a great deal if we're willing to listen.
There are several different and effective therapy approaches to treating issues of anxiety. The approach in which I am trained, Sensorimotor Psychotherapy, teaches techniques to better regulate the nervous system. We work to change past limiting beliefs, and to create new, more fulfilling ways of living. Where there are issues of trauma, we can work to process traumatic memory so that it becomes far less intrusive in the here and now. Where anxiety has been created by failed attachment experiences, we can work to heal past wounds and to find greater compassion for ourselves.
I hope this blog post might offer some new thoughts, or information, about our relationship to fear. If, after reading this, you find yourself curious about fear or anxiety you may be holding, particularly if it has surfaced or worsened during the last few months, it may help you to talk to a trained professional. If you would like to discuss any aspect of this with me, you're welcome to get in touch. I'd be happy to see if I can help.