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Increased mental ability allowed mammals to detect false alarms and avoid unnecessary mobilization. However, if stress hormones have disabled reflective function, we are no longer intuitively aware of what kind of mental processing is going on, which means imagination can be mistaken for reality. We may believe that our worst fears are coming to pass. And if we see no way to escape, we experience panic.
In addition to creating an urge to flee, the release of stress hormones, triggered by the amygdala, activates a decision-making capacity called executive function. When activated, executive function inhibits the urge to run, identifies what the amygdala is reacting to, determines whether the threat is real, and seeks a strategy that, by avoiding unnecessary running or fighting, conserves energy and reduces the risk of injury or death.
When executive function identifies a threat, if it can commit to a plan to deal with the threat, it signals the amygdala to stop the release of stress hormones, and goes forward with its plan. If executive function cannot identify a threat, it signals the amygdala to stop releasing stress hormones and drops the matter.
The catch with executive function is that the amygdala reacts the same way to imaginary threats as it does to real threats. The job of differentiating between the two is carried out by reflective function, a subsystem of executive function that looks inward to sense what kind of mental processing is going on.
When we are calm, reflective function has no trouble determining what is real and what is imaginary. But stress hormones can cause reflective function to collapse, especially if it is not well developed. In that case, an imaginary threat may be experienced as a real threat.
In an elevator, for example, thinking “What if the elevator gets stuck?” triggers the release of stress hormones. If those hormones incapacitate our reflective function, we experience the imagined situation of being stuck as if it were really happening. Similarly, imagination of a heart attack may be experienced as a real heart attack. In a high place, the thought of falling feels like falling. An imagined experience, if mistaken as real, can result in terror and panic.
The Difference between Anxiety and Panic
The brain needs a certain level of stress hormones to function at its peak. When we first wake up, our thinking is foggy. We drag out of bed and get going. Soon our body clock, perhaps with the help of a cup of coffee, will have us thinking more clearly.
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But if something shocking happens, stress hormone levels may rise too high for peak cognitive function. Though we are wide awake, our high-level thinking is no better than when we first woke up.
Anxiety is not panic. What’s the difference? When we are aware that what we imagine may come to pass, that’s anxiety. But if we experience a flood of stress hormones powerful enough to cause reflective function failure, then what we imagine becomes our reality. We believe that the thing we fear is really happening. If we also believe we can’t escape, we panic.
For example, if we hyperventilate, imagining that we might suffocate can make us anxious. If imagination takes over, we believe we are suffocating. If we believe we cannot escape this experience, the mobilization system cannot regulate us, and the immobilization system takes over. That’s panic.
All of us have out-of-control thoughts at times. If we worry that we might be going crazy, that is anxiety. But if out-of-control thoughts release enough stress hormones, reflective function collapses, imagination takes over, and we believe we are going crazy. If we can’t find our way out of this belief, we feel trapped in insanity. The immobilization system takes over, and we panic.
Imagined danger can cause panic more easily than real danger. Once, counseling a client who was a lawyer, I wanted to help him recognize the difference between imaginary danger and real danger. I asked if he had ever been in a truly life-threatening situation. I was expecting him to come up with some imaginary situation that he had overreacted to, but he surprised me. He said a person had once come into his office and put a gun to his head. I had to agree with him that that was a genuinely life-threatening situation. I shifted gears, and asked him, “On a scale from 0 to 10 — with 0 being totally relaxed and 10 being the most anxiety you’ve ever felt — where were you while the gun was being held to your head?”
He said, “I was at a 2. But, the next day, I came to work and I went straight to a 10. I was a basket case. I couldn’t do any work at all. So I went home. I came back to work the following day, and the same thing happened.”
Why would a person experience only level 2 anxiety with an actual gun to their head, but level 10 when merely thinking about it? When the lawyer was being held at gunpoint, the situation was simple. He was forced to focus on one thing — the gun to his head — and nothing else. His amygdala reacted to the gun as a single unfamiliar situation and released only a single shot of stress hormones.
The next day was different. The attorney was free to imagine one gruesome scenario after another. For example, he could think, “What if that guy had pulled the trigger? I would be on the floor right there bleeding to death.” His vivid imagination of the scene released a second shot of stress hormones which, added to the first, took him to 4 out of 10 on the anxiety scale. Then he imagined someone finding him and calling 911. He pictured himself in an ambulance being rushed to the hospital. That produced a third shot of stress hormones, which took him to level 6. He saw himself on a table in an operating room as his wife got a call telling her that he had been shot and it was not known whether he would survive. Imagining her anguish gave him another jolt of stress hormones. Imagining his daughter hearing the news and bursting into tears took him to a 10.
In real life, we experience only one outcome out of many possibilities. In our imagination, we can experience multiple outcomes, each of which can trigger the release of stress hormones. Imagination, then, can produce more stress than reality.
Knowing that, some of us keep our imagination on a short leash, rarely allowing our mental scenarios to stray far from what is likely to happen. Others are less restrained. A psychiatrist I know, rather limited in how far he let his imagination go, was married to a woman whose imagination knew no bounds. Sometimes he would say to her, “Don’t you realize how irrational that is?” It didn’t alter her thinking.
Early one morning, a neighbor knocked on their door. She had locked herself out of her house while stepping out to get the newspaper. The psychiatrist said, “No problem. I’ll call a locksmith.” But his wife interjected, “Why don’t you try our key?”
The psychiatrist smirked. This was the chance he had waited for. His wife would at last recognize how irrational her ideas often were. So, saying nothing, he handed his wife a key. She went across the street with the neighbor, put the key in the lock, turned it, and the door opened! The psychiatrist said it taught him that he wasn’t as much an authority on what is and isn’t rational as he had thought.
If the prospect of an unlikely disaster comes to mind, most of us dismiss the thought as irrelevant. But a person whose imagination is freewheeling — like the psychiatrist’s wife — can’t easily stop worrying about things that are highly improbable.
For most urban professionals, obsessing about someone holding a gun to your head would be irrational because it is so highly unlikely. Nevertheless, that was the lawyer’s experience. Is it irrational for him to now obsess about being shot? Yes, and no. On the one hand, he has firsthand evidence that it’s possible. On the other hand, the fact that it happened yesterday does not increase the likelihood of its happening again today.
Psychologically, however, it proves — or seems to prove — that it is rational to worry even about things that are statistically rare. The psychiatrist was sure his wife was crazy to even think of trying their house key on a neighbor’s house. Yet the key opened the neighbor’s door.
Rational or Irrational?
Though our executive function is smart, its thinking doesn’t always match actual probability. For example, when flipping a coin, if it comes up heads seven times in a row, how likely is it that it will be tails next time? Most people would insist that it almost has to come up tails. Yet, statistically, the probability is still fifty-fifty. One way to explain the phenomenon is to say the coin has no memory. And since it has no memory of coming up heads seven times in a row, it doesn’t know it should now come up tails.
So it is not irrational for the lawyer to believe he is at risk of being shot if he stays at the office the day following the gun incident. But ruminating about what might have happened triggers a barrage of stress hormones that impairs his ability to sense which mental processing mode he is in. Each disaster that goes through his mind — a combination of memory and imagination — triggers the release of stress hormones.
If stress hormone levels rise high enough to disable reflective function — which ordinarily allows us to separate memory and imagination from what is real — what is in his mind has the same emotional impact as the event that actually took place.
The collapse of reflective function, whether it is due to excessive stress hormones, as in the lawyer’s case, or to underdevelopment that makes reflective function excessively vulnerable to stress hormones, sets the stage for panic. Fears about what might happen solidify into a belief that it is happening. And, if we cannot see a way to escape from what we believe is happening, we panic.
©2019 by Tom Bunn. All Rights Reserved.
Reprinted with permission of the publisher,
New World Library. http://www.newworldlibrary.com
Panic Free: The 10-Day Program to End Panic, Anxiety, and Claustrophobia
by Tom Bunn
What if you could stop panic by tapping into a different part of your brain? After years of working to help sufferers of panic and anxiety, licensed therapist (and pilot) Tom Bunn discovered a highly effective solution that utilizes a part of the brain not affected by the stress hormones that bombard a person experiencing panic. The author includes specific instructions for dealing with common panic triggers, such as airplane travel, bridges, MRIs, and tunnels. Because panic is profoundly life-limiting, the program Tom Bunn offers can be a real life-changer. (Also available as a Kindle edition and an Audiobook.)
About the Author
Captain Tom Bunn, MSW, LCSW, is a leading authority on panic disorder, the founder of SOAR Inc., which provides treatment for in-flight panic sufferers, and the author of SOAR: The Breakthrough Treatment for Fear of Flying. Find out more about the work of author Tom Bunn on his website,