Anxiety, on the other hand, is akin to suffering a pinched nerve in the brain’s fear-threat system. The pain is real enough, but it’s the result of something happening inside of you, and not a response to an external, physical threat. For instance, if you had a pinched nerve in your leg, you wouldn’t call an ambulance. You would feel pain, and it might hurt terribly, but you would (1) recognize that the pain was coming from the inside of your body, not from an outside assault; (2) focus your attention on trying to breathe through the cramp and relax your leg; and (3) eventually engage in some limited exercise to work through any remaining soreness.
Three Steps to Anxiety First-Aid
One of the simplest ways to help your brain do a better job of dealing with anxiety is similar to that intuitive three-step approach I described that most people use for dealing with any other pinched nerve in their body: Relabel, Reattribute, and Respond. These steps are adapted from psychologist Jeffrey Schwartz’s groundbreaking work treating OCD as described in his book Brain Lock.
Step One: Relabel the Threat
You feel anxious. Don’t act out. Don’t start thinking obsessively about what you can or should do to try to get control of whatever is happening around you. Instead, check the feeling. Ask yourself, “Am I responding to an imminent (not a past or potential future) threat to my life or safety?”
Remember, fear is an appropriate response to an imminent threat. It kicks you into high gear in the moment so that you can escape some clear and present danger — and then it goes away. That’s how fear is supposed to work.
Anxiety, on the other hand, tends to be a fear response triggered by something that has either happened a long time ago, has not yet happened, or may not actually be happening at all. Likewise, instead of kicking you into high gear so you can escape an imminent threat to your life or safety, anxiety tends to hang around and haunt you. For instance, if you are afraid you might have said something embarrassing while out to dinner with your friends last week, you might keep replaying the scene over and over in your head and experience a low-grade sense of dread. Or if you have to give a presentation at work next week, you might imagine all the ways you might make a fool of yourself and struggle with a constant feeling of dread and terror. Or, alternatively, for no reason at all, you might just be suddenly struck with an overwhelming sense of panic that causes you to feel like something terrible is going to happen.
The feelings associated with each of these experiences is not fear, but rather anxiety, because you are not responding to an imminent and obvious threat to your safety or wellbeing. In each of these instances, your fear-threat system — the part of your brain that is supposed to help you respond to imminent threats to your health and safety — is actually being hijacked by something that may be concerning but is certainly not an imminent threat.
What difference does this make? It means that in each of these cases, you are not really experiencing fear. Rather, you feel fearful in these instances because the concerning event caused a misfiring of your fear-threat system. This is a small, but significant difference. It means that the answer to your problem — despite how you might be feeling — is not obsessively thinking about how you could apologize for an offense you’re not even sure you committed, staying up all night trying to figure out how you are going to pay your bills and where you are going to live after your boss fires you for messing up the presentation, or obsessively looking around for something — anything — to blame for your looming sense of panic and dread. Instead, you must step back and help your insular cortex relabel your experience of anxiety, not as a reasonable reaction to an obviously threatening situation, but rather as a sign that your fear circuits in your brain are misfiring. Instead of running around trying to figure out how you can fix something going on around you, you must instead figure out how to control your brain and body. Then, and only then, will you be able to correctly assess what to do about the situation itself.
Step Two: Reattribute (and Relax)
Once you have determined (however tentatively) that the situation triggering your anxiety is not the source of any imminent, immediate danger, the second step is to relax your body. As I indicated above, instead of continuing to tell yourself that “I am anxious because X (non-life-threatening event) happened” you must reattribute the anxiety you feel to a “pinched nerve” in your brain that results in the misfiring of your fear-threat system. You can then intentionally shift your focus away from the concerning event for the time being (we’ll come back to it in a minute) and refocus on relaxing your body and getting your fear-threat system back under control.
I want to be clear. In stating this, I am not saying that your anxiety is not real. It is very real. Because anxiety hijacks the fear-threat system, you are feeling genuine fear, perhaps even a crushing amount. What you are reading here should not be interpreted to suggest that your anxiety isn’t a serious problem. In fact, what I am asserting is that more than some figment of your imagination, problems with anxiety are always serious physiological events. The good news, however, is that rather than being made fearful because of some situation that is largely outside of your control, your anxiety is actually being caused by a process that, with practice, you can learn to control.
Anxiety is controlled by two different systems in the Autonomic Nervous System, the neurological system that is responsible for things like heart rate, respiration, blood vessel constriction, temperature, etc. The sympathetic nervous system (your “speed up” system) acts like a gas pedal. Stimulating it makes your bodily systems race. By contrast, the parasympathetic nervous system (your “slow-down” system) is like a brake pedal. These two systems function in harmony with one another, but they can also function independently — just like the gas and brake pedals on your car can be used separately or simultaneously depending on what the situation calls for.
When you feel anxious, your “speed up” (sympathetic) nervous system is being hyper-activated. In essence, the gas pedal is floored and stuck. The good news is that you can unstick the gas pedal by tapping the brake, i.e., activating the parasympathetic nervous system. At first, your metaphorical engine might continue racing, even after you’ve applied the break. But within about fifteen to twenty minutes, your brain should re-regulate and sync back up again. With practice, it’s possible to learn to get this process to happen within seconds. There are actually a few simple ways to do this.
One of the most effective, yet simplest, techniques involves consciously speaking and acting more slowly than you feel like you want to. Often, when we are anxious, our thoughts and speech automatically race. On top of this, because our brain is preoccupied with being anxious, we stop paying attention to what we are doing. Both of these symptoms are signs that our sympathetic (speed-up) nervous system is over-engaged.
But we can learn to reach down and “unstick” the gas pedal by intentionally activating our parasympathetic nervous system (slow-down system). Intentionally speaking a little slower than we want to, acting a little more slowly and intentionally than we naturally prefer in that moment, and forcing ourselves to pay attention to what we are doing taps the brake pedal. This creates little bit of a jarring sensation as the speed-up and slow-down nervous systems try to sync up with each other. They don’t like to be at odds with each other, so consciously depressing the brake on the slow-down nervous system unsticks the gas pedal and forces the speed-up