Panic Free. Tom Bunn

links between the landmarks and a calming memory — hers was being with a friend who knew her struggles well — she was well on the way to automatically controlling her anxiety during the trip.

      How did her trip work out? Carole reported that when she first saw the Holland Tunnel, she got a jolt of stress hormones. But because she had already worked to associate the tunnel with the memory of a calming person, the effects of the stress hormones quickly abated. She continued through the tunnel without difficulty. After picking up her friends at the airport, she came back through the tunnel. Then she encountered the situation she had dreaded. “I got stuck in the middle of the tunnel for thirty minutes. But nothing happened. I was fine. I didn’t panic at all.”

      That was a few years ago. Recently, Carole reported she had just traveled through the Chesapeake Bay Bridge-Tunnel, excitedly saying it was twelve miles long and she “didn’t feel a thing!” Carole’s regulation systems, boosted by links to calming memories, worked well.

      Our arousal-regulating system is called the autonomic nervous system. Auto is a Greek prefix meaning “self.” Nomic means “management” or “control.” Thus the name refers to a self-regulating system, the part of our nervous system that operates automatically outside our conscious control. The autonomic nervous system has two parts, one that revs us up and another that calms us down.

      The sympathetic nervous system automatically revs us up when stress hormones are released. The part of the brain responsible for releasing these hormones is the amygdala. It is often said that the amygdala responds to threats, or to danger. That is misleading. It is more accurate to say the amygdala responds to change. The amygdala cannot tell what is and is not a threat, or what is or is not dangerous. By far, most of the changes the amygdala responds to are inconsequential.

      The amygdala can be compared with the brake lights of a car ahead of you in traffic. Illumination of the brake lights mean change: the car is slowing. Is this a threat? It depends how close you are to the car and how rapidly it is slowing down. Like the brake lights, the amygdala alerts you to change. The amygdala cannot determine what you need to do about the change. That is the job of the thinking part of your brain.

      The calming part of the autonomic nervous system is the parasympathetic nervous system. Its key component is the vagus nerve. Vagus is a Latin word that means “wandering.” This nerve wanders through the chest and abdomen, connecting the heart and the organs of the digestive system to the brain. When the vagus nerve is stimulated, it overrides the effects of stress hormones and decreases the heart rate. The neuroscientist Stephen Porges refers to this process as vagal braking. As this happens, you may feel your guard letting down, a reflex caused when we receive signals from a person that they are no threat to us in any way.

      Panic happens only when automatic regulation of arousal is not working. When you start to experience panic, you may try to control your reaction consciously. But that may not work, for two reasons. First, your capacity for conscious thought, located in the cortex, breaks down when stress hormones build up. Second, conscious thought may not activate the parasympathetic nervous system. The solution to panic is to train your unconscious procedural memory, located in the subcortex, to calm you automatically, by repeating the exercises in this book.

      First, we train your unconscious procedural memory to keep your sympathetic nervous system from getting you revved up in situations that might trigger panic. Unconscious procedural memory can be taught to automatically release oxytocin, and thus to block the release of stress hormones when you are in a panic-provoking situation.

      Second, we train your unconscious procedural memory to activate the parasympathetic nervous system any time you begin to panic. The parasympathetic nervous system will automatically apply vagal braking to override the effects of stress hormones.

      Either of these trained responses can be used independently to control panic. When your unconscious procedural memory has learned to use both, panic doesn’t have a chance.

       CHAPTER 4

       How Carole Used a Memory to Calm Herself Automatically

      How would you like to have a switch that could simply turn off your panic attacks? We can set one up, using a system you were born with. Your parasympathetic nervous system can override stress hormones. It can stop a panic attack in its tracks. All you need is a way to turn it on using the right kind of memory.

      What kind of memory can do this? Surprisingly, the answer is not recollection of a happy time or a day relaxing on the beach. At those times, we are relaxed — not because the parasympathetic nervous system is actively calming us, but because the amygdala finds no cause to release stress hormones. We need a memory that activates your parasympathetic nervous system, and calms you in spite of things going on that stress you.

      What activates the parasympathetic nervous system? Think for a moment about what a mother does to calm a crying infant. She presents her face. Her soft, loving smile activates the infant’s parasympathetic nervous system. She speaks to the baby. Though the baby does not understand her words, the baby’s parasympathetic nervous system responds to the quality of her voice. In addition, touch — being held or caressed — activates the young child’s parasympathetic nervous system. So there is your answer. The parasympathetic nervous system is activated by face, voice, and touch, provided that the signals being sent are calm, attuned, and caring.

      We don’t need to go back to infancy: we don’t remember that far back. But we can use any memory we can recall of being with a close, trusted friend, ideally at a time when we felt our guard let down. Note that when you feel your guard let down, you don’t cause it consciously: it happens unconsciously when the vagus nerve, fully stimulated, releases all the tension present in your body.

      In most social situations, we receive signals that we are physically safe. But because people are often competitive and judgmental, the signals they unconsciously send, and which we unconsciously receive, can keep us from feeling emotionally safe. We remain careful about what we say; we do not reveal our private thoughts or genuine feelings. We may even employ a facade to hide behind and protect our real self from being judged by others. But with a good friend, who does not judge us, we may at times feel our guard let down. This happens, according to Porges, when the signals we unconsciously receive are optimal, and cause us to feel physically and emotionally safe.

      This was the experience we wanted to evoke when Carole took her drive. To make sure her vagus nerve would be stimulated repeatedly, she linked landmarks along the way to memories of a time with a friend with whom she felt her guard let down. First, Carole remembered being with her friend, and then she imagined that her friend was holding up a photograph of one of the landmarks. By picturing her friend’s face juxtaposed with the photograph, Carole established a visual link between the calming face and the landmark. Next, Carole imagined that she and her friend looked at the landmark photograph together and exchanged a few words about the photograph. This linked her friend’s calming voice to the landmark. Finally, she imagined that as they looked at the photograph together, her friend gave her a reassuring touch, which was also linked to the landmark. Carole continued this process until each landmark had visual, auditory, and physical links to her friend’s calming presence. As Carole took her trip, each landmark she passed, linked to the memories of her friend, activated vagal braking and kept her calm.

      This technique can help you regulate arousal in situations that have previously caused anxiety or even panic. Like Carole, you can break the challenging situation down into a series of events or steps and link each of them to a memory of a time when you felt both physically and emotionally safe. This activates your vagus nerve and calms your mind and body.

       CHAPTER 5

       How Arousal Regulation Works

      If you are skeptical about the power of Carole’s memory of a friend’s face, voice, and touch, you might be persuaded by some research on smiles.