Panic Free. Tom Bunn

psychology was a new science, the central importance of relationship to human development was not understood. “Nobody then anticipated how dependent the infant’s brain was on the mother’s caregiving and social interaction,” wrote the psychiatrist James Grotstein. Gradually, as psychology matured, researchers demonstrated the importance of bonds with others, particularly in early childhood. In the mid-twentieth century, the psychologist Carl Rogers founded a therapy movement aimed at adults that was based on “unconditional positive regard.” In the 1960s, experiments by Harry Harlow showed that baby monkeys preferred soft dolls they could cuddle with over hard dolls made of wire that provided milk. Following that, research by John Bowlby showed that infants need relationship and are genetically programmed to seek it. The theorists Anthony Bateman and Peter Fonagy now tell us that every child is “constitutionally primed to find a version of their internal states mirrored by their caregivers.”

      It’s easy to see your physical self: just look in a mirror. But how do we get a sense of who we are as a person? Our psychological self develops based on the way others respond to us when we express our thoughts, our ideas, our needs, and our feelings. Their response is like a mirror. It tells us who they think we are, and whether — to them — we are valuable or not. While the way others respond to us as adults has an effect on us, the way parents respond to a child early in life forms the child’s sense of self and the child’s emotional regulation. These develop in tandem, and both are relationship dependent.

      Our identity and our emotional regulation develop based on relationships during our formative years. Good emotional regulation cannot develop if a child cannot count on physical and psychological safety. The need for physical safety is obvious, but parents may fail to understand how to provide psychological safety. If the child’s need for safety is not met, the child may develop into an adult who controls hyperarousal by trying to control the situation he is in. If he is not in control and things don’t go well, he cannot control his arousal. To regain control, he must fight to regain dominance or escape.

      When a child is not afraid of the caregiver, the child feels safe in the caregiver’s presence. But children also need to feel secure when their caregiver is not physically present. When the caregiver is absent, a secure child knows — because of the nature of their relationship — that the caregiver has him in mind, values him, and therefore will return to him. An insecure child, by contrast, is unsure about being valued or even wanted. The child feels abandoned when the caregiver is absent: out of sight, out of mind. Insecurity arrests the development needed to learn to regulate emotion and to prevent panic.

      Fortunately, those of us who did not develop adequate emotional regulation during childhood can now pick up where its development left off. We can activate our calming parasympathetic nervous system by linking challenging situations that cause arousal, and the onset of arousal itself, to a person who — to use Carl Rogers’s term — holds us in unconditional positive regard.

      Think of being in an elevator surrounded by people you don’t know. Your amygdala is sounding the alarm. Stress hormones create the urge to escape. Your primitive emotion-regulating system, the mobilization system, is saying, “Get out of here!” But your more sophisticated executive function pushes back as if to say, “You think you need to escape, but you don’t. Just wait. We’ll be out in a minute.” As the elevator trip grinds on, the tension between the mobilization system and executive function, between the messages to flee and to stay, intensifies. We call this feeling claustrophobia.

      Which system seems to be winning may depend on how crowded the elevator is. But — and this is important — it may also depend on seeing someone in the elevator who is not a stranger. Imagine that as you warily look around, you see a friend, the special friend who never judges you in any way. He or she is not just smiling, but beaming at you. Maybe you unconsciously picked up the signal from that special face. Maybe that is why you felt comfortable enough to look around. Now, as you see each other, your friend is activating your social engagement system, the advanced system humans have that overrides the effects of the stress hormones when we receive signals of physical and emotional safety.

      Your friend’s presence changes everything. Strangers in the elevator become irrelevant. The urge to bolt disappears. The feeling of claustrophobia subsides.

      In an elevator or anywhere else, the amygdala reacts to the presence of strangers and triggers the release of stress hormones. Just as they did two hundred million years ago, stress hormones produce an urge to escape. But until the elevator stops and its door opens, we can’t relieve the stress. Our high-level thinking, executive function, tries to reason with us and tell us there is no cause for fear. In some people, executive function is so well developed that it completely inhibits the urge to escape; they have no awareness of discomfort. But not everyone has such robust executive function. Most people feel some discomfort. Some of us feel a lot.

      Here is where the social engagement system can step in and make the elevator ride comfortable. If we receive the right signals from another person, the social engagement system activates the parasympathetic nervous system. It applies vagal braking, which overrides the stress hormones and makes us feel at ease.

      But what if there is no one physically present whose face, voice, and touch have that effect? Research at the University of Arizona, published in 2019, shows that having a calming friend in mind is as protective against stress as having the friend physically present. The research involved 102 participants who were in a committed romantic relationship. Participants were split into three groups. Members of each group were exposed individually to a stressful situation. In the stressful situation, those in the first group were asked to think about their day. Those in the second group were asked to think about their romantic partner. Those in the third group had their partner present. Those assigned to the second and third groups had lower blood pressure during stress than those in the first group. There was no difference in the blood pressures of those in the second and third groups. One of the researchers, Kyle Bourassa, said, “It appears that thinking of your partner as a source of support can be just as powerful as actually having them present.” The conclusions of this research study, regarded as ground-breaking, correspond with the results thousands of clients have achieved using the method in this book.

      When Carole drove through the tunnel, she had no one physically with her to down-regulate her. Prior to her trip, however, she had made sure she had someone with her psychologically. She linked her trip through the tunnel, landmark by landmark, to the memory of a person whose face, voice, and touch activated her parasympathetic nervous system. Vagal braking calmed her. This method can be applied to any stress-producing situation.

       CHAPTER 6

       Control Panic and Claustrophobia with Vagal Braking

      Becky emailed:

       I have been terrified of elevators. As a nurse, I would climb ten or more flights of stairs at the hospital to avoid taking the elevator. This is part of a severe generalized anxiety disorder that resulted in years of daily panic attacks. I am fifty-two years old, and after seeing a variety of therapists over many years, this [the SOAR program] has helped me tremendously.

      Carole’s experience navigating the Holland Tunnel proves that we can intentionally evoke the effects of a friend’s calming presence to manage panic. In some cases, calming signals from other people are built into our memories serendipitously. For example, even if you were scared when you first used an elevator, if you were with someone you felt physically and emotionally safe with, you likely associated that person’s presence — and their calming signals — with the elevator. Thereafter, when in an elevator, the invisible psychological presence of that person quelled your fears. Your friend’s psychological presence overrode the urge to escape and stopped the panic before it even started.

      But if calming associations were not built into your brain serendipitously earlier in life, you can build them in now, as Carole did. It’s really simple. We need to find a memory of a time when you were with a person whose presence activated your parasympathetic nervous system. Do you have a friend with whom you have, at times,