Panic Free. Tom Bunn

mean danger. Stress hormones can also prepare us to escape or to fight if the changes turn out to mean danger. Thus the release of stress hormones has value for individual survival. But from the perspective of evolution, individual survival is less important than reproduction, which enables our species to survive. This requires physical intimacy, which in turn requires that the “fight or flight” response be put on hold. The hormone oxytocin blocks the release of stress hormones that cause the “fight or flight” response.

      Just as the memory of a calming friend can override stress hormones, the memory of an oxytocin-producing experience can prevent the release of stress hormones and feelings of panic and claustrophobia. Oxytocin is produced in the following situations:

      1. Sexual foreplay. If the signals are right, oxytocin sets aside the fears of acting on our desire.

      2. Sexual afterglow. Oxytocin causes feelings of attachment between sexual partners, making it more likely that a child will have two parents to provide care and protection.

      3. The first sight of a newborn baby. Oxytocin causes bonding and protective feelings toward the infant.

      4. Breastfeeding. By inhibiting anxiety about other things that need to be done, oxytocin gives priority to a baby’s need for nourishment.

      5. Gazing into your dog’s eyes. We say that lovers look at each other with “puppy dog eyes,” as if there were no one else in the world. By looking at their owners with complete devotion, dogs tap into the chemistry that causes these feelings of attachment.

      6. Hugging. Oxytocin is produced when a hug continues for twenty seconds or more.

      When Carole and I were preparing for her trip through the Holland Tunnel, she identified landmarks she would see every few minutes on her trip and linked each landmark to her memory of an oxytocin-producing situation. This was similar to the way an intravenous pump can administer small, frequent doses of anti-anxiety or pain medication. Regular releases of oxytocin kept Carole calm throughout her trip.

      Using both oxytocin production and vagal braking combats high anxiety and panic in two ways. Oxytocin inhibits the release of stress hormones. The vagal brake overrides their effects. In addition to linking each challenging situation to a friend whose calming presence stimulates your vagus nerve, try linking each challenge to a memory that triggers the release of oxytocin.

Part III

       Regulation of Arousal

       CHAPTER 8

       Accepting Arousal as Normal

      We’ve covered how to teach your unconscious procedural memory to automatically control panic that is triggered by something happening around you. You can also learn to control panic caused by something going on inside you. This is important because although you may be able to run away from an external threat, you can’t run away from what goes on inside.

      To avoid feeling trapped by what is going on inside, every child needs to learn that arousal is normal and that the feelings produced by arousal are normal. Only a caregiver can help the child learn this lesson. In addition, by responding to the child’s arousal in an attuned, calm, and nonjudgmental way, the caregiver’s response stimulates the child’s vagus nerve, which calms the child through vagal braking.

      If the caregiver does not respond calmly, the response may not produce vagal braking and may in fact lead to the opposite result. The caregiver’s own hyperarousal becomes linked to what is going on inside the child and may cause completely normal feelings of arousal to trigger hyperarousal, fear, and feelings of danger. This response may persist into adulthood.

      The failure to experience states of arousal as completely normal can have a profound effect on a child’s development. If caregivers respond negatively to the child’s arousal, the child may be afraid of being punished or of what might happen if they become overwhelmed. The child may fear that arousal could produce feelings or behavior unacceptable to the caregiver, which could result in the caregiver’s disapproval, loss of love, or abandonment.

      How many of us have been shamed for “acting like a baby”? The child who learns to fear their own feelings is in a terrible bind. Pressured to not express emotion, the child seeks to keep emotion contained. But how does a child learn to control emotion when the caregiver does not demonstrate this capacity? Caregivers who pressure children about emotional control invariably lack emotional regulation themselves. As a result, they are unable to teach a child healthy ways to regulate emotion, either by example or by acting in a way that produces vagal braking in the child.

      Dozens of studies have shown that the ability to regulate arousal develops from a child-caregiver relationship in which the caregiver is attuned and consistently responds to the child’s arousal calmly and nonjudgmentally. This response produces vagal braking which, when linked in the child’s mind to the situation or the emotion, establishes automatic emotional regulation in similar situations.

      By contrast, a caregiver who is judgmental or critical of the child’s emotions undermines the child’s development of self-regulation. Responding to a child’s emotional outbursts with punishment, such as spanking, can cause long-term damage. Researchers at the University of Texas at Austin conducted a meta-analysis of fifty years of research showing that spanking and child abuse produce the same results. One of the researchers, Elizabeth Gershoff, a professor of human development, said, “We as a society think of spanking and physical abuse as distinct behaviors. Yet our research shows that spanking is linked with the same negative child outcomes as abuse, just to a slightly lesser degree.”

      A caregiver who becomes hyperaroused in response to a child’s arousal may force the child to shut down rather than self-regulate. A caregiver who withdraws when the child is aroused provides the child with no basis for feeling safe. Neither response establishes the links between arousal and vagal braking that are needed to develop healthy down-regulation of arousal.

      Note, however, that regulation does not always mean down-regulation; it can also mean up-regulation. The developmental researcher Allan Schore, a leading authority on emotional regulation, asked therapists attending one of his workshops to imagine a mother playing with a little child, perhaps six months old. The child smiles; the mother reciprocates with a smile. That causes the child to giggle, which in turn causes the mother to giggle. The child responds to the mother’s giggle with a laugh. Both become more and more aroused, perhaps almost unable to stop laughing. But because the mother and the child experience a high level of arousal together, the child learns that this is a normal, nonthreatening experience. Thus arousal is unlikely to lead to panic in the future.

      The wise caregiver enjoys sharing excitement with the child but does not try to keep the child in a prolonged state of high arousal. For example, tickling can be fun if it is brief, but too much tickling is intolerable. When the mother is attuned and responsive to the child’s signals, stimulation is comfortable and delightful for both. The child learns that every level of arousal is part of the normal range and is tolerable if experienced briefly.

      Beatrice Beebe and Frank M. Lachmann have studied mother-child interactions in which mothers keep children highly aroused for too long. When the mother’s stimulation becomes too much for the child, the child turns his head away. If the mother feels rejected, she may try harder to engage the child by increasing the stimulation. The child turns away as much as possible. If unable to escape the mother’s overstimulation, the child becomes relationally traumatized and experiences ordinary arousal as an overwhelming threat. Because the child is helpless to defend against it, unbearable intrusion may cause lifelong avoidance of close relationships and obstruct the normal operation of the social engagement system. The child, and later the adult, is afraid that feelings will develop that they cannot endure.

      Teaching