On the Anxiety Case

I have written about anxiety many times.  But I want add a couple of things that may round out the picture.  As we know now anxiety comes from deep in the brain where primal terror is organized.  No matter what we call it, it is always basic terror; it happens early in life either at birth or during gestation when the brainstem is dominant and where breathing is organized.   Some of us are chronic shallow breathers, others suffer sleep apnea where the whole system stops functioning for seconds at a time.   In both cases it is an attempt to conserve oxygen due to diminished oxygen both at birth through anesthesia given to the mother (and therefore the baby), or during womb-life when the mother smokes heavily.  In this case there is oxygen deprivation and the automatic tendency to hold one’s breath.  We see this when a person is shocked at something and puts her hand over her mouth; this is a survival reflex to hold down breathing.

   The point is that from the very start there is a survival response which means conserving oxygen and it becomes a template for any later threatening situations.  By the time we are born the agitation, galvanizing response is in action; therefore there is this constant input from within.   The imprint of threat becomes imprinted and is a constant menace.  Holding one’s breath even for a few seconds is the automatic response,  Terror has now become anxiety, only becomes we cannot peer down into the medulla of the brainstem to see how it all got started.   We cannot see the terror for what it is so we give it a label—anxiety.

    So we have constant activation from within that fights for space from whatever is coming in—a homework assignment, instructions for how to put together a table, etc.    The internal input usually wins sense it is primordial, is survival driven and is incredibly strong.   Later in life when there is a gathering of many people there is far too much possibility for input and so the anxiety person can be overwhelmed.  She may avoid any large gathering.   Or if she attends the party, for example, she suffers and cannot wait to leave.  The whole idea is to reduce or eliminate input.   She wants everyone to do anything complicated for her.  She will feign helplessness or not understanding when all it is that too much information/activation is forcing its way toward conscious/awareness.  The information is in the form of nerve impulses that travel at great speed throughout the system trying to “tell” the whole system to get ready for danger.  And the danger is……..reduced oxygen.  Those impulses tell the chemistry to pour in more cortisol (stress hormone) or inform the immune system to lower its functioning.  No words in those transmissions; just key information warning of danger.  That takes precedence over all other input; so trying to figure out geometry while anxious is far too much.   Anxious means life-threatening input and that cannot be ignored.

  This person often has breathing and lung problems. She goes to doctor after doctor to no avail because he has no idea what is wrong.   But looks into her lungs deeply and can only see the alveolas, not able to see those life and death memories at work in them.  He cannot see deep-lying terror sequestered far below the comprehending cortex.  He cannot see its causes.     He is, in effect, blind.  And so she rushes to a psychiatrist, and he too cannot see what lies deep in the brain so he focuses on her behavior: she has to learn to focus and not pay attention to other input.  She must learn patience, and blah blah.  He too is blind.  They cannot believe what does not seem to be there but, in fact,  it is there if we look.  None so blind who refuse to believe what is there and continue to believe in what isn’t there.