Understanding Anxiety to Cope with It Better

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Many dysregulated eaters are plagued with anxiety which causes them to run to the proverbial cookie jar when they get tense and worried. But, for all that anxiety plagues them, my clinical experience says that they understand very little about how the state of anxiety gets generated. A simple definition of anxiety is that it is a perceived threat to self. It is not harm that is verifiable and guaranteed to come your way. It is a mind-body reaction to something you imagine/think/believe/assume will hurt you physically or emotionally.

Often we become anxious because we’re tossed into situations similar to ones which have caused us anxiety in the past.

Sometimes we recall the incidents with great clarity, but more often, we fail to make an association to whatever happened to us and what’s going on now, so that the roots of the anxiety remain beyond our awareness.

Here’s why that happens. The job of the amygdala is to store our emotion-laden memories from events that were a threat to us in order to be accessible to warn us if anything similar seems to be happening in the present. So, in childhood, if Mom used to pitch a fit whenever your room wasn’t neat as a pin or Dad would call you stupid and shiftless when you received bad grades, you might become anxious now, as an adult, about the house looking perfect when you have people over for dinner or about meeting with your supervisor for your annual review.

Remember, these aren’t just any old memories that produce anxiety. They’re imprints of events that caused you deep fear or helplessness. Here are a few more examples of how events from the past can trigger anxiety in the present. Say, you don’t get invited to a party and feel devastated and unloved—just like when you were a little girl and your classmates refused to play with you and teased you because you came from a poor family and lived in the shabbiest house on the block. Or your boss makes disparaging remarks about a presentation you made in front of your colleagues and you feel paralyzed and go speechless before him, exactly as you did when you were a boy and your father berated you for being a good-for-nothing, lazy loser because you tried out for the softball team and didn’t make the cut, preferring to read books rather than attend batting practice.

In each instance, the intensity of emotion stems from your memory of being hurt and—more importantly—of being powerless to respond effectively because you were a child dependent on parents or other care-takers. Remember, the “primitive” parts of the brains are charged with keeping us alert to possible threats. That’s their job. And, when were those brains most vulnerable? In childhood, of course, when they were not fully developed (that doesn’t happen until your early thirties!) and we didn’t yet have our frontal lobes, the decision-making part of the brain, to rationally understand what was going on in our lives. We depended on our amygdala to tell us when we were safe from harm and when we needed to be on guard. It is a very primitive alarm system that was useful when it was all we had, but in adulthood may generate more false alarms than true ones.

Intense emotional situations, especially when our brains aren’t fully formed, leave a deep imprint on the mind.

Think of a time when you were terrified in childhood or even in adulthood and what reactions your mind and body experienced. You might have felt in a fog with no ability to think clearly, had racing thoughts, a pounding heart, and a throat that was tightly constricted. You might have had surges of adrenalin and wanted to run or hide. Or you might have felt frozen in place.

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These are signs of a dysregulated nervous system which we all experience at one time or another. It’s bad enough when you’re alone in your house or apartment now and hear a creaky sound that you think might be an intruder. What do you think it was like when you were a pre-adolescent and your parents went over to the neighbors’ house for a few minutes, leaving you alone, and you heard those same intruder-like sounds? All dangers get magnified in childhood.

When we become anxious due to real threats or recall-triggered ones, our nervous system suffers serious, temporary dysregulation, an extremely upsetting sensation.

This discomfort is why we rush off to find comfort in food or in compulsively weighing ourselves. We are making our best attempt to relieve our symptoms of anxiety and re-regulate. However, much of the time that we turn mindlessly to food or to weight obsession, we have no need to be anxious because we’re really quite safe and fine and the sense of threat is being generated from within us, not from outside.

Here’s a simple example to illustrate what I’ve been talking about. Several years ago I fell off my bicycle and broke my elbow so badly that I needed to have three subsequent surgeries. I had just bought the bike (that was part of the problem) and returned it right after the accident. I also vowed never to ride a two-wheeler again. So, imagine my surprise when one day, sitting in my living room reading a book, I looked out the window and saw someone riding a bike around the circle in front of my house and my body started to shake. My amygdala was doing the equivalent of shouting: “Bike, watch out, you’ll get hurt,” doing its darndest to keep me safe. I had to remind my brain that I was safe and needed no warnings, thank you very much. No harm was going to befall me because I A) didn’t own a bike and B) was comfortably ensconced in a chair. The point—and it’s the major one I want to make here—is that I didn’t need to be anxious because there was nothing in reality to be anxious about: there was no actual threat to me. I was safe.

When I explain this recall-versus-reality dynamic to clients, they love it. They understand how fluky our brains can be and are relieved that they don’t need to be as anxious as they often are (because many had childhoods in which they were neglected or abused or they had suffered trauma later in their lives). Once they understand that most of the time as adults, they are safe, they want to learn how to distinguish between the need for anxiety (a real threat) and a recall-triggered memory which is a false alarm. The answer is that you are in recall when your internal distress is intense and out of proportion to the current situation. Using the examples above, is real harm going to befall you if you don’t get invited to a party or if your boss yells at you? As an adult, you are equal to other adults and you can think more clearly and put events into context. You didn’t know back in childhood that Dad had a drinking problem that made him full of rage or that Mom was depressed. In short, you were at the mercy of their whims. Now you can put events into context and take care of yourself.

To function as emotionally healthy adults, we can’t let our memory triggers dictate our current reactions.

As an adult, you want to realize that failing to receive a party invitation doesn’t mean you’re not liked or loved, only that not everyone gets invited to everything. As an adult, you want to know that it’s wrong for your boss to demean you in front of your colleagues, that you may have done nothing or little to cause his tirade, that his opinion has nothing to do with your actual worth, and that you have recourse in your response.

The big payoff is in identifying and recognizing your triggers. We all have certain prompts to anxiety based on whatever happened to us earlier in our lives. Think about the situations that trigger your anxiety and trace them back to their origins. Try to understand the events that caused you anxiety as a child and connect them to the ones that cause you angst now. Is anxiety about being judged, confronting authority, being left out or excluded, making mistakes, not being perfect, failing to do what was demanded of you, being shamed, not knowing when someone was going to erupt at you, not feeling good enough, feeling put upon at having to take care of someone, or not being accepted into a group?

To stop recall triggers, make a list of troubling memories regarding how you were hurt in childhood such as being shamed, abandoned, neglected, compared unfavorably to others, forced to compete with others, ignored, teased, undermined, invalidated, feeling unheard or invisible, regularly being forced to do things against your will, being manipulated, etc. Include later incidents in which there was trauma such as rape, bullying, harassment, accidents, and other situations in which you were frightened and helpless or traumatic events later in life (rape, robbery, accidents, etc.). Recognize that similar present situations might kick up these memories as well. My bike accident is one of these later life incidents.

Once you are armed with your list and are sure you understand that much of your anxiety is due to recall, not reality, you’re ready to go out into the world. If you become anxious and emotionally dysregulated, the first step is to notice this feeling and neither dismiss it nor assume it’s unnecessary, but rather, to decide whether it’s out of proportion to the current situation or not. If it is out of proportion, notice if the situation is on your trigger list and, if so, assume that a memory is causing you to be so upset. After that, remind yourself that you’re safe and self-soothe until you’re less anxious. For example, if you’re running late to meet a friend to go shopping and feel panicked that she’ll hate you for not being on time, you’d want to connect that to regularly being shamed by your first grade teacher who made you stand in the corner when you came to class late (because Mom or Dad overslept most days).

Here’s another example. Say, when you were a child your father, divorced from your mother and living in the next town, often promised to visit you or take you out and rarely fulfilled his promise. Here you are now and your friend cancels movie plans at the last minute and instantly you’re thinking about raiding the refrigerator. Could it be that your friend canceling plans triggered memories of your great disappointment and sadness whenever Dad didn’t show up when he said he would? I’d say so. You couldn’t do much about Dad, and it may have felt like the end of the world when you’d gotten your hopes up only to have him dash them. But, it isn’t the end of the world that your friend can’t make it: you have other friends, can entertain yourself, and are able to understand that these things occasionally happen.

Rather than raid the refrigerator, you can acknowledge feeling disappointed, then use your fully developed brain to decide what you want to do with your unexpected free time.

You will soon get adept at knowing when you’re being triggered by emotional memories, registering which ones are causing you to misperceive a threat in your current reality, reminding yourself that you’re fine and safe and have nothing to be anxious about, and re-regulating yourself emotionally. There are many ways to handle anxiety. In my book, however, understanding and applying the concept of recall versus reality is of the most profound and effective ways of remaining (relatively) anxiety free.  

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  • Pre-order Karen’s new book co-written with Paige O’Mahoney MD, Helping Patients Outsmart Overeating: Psychological Strategies for Doctors and Health Care Providers on Amazon or Barnes & Noble.
  • Karen thanks Dr. Jon Connelly of the Institute for Rapid Resolution Therapy(http://www.rapidresolutiontherapy.com) for his work in the area of trauma on which this article is based.

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