Introduction:
Rewire Your Brain
Most people experience anxiety, and when it becomes extreme, a disorder can develop. Living with an anxiety disorder can be a real challenge. It can make getting through the day and enjoying your life difficult. The good news is that you can bring your anxiety under control. Because your thoughts and behaviors are related to your emotions, you have a way to change the way you feel. Just as your body has the ability to heal wounds, your brain has the potential to heal your emotions.
Your brain has the capacity to rewire itself and help you change. In this book, Cognitive Restructuring: Rewire Your Brain and Rescue Your Life, you will discover how anxiety develops, and what you can do to make your brain more capable of rewiring. You will learn how to restructure your thinking, so that you can make your anxiety work for you, instead of against you. And you will learn how to keep from overreacting to the physical sensations associated with anxiety.
By following the strategies in this book, you will change the way you think, which will help you change the way you feel. You will discover how to restructure your thoughts, and your emotions will begin to temper. You will also learn to use the social world around you to enhance your comfort level. By giving the strategies in this book a chance to work, you can change your life.
Anxiety originates in portions of the brain designed to help you deal with danger. Like fear, it is a complex emotional response, except anxiety occurs in the absence of immediate peril. In other words, you feel fear when you actually are in trouble, like when someone is about to run into you on the highway. You feel anxiety when you have a sense of dread, but you are not in danger. Anxiety arises when you worry about the safety of a loved one who is far from home, or when you contemplate everything you need to complete before a deadline at work.
Many people feel anxious quite often, especially when under stress. Problems arise, however, when anxiety interferes with important aspects of your routine. In that case, you need to get a handle on your anxiety and regain control. Even though anxiety has the power to temporarily rob you of the capacity to complete many of your basic activities, you can return to be fully engaged in life. You have the capacity to understand the cause of your difficulties and begin to find confidence again. This understanding is possible thanks to a recent revolution in knowledge about the brain structures that create anxiety.
In the twenty-first century, research on the neurological underpinnings of anxiety has been conducted in a variety of laboratories around the world (Dias, 2013). Research on animals has uncovered new details about the neurological foundations of fear. Structures in the brain that detect threats and initiate protective responses have been identified. At the same time, new technologies like functional magnetic resonance imaging and positron emission tomography scans have provided detailed information about how the human brain responds in a variety of situations.
When reviewed and analyzed, this knowledge allows neuroscientists to make connections between animal research and human research. As a result they are now able to assemble a clear picture of the causes of fear and anxiety. This research has revealed something very important. Two fairly separate pathways in the brain can create the anxiety we feel.
One pathway begins in the cerebral cortex, which is the large, convoluted gray part of the brain that involves our perceptions and thoughts about situations. The other travels more directly through the amygdala, which are two small, almond-shaped structures, one on each side of the brain. The amygdala (generally referred to in the singular) triggers the ancient fight-or-flight response, which has been passed down virtually unchanged from the earliest vertebrates on Earth.
Both pathways play a role in anxiety, although some types of anxiety are more associate with the cortex, while other can be directly attributed to the amygdala. In psychoanalysis, attention has typically been focused on the cortex pathway, using therapeutic approaches that involve changing thoughts and arguing logically against anxiety. A growing body of research now suggests that the role of the amygdala must also be understood to develop a more complete picture of how anxiety is created and how it can be controlled.
In this book, both pathways will be examined to give you a full picture of anxiety and how to change it, whatever its origin. The cortex is the portion of the brain that fills the topmost part of the skull. It is the thinking part of the brain, and it enables you to reason and create language. Species that have a large cerebral cortex are often thought to be more intelligent than other animals.
Approaches to treat anxiety that target the cortex pathway are numerous, but typically focus on cognitions, which are the mental process of thinking. Thoughts originating in the cortex may be the cause of anxiety, or they may have the effect of increasing anxiety. In many instances, changing your thoughts can help you prevent your cognitive processes from initiating or contributing to your anxiety.
The Amygdala
Until recently, treatments for anxiety were less likely to take the amygdala pathway into consideration. The amygdala is small, but it is made up of thousands of circuits of cells dedicated to different purposes. These circuits influence love, sexual behavior, aggression, and fear. The role of the amygdala is to attach emotional significance to situations and form emotional memories. The emotions and memories can be positive or negative.
The focus in this book will be on the way the amygdala attaches anxiety to experiences and creates anxiety-producing memories. This will help you understand the amygdala, so you can learn how to change its circuitry and minimize your anxiety. You are not consciously aware of the way the amygdala attaches anxiety to situations, just as you are not consciously aware of that your liver is aiding in your digestion.
However, the amygdala's emotional processing has profound effects on your behavior. The amygdala is at the center of where the anxiety response is produced. Although the cortex can initiate or contribute to anxiety, the amygdala is required to trigger the anxiety response. This is why a thorough approach to addressing anxiety requires dealing with both the cortex pathway and the amygdala pathway.
The ways the different pathways work will be explained, both separately and in conjunction with one another. Once you have a good foundation in how each pathway creates anxiety, specific strategies to interrupt and inhibit your anxiety will be introduced. This approached has proven to be successful.
Neuroplasticity
In the past two decades, research has revealed that the brain has a surprising level of neuroplasticity, which means the ability to change its structures and reorganize its patterns of reacting. Even parts of the brain that were once thought impossible to change in adults are capable of being modified, revealing that the brain actually has an amazing capacity to change (Pascual-Leone and Amedi, 2005). For example, people whose brains are damaged by strokes can be taught to use different parts of the brain to move their arms (Taub and Uswatte, 2006).
Under certain circumstances, circuits in the brain that are used for vision can develop the capacity to respond to sound in just a few days (Pascual-Leone and Hamilton, 2001). Furthermore, exercise has been shown to promote widespread growth in brain cells (Cotman and Berchtold, 2002). In some research, just thinking about taking actions, like throwing a ball or playing a song on the piano, can cause changes in the area of the brain that controls those movements (Pascual-Leone, 2005).
The brain is not fixed and unchangeable, as so many people once assumed. The circuits of your brain are not determined completely by genetics. They are also shaped by your experiences and the way you think and behave. You can remold your brain to respond differently, no matter what age you are. There are limits, but there is a surprising level of flexibility and potential for change in your brain, including changing its tendency to create problematic levels of anxiety.
Strategies in this book will help you use neuroplasticity, along with an understanding of how the cortex and amygdala pathways work, to make lasting changes in your brain. You can use this information to transform your brain's circuitry so that it resists anxiety, rather than creating it.
Psychotherapy
As you work through the strategies presented in this book, it is recommended that you consider seeking professional help from a cognitive behavioral therapist. When choosing a therapist, it is important to ask whether the individual is knowledgeable about cognitive behavioral methods of treatment, especially exposure and cognitive restructuring. If you take anti-anxiety medications, it is important to use them wisely to support the process of modifying your anxiety.
If a family practitioner prescribes your medications, you might consult with a psychiatrist, who will have more experience with anti-anxiety medications and the brain. That said, psychiatrists are not necessarily trained in the various amygdala-based and cortex-based strategies for reducing anxiety outlined in this book. Many people seeking treatment for anxiety expect a psychiatrist to provide therapy, and they are surprised when the psych- iatrist instead focuses on medications.
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