Título: Rewire Your Anxious Brain

Autor: Catherine M. Pittman, Elizabeth M. Karle.

Fecha de publicación: 2015, New Harbinger Publications

Contents:

Introduction: The Pathways of Anxiety.

Part 1
Anxious Brain Basics.
1. Anxiety in the Brain.
2. The Root of Anxiety: Understanding the Amygdala.
3. How the Cortex Creates Anxiety.
4. Identifying the Basis of Your Anxiety: Amygdala, Cortex, or Both?

Part 2
Taking Control of Your Amygdala-Based Anxiety
5. The Stress Response and Panic Attacks.
6. Reaping the Benefits of Relaxation.
7. Understanding Triggers.
8. Teaching Your Amygdala Through Experience.
9. Exercise and Sleep Tips for Calming Amygdala-Based Anxiety.

Part 3
Taking Control of Your Cortex-Based Anxiety
10. Thinking Patterns That Cause Anxiety.
11. How to Calm Your Cortex.

Conclusion: Putting It All Together to Live an Anxiety-Resistant Life.

Resources.
References.

Important Points:

Anxiety Pathways (how it originates):

- Cortex:
- Interpretation of sensory information (thalamus->cortex/thalamus->amygdala->cortex)
- Independent of external information (left lobe=thoughts/rumination, right
lobe=catastrophic images)
- Amygdala:
Receives information before the cortex does and can activate the Sympathetic Nervous
System due to triggers that might be unknown to the cortex (stimulus previously
associated with emotional reactions: emotional memories).

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Association is an essential part of the language of the amygdala.
If you want the amygdala to change its response to an object or a situation, the amygdala needs
experience with the object or situation for new learning to occur. Experience is most effective
when the person interacts directly with the object or situation, although observing another
person has also been shown to affect the amygdala.

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Experiencing stress response symptoms (pounding heart, rapid breathing, stomach distress...)
means the amygdala has been activated. In order to decrease amygdala activation, it’s very
effective doing breathing exercises as well as muscle relaxation exercises and physical
exercise.

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When you feel panicky, it’s important to resist the strong urge to flee the situation. This is
essential to gain control over your amygdala, since the amygdala learns from experience. If you
leave the situation, your amygdala will learn to escape the situation rather than learning that the
situation is safe.

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Although you can’t easily erase the emotional memory formed by the amygdala, you can develop
new connections in the amygdala that compete with those that lead to fear and anxiety. To get the
amygdala to create these new connections, you need to expose it to situations that contradict the
association between a trigger and negative event. When you create a new neural path and
practice traveling it again and again, you establish an alternate route that avoids trouble. You can
establish other calmer responses as a way around your anxiety.

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Exposure Therapy, Systematic Desensitization and Flooding (pg 126-141)

With either approach, in most cases people initially confront feared situations mentally, by
imagining themselves in the feared situation.
Research indicates that intense, extended exposure to triggers that produce fear (flooding) is
more rapid and effective than a gradual approach. But for an approach to be effective, a person
must be willing to use it.
During exposure, you need to experience the sights, sounds, and other stimuli that create anxiety
in order to activate the exact neural circuitry that holds the emotional memories you want to
modify. Activating these circuits creates the potential to develop new connections between
different neurons-connections that will modify the amygdala’s responses. You must activate the
neurons to generate these connections. You must experience fear or anxiety in order to conquer
it.
When facing feared situations, the discomfort can sometimes seem unbearable, and the desire to
escape, irresistible. This dynamic of experiencing anxiety and then escaping it by avoiding the
situation just serves to maintain anxiety. In this way, anxiety can be self-perpetuating.
If you want to generate new connections, you must activate the circuits that store the memory of
the feared object or situation. The emotional arousal and anxiety that occurs is a sign that you’re
activating the right circuits.
The optimal condition for learning to take place in the amygdala is when the neurons are excited,
just as the optimal condition for building muscle mass in the body is when the muscle fibers are
fatigued. In a parallel way, as you do more repetitions, you grow stronger.
You shouldn’t try exposure until you’re confident you’ll follow through, because it’s possible to
actually strengthen anxiety if you leave the exposure situation before your anxiety decreases.
You need not experience a high level of anxiety for rewiring the circuits, but if anxiety is high
during exposure, this can speed the process of change.
When exposure is quite challenging, you can strenghen your resolve by reminding yourself that
you’ll experience changes in your anxiety relatively quickly.
When you’re practicing exposure exercises and you feel your anxiety decrease, you’ll know that
you’ve gotten the amygdala’s attention and are making progress.
Exposure to each step must be done repeatedly for change to occur in your amygdala. Typically
each repetition of a specific step is easier than the previous one, but sometimes there are ups and
downs.

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Exposure coping thoughts:

• I expect my fear to rise, but I can manage it.
• Stay focused on this situation. This is all you have to manage.
• Keep breathing. This won’t last long.
• Relax your muscles. Let the tension go.
• I’m activating my fear circuits to change them. I’m taking control.
• Just stay until the fear decreases. It will decrease if you wait.
• I must activate to generate.

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If you anticipate that a particular event or phase of your day may amp up your anxiety, a carefully
timed exercise routine (yoga, breathing, muscle relaxation) may allow you to get through it with
less anxiety. In other words, you may be able to achieve a tranquilizing effect without taking
tranquilizers.

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Cognitive restructuring techniques, anxiety-igniting thoughts, coping thoughts (pg 184-198)

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Instead of getting stuck in worrying or ruminating, plan! If you anticipate that a situation will
actually arise, come up with possible solutions and then move on to other thoughts. If the
situation actually arises, you can put your plan into action. In the meanwhile, you don’t need to
keep thinking about it.

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