Chapter Panic attack brain zap

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Fear in the brain

This is one writer's depiction of having his head scanned by a functional magnetic-resonance imaging (fMRI) machine to see how fear works in the brain:

My head was recently scanned by clinical psychologist Philippe Goldin, a researcher in the lab of James Gross, director of the Stanford Psychophysiology Laboratory. Goldin and his team are studying 30 "healthy controls" and about 60 social phobics in an effort to plot the pathways of anxiety—and, more important, how people are able to damp down their impulses to fight or flee.

On the monitor, the story of my mortification is interrupted by a single line of words in bold:

I AM A LOSER

I read more of my story, then this line pops up:

I'M TOO INSECURE TO STAND UP FOR MYSELF

Two primary regions of the brain show increased blood flow in the scanner—to use the vernacular, they "light up"—in response to an anxious or frightening situation. One is the amygdala, which is associated with emotions; the other is the hypothalamus, which gets you ready to take action by increasing your heart rate, respiration, and sweating.

Next, the write is asked to regulate his emotions with reason:

I do what Goldin has asked: I tell myself in the scanner that I'm not a loser; that I do stand up for myself.

In fact, back in the managing editor's office, I did speak up, telling him I'd worked hard on that story and deserved to write it. I also suggested that next time he tell me first before announcing it to the staff. The editor responded by looking me over like he'd never noticed me before.

He said I was right, he should have come to me first, and that I was ready to write the story. But changing his mind didn't change his decision—I'd get a reporting byline, but the other guy would write it. "Next time, though, the byline will be yours," he said.

I kept my cool long enough to casually walk out of his office. Then I ran to the men's room, and nearly threw up. This episode is a key moment for me in learning to push down my anxiety to the point that it bothers me far less today—though it took years of similar episodes.

My struggle to overcome anxiety is exactly what Goldin and Werner are measuring in the f.M.R.I. They can actually see the pathways lighting up from the frontal lobe—the seat of rational thinking, and where we make decisions—essentially telling the amygdala to settle down.

"The amazing thing is that the brain can make changes," says Goldin. "Most of this happens in the amygdala, and it can be tempered to learn and adapt."

My results did show adaptation in action. When I read my story and saw the lines about being a loser, my brain grew anxious. But I was able to modulate its reaction—to tell my amygdala to chill out.

Meditation, cognitive-behavioral therapy...some of the best tools for coping with panic and anxiety depend on exactly this idea: while it might be a struggle, with mindful focus reason can mediate anxiety.