This post covers two simple exercises you can do to manage anxiety and panic which are grounded in an understanding of the neuro-physiology of the brain and the body. (For an overview of the neuro-physiology of panic, please see my previous post.) The capacity to regulate fear (anxiety and panic) comes fundamentally from the ability to maintain self awareness and stay in touch with your body. The more you try to push your awareness away from the internal signals and sensations of distress, the more likely they are to escalate. It is often said that what we resist, persists. When you can not tolerate noticing what is going on inside your body, you may develop a fear of the sensations of fear. This may result in anticipatory anxiety or panic about experiencing panic.
Recent neuro-scientific studies indicate that one of the best way to manage states of over arousal (hyper and hypo arousal) is to activate the part of the cortical brain referred to as the medial prefrontal cortex which gives us the capacity for “interoception”. This is the ability to look inside our selves and to notice what is going on inside and and to feel what we are feeling. It is thought that this capacity coupled with the capacity to stay calm by using your breath to stimulate the parasympathetic nervous system is essential for regulating emotion and arousal. When we engage the prefrontal cortex and pay focused attention to our bodily sensations (while breathing deeply and consciously by paying attention to the sensation of the breath particularly as we exhale), we increase our control over our emotions and our nervous systems.
Another technique is to be mindful of your thoughts, emotions and bodily sensations without judgement. This involves noticing, labeling (describing), and accepting your moment-to-moment cognitive, emotional and somatic experience. For example, you may notice that you are scared that you may have a panic attack. You might label this “fear”. You simultaneously notice that that this fearful thought runs through your mind repetitively. You might label this “ruminating”. You then bring your awareness to your body and notice that there is a tightness in your chest. You might label this “chest tension”. Doing this strengthens the part of your cortex which is responsible for self awareness and decreases arousal. This simple technique has been shown to activate the brain regions associated with emotional regulation and lead to positive changes in the regions involved with body awareness and fear. Practicing mindfulness techniques regularly has also been shown to decrease the activity of the amagdala, the alarm station of the brain.