Review of Rewire Your Anxious Brain
Anxiety is a phenomenon that involves the whole person—the brain, the nervous system, the mind (thought life), and the heart (spiritual aspects). I found Rewire Your Anxious Brain extremely helpful in one of those aspects. The brain. The authors provide an excellent summary of findings of neuroscience as it relates to anxiety. And the instruction on how to retrain the brain and create new neural pathways are very helpful.
I found the tips on how to change your conscious thinking less helpful. And there is no instruction at all on the spiritual aspects of anxiety.
Amygdala (Subconscious) Anxiety
At the core of the physical aspects of anxiety is the amygdala, a part of the brain that stores emotional memories that aren’t processed in the cortex, so you have no conscious awareness of them. Most people would refer to this as subconscious anxiety, though the authors don’t use that term.
They cite the example of a woman suffering from memory loss in a hospital. One doctor shook her hand but had a pin in his palm that pricked her. She withdrew her hand. The next day, because of her condition, she had no memory of that doctor at all. But when he extended his hand to shake, she withdrew. They asked her why and she had no idea. The memory of that pain stored in her amygdala but was forgotten by the cortex.
The authors tell another story of a girl who became panicky in some social situations but not others. Someone quizzed her about it and helped her realize it only happened when people were seated in a circle. Finally, she remembered a time when she was a child and was humiliated at school in a circle of students. Her amygdala recorded the negative feeling in association with the circular setting. So that arrangement became a trigger to the amygdala without the cortex knowing it.
This is why panic attacks often make no sense. The amygdala does not have the capacity for logic or reason, only association. Neurons that fire together wire together. A soldier had recovered from his PTSD, but then inexplicably began to relapse when he showered. He finally realized his wife had switched the soap brand to one that he had used when he was in combat. It wasn’t that he smelled the soap and thought, “Wow, this reminds me of that horrible time in my life.” It was not a conscious memory—just an association in the amygdala. He changed soap brands and the panic attacks went away.
The Body’s Alert System
The amygdala’s job is to set off the red alert signals in the nervous system to enable the body to deal with danger—increased heart rate, rapid breathing, tense muscles, adrenaline release, etc. It doesn’t go through the cortex because reactions to danger sometimes need to be instantaneous. If an object is flying at you in your peripheral vision and is about to impact your head, your amygdala can set your body in motion to duck or brace before your cortex even knows what’s going on.
This is why you can’t talk yourself out of a panic attack. You can tell yourself (or someone else can tell you) all day long that you’re not in danger, and that the feelings of panic are unwarranted, but the amygdala doesn’t respond to logic or reason. Talking yourself out of a panic attack with reason is like using logic to tell your heart to stop beating. It won’t listen. The responses of the amygdala are essentially a mechanical action, not a rational one.
In fact, logical reasoning during a panic attack can make matters worse. If you have thoughts like, “Am I having a heart attack?” or “Am I going crazy? What’s wrong with me?” can cause negative emotions that only strengthen the amygdala’s panic response.
Retraining the Amygdala
The best way to think during a panic attack is to simply remember, “This won’t hurt me, and it will soon pass. My amygdala is simply responding to some trigger, and my nervous system is doing exactly what it’s supposed to do when the amygdala signals an alert.”
And while the amygdala doesn’t respond to logic, it does respond to physical actions. When it sets off the red alert, if you respond with calming actions, such as slow, deep breathing, muscle relaxation, pleasant social interactions, and physical activity to burn off the adrenaline, it can retrain the amygdala to stop setting off alarms when that trigger arises. But if you do what comes naturally (fight/flight/freeze), that only reinforces the amygdala’s association of that trigger with danger. So it’s important not to withdraw or become aggressive.
The amygdala can’t be retrained unless it is in an activated state. So it’s important to respond in calming ways, especially with slow, deep breathing, during the panic attack.
It’s not necessary to discover what caused the negative memory. If people sitting in a circle triggers panic attacks, it doesn’t matter how the circle configuration got associated with danger in the amygdala. The retraining will work just as well regardless of whether you are aware of how the association first began.
While retraining the amygdala, it’s crucial that you behave in a way consistent with not being in danger. For this reason, anything you do as a safety mechanism, like retreating to a safe space, clinging to a trusted friend, or even clutching some soothing object–those actions will train the amygdala in the wrong direction, affirming the idea that the trigger really is a threat. To create new neural pathways in the brain, it’s necessary to expose yourself to the frightening trigger and remain in that situation until the feelings of anxiety are gone. This teaches the brain that the situation is not dangerous. Leaving while you still feel anxious only solidifies the fear.
This principle guides the authors’ discussion of medications. Benzodiazepines (drugs that have a tranquilizing effect) can interfere with the retraining process. For the retraining to work, the amygdala must be activated (generating an anxious response). Tranquillizers calm the amygdala, preventing it from becoming activated. This makes you feel calm, but it prevents any rewiring in your brain. Rewiring can only happen while in an anxious state.
On the other hand, SSRI’s can assist in the retraining process. These drugs promote growth and change in neurons. Care must be taken, however. The SSRI drugs will strengthen whatever activity is taking place in the brain. So if you are thinking in good ways, SSRI’s can strengthen those neural pathways. However, if you are thinking in bad ways (worrying, fretting, negativity, etc.) those bad pathways will be strengthened.
Cortex-Induced Anxiety (Your Thought Life)
Another section of the book addressed the thought life, offering tips on how to avoid excess worry or fretting. This section may be helpful to some who haven’t given the matter any thought. Personally, I found most of it merely observations of common sense. Nothing especially profound.
I did like the section on catastrophism (overreaction to a negative event, such as yelling and pounding on the steering wheel when someone cuts you off, as if that were a catastrophe). Very often I dislike the terminology coined in the psychology world because they tend to be misleading. But the term catastrophism is, in my judgment, both helpful and humorous. The idea that I’ve suffered a catastrophic setback in my life because someone pulled in front of me on the highway is a funny way to highlight how irrational the response is. And simply asking myself, “Why am I reacting to this as if it were a catastrophe?” may be enough to change my reaction.
Cognitive Fusion (Mistaking Your Thoughts for Reality)
I also liked the section on cognitive fusion, which is when we confuse our thoughts about a possible event with actual events. A boyfriend doesn’t respond to a text, and the girl imagines he has lost interest in her. Her emotions react as if that were actually true, even though it may be his phone battery is dead. When worrisome thoughts take over, it’s good to remind yourself, “These are only thoughts, not actual events. Don’t respond to them as if they were events.” This calls to mind the saying, “Don’t believe everything you think.”
Reminding yourself that thoughts are only thoughts, not reality, is helpful. We can analyze our own thoughts. “Oh, here comes that pesky thought again. I’d better be careful with it. Too much time on it and it could activate my amygdala.” They compare our thoughts to channels on TV. Getting stuck on the anxiety channel is harmful, and the solution is to turn to another channel. The circuitry in the brain that is used the most becomes the strongest. Circuitry you don’t use becomes weaker and less likely to be activated.
Nothing on Good Anxiety
One glaring omission in the book is the fact that very little is said about purpose of anxiety and how to use it properly. With a few exceptions, the authors mostly assume reduction in anxiety is a good goal. But Scripture condemns the lack of anxiety over important matters (Philippians 2:19-20; Romans 12:11; 1 Corinthians 7:32; 12:25-26; Ezekiel 16:49). Anxiety is a gift from God and is crucial for a healthy, vibrant life. It’s designed to motivate us and give us energy to handle problems. If you have not yet used your anxiety for its intended purpose, and you take steps to deaden the intensity of that anxiety, you may be harming yourself.
The authors speak of “activating the amygdala” like it’s always a pitfall to avoid. But God gave us amygdalas for a reason. The authors acknowledge it is valuable for situations of high dangers or when instant reactions are necessary, but anxiety is also important for situations that are not emergencies, but that warrant an emotional response. If I hear that my child is being bullied at school and that doesn’t affect me emotionally, something’s wrong with me. I wish I had far more anxiety than I do over lost people going to hell. There are plenty of situations where it would be wise to use our cortex to think rationally in ways designed to activate the amygdala so that we have the anxiety we need to function properly in life.
Devoid of Spiritual Content
Completely missing from the book are the most important principles regarding anxiety—spiritual truths from God’s Word. Our goal should not be to simply reduce our anxiety. Our goal should be to use all anxiety in ways that please God. That will be the path to the healthiest life.
Instead of exploring God’s purposes for anxiety, the authors speculate as to evolutionary “purposes” (as if natural selection of a series of random birth defects could have anything accurately described as “purpose”).
This is not to say no biblical principles are present in the book. There are several cases where science catches up to Scripture, and biblical principles are presented as scientific discoveries. One example is the “put on, put off” principle from Ephesians 4. The idea is that sin cannot simply be eliminated. It must be replaced by the corresponding virtue. Thoughts are the same way. Anxious thoughts cannot be eliminated without replacing them with different thoughts. Examples in the book are somewhat simplistic, but they do follow the Ephesians 4 principle.
I am currently writing a book on what the Bible teaches about anxiety–how to make good use of good anxiety and how to replace bad anxiety with the peace of God. The basic content of this book is available in this podcast series: Stress and Anxiety Podcast Series | SermonAudio.
For more info on the podcast, see the podcast page.