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PLUM SPRING CLINIC
MICHAEL SHARP, MD

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Triggers

By Michael Sharp, MD

In my last column I discussed the origins of anxiety as the body’s way of alerting the body and mind to danger. Both body and mind are activated by anxiety, and all of us will note both the body’s physical change in feeling states (rapid heart rate for example) and the mind’s mental changes in the thoughts (tendency to catastrophize for example) that cross our consciousness when anxiety is present.

Michael Sharp, MD

In that column I also noted that these manifestations of anxiety can occur or be triggered by events in our surround that do not seem dangerous to our logical mind but create vivid states of alarm. Often the mysterious nature of the trigger contributes to the degree of alarm. When our sensory early warning system cannot locate the danger, we feel more vulnerable. But the body is almost certainly reacting to something it (even if not the conscious mind) associates with danger.

In that article, the example I used was of someone whose “favorite song” was playing on the car radio during a serious automobile accident. A year later, when the same song comes on the car radio during what seems like a safe ride in the country, it triggers tremendous anxiety—because, unconsciously, the body connects song and disaster. The smart brain says, “nice song—what’s all the rapid heart rate about?” But the Danger Monitoring and Action Center (DMAC) says “Watch Out! Bad Things Are About to Happen!”

I don’t know anyone who likes anxiety. So, we have a tendency to want to make it go away—to breathe easy, reframe our mindset, take a medication, learn to meditate. Modern neurobiology is suggesting some alternatives that may be more effective in the long run. The hard part, however, is that they all ask us to turn into the anxiety rather than away.

The first turn into anxiety asks us to be curious about what the trigger is exactly. The cool part of this is that even though the cognitive brain doesn’t have a clue, the body does, and it will tell you when you are getting close, and alarms will go off when you land on it.

In the case of the drive though the country you can do this after you get home. Close your eyes, imagine yourself in the car—feel what it was like before your heart started racing. What was going on, what did you like? Imagine the smell, the feel, the degree of light, what were you thinking about? Let yourself be in the moment. Be patient. This is like trying to feed a wild bird—it isn’t an act of willpower, it is an act of surrender. And I don’t for second forget how hard it is to “let go” when your DMAC goes off. But the act of feeding a wild bird is done with patient kindness—nothing more.

As you scan your setting, you can notice your anxiety like a Geiger counter combined with a radar. Scan and watch the needle. As you get closer to the trigger your instrument will start to buzz more actively. You can feel your body get tense as you get close.

This process is best done with another person. Going into the dark is best done holding the hand of another—someone who is comfortable in the dark. There are now a cadre of “somatic” practitioners who are specializing in these newer techniques of calming the DMAC and may be helpful in this process.

Now you know it is the song playing on the radio. Now begins the process of allowing your DMAC to recall the association with the accident. Again, another person will be helpful to make the association. I worked with a woman this week after we had identified her strong negative association with her amazing capacity to spend time productively working on the computer. It turns out her DMAC associated this activity with her father’s emotional neglect. Once a link is made, you will begin to notice a moderation of the tenseness and the noise of the alarm system. The song will not lose its ability to trigger you, but it will lose much of its power. Knowing the connection takes the unknown out of the equation and allows you to process, using some additional techniques, the original trauma. We’ll talk about that more in my next column.

To Your Health!