Friday, October 7, 2011

Fearfully Made . . . Celebrating the Gift of Terror Part VII

 The Model of Anxiety:

   Sensory input --------> Cognitive Interpretation <------------->Limbic System (deep emotions)-------------> Hypothalamic-Pituitary-Adrenal Axis (the release of adrenalin and cortisol).

I'm not smart enough to know how to draw in this blog, so I will have to add another dimension via text, which is memory.  Memory has direct input into the cognitive interpretation process and limbic system.  Notice too that the arrows between the cognitive system and the limbic system have points on both ends. The same is true between memory and those two areas. This means that emotions and memories directly effect the way we perceive, or more accurately interpret, the input of our senses and our interpretation of the senses directly influences memories and emotions.

So, lets look at how the fall of Adam can impact this process, rendering us as anxious people.

I can't imagine how errors in the first step, a broken sensory input, can lead to anxiety.  It can lead to deafness or blindness.  So the first really vulnerable spot is the second point on the graph, the cognitive interpretation of the senses. The second vulnerable spot is the limbic system. I will lump memory in with those two systems.

There can be disorders of the last part, the Hypothalamic-Pituary-(+Thyroid)-Adrenal Axis, but those are rare.  In those cases you would have the physical feeling of a panic attack, fast heart rate, shakiness, without the emotions of it.  The most common example is a thyroid storm. Another example is a tumor (which secretes adrenalin) called a pheochromocytoma. But I'm not going to talk about those influences of the fall on humans, because they are rare and don't represent true anxiety.

So, the major problems come down to disorders in the first two areas, cognitive interpretation and limbic systems.  God designed the system to help us defend ourselves against threats.  I think there are two areas of threats, bodily and value.

In the area of bodily, we fear physical pain, and death.  But the later issue is greater, and that the intense fear of being devalued.  I say it is greater than the fear of death because people will commit suicide if they think they have no value.

So the fear of bodily harm is pretty simple. We (think of us living in Africa) walk into the savanna where lions habitually sleep.  The senses come into the frontal lobes where we start to deconstruct and find meaning in the sensory input.  It is recognized that this is lion habitat. The memory of watching a lion tear apart one of our clan members will enhance that interpretation. In a very healthy way, that repackaged information is sent to the limbic system, where it creates the general fear response.  The God given purpose of that anxiety is to make us either avoid the area altogether or to proceed but with a heighten state of awareness. This is a good thing . . . actually a very good thing. The anxiety, working backwards though the system, then starts to increase our sense's abilities to perceive danger.

If a lion was to suddenly stand up from the deep grass and start charging towards you, the limbic system would then trigger the hypothalamic-pituitary-adrenal axis causing the sudden dump of stress hormones, adrenalin and cortisol.  Once dumped, the stress hormones are irresistible (until they are metabolized and leave the blood stream).  You are prepared to run, fight, or in some cases fall down and be catatonic.

I know that I'm being redundant but I just wanted to make sure I was clear in that. It is truly a gift. Without this system in our brains, we would surely die quite young. We wouldn't have the apprehension that keeps us from climbing over the fence at the Grand Canyon rim, or walking out in traffic, or looking down the barrel of a loaded gun.  Fear is a great gift of God as is anxiety. The panic mode is a great gift as well.

When I was in college, I once fell (more like slid) off a cliff onto a frozen river in the dead of winter.  As soon as I broke through the ice (actually the moment I started my slide down) the adrenal glands kicked in.  I felt a complete panic.  My hiking friend was able to reach  me with a long limb so I could crawl out.  We were about three miles from the nearest road so I ran the whole way back to the truck.  I think my fight or flight response saved my life because my running stopped me from getting hypothermic. Once again, it is a gift from God.

The way that this wonderful system can malfunction can be from nature or nurture or, most commonly, a mixture of both. First I will talk about the Fall's influence on the nature of our anxiety system. When I speak of nature, I'm speaking of genetic influences or, less commonly, injuries to the system in the womb.  Nonetheless, both result in a proneness towards anxiety.

I would be foolish to describe what these errors could be, as even the scientists who research anxiety, don't have it mapped out yet. But it would involve the brain's hardware, meaning neurons, how they connect and the chemicals, such as dopamine, which they use to communicate with each other.  So, many people . . . due to no fault of their own . . . come out of the womb more anxious than others. So as Lady Gaga would say, they were "Born that Way." But I certainly would differ from much of Christian teachings by opposing the notion that "God created us that way" or, due to our sin we became that way. It is old sin. The sin of our forefathers, the fall of Adam on the universe that has caused these defects.  Those who suffer from them are completely innocent victims in the same way someone is born with one leg . . . or blind.

The second area of course is in the nurture.  I said the brain is like a supercomputer . . . but again different. It is different because the brain is not static silicon chips with electrons setting on them creating a charge. But the brain is biological and dynamic. The structure of the brain is constantly changing.  A computer's structure never changes on its own unless you physically upgrade it. The brain changes by growing dendrites and axons and changing the way certain neurotransmitters (chemicals) are released or suppressed.

Lets go back to the savanna.  If you had never seen a lion, your brain's system for processing the sensory input of the savanna and interpreting those senses would be vastly different if you were from a clan where you had been an eye witness of hundreds of brutal killings of your fellow clan members by lions.  The memory part of your brain is closely tied to your limbic system and your cognitive interpretation system. Just the smell of the grasses of the savanna would automatically cause the hairs on the back of your head to stand up if you were the later person.  You would fill a strange feeling in your stomach (as the blood is being redirected from your GI track to your skeletal muscles) and your palms would get sweaty.  The other person, the one who had never seen a lion, would stroll into the grasses like he or she were walking into their living room. They wouldn't experience anxiety because they do not have the neurons circuits in their memories and limbic system.

So, a real threat, say B's father storming into her room in a drunken rage, creates a deep memory and circuits in her limbic system. These are real, physical, changes in her brain.  While some other person, who's memory of their father was him hugging her, building her doll houses and singing her praises, wouldn't have these circuits.

In this later case, the fall is manifest by the sin of others. The abuse and mistreatment.  Once again, the sufferer of the anxiety is the innocent victim.

This post is getting too long so I will stop. But next time I want to talk about how the individual (the person suffering from the anxiety) can change their own brain structure. It isn't easy nor automatic. There is no magic trick or vitamin that fixes things. There are no simple spiritual exercises which can do it either. It is hard, long and arduous.  I also want to compare that to the misinformation promoted in Christian circles, that anxiety is the opposite of faith or trust in God or simply sin.  I also want to explore this other, more common area, of fear and that is the intense fear of insignificance or loss of value.


Anonymous said...

I have been following your blog for a few months now and appreciate your posts regarding matters of neurology. In fact I bought Anatomy of the Soul based on your reading list...great book, and it has sparked an interest in neurology for me.

This may be too personal, but I was just curious how you got into this field. What degree is required (short of an MD) in order to prescribe medication? Again, that may be too personal, so no pressure to answer.

I enjoy your blog and your perspective. Both my parents were Navs, and I spent a couple of years in it as well. To top it off I am an has been a blessing to read your honest posts. Keep up the good work.


jmj said...

JRT, I'm a PA (Physician Assistant or AKA Physician Associate), we, along with physicians and nurse practitioners are licensed to practice medicine and prescribe medications.

So what country did you grow up in?

JRT said...

I spent 14 years in China, I few years in limbo (back and forth), and came back here for college. Been here for about 7 years now, so well adapted now. At least that is how I view myself :). Other people might have opinions that differ...