Anxious? Panicky? Is It Really Just "All In Your Mind?"
If our imagination triggers enough stress hormones, what we imagine seems to be happening.
Powered by stress hormones, psychological illusions cause anxiety and panic.
If activated, the parasympathetic nervous system can eliminate these problematic illusions.
In Hans Christian Andersen's "The Princess And The Pea," a princess is unable to sleep. She is disturbed by the pea underneath the stack of mattresses she is resting on.
We know a pea could not protrude through several layers of mattresses. Therefore, no one - not even a princess - could detect it. So why is the princess disturbed?
She doesn't have to detect the pea to be disturbed by it. She can be disturbed by simply knowing it is there. But there is a more interesting possibility. Her sleep could be disturbed by imagination of a pea that doesn't even exist. In the state psychological theorist Peter Fonagy calls "psychic equivalence," what we imagine - whether it exists or not - is experienced as real.
Fonagy says we spend the first few years of our lives in a state of psychic equivalence. We believe whatever is in our mind exists in the world around us, and believe everything in the world around us exists in our mind. As we become able to look within and observe our mental processes, we discover some things in our mind do not exist, and some things exist that are not in our mind.
This ability to look within has various names: meta-awareness, observing ego, and reflective function. Looking inward allows us to sense what kind of mental processes is going on. When aware that we are engaged in imagination, we know what we have in mind is not real. But, if we are not aware we are imagining we experience our imagination as perception, and thus as real.
We don’t have to be royalty to be distressed by something that does not exist. If the thought of something terrible releases enough stress hormone to cause psychic equivalence, it makes us believe the terrible thing is happening or is going to happen. Again, the pea doesn't have to be detected to be experienced. In fact, the pea doesn't have to exist to be experienced!
For most of us, the thought of a pea under a mattress would not be stressful enough to cause psychic equivalence. But what about a bedbug? If we checked into a motel and somehow learned the room had just been treated for bedbugs, we could easily imagine there is one somewhere in the bedding.
Does a bedbug physically exist? We don’t know. But its psychological existence is powerful enough to make us feel like we are being bitten. It doesn't help if someone says, "It's all in your mind, so forget it." Even if a bedbug is only in the mind, if it causes psychic equivalence, it is hard to reckon with. Feelings about something awful that might be true or could be true are not easy to dismiss cognitively. For example, even if you know the door is locked, a mental image of an unlocked door can cause discomfort until you go and check it again. Knowing that planes rarely crash is no match for the feelings caused by the thought of being on one that crashes.
It is human nature for emotional reality to lag behind physical reality. Though we understand that flying is remarkably safe, we can still feel unsafe in the air. It is not just thoughts that release stress hormones. In turbulence, every downward motion triggers a release of stress hormones. This is because the amygdala interprets downward motion as falling. The stress hormones cause the sympathetic nervous system to increase our heart rate, breathing rate, and perspiration. If the parasympathetic nervous system does not activate, the sympathetic nervous system is unopposed and arousal becomes hyperarousal. Reflective function is weakened. Psychic equivalence takes place, and the thought that the plane could fall out of the sky is experienced as plunging toward the earth.
Like the pea under the mattress, what can we do about a screw that may be loose on the plane? Stop thinking about it? Good luck with that. You can’t control your thoughts. What you can control is the effect thoughts have on you. You can condition thoughts so that, even if they trigger the release of stress hormones, they also activate the parasympathetic nervous system. When the parasympathetic nervous system is active, it opposes the sympathetic nervous system. This maintains an emotional balance that keeps you calm.
How is this done? Just as an infant is calmed when its parasympathetic nervous system is activated by its mother's face, voice quality, and touch, you can be calmed when your parasympathetic nervous system is activated by the memory of a friend's face, voice quality, and touch. You can provide this calming effect by linking a memory of your friend's face, voice, and touch to the things that are emotionally challenging.
The princess could have gotten a good night's sleep had she linked the imaginary pea to seeing a friend's face, hearing the friend's voice, and feeling the friend's touch.