## Exposure Therapy The best treatment for amygdala based anxiety solves for the root cause. Recall that the amygdala forms [[Emotional memories]]. If, for example, you were bitten by a dog as a child, your amygdala may associate the sound of barking with a highly negative event. Barking, whether that's from a dog in real life or just an audio clip, will trigger anxiety. If you consistently avoid dogs the moment you hear them, you may be reinforcing your amygdala that the right thing to do is to flee. Over time, your amygdala will have learned that barking should lead to anxiety, which will lead you to flee, and thus "solve" the problem. How can we fix this? Well, the authors mention there's only one way: > when it comes to amygdala-based anxiety, there’s only one sure way for the amygdala to learn: experience. (p. 49). In other words, we must face our fears. Therapists often employ a practice called "exposure therapy" for their clients and it generally comes in one of two forms: systemic desensitization (gradual) or flooding (diving into the deep end). Systemic desensitization: > Systematic desensitization involves learning relaxation strategies and approaching feared objects or situations in a gradual manner. (p. 127). Flooding: > With flooding, in contrast, people jump right in with the most fear-provoking situation, and the exposure may last for hours. (p. 127). Which one works better? Flooding _may_ be more effective > Research indicates that intense, extended exposure to triggers that produce fear (flooding) is more rapid and effective than a gradual approach (Cain, Blouin, and Barad 2003). (p. 127) But it is important to note that you have to see it through and experience anxiety for potentially hours. If you don't, it can backfire: > it’s possible to actually strengthen anxiety if you leave the exposure situation before your anxiety decreases. (p. 132) One technique you may wish to employ is to create an "exposure hierarchy". As the name suggests, you create a list of situations that give you anxiety, from least to most. And then you start tackling the least scary ones first. For example, if you have a fear of driving, and in particular on the highway, your list might be: * Turning the car on * Backing out of the driveway and driving around the block with a friend * Same as above, but solo * Driving on local roads with a friend, for 10 minutes * Same as above, but solo * Driving on highways at night (low traffic) with a friend * Driving on highways during the day (medium traffic) with a friend * Practicing lane changes on the highway with a friend * Doing the above highway exercises solo Give each of these a rating of anxiety level from 1 to 100. Everyone will have different items that trigger more anxiety. For example, for two people who both get anxious driving on the highway, one might be anxious about the speed. Another may be anxious driving on the road by themselves. The book recommends some particularly useful self talk. When you're about to do something that activates your anxiety, keep the following messages in mind: * "I expect my fear to rise, but I can manage it" * "I'm activating my fear circuits to change them. I'm taking control" Facing your fears is the only way to address amygdala based anxiety in the long run. There is no other way to retrain your amygdala. ## Exercise While exercise will not _solve_ amygdala based anxiety, aerobic activity will dampen the activation of the amygdala. Given that all anxiety, even anxiety that originates from the cortex, must pass through the amygdala - exercise is important for anyone who wants a calmer brain. The short term effects of exercise can last for many hours: > exercise results in decreased muscle tension for at least an hour and a half afterward, and reductions in anxiety last from four to six hours (Crocker and Grozelle 1991). (p. 145) Over the long run, it has a particularly calming effect on the amygdala: > Exercise appears to affect a certain type of serotonin receptor that’s found in large numbers in the lateral nucleus of the amygdala (Greenwood et al. 2012). Regular exercise seems to make these receptors less active, resulting in a calmer amygdala that’s less likely to create an anxiety response (Heisler et al. 2007). (p. 147) The effects of exercise on your brain are far reaching and not just limited to anxiety and the amygdala - it's one of the best things you can do, not just for your muscles, but for your mind. ## Breathing Try this: Take a deep breath. Watch your chest expand slowly. And now let go. Did you feel the slightest sensation of relaxation? Didn't work? Try it again but slower. Slow, deep breathing can help to bring down your heart rate and calm your amygdala. It works to counter your amygdala's [[Fight-flight-freeze response]]. A more advanced form of breathing that is known as [diaphragmatic breathing](https://www.healthline.com/health/diaphragmatic-breathing), which are colloquially referred to as "belly breaths". They're known to have an even stronger physiological calming effect on your body. ## Other Relaxation Techniques The book also mentions a few useful relaxation techniques. I personally don't use them very often, hence I won't dive much into them, but they're known to be useful for many people: * [Progressive Muscle Relaxation](https://www.healthline.com/health/progressive-muscle-relaxation) * Relaxing Imagery - visualize a calming scene. The more details (objects, textures) and senses engaged (not just visual, but sound, touch, taste) the better Clipped from [Rewire Your Anxious Brain - Review](https://philipliao.com/books/rewire-your-anxious-brain) at 2021-02-26T19:23:50. #psychology