Monday, July 4, 2011

Paving new pathways

The more I share about my own dark struggles with anxiety, the more people open up to me about theirs. Likewise, as I make progress, and live each day a little lighter, those same people have wondered aloud to me about it. What did you do? What do you do? How can I find what works for me, and let go of all this emotional sludge?

Well, I am not a therapist. I am just on a journey, maybe a bit like yours. I have no tricks, and no quick fixes. But I can share what I know, and what is working for me. Maybe it will work for you, too.

In a previous post, Unwritten, I wrote about my patterns of being worried, self-critical and defensive. These patterns, along with a generally pessimistic view of myself and my life, had become so ingrained, so part of my own self-concept, that I could barely even see them anymore. Later, in Practice, I talked about how, once a problem pattern is recognized, it is difficult to change, even when you want to. It takes daily effort, and can be a long and tiresome process. Both of these things are rooted in what we understand from basic neurochemistry.

How we learn patterns

Think of a piano student. This student has a new piece of music, and the first time she attempts to play the piece, many mistakes are made. It is slow and frustrating to get through the piece the first time. But if she keeps at it, and plays the piece again and again, and especially if she gives extra practice to those parts that are particularly challenging, the piece gets easier to play. As learning occurs, the student has to concentrate less and less, the piece sounds better and better, and playing the piece transforms from a difficult and frustrating experience, to a joyful one.

What we don't observe directly, is what happens in the pianist's brain. Brains are full of tiny neurons, that act like stepping stones in a pathway. Every time a path is followed, the electrical impulses in the brain actually cause the neurons to grow towards each other, as if the stepping stones are moved closer together. A substance called myelin also grows around neurons that are frequently used, making the impulses faster. Before we learn something, it is as difficult to follow the path as jumping from one far placed stone to the next, in heavy boots. It is slow, clumsy, and missteps are common. But as things are learned, those stones grow together, and soon it is like traveling an asphalt path in roller blades.

Unfortunately, this amazing, organic process is not only in place when we practice music. It is there when we practice anything. It is there when we practice putting ourselves down. It is there when we practice reacting in anger or fear. It is there when we practice blame, or perfectionism, or defeatist thinking. And sooner or later, our unhelpful patterns too become asphalt paths for our roller blades.

The helpful paths are not gone from our brains, but they are much harder to travel. The stones are far apart, and rough. That path is hard and slow-going. Left on automatic pilot, our brain will not choose to travel that path. Automatic pilot likes ease and speed. No, to find your way back to a helpful path will take effort, over and over. But each time you use the better path, you give it energy. Energy that it can use to grow, and get smoother. And the longer you ignore the old path, the more it will fall into disrepair.

This is not just a metaphor. Scientists have long known that brain tissue needs to be active to live. Neurons that are not used shrivel and die. As you build new pathways in your brain by consciously giving energy to a new way of thinking, the new path gets stronger, and the old path gets weaker. After a long time, the new way will be the faster pathway, and even old autopilot will choose it. But first you have to get there. You have to change your brain.

How we change patterns

Step 1 - Noticing
To shift your thinking from an old pattern to a new one, first you have to recognize what your old pattern is. One of my most pervasive patterns is that of self-critical thoughts, and that is the pattern I will be using in my example, but your unhelpful pattern may be different. Many people find it helpful to record the thoughts they are having during those times that they are feeling at their worst. As you record the thoughts and accompanying feelings, you can get an idea of where you need to focus.

It is important not to sugar coat your thoughts when you record them. For example, let's say I am driving, make some sort of error, and am suddenly feeling awful, anxious and ashamed. If I record the thought, "Gee, Lisa, you should really be more careful." I am not really being honest with myself about my inner voice. The statement, "You should be careful" would not elicit such strong feelings of anxiety or shame. It would be best to record as accurately as possible what I said to myself, and even try to capture the tone:

"Hey! What are you doing? Couldn't you see he was trying to make that turn? You totally cut him off! I can't believe you have your kids in the car and are driving like that. Just you wait and see, one of these days you will really cause an accident. Hurt your kids. Yep. What business do you even have behind the wheel?"

Wow. I am a meanie.

Can you see how those thoughts elicit those feelings of anxiety and shame? Of course I will feel anxious and ashamed if I think I am the worst driver and am going to wind up killing my own kids! The feelings and the self-talk usually match in intensity.

Step 2: Stopping
When you get a feel for your own voices, it is time to step up, and interrupt them. You make that traffic mistake, feel the anxiety, pay attention to what it was you were telling yourself, and just stop talking. Stop. Not another word. No. Some people visualize a giant stop sign, or say 'Stop' out loud to themselves. However you do it, just do it. You are not allowed to talk to yourself like that anymore.

Step 3: Restructuring
Now comes the rewrite. Question your own judgement. Does making that traffic mistake really mean you are an unobservant, rude, incompetent driver who deserves for her kids to die in a car accident? What would be a more realistic reaction? Practice saying that to yourself.

"You were distracted by your crying baby, and forget to shoulder check during that lane change. It is hard to ignore your own crying child, but accidents can happen on busy roads. You usually shoulder check. Remember to do it, even when it is loud in the car."

This is not about false optimism. You don't want to falsely congratulate yourself on your driving skills after an error. But take context into account. If you are usually a good driver, make sure to include that in your perception of events. One mistake does not a terror to the roadways make.

This is just one strategy to use when fighting the battle against anxiety and depression. It is not the only thing I have done, but it is probably the thing that has had the greatest impact. It is also not my own idea, but a simplified and adapted version of strategies conceived of and promoted by many therapists, based on the work of many researchers. Maybe it can help you. It has helped me.

drawings by Frits Ahlefeldt, and downloaded from:
Thanks, Frits.


pam said...

Thanks for sharing this. Very good information.

Amy said...

I've had to do this at different points. What I found most helpful was to think about how I would feel hearing someone else say those things to a friend or someone I loved. It wasn't nice, so I decided I deserved to be treated better than that. Life is so much easier without those mean voices in your head.

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