We are programmed by evolution to be anxious – fear was a lifesaver for early humans! So are why are some 21st century humans crippled by it?
Catherine Pittman, PhD, chair of psychology at Saint Mary’s College in Notre Dame, is an expert on how different parts of the brain create and manage anxiety, and how to overcome it.
Learn just how fast your amygdala responds to a threat (before you even perceive it), and how your cortex jumps in to process the information. Turns out your amygdala has been watching too much Cortex TV, and you can train your brain to change the channel.
Phil Stieg: Today our guest is Dr. Catherine Pittman. She is a licensed clinical psychologist and professor at St. Mary’s College in Notre Dame, Indiana, where she specializes in the application of neuroscience to therapy, particularly in the treatment of anxiety disorders.
In her acclaimed book, Rewire Your Anxious Brain, she demystifies the complexities of how our brains process fear and anxiety and provides actionable insights for those looking to find relief.
We are thrilled to have Dr. Pittman with us to explore the intricacies of the human mind and share her invaluable strategies for managing anxiety. Catherine, thank you for being with us today.
Catherine Pittman: Oh, thank you so much for inviting me. I’m so happy to share this information.
Phil Stieg: I live in an environment where it seems pervasive. But really, how prevalent is anxiety in the United States?
Catherine Pittman: Well, during the pandemic, we really had a spike in both anxiety and depression that really has not returned to normal yet. So that has been a challenge for so many people – definitely a big part of our lives.
Phil Stieg: Well I was a little bit shocked. And this is 2005 data. In your book “Rewire Your Anxious Brain,” you stated that there were 40 million people, which I’m sure now is because of the pandemic–
Catherine Pittman: It’s definitely more than that. Anxiety disorders are the most frequently diagnosed disorders that we have.
Phil Stieg: So the take home message from that, as I hear it, is that one shouldn’t feel badly, or for that matter, anxious, about the fact that they have an anxiety disorder.
Catherine Pittman: Also it’s just part of being human. Actually, our brains are not built to be happiness producing. We actually have brains that seek out information about potential dangers. And so we are kind of programmed from ancient times to be prone to stress.
Phil Stieg: So that everybody’s on the same page, can you define anxiety for us from a clinical perspective?
Catherine Pittman: Well, it all kind of starts with stress. Anxiety and fear are related to something we produce called the stress response. And some people know it as the fight or flight response, which is kind of limited, because actually it’s the fight, flight, freeze response.
Our brains produce it very much in the same way that other animals do, which is why we know much more about it, because we can study other animals brains and find that many times the same processes are occurring in us.
What that tells you is we are programmed to look for dangers. And to have an automatic response at our disposal that is going to allow us to protect ourselves, to run away, to fight, to freeze, so that we’re not noticed. That response is really what leads us to experience anxiety.
Now, anxiety and fear are both coming from the same place in the brain that creates it. But anxiety is the word we give when the response doesn’t seem to be justified or understandable, like, why are you afraid? Then we call it anxiety. But when we see someone in a situation, like when they’re in the road and a car is coming toward them, or a dog is snarling at them, then we call that fear because we see the reason for it.
But to tell you the truth, it’s a very similar process going on in the human body, in the human brain, in the human experience. It’s just we call it different things.
Phil Stieg: I think everybody understands the fight, flight, freeze phenomena. That’s one end of the spectrum. The symptoms that a person is going to experience with garden variety day to day living in America, anxiety are what?
Catherine Pittman: So your heart might start pounding, your mouth might get dry, you may feel like, I need to leave this situation. That’s a thought you might have. Like, this is an unacceptable situation or a threatening situation.
There are physical changes in your body where there may be muscle tension. There’s also things you don’t even realize are happening. Like, for example, do you know your stomach stops processing. Your intestines start to do things differently. Your blood flow is shifted to your extremities, your arms and your legs, and your stomach and your gut kind of feel weird. And it’s because they’ve been kind of shut down to allow blood flow to go to different parts. Because why have blood flow in your gut?So there’s so many aspects, and some people say they feel like they have to go to the bathroom.
There’s all kinds of different symptoms, but they are all related to this defense response, and they’re all rooted in that. And once we start to understand ourselves a little better, it really helps us to cope with this response.
Phil Stieg: So you go through this in great detail in the book about the two centers for anxiety. I’ll refer to it as the lower brain, i.e., this amygdala that you talk about. And then the upper brain that everybody understands is the cortex. And the two of them play a role in doing what you mentioned earlier, making us descendants of worriers. Right?
Catherine Pittman: We are the descendants of the worried people. The people that didn’t worry didn’t survive as well as the people who worried. Or the scared people survived better than the calm people.
Phil Stieg: But that’s the purpose of the fight-flight-freeze thing, is to protect you. And the function of the brain overall is to keep you surviving. Right. So let’s get into how does the amygdala, the lower brain, play a role in creating anxiety?
Catherine Pittman: When you talk about the amygdala, it is the source in the brain that initiates the fight-flight-freeze response. And in some cases, some of us are more the flee people, and some are the fight people. So it’s different in different people, but all of us have it.
Start with the amygdala as this little control center in the brain. It’s about the size and shape of an almond in our brain. And what it does, is it is constantly watching for dangers that come in, indicated in all of our sensory systems. And if we have an indication of danger, then it can produce a very quick response.
Here’s what’s really important for people to understand, people who want to control their anxiety. The amygdala can produce responses in your body before you even see or hear what it’s responding to. And that is very, very important for people to understand, because people say, I want to stop feeling anxious. But the part of your brain that’s producing anxiety acts quicker than you can even process and think about a situation. So we’re kind of always lagging.
Now, that might sound like, what the heck? But see, that has saved people’s lives, too. If you’ve been on the highway and something’s come into your lane and before you have even processed visually what is happening, often you find your body has reacted. Now, when you have that situation where your body reacts — who is reacting? It’s not you. You kind of watch yourself sometimes, and if we were to ask you, how did you decide to hit the gas and go around the car rather than hit the brake? And you’re like, my foot just decided for me, I guess. But what it is, is your amygdala is set up to be able to seize control in a situation.
Phil Stieg: It’s a reflex.
Catherine Pittman: No, it’s not a reflex. Reflex comes from your spinal cord. This is actually in your brain, a part of your brain, but it’s a part you don’t really know. It’s not that you feel something and you pull your hand away because you’re feeling a burn — that’s a reflex.
This is a part of your brain that’s actually watching and listening and reacting, producing complicated reaction, not just pulling back, but turning the wheel quickly in the car. So it is really a part of our brain.
Phil Stieg: You talk a lot about also sensitizing the amygdala, and one of the examples that you cited in the book, I thought was interesting, about Dan, who was the Vietnam war veteran and had PTSD. And the thing that it took him a while to figure out, what was sensitizing him. Can you give that example?
Catherine Pittman: Yeah. Okay, so the thing we’re talking about now is that the amygdala doesn’t just react to something that is obviously a danger in the situation, and this is what makes it valuable for us, even in the 21st century. It can learn to recognize dangers that it has never seen before as something that is a potential cue or trigger for danger.
So, for example, a Vietnam vet was doing very well, not really having panic or anxiety so much anymore. But then he started coming in, saying, every morning I get up and I’m fine, but something triggers me, something. I’m having a lot of trouble.
So we said, okay, we knew that was the amygdala, but what was triggering the amygdala? So we started trying to think, is there anything to talking about things that were relevant to Vietnam? But he couldn’t think of anything. But we did kind of get him to be able to say, it always starts after my shower. I think it’s related to the shower. So I said ah – it rained in Vietnam. I mean, it was getting wet. He said, “I’ve been taking showers for years.” But it got him sensitized to this idea of, something’s going on in the shower.
So he got in the shower, and he suddenly realized the soap that his wife had bought that was in the shower was the same brand of soap they had used in ‘Nam. And the smell of that soap was just setting him off. Now not him, Dan, because he didn’t know what was going on. His amygdala was getting set off.
So what happens is we have experiences in our life where the amygdala suddenly sees something as an indication of danger. And you might say, how can soap be danger? When something is paired with a bad experience, for him it was the smell of this soap, this particular soap. When he was in combat situations, those things happened at a similar time. So when that soap was presented to him, it activated the amygdala, which said, I have a memory. It had created a memory of this. And memories can be all kinds of things.
Phil Stieg: So there’s an emotional component as well as a sensory experience.
Catherine Pittman: It’s an emotional reaction happening. And that’s why I say, this is the defense response. The amygdala is saying, this is a dangerous situation. Get the hell out of here. This is not good. Right? But it doesn’t say it in words.
It produces the increase in heart rate, the shift of blood flow necessary for you to run away from the situation. And so you’re feeling that, but you’re also feeling, this is it. It’s kind of like an alarm going off. The alarm is a feeling in your body. It’s a feeling of dread. It’s a feeling of wanting to move away from the situation. It’s your heart pounding. It’s a dry mouth. It’s needing to pee right now. Like, some people do have an accident because they’re so afraid. But it’s all related to the defense response.
But the thing is, the amygdala is not designed for the 21st century. It’s not. It’s designed for when the answers to problems were running away and fighting. That’s what the amygdala is designed for.
Interstitial theme music
Narrator: Our early human ancestors didn’t know anything about the amygdala, but they relied on its lightning-quick reaction time to keep them safe.
Those whose fear response kicked in the fastest were able to survive in a dangerous world – and to pass on their genes to future generations.
Or, as Dr. Pittman expressed it – the calm people didn’t survive.
So if we have evolved to have a robust amygdala, is it even possible to live in the modern world without fear and anxiety? As it turns out, yes.
It’s rare, but the scientific literature introduces us to a few individuals who seem to have lost all defensive fear responses. What they have in common is that they’ve had disease or surgical intervention that affected the amygdala. Without that deep-seated fear, they live very… interesting lives.
Jody Smith, a 28-year-old man from New Jersey, had been an avid hiker before having surgery to control his severe epileptic seizures. After surgeons removed parts of his amygdala, Smith discovered that the experience of hiking near cliff edges had changed. He could calmly walk right to the edge of a cliff without a shred of fear.
Smith: Hello!…(echo) Hello!…
While he understood the danger of falling on an intellectual level, the sense of fear that used to keep him away from the edge was gone.
Smith: Hi – Hello down there!…(echo) Hi – Hello!…
Probably one of the most closely studied cases of fearlessness involved a woman in the Midwest known by her initials “S.M.” SM had a rare genetic disorder known as Urbach-Wiethe disease, which slowly damaged the amygdala on both sides of her brain.
She recalls feeling fear as a child, and remembers being startled by her brother playing tricks on her, but as an adult she seems immune to fear. She had no reaction at all to the most notorious “jump scares” in the horror film clips researchers used to test her.
Years ago, when SM was walking through a small park at night, a man beckoned her over to a bench. With none of the fear that should have sent her running, she approached him. Suddenly the man pulled a knife and held it to her throat.
Man’s voice: “I’m going to cut you, (BLEEP)”
SM’s assailant was caught by surprise when she didn’t panic. Hearing a church choir sing in the distance, she confidently said, “If you’re going to kill me, you’re gonna have to go through my God’s angels first.”
The man let her go and, rather than run, she calmly walked away.
To some of us, being fearless might seem like a superpower. But, as the close call SM experienced in the park that night demonstrates, fear itself can be a superpower – protecting us from blundering into dangerous situations!
Interstitial closing music.
Phil Stieg: So let’s talk now about the other component of anxiety. And that’s the role that the upper brain, the cortex, plays in this. How does the whole thinking rumination part of your cortex play a role?
Catherine Pittman: Here’s what it is. It’s really important, and we’re going to get a little nerdy now, talking about the brain.
First of all, we don’t see things right when things come into our eyes. We don’t hear things right when our eardrums are vibrated by sound waves. That information has to be carried up into your cortex and processed. It takes a little bit of a time for our cortexes to process information. This is a really clever thing. The brain is set up in such a way that when information is coming in through the eyes and ears that information goes to a place called the thalamus. And the thalamus is kind of like Grand Central Station, knowing where to direct trains out to different areas. So it’s like, okay, this is visual information. Going to send it to the back of the brain for processing. This is auditory, and so it takes a little bit of time for you to process the sound waves and turn them into meaning.
Well, the thalamus, when it’s sending stuff off to the cortex, it also sends it directly to the amygdala. Now, what the amygdala does is it gets kind of a quick and dirty picture of what’s going on. But when I say quick and dirty picture, I’m saying it’s not yet processed into details that the cortex gives us. So what happens is, an example would be like, let’s say you’re in the shower and you see a little brown shape down in the corner.
The amygdala is going to see it before you see it. Now, if that little brown shape looks like it could be a spider down there, then the amygdala is going to create that defense response in your body. You might jump right out of the shower.
Phil Stieg: If you don’t like spiders.
Catherine Pittman: We’re kind of built to not like spiders. You really are kind of built with the amygdala having certain fears. Okay?
So if you are in there and the amygdala is like “insect in close proximity,” you may have that all react before you can even see it. But in just a moment, your cortex is going to get that information. It takes a minute. But then you see that little brown shape is actually a little wad of hair that’s in the bathtub. So the amygdala then sees, “oh, that’s a wad of hair.” But how did it get that information? From the cortex.
The amygdala is watching what goes on in your cortex. The amygdala is actually watching cortex television I say. Our brain is set up to make us jump away from something that looks like a snake, even before we know whether or not it’s a snake. So if we have that kind of a brain, then we often have false alarms where the amygdala thinks something’s a danger when it’s not.
But we are also set up for the amygdala to use the cortex for further information. So if the amygdala then gets the information by monitoring the cortex, that that is a wad of hair and not a spider, then the amygdala kind of starts to tone down the defense response.
But guess what? Once you’ve released adrenaline, once you’ve changed the heart rate, it doesn’t click off. It’s going to take your body a while to relax.
And this is why we don’t really get it sometimes. Like, we’ll say, okay, I see it’s not dangerous, but why am I still feeling nervous?
Phil Stieg: So the cortex can calm the amygdala down by providing it more detailed information. That sounds very helpful. But you also cite instances where the cortex actually gets the amygdala all fired up. Like your story about the young couple and the babysitter. Can you explain how that works?
Catherine Pittman: Let’s talk about that for our audience. So, imagine this couple who’s left their baby home for the first time. They’re sitting at a beautiful restaurant, wonderful food, nice music playing. They’re in a perfectly safe situation. But if in their cortexes, they are thinking, can we really trust that young girl with our baby? The baby could be needing something, and she could not be very attentive. And if in their cortex, they are imagining the baby being abandoned, the baby being mistreated, that is something the amygdala is going to watch.
Like I said, think about your amygdala as watching cortex television. So the amygdala, even though you’re in a safe situation, even though you’re having wonderful food, beautiful music, nice time alone with your partner, in your cortex, images are playing, like, on the channel on television, that are scaring you, this is going to get your amygdala started.
It’s because the amygdala responds to what you’re thinking. And this is a good message for all of us. What you think does matter.
If you are thinking frightening thoughts, it seems that the amygdala processes imagined images in very much the same way that it processes actual images that are coming in through the sensory system.
So this is something we all should be made aware of. Like, someone should be giving us an instruction manual about how the brain works, because then we would know that it matters if you scare yourself, because you’re scaring your amygdala.
Phil Stieg: The title of the book is rewire your anxious brain. So tell me how I can proactively rewire my brain to manage my anxiety.
Catherine Pittman: Well, first of all, I just want to say there’s some things that people don’t even see as therapy that are so helpful for the amygdala.
One of the things I try to do is teach people – if we know that our anxiety comes from the amygdala, and I start telling people we know some ways to change the amygdala, they say, “wait, I can change the amygdala? Okay, what are these?”
Surprisingly, exercise. Just going for a walk sometimes can calm your amygdala down and thus calm your whole body down. So let’s say the dean calls me over for a meeting in her office. I say, “oh, what did I do now?” I’m on my way there. You know what? Sometimes the best thing for me to do is not just walk over there calmly, but I might want to just rush over there quickly, walk very briskly, or maybe even take a little run around the parking lot and go. Because what’s going to happen is, any thoughts that I’ve had that have activated my amygdala, about the dean talking to me about something that I could get in trouble for, any thoughts like that that, have activated my amygdala, that exercising tunes the amygdala back down.
Now, you say why? You ran toward the dean, that was kind of silly. But see, the amygdala isn’t logical. It just says, the best thing for you to do is to run away. So I run, and it says, oh, apparently we ran away. And that is kind of built in. Right.
So there’s some things I tell people that can reduce their anxiety. Just in general.
Also, sleep is very important to the amygdala. When you do not get sleep, your amygdala is activated if you don’t get long, extended periods of sleep. That gets you a certain kind of sleep called REM sleep.
So these are some things I do right away with people saying, I just want to help you tame your amygdala. And they say, “I didn’t even know I had an amygdala.” I know. And it’s causing you a bunch of problem. And we’re going to just try to calm it down. Try to calm it down. So those are the kind of things that I do that people might not even think of as part of therapy.
Now, here’s another thing that for years we therapists have been trying to talk to our clients about. We have certain kinds of breathing and relaxing your muscles. But I don’t know about you, Phil, but when I suggest this, you know, my clients are really likely to roll their eyes at me, kind of like, “What? Breathing? What does that do?” But you know what? Here’s what I now say, and it helps so much. I say we are now able to see the amygdala in action.
We can put someone in an MRI machine, and we can see when the amygdala is all activated. And we’ve learned there’s certain kinds of breathing that can calm it down faster than Xanax.
And then people say, “wait, wait, what breathing? Tell me about this breathing.” Because breathing sounds like it doesn’t do anything, you know. You breathe all the time. But there’s this certain kind of diaphragmatic deep breathing that turns on your parasympathetic nervous system and fights against what the amygdala is trying to do, turn on your sympathetic nervous system.
So, all the things that I talked to you about are about taming your amygdala in the moment or, in general, making it a calmer amygdala. But what if you say, I want to rewire and change my amygdala so it reacts differently and it doesn’t do this thing?
Well, the way that we do that is we have to teach it in the way it learns. So this process is a process called exposure, where we take someone, whatever they’re afraid of, and we gradually expose them to the situation. And you know what’s happening? The amygdala learns from those situations. And I think if we just have people think about their lives, they can often think of examples where they say, “I used to be afraid of this. And then I got over that.” How did you get over it? They’ll often say it was this kind of exposure process where I was around, like, I was around a dog that was friendly and cute, and then I started being able to be around another couple of dogs, and suddenly my fear of dogs was going away.
It’s a special way to do this. I don’t just tell people, go out and expose yourself. You need someone trained. Oh, that didn’t sound right, did it? Go out and expose yourself to things that trigger you. Right.
Phil Stieg: Better expression.
Catherine Pittman: Better way to say that.
So go out and present whatever you’re afraid of. A dog, a spider, whatever, and learn to be in the presence of that without anything bad happening.
You really want someone who’s trained to do this, because it can go badly if something goes wrong in the situation.
What we do as therapists, we keep our people very safe. So, yes, they’re around a spider, but nothing bad is happening to them other than their anxiety, other than that. And as they stay in the presence of the spider, we get them gradually able to be more around, maybe a spider that’s not in a box, in a little cage, a spider that’s just walking around on the floor. Right. And we change this. Right. And we may ultimately even have them able to have a spider on them. That may be necessary, it may be not, but we’re trying to get them to the point that their amygdala learns.
And this is the only way the amygdala learns. Doesn’t learn from lectures, doesn’t learn from sitting in therapy sessions. It needs experiences to learn.
Now, you don’t have to get over all your fears in life, but there’s certain fears that are blocking you, and those are the ones we focus on in therapy. Those are the ones we use exposure for. But it is a process of making new connections in the brain. You are literally rewiring your amygdala.
Phil Stieg: I want to help somebody that has anxiety over test taking. What do you do for them? How do you rewire the brain in that circumstance?
Catherine Pittman: Well, okay, first of all, we tell them that they often activate their anxiety by thinking thoughts that make the amygdala react.
So the amygdala is watching what you’re thinking, watching cortex television, and it’s a horror movie. It’s you failing out of college. It’s you, your professor, telling you, you are stupid after seeing your exam, rolling their eyes as they–these thoughts you’re having. So we say, those thoughts are not necessary. You’re scaring your amygdala. You are activating the amygdala when–look around. Are you in any danger here? There’s no danger. You are producing a danger in your thoughts.
Phil Stieg: So what do you do?
Catherine Pittman: We work with them to not necessarily think about, like, head to your class with headphones on, listening to a song. Don’t be thinking frightening thoughts.
One of my younger clients one time who was a teenager, I said, would you present these kind of ideas to your younger sister and try to scare her? “No, that’d be mean.” I said, well, you’re being very mean to yourself, thinking all these scary thoughts that activate the amygdala when, when I look around, you’re not in any danger, but you’re thinking, I’m going to fail this exam. I’m going to fail this exam. So sometimes that anxiety interferes with our ability to think.
It’s tricky to control your thoughts. You don’t want to just say, I’m not going to fail the test, because you’re still on the test channel. You need to get off the test channel completely, if you know what I mean. It’s important that you learn how to have some control over thoughts that activate the amygdala, that make your amygdala anxious, you would say. That scare your amygdala.
Phil Stieg: So it’s another quote from Donald Sutherland and Kelly’s heroes, “enough of the negative waves.”
Catherine Pittman: Enough of the negative waves. That’s right. Because you know what? Actually, I say you’re scaring your amygdala. Your amygdala doesn’t always know the difference between you just thinking about something happening and something that is going to happen.
Knowing that you can, with mere thoughts, activate the amygdala is a really important and powerful bit of knowledge to have. That it does matter what you think about.
Phil Stieg: Let’s hope that everybody absorbs that.
Dr. Catherine Pittman, thank you so much for demystifying the complexities of how our brains do process anxiety and fear, but more importantly, how we can do something about it and in actuality rewire our brain.
Thank you so much for being with us.
Catherine Pittman: I’m very happy to have spent time with you. Thank you so much, Phil.