Working with Surprises
Below is an introduction to some research that might be helpful for seeing anxiety a bit differently than we normally would. Many therapists, or individuals that are used to psychology terms, are probably familiar with anxiety being a nervous system response. Yes, that’s true - and - it can be seen as more. Anxiety is the internal [signal] that something is not balanced – we’re not in homeostasis - and is a particular mode we can that helps us return to homeostasis.
I’ll start off illustrating a new fundamental principle that can be applied to the universal pain felt by mental illness - and for our purposes, we will be focusing on the many manifestations of anxiety. If our physical bodies raise our temperature when there’s a virus, we are using that imagery of a virus as it affects our thinking. That virus is uncertainty.
Karl Friston and the Wellcome Centre for Neuroimaging have proposed the theory of free energy principle (FEP). In this theory, uncertainty - a very intellectual, worrisome-sounding notion - is simply ‘surprise’, something ‘unexpected’, or outside of what our minds had conceived. That’s the first half of FEP. The second half of FEP is that cognition and action are synonymous. Meaning, when you notice ‘surprise’ it is, by definition, a feeling of being surprised and a category for something your mind had not anticipated. Therefore, you can use your actions to soothe the sense of ‘surprise’ or you can sit back, learn what caused the unanticipated. This second proponent is called embodied cognition. What that means is that your actions are going to have a direct result on your perception, not just that what you perceive will guide your actions.
Now, FEP has a good deal to say about how to change uncertainty, but for introduction-sake, we will set the scene for anxiety. Thinking about something that has us feeling anxious (social situation, going home to family, new job, anything), it’d be fair to say there’s some uncertainty there. That’s one kind of uncertainty. The other kind of uncertainty is not knowing what effect it will have on you and whether/if you will be okay. Being okay is this idea of homeostasis. So think of how your body returns to its usual resting temperature and how a fever is necessary for doing so. Anxiety is trying to anticipate ways to make sure you can get back to homeostasis.
However, there are certain points where anxiety reaches a threshold and becomes an anxiety disorder. In this sense, think of your anxiety becoming disordered, disorganized, chaotic. It no longer functions - to get you back to homeostasis - as it should. Solms (2021, p. 101) reminds us of the embodied cognition principle in that voluntary behavior is “feeling your way through the problem”: you will continue to make actions in hopes that they will help you feel better in a situation. With anxiety disorders, though, your anxiety increases to a point where your voluntary actions are impacted. You freeze and you feel frozen. That is because your mind is telling you to stay still so that the threat does not get worse. Adaptive, yes, but it doesn’t help us change our perception in that very real way of guiding behavior. And this is where we hope to expand by giving you more awareness of how anxiety becomes disordered and how FEP can help you change your perception through changing actions.
The impression of FEP is that this occurs without conscious thought, but conscious thought is still necessary (hence the hard problem of what is mind and brain). The FEP uses terms like ‘action’, ‘prediction’, and ‘belief’ with ideas like motivation, movement, navigation, adaptability. Solms also uses the navigation motif in his illustration of the FEP brain at work. Many might be familiar with the more-mature areas of the brain responsible for decision-making, memory recall, and logic (think hippocampus, prefrontal cortex, and its associated substructures). FEP occurs in another area of the brain. Just to situate ourselves in brief terminology, there are a number of brain structures that are going to be good to know going forward, as detailed by Solms (2021, p. 140-141):
Superior colliculi - This area of the brain likes to draw maps of whatever we might be planning to do and draws out the expected path. Think of the chess board. And then the prefrontal cortex is responsible for determining what the actions and targets are going to be, i.e., creates the chess pieces.
Basal ganglia, subcortical - We just discussed how the chess pieces are laid out by the cortex, well now think as if the chess pieces were on their own tracks and moving like machinery. The basal ganglia is responsible for maintaining these tracks that deal with automated behavior.
Future blog posts will continue this discussion of FEP,. It’ll be good to keep in mind that not only is the content of anxiety automated. We already see this in many of the discussions surrounding (para)sympathetic nervous system responses. But the content has a role to play in being an element of a larger prediction your brain does. In the future we’ll see how there are two routes to managing anxiety.
Solms, M. (2021). The hidden spring: A journey to the source of consciousness. W. W. Norton &
Company, Inc.
What’s Self-Awareness if I Don’t Have a Self?
Over the years I’ve found that myth and metaphor can be quite powerful in therapy. Donna Christina Savery’s Echoism: The Silenced Response to Narcissism is perhaps one of the most inspiring takes on working with survivors of abusive relationships and traumatic situations. My hope with this post is that readers, those in relevant situations or those interested in learning more about what psychotherapy tries to do when we talk about a self, may find the following stories, depictions, and metaphors encouraging.
The ancient Greek myth of Narcissus tells of a man cursed by the gods to stare at his reflection in a lake, due to his own vain and pride. He eventually, in being consumed by his own vanity, withers incapable of taking care of himself. And then, all that is left is a small white flower (a flower carries his name today). Characteristically, what gets missed, though, is the other character in the myth: a tree nymph named Echo is cursed by Hera (after being caught spying on one of the several affairs in Greek mythology) to only repeat the last phrase she hears someone hear – as a punishment for being “nosy”. She stumbles across Narcissus at the same spot, the lake, where she becomes trapped in this endless loop of repeating “Narcissus” over and over as she hears Narcissus clamor on about how much he adores himself. Unfortunately, this means that she also withers away. And sadly, the myth goes on to say that he never acknowledged her.
So here we get to what Savery means by the title of her book: those that are either in relationship to, or in close proximity to, a narcissist take on the role of Echo. Now there’s several writings about what narcissism or a narcissist is or is not. And to avoid the characteristic draw to focus on the narcissist, I’m going to simply refer anyone to this article that does a tremendous job of explaining narcissism in clinical terms: Current understanding of narcissism.
Instead, this article is for the Echo, the one that feels as though, for very good reason and from deep hurt, they have lost their voice and place in this world. The Echo doesn’t make the choice not to speak or advocate for themselves. No, they have lost that ability; it’s the all-encompassing realization that someone else is naturally more prioritized than themselves. So often I work with an individual whom has experienced some degree of trauma and betrayal that they lose touch with themselves, they lose that ability to effect change in their lives, and they lose the compassion to motivate themselves. It goes without saying that much of this has come about due to repeated abuses and affronts on their personhood.
This sense of self is natural and also natural in the sense that part of it comes from our brain’s own abilities. The area of the brain responsible for putting this sense of self together, the Anterior Insular Cortex and Anterior Cingulate Cortex, are also used in responding to and account for pain. After so many affronts, an individual can find that the areas responsible for a sense of self are overwhelmed, and turn off to a degree, due to responding to so much pain. Now thankfully, we see that this bit of theory is backed up by empirical research (Sense of self).
One part of psychotherapy is being curious about and getting in touch with your sense of self, in all the many ways therapists describe that. The natural inclination from an Echo, though, is to pull away from this idea because of a) possible fear that could’ve been experienced before and b) no longer feeling as though they’ve exercised that ability to be a self. Several times I hear individuals say that focusing on themselves feels selfish. I have found this metaphor to be quite helpful:
Imagine you’re on a road with where one end is a town called Selfless and the other end is a town called Selfish. You’ve perhaps stayed in this town of Selfless, in part thinking you were humble, but maybe you weren’t given the liberty to express yourself. And so this place has a double-meaning of being a place where you are also Self-less, without a Self (the Echo). Say you don’t want to repeat the story of Echo and you begin therapy. We’ll begin walking that road of discovery and curiosity into who you are as a person. And what will happen is as you move closer to the other end of the road, Selfish it will become larger in your view. You can do this with anything, you move closer to an object and it grows in your field of vision becoming larger. And so the perception becomes the fear – the threat of being Selfish, like Narcissus, becomes larger because it becomes larger in your field of awareness. And this is where many struggle. But, that is only perception. While that perception is strong, there is somewhere else to go in the metaphor. What you come to find out is that there is a town in the middle of the road, Self-Aware, and this is where we are wanting you to get to. Here you can find the tools necessary to take care of yourself and the insight to empathize. Here you can prioritize your needs and negotiate other’s so you have meaningful relationships. Here you can ask questions with curiosity and hold onto the moments that are important to you.
And so, reflect on this place of Self-Aware as you think about the myth of Echo and Narcissus. And please reach out if you find that you want to get to that place.