Letter One – a series of therapeutic letters for the self-isolated

My soul is like a hidden orchestra; I do not know which instruments grind and play away inside of me, strings and harps, timbales and drums. I can only recognise myself as a symphony.  –Fernando Pessoa, The book of Disquiet 

For reasons beyond anyone’s control, we are finding ourselves suddenly faced with the prospect of spending many hours at home. I often day dream about living alone in the the countryside but, importantly, in these day dreams I am always there by choice and never ever is the dream set in my apartment, alone, in Berlin. 

 Whether you are self-isolating or in quarantine, having your freedom restricted is an anxiety provoking experience for all of us. During the next couple of weeks, we can expect to feel anxieties in relation to financial uncertainty; fear for our health and the health and life of our loved ones, loneliness and a good dose of cabin fever. As time progresses we are also likely to come up against some anxieties specific to our own mind and personal histories which in the context of our busy modern lives may seem seem daunting and even unfamiliar.

My intention with these letters is to share some tools that will potentially allow you address some of these anxieties in a way that is therapeutic and that maybe even will lead to some self discovery. In short, I hope this helps to pivot our focus and attention towards what we can control.

 So, lets start from the beginning. 

What is anxiety: A brief class in neurology.

 According to Öhman A (2000) anxiety is related to the specific behaviours of fight-or-flight responses: Defensive behaviours or escape. It occurs in situations perceived as uncontrollable or unavoidable, but that are not always realistically so. Anxiety is very closely related to fear and for the purpose of these letters I will use the two words interchangeably, so my apologies to any colleagues or neurologists who take offence to this.

 When we feel fear or anxiety the brain’s alarm system is activated, which automatically triggers the preprogrammed escape strategies that exist in our “reptilian brain” and releases relevant stress chemicals.

As humans we have three brains; the so called reptilian brain or first brain, the social brain and our higher brain. The reptilian brain is the one we share with all animals and reptiles alike, and it is in charge of regulating all of our automated bodily functions like breathing and digesting; our social brain or mammalian brain does just what it says on the tin and is the one that we share with all socially orientated animals that live in groups and nurture their young. Our “higher brain” is the part of our brain which is unique to us humans and enables us to have language, impulse control, imagination and is where we essentially experience consciousness. 

When our reptilian brains take over it partly shuts down our higher brain, our consciousness, and propels the body to run, hide, fight or on occasion freeze. By the time we are aware of the situation our body has usually already acted. If the pre-programmed escape plan was successful and we are able to get away from the real or perceived danger, we slowly begin to recover and “regain our senses”. If, for some reason, our response is blocked – if we are prevented from taking action for example—the body continues to secrete stress chemicals and the brain continues to operate on mode “danger” in vain which is why, if you can, it is important to act. (We will explore all the ways you can act in the following letters).

The reptilian brain and social brain make up what is essentially the “emotional brain”. The emotional brain is at the heart of the central nervous system and its key task is to look out for our welfare. If it detects danger or a special opportunity it alerts you by setting off a series of chemicals and pre-programmed bodily reactions. The body will consequently experience sensations such as queasiness or panic, heart palpitations or increased breathing that are designed to interfere with whatever you are doing and prompt you to act. (These reactions are messages, not problems, and it can help to view them as such). Importantly our brain’s cellular organisation and biochemistry are simpler in the emotional brain than in those of the higher brain and it assesses information in a very quick, global way. An example often used is jumping in fear when you see a snake only to realise later it was actually a stick. These pre-programmed muscular and physical reactions are automatic and happen without any thought or planning on behalf of your consciousness which include the elevated heart rate, sweating and hyperventilating you feel during anxiety.

To borrow an analogy from psychiatrist Bessel Van Der Kolk let’s say the emotional brain is like a smoke detector and the higher brain is like a watch tower. The smoke detector doesn’t make many judgements and is designed to act fast; it will prepare you to run or fight before it has consulted with your conscious mind about anything. Sometimes there is a fire but sometimes you are just making dinner- the smoke detector doesn’t differentiate. The higher brain or conscious brain is like a watch tower in that it looks out and assesses the possible dangers. If you are not too upset, then you can use this part of you brain to asses the situation that set off the alarm and calm down and abort the stress response if necessary (when the snake is really a stick). 

Effectively dealing with stress and anxiety depends on achieving a balance between the smoke detector and the watch tower. To quote Van Der Kolk: “If you want to manage your emotions well your brain gives you two options: you can regulate them from top down or from the bottom up”. Top down regulation means strengthening the capacity of the watchtower to monitor your body’s sensations; mindfulness, meditation and yoga can help with this. Bottom up regulations involves recalibrating the nervous system which we can access through breath, movement or touch. The more successfully you regulate yourself the more your conscious mind will remain in control of your actions. 

(Breathing is one of the few things that works top down as well as bottom up so I recommend that that’s where all of us start. Inhaling for four counts, retaining the breath for two counts, and exhaling for six counts a minimum of four times can help regulate your emotional brain).

It is my hope that having this information about your brain is helpful in that A) you will notice you are not in fact crazy, incapable or a useless bag of nerves but instead a human, with a brain and a body, reacting in a normal healthy way to threat and: B) Understanding fear and anxiety is the first step towards knowing how to behave in response to it. Misunderstandings and stigma around anxiety cause us to isolate or feel shame which only serve to compound the feelings of fear and anxiety and this is helpful to no one.

This letter is already very long so let’s leave it there for today; I recommend turning your attention to the fear and anxiety you may be feeling with curiosity about what the triggers may be. Making lists and writing about what you find is a positive way in which you can “take action” allowing your body to feel like you are doing something in the midst of so much helplessness. Online you may find resources like making a “fear inventory” which further allows you to take action in relation to the sound of alarms going off in our minds. 

Warmly, 

Katherine Dennis Gonzalez