"It is hard to fight an enemy who has outposts in your head"

Estimates vary as to how many people in their life will suffer with an anxiety related disorder, such panic disorder, obsessive compulsive disorder or generalised anxiety disorder. Calculations vary, but statistics seem to point to a figure between 1.5 and 4.5% of the population. That is a lot of people. It crosses all borders and boundaries, colours and creeds.

Many people are afflicted, yet sadly, many never find a cure. This is for many reasons I imagine, but largely due to the fact they are not aware that it is possible to overcome anxiety. Part of the process of overcoming, I believe, is to "know the enemy". Develop an understanding of what's going off in your brain, mind and body that creates this most frightening of issues. Knowledge is the primary tool with which to begin the fight back to non-anxiety.

In this segment of my Blog, I'll endeavor to describe the basics of what takes place in your brain and body during a state of high anxiety, panic or period of obsessive compulsive behaviour.

Lets begin within the brain, and focus on a small portion of it known as the "amygdala". The Amygdala (amygdalae; plural) are a pair of small organs within the medial temporal lobes of the brain (located near the base of the brain). The amygdala are part of the limbic system and their primary role is in the processing and memory of em0tional (fear, terror etc) reactions such as the anxiety reaction or 'flight or fight' response.

In humans, the amygdala perform important roles in the formation and storage of memories associated with emotions including anxiety. Scientists have shown that fear conditioning, experienced for example by those who develop an anxiety disorder such as generalised anxiety, panic attacks, phobias or obsessions (OCD), happens within the amygdala and is stored by it as an inappropriate anxious reaction.

The amygdala reacts to 'fear conditioning' in the same way as Pavlov's dogs were conditioned to salivate on hearing a bell; this kind of conditioning is called operant conditioning and was studied extensively by eminent psychologist Burrhus Frederic Skinner who found that through repetition, the subconscious mind could be affected in a way which would alter the autonomic reactions stored in it.

John Broadus Watson, an eminent psychologist with theories similar to Skinner's, believed that he could take a human child and 'create' the kind of person he wanted by manipulating their behaviours; this stands to reason when histories of anxious people reveal the catalysts for their condition, more often than not, a specific catalyst can be identified and these include family situations, bereavement, exposure to other sufferers and general social environment amongst many more.

Through behavioural modifications, the amygdala can be modified to react differently. During high anxiety, the amygdala can be modified to react with higher levels of anxiety and this can then become fixed causing an anxiety disorder such as panic disorder, OCD or phobias. Similarly, those with anxiety conditions can, through a structured programme, modify the inappropriate reactions of the amygdala in order return it to a more appropriate level, thus eliminating the anxious symptoms associated with the disorder.

Interestingly, it is now theorised that the anxiety and panic response is a 'pre-programmed' response which is present from birth. The level of 'normal' anxiety is pre-set genetically but can be modified through behaviour. These behavioral modifications happen when the amygdala becomes 're-calibrated' at a higher than normal benchmark level.

This raises the general level of anxiety and in turn also affects the level of anxiety experienced in 'emergency' or perceived dangerous situations, which is controlled by the amygdala. This extreme level of anxiety can give rise to panic/anxiety attacks.

The amygdala, like all areas of the brain, can be affected by medication, however, there is no clear evidence to suggest that medication can eliminate panic attacks by addressing the amygdala directly. Panic/anxiety attacks medication is usually an antidepressant or a sedative and whilst these have therapeutic value in some conditions, the amygdala and panic/anxiety attacks will not be therapeutically treated.

In a nutshell, this means that panic and anxiety, which originate in the amygdala, can only be eliminated using behavioral methods, reassurance, support and vigilant reconditioning of the amygdala's anxious response.

Panic attacks are the extreme manifestation of anxiety - anxiety itself can be reduced and eliminated by addressing the amygdala directly.

The amygdala produces panic attacks because of learned behavior. By targeting the brain's ability to learn new behaviours directly, scientists such as Watson and Skinner have shown that distinct and powerful changes can happen which affect the anxious response originating in the amygdala.

The amygdala is involved, in humans, with the formation and storage of emotional reactions and events. Scientific research has found that in fear conditioning, which is what happens during the development of an anxiety disorder, the senses 'feed back' anxiety provoking signals to the Amygdala causing it to store memories of that anxious event. This then causes the amygdala to react differently when the event arises again. Over time, or during times of high anxiety (bereavement, divorce, work stress etc.) this 'learning process' can cause an anxiety disorder to form, sometimes without warning and very quickly.

Memories of emotions experienced become ingrained in the neural synapses and create 'fear behaviour' with the Amygdala. The central nucleus of the amygdala are connected directly to the creation and perpetuation of the fear responses and control the release of stress hormones which cause the common symptoms of anxiety disorders.

John Broadus Watson was an American Psychologist who established the Psychological School of Behaviourism. Watson believed that he could take twelve healthy infants and by applying behavioural changes, could 'design' people to be how he wanted them to be.

Watson stated that emotions such as fear could be conditioned using behavioural techniques. He took a small child (11 months) called 'Little Albert' and conditioned him to become fearful of random objects: a rabbit, a dog and (believe it or not) some wool! Watson presented these objects and at the same time, made a loud noise.

The experiment worked and Little Albert became conditioned to respond with fear when presented with the objects alone. He had conditioned anxiety and this sent shockwaves through the psychological community that had, until then, believed that fear, was pre-programmed in the subconscious (Sigmund Freud).

As unethical as this experiment was, it proved that fear responses could be raised by fear conditioning and that anxiety disorders can be created and eliminated given the correct treatment.

Burrhus Frederic Skinner was an American psychologist who pioneered research and advocated behaviourism which concentrates on understanding how behaviour is the manifestation of environmental history with regard to the experience of consequences.

Skinner also proposed the use of behaviour modification, much like Watson, he believed that a person could have their experience of life modified by behaviours. Skinner developed the theories behind operant conditioning as a way of engineering society, happiness and people's experiences of their lives.

Skinner believed that any experience backed up by a consequence would become imprinted on a person's psyche; the experience of anxiety disorder sufferers would back this up; repeated stimulation of the amygdala through anxious behaviour would reinforce and imprint those behaviours as a form of 'habit' into the subconscious mind.

Conversely, by using behaviour modification as discovered and pioneered by Watson and Skinner, the reversal of the formation of 'anxious habit' is also possible.

Hypnotherapy is an excellent tool with which to modify behaviour in a very subtle, yet powerful way.

There! Heavy going in places, but I hope that it enlightens the ones who need it the most. If you're one of the millions of sufferers worldwide, consider all of your options regarding approaches to treatment. Above all, do not give up. You can change your mind!