Lockdown Life 3: Physiological Reactions and Cycles
Having now familiarised ourselves with the ABC model, automatic thoughts, intermediate beliefs, core beliefs, and thinking traps, we are now almost ready to start considering disputation; the process by which old, maladaptive thoughts and beliefs are transformed into new, functional ones. But before we do that, we will add one more layer of information to our knowledge base. This layer presents two new considerations; the role physiological symptoms have in the creation and maintenance of unhelpful thoughts and beliefs and the way those physiological symptoms entwine with feelings, thoughts/beliefs and behaviours.
What exactly is a physiological reaction? In a sense, it is a middle point between behaviour and emotion. It is somewhat involuntary, like an emotion, but it is observable or at least physically “real,” like a behaviour. A physiological reaction is essentially the external manifestation of an internal emotional state; when you are anxious your heart rate is likely to increase and you are likely to sweat, for example. Physiological reactions can also be subtler, such as when you blush due to embarrassment, or slightly more voluntary, such as when tense your muscles in response to fear or anger. They can be understood as automated physiological responses to emotions or as the automated physiological manifestation of those emotions, but their automated nature doesn’t make them completely beyond your conscious control; muscle tension can be relieved once it is properly noticed and breathing exercises can be used to lower a panicked heart rate. Behaviours, alternatively, are actions rather than bodily responses. This is an important distinction to make because behaviours and physiological reactions are sometimes mixed up.
It is worth noting that the material we are discussing is complex and potentially difficult to understand. There is no shame in working through this series slowly or in rereading previous parts (Part 1 & Part 2). Knowing yourself and how you learn is something that you should consider rewarding yourself for, right now. Participating in this process, reading this series of articles is also something that you should consider rewarding yourself for, right now. I recommend that you take a moment to have a brief dialogue with yourself; are you proud of yourself for being curious, for being determined to become your true self, for seeking out information which will empower you? If you’re not, then you’re not giving yourself enough credit. The greatest way to pay tribute to yourself is to explore the darker recesses of your mind and fulfil your potential, and you are moving in that direction right now. Show yourself some love for that; say something nice to yourself (and say it forcefully, as you believe it), show yourself gratitude and appreciation, consider even writing a short note thanking and encouraging yourself. If you can’t say or write it like you believe it, then act it out as if you believe it. This is essentially what disputation is; a transformational conversation with yourself. We’ll return to this matter and explore it properly later in this article.
Returning to physiological reactions, it will be particularly beneficial to understand them in the context of the ABC model. Allow us to do so by revamping an example we have already used in a previous part of this series. Imagine that you are wandering the supermarket, and someone carelessly bumps your shopping trolley with theirs and then insults you. Let us also assume that you are a particularly anxious and meek person who holds core beliefs like “people will always hurt me” and “the world is inherently hostile and unpredictable”. The activating event (the A) is the brusque interaction itself as well as your interpretation of it as unnecessarily rude and aggressive. The thoughts and beliefs (the B) at play are, of course, the explicitly stated core beliefs; they determine how you interpret the activating event on an evaluative level (what the event means about you, others or the world). Previously we described the consequences (the C’s), that result from merging A’s and B’s, as being emotional and often also behavioural; that is to say that an event which is observed or experienced is coloured by one’s moods, thoughts and underlying beliefs, thus resulting in certain emotions and behaviours. Physiological reactions, however, also belong in the C category as they are also consequences of A’s and B’s. Physiological reactions, like behaviours, tend to be responses to emotions. Emotions are the dominant part of the C category, as without them behaviours and physiological reactions would occur much less frequently and at much lower intensities (if they were to occur at all; in the absence of emotions it is easy to imagine our spirits drying up and our bodies becoming inert, turning our living forms into soulless statues). Physiological reactions are, for this reason, good measures of one’s emotional state, one’s mood, one’s level of relaxation or vigilance. If you are unsure of how to interpret your emotional state, then refer to your physiological reactions: Are you tensing your muscles involuntarily? Are you breathing rapidly? Are you sweating abnormally? These are all potential signs of a maladaptive negative emotion such as anxiety or anger (quite possibly both), but they can also be signs that you are facing a genuine threat. If there is no such threat present, then you are probably experiencing a maladaptive negative emotion due to an underlying irrational thought.
Herein lies another worthy detour: It is not uncommon for people to struggle to properly label and understand their own emotions. It is not even uncommon for people to struggle to differentiate between their thoughts and their feelings. Your internal world is a difficult place to navigate; it is felt out gradually rather than instantly observed because it is built out of concepts and ideas instead of matter. The mind must be gently sifted through and can’t be captured by a glance, a grasp or any other endeavour of the body and its senses. For this reason, you must be patient with yourself as you develop this new skill. Any frustration you experience while you do so is not a reason to quit, but an opportunity to grow further. Is there a concept you are struggling to comprehend or a part of yourself which you can’t see or understand? Is it causing you to become frustrated and despondent? If so, then take a break to focus on those emotions and try to locate the thoughts which are feeding them. There is a good chance that what you are experiencing is an underlying negative thought about yourself and your competence or worth. If you can locate the thought, then consider isolating it and distancing it from your internal world by writing it down (and keep it close because we’ll go over it at the end of this article). If locating the underlying thought was unsuccessful, remember that this is a skill like any other, a skill which you will learn. If you wouldn’t say something to someone else who you love, then don’t say it to yourself. If you wouldn’t expect someone else who you love to be adept at a new skill, then don’t expect it of yourself. Accept your humanity and give yourself permission to be a beginner.
Having established how physiological reactions fit into the ABC model, it’s now necessary to explain the model’s cyclical nature. To do so, let’s return to our previous example of the “supermarket encounter.” You’ve now been bumped and verbally insulted, and your anxious disposition and the appended underlying beliefs have filtered that experience into an emotional response which is a mixture of anxiety and depression. Your belief that the world is malevolent and pathologically unpredictable, and that people are dangerous, have caused this incident to symbolise a threat to your safety; in that moment you don’t just experience an insult but the evidence that reality itself is shaking its fist in your direction. Your fight-or-flight response activates, causing your heart rate to increase significantly and your law to tense and grind somewhat involuntarily. You notice that your physiological responses are paired with your anxiety, you interpret them as signs of an impending panic attack, and you flee the supermarket.
First, let’s examine this sequence as a single cycle of consciousness and action. The cycle begins with the incident itself and the relevant thoughts and beliefs spiralling it into a maladaptive emotional response. Naturally, the body responds physiologically to the emotions welling up inside it, producing tensing and an increased heart rate. So far this is a normal linear application of the ABC model (A-B-C). Where it changes is after the physiological reactions. The physiological reactions themselves don’t result in the behaviour of fleeing the supermarket, it is your beliefs about those reactions that then causes the production of even more maladaptive emotions which eventually overwhelm your consciousness and “cause” you to flee. This is not a simple A-B-C trajectory, but an A-B-C = A-B-C trajectory instead (the C becomes an A, an activating event, which then sets off a new loop); after the C (the physiological reactions) the individual’s thoughts (the B) about that C (“Oh no, I’m going to have a panic attack”) then cause another C (which might mean the production of new emotions or, as in this example, the intensifying of emotions which are already present). This new emotional response can then cause even more heart rate increases and muscle tension which can then result in more irrational thoughts which in turn produce more maladaptive emotions. This is essentially how a panic attack develops and manifests within the mind.
When we examine this sequence as a broader pattern of behaviour a longer-term cycle can be discerned. This cycle revolves around the individual’s behavioural response to the rest of the process and is, in essence, a self-fulfilling prophecy. In our present example, it is the behaviour of leaving the supermarket which initiates a “feedback loop.” You went through the internal ABC process and ended up in a loop which created a state of panic and the appended fleeing behaviour. When you fled the supermarket, your anxiety receded because you exited the atmosphere in which the feedback loop began and peaked; your fear for your safety subsides, your physiological reactions dampen, and you are extricated from direct reminders of the “offending” third party. Unfortunately, whilst this emotional relief is somewhat desirable, the way it was obtained is not. What fleeing behaviour (and avoidant behaviours in general) teaches you is that the most efficient and effective way of alleviating your anxiety is to flee the source of that anxiety. In other words, you form an attachment to an avoidant coping mechanism that prevents you from confronting your anxiety, from being in its presence long enough to test its predictions.
One way in which fears, particularly phobias, are addressed is called exposure and ritual prevention therapy, commonly referred to as “exposure therapy.” This therapeutic technique involves individuals exposing themselves to increasing levels of the source of their fear for increasing periods of time. When this is done, the individual can disprove the catastrophic outcomes prophesized by their anxious thoughts and beliefs. Assume you are deathly afraid of dogs due to the underlying belief that they will bite you (a belief likely incurred during a past experience). Repeated exposure to a dog that doesn’t bite you will eventually weaken this belief and the appended phobia and anxiety. In our supermarket example you have two main options; to flee the sources of your anxiety (your physiological reactions, underlying thoughts and the scene of the event that triggered them) and thereby reinforce the catastrophic predictions which triggered it (both the primary prediction that you are in danger and the secondary prediction that you are about to have a panic attack), or to remain in place and test those predictions empirically. We will delve further into EX/RP in the next article.
To finish, let’s introduce three disputation questions that can be used to test potentially maladaptive, dysfunctional, irrational thoughts (such as the one you may have written down earlier while reading this article). Remember, this is a simplified version of cognitive disputation and is in no way a replacement for actual psychotherapy. The questions provided should, however, be of significant benefit when used in the right way. If you did not write down a suitable thought earlier during this article, consider doing so now before we continue. It needn’t be particularly inflammatory or irrational, any thought which causes you noticeable distress or discomfort is suitable. Write down this thought at the top of a piece of paper. Try to keep it as concise as possible without losing its purport; “I’m incompetent and can’t do anything right” is a suitable thought while a longer sentence elaborating further might be too detailed. The thought can be more specific and describe a particular event, as well; “I haven’t started cleaning my room yet and therefore I am lazy and incompetent”.
Once this thought is penned, once it is solidified on paper you can begin to question it (this can include analysing it for thinking traps). There are two parts to this simplified disputation process, the “for and against” and the “alternative explanation.” The for and against questions will ideally be done first to clear the way for the “alternative explanation.”To start, it is necessary to divide the rest of the page into two columns, one assigned the heading “for” and the other “against.” In the “for” column you will list the evidence for that belief being true. In the “against” column you will list the evidence for that belief being false. This can be a very difficult thing to do alone because your biases (particularly thinking traps like filtering) will predispose you to notice and exaggerate the evidence in the “for” column while ignoring and minimizing the evidence in the “against” column. Accordingly, it is important that you take this analysis seriously and open your mind as much as possible to the evidence in both directions. Once a relatively exhaustive list is accumulated the alternative explanation can be properly considered.
The alternative explanation is essentially an explanation for the evidence other than that offered by the thought or belief that you are questioning. Usually, when a thought is irrational there is enough counter-evidence opposing that thought for it to be considered highly questionable if not demonstrably false. In light of all the considered evidence, in other words, there is usually a more realistic “alternative explanation,” and one which will serve you better (the value of a belief is not only in its truth, it's rationality, but also in its utility; does it improve who you are and how you operate or does it cripple you?). Alternative explanations can be listed in any remaining blank space or conjured up and considered internally. What is most important is that the pieces of evidence for and against the belief, as well as the belief itself, are written down so that they can be observed with greater psychological distance and objectivity. Consider every “for,” every “against” and every “alternative explanation”. Be as honest with yourself during this process as you can and keep the resulting notes somewhere accessible; do your best to review them and repeat the process regularly. That should help to keep you busy until the next part of this series manifests itself.
We have covered a huge deal of ground in this article, let alone this entire series so far, and we appreciate you travelling alongside us. We have so much more to share with you as this series progresses and we are excited about the possibilities!