Balance, context, and anxiety: balance beams, part 2

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We are a nation that’s plagued by anxiety. We worry about what’s going to happen tomorrow, we worry about what others think, we worry about the state of the world. 

The worry can be incessant, and for some, the worry feels overwhelming. Another way to think of anxiety is that it’s fear- fear of what will be. 

Fear works in a very specific part of the brain, the amygdala. The amygdala, a small portion of the brain located in the mid temporal lobe sends out all of the appropriate physiological signals when fear is present, including elevated heart rate, elevated breathing, and a change in muscle tone. Fear also sharpens our memory and increases perception- it’s probably no surprise that obsessive compulsive disorder is related to anxiety

Living in a state of constant worry or fear is exhausting, It affects our relationship with our body and makes the perception of pain more present. As Robert Sapolsky notes in the book “Behave,” “The amygdala receives news of that reliable trigger of fear and aggression, namely pain. This is mediated by projections from an ancient, core brain structure, the “periaqueductal gray” (PAG); stimulation of the PAG can evoke panic attacks, and it is enlarged in people with chronic pain attacks. Reflecting the amygdala’s roles in vigilance, uncertainty, anxiety, and fear, it’s unpredictable pain, rather than pain itself, that activates the amygdala. Pain (and the amygdala’s response to it) is all about context.” 

There is also a correlation between hyper mobility syndrome and anxiety (and pain), perhaps partially because individuals with hyper mobility have decreased proprioception due to their joint laxity. Basically, the brain doesn’t quite know where the joints are located in space because the information it’s getting from the joint’s internal GPS is a little off, so we could also say the state of the body affects the state of the mind. 

What does this have to do with balance beams? One of the most intriguing research articles I have happened across in the last year examines rats that are bred specifically to exhibit anxiousness. One group was placed in a contextually rich environment, filled with balance beams, things to hang from, and obstacles to maneuver. The control group was placed in an environment without obstacles. The rats in the first group exhibited a reduction in anxiety, despite the fact they were born anxious.

If rats can reduce anxiety through interacting with their environment, it stands to reason humans should be able to do the same. (Or maybe it doesn’t, but you can obviously see where I am going with this). 

A few things happen when you figure out how to use your body to balance, climb, and maneuver over and around things. First, you become stronger and feel more capable in a way that promotes adaptability and problem solving. Those of you who have read previous blogs know I am all for mindfulness and improving awareness—in fact, it’s a large part of what I do. I also strongly believe in giving the body and the brain a chance to learn through doing, with less input from me. It gives people a chance to self organize and, if they don’t succeed the first time, their neuromuscular system works to figure out a new way to try based on its available options. I feel like this is valuable. I step in and offer suggestions when people are stuck, but learning by doing, I think, is empowering.

It could be argued that being able to figure things out gives an individual back a sense of control. People exhibiting traits of anxiety often don’t feel in control, so the context of controlling an outcome, such as successfully maneuvering the body through space, potentially increases a sense of resilience.

Additionally, when you move in a novel environment, if you are successful at least some of the time, dopamine, your brain’s reward chemical, is released, making you feel good. It’s difficult to feel anxious when you feel happy. Plus, according to neuroscientist Daniel Wolpert, our brains evolved for movement, so maybe incorporating this type of contextual problem solving calms us down simply because we are using our brains in the way they were intended: to produce complex motor coordination.

Finally, moving your body and interacting with the environment directs attention, so you are no longer thinking about whatever you were feeling anxious about and it improves your sense of physical self. Motor control research suggests simply by interacting with something you find challenging, in a variety of ways, you will become more efficient, indicating a reduction in motor noise. Noise can be thought of as the awkwardness you experience when you are trying something new. Whatever you are trying doesn’t look pretty—it looks disjointed as your neuromuscular system figures out the best way to accomplish the task, throwing everything it has at it, even if your right elbow has nothing to do with your ability to land on your right foot, or your jaw doesn’t really help you turn around on a narrow surface.

With practice, things get smoother and more efficient Another way to look at this is maybe by working on a physical challenge and reducing the noise it takes to do the task, you also reduce the noise in your head. Maybe.

Plus, when you use your physical self, you begin to feel the body parts and muscles that are required to navigate the obstacle. The more of yourself you feel, the more complete picture you have of yourself. 

I am not suggesting walking on balance beams will cure anxiety, but I do think it might very well help. Clients differ from baby rats in a number of ways, and one of the most important thing to take into account is current skill level and fear.

Fear activates the sympathetic nervous system and makes it harder to perform certain physical tasks. If someone doesn’t feel secure on his feet and you ask him to walk across a slightly elevated surface, heel to toe, it will probably make his anxiety worse because he is afraid of falling. It’s important to make sure whatever obstacle you are giving someone is appropriately challenging and isn’t going to send the person’s sympathetic nervous system into overdrive.

How can you tell whether or not an obstacle is appropriate? If the likelihood of the person trying and succeeding is about 80% and the risk of injury is extremely low, then you are on the right track. Let’s look at two examples.

I have a client I will call Ron. Ron has had 6 open heart surgeries and several little strokes. He has neuropathy in his feet and his peripheral vision is poor. How can Ron be challenged in a way that is appropriate?

Ron is scared of falling and doesn’t have very good balance because of the neuropathy and lack of vision. However, I can challenge Ron by having him by doing things like walking around obstacles, walking through spaces that are narrow for him, and walking over very low obstacles like dowels.

Ron struggles with these tasks, but feels safe doing them and gives 110 percent. He is (usually) successful, and the risk of him falling is very low--I spot him so he feels safe. He often tells me that he feels like he gets his money’s worth from these types of activities because they make him feel more confident in navigating his environment during every day life. Confidence reduces overall anxiety (and he does have a bit of anxiety), so it’s a win/win.

Let’s contrast this with a client I will call Megan. Megan is in her mid 30s and is also prone to feelings of anxiousness. She has a lot of natural mobility and had a lot of pain when I first began training her from a stint of bed rest during her most recent pregnancy. Megan quickly progressed to balancing on 2x4s, walking side ways, and moving between 2x4s. She often jokes that I am training her for the circus, but in addition to her pain completely resolving, her husband tells me she is the most confident and calm she has ever been—a change he credits to the confidence she has gained through physical training.

The less capable we feel when interacting with the outside world, the smaller our world becomes. Fear comes from so many things, not the least of which is not feeling confident in our physical abilities. Physical challenges that don’t require much instruction and give the client an opportunity to figure things out using his body and his brain closely resembles play; play is something children need in order to thrive, so wouldn’t it make sense that adults who use some form of play training would thrive physically and emotionally as well?

 

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