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The sweetness of anticipation, the sourness of anxiety: two sides of the same coin.

Posted Sep 22 2008 11:07am

According to a recent study described in a post on the Anxiety Insights blog, the production of pleasure and dread are closely related processes in the brain. The same chemical, dopamine, works in closely proximate regions to produce these seemingly antithetical emotional responses:
Kent Berridge, PhD, and his colleagues at the University of Michigan, identified dopamine's dual effect on the nucleus accumbens, a brain region that motivates people and animals to seek out pleasurable rewards like food, sex, or drugs, but is also involved in fear. They found that inhibiting dopamine's normal function prevented the nucleus accumbens neurons from inducing both rewarding and fearful behaviors, suggesting that dopamine is important in both.

In previous research, Berridge and colleagues showed that a distance of only a few millimeters separated desire and dread functions in the nucleus accumbens (which is only about 5 millimeters long in humans).

I don't pretend to understand brain functioning, but abstractly it doesn't surprise me that pleasure and anxiety are neurologically linked. There's a lot of overlap in what these sensations are like in the body and mind. Physiologically, both involve a state of heightened alertness; psychologically, both are more intense than and therefore distinct from the humdrum of the everyday.

Think of what it's like to perform in front of others, whether it's in a school play or in a business meeting: For some, it's the very definition of pleasure, while for others it's excruciating, the last thing in the world they want to do. In either case, though, there are the sweaty palms and the racing heart and the concomitant narrowing of focus to the situation at hand.

This makes me think about the cognitive aspect of panic, the way we choose whether a given scenario we face brings us pleasure or mental pain. In the case of performing in front of others, some people experience excitement, and others experience anxiety. What distinguishes them? The cognitive psychologist would say it's all about our interpretation of we're experiencing. If you tell yourself your sweaty palms and racing heart are a sign of excitement, excitement is what you'll feel; if you tell yourself your sweaty palms and racing heart mean something dreadful is about to occur, on the other hand, you'll experience anxiety. Change the interpretation, and you change the experience.

This concept plays a big role in both cognitive-behavioral therapy (CBT) and Buddhist meditation. In both cases, you're taught to reconsider the stories you tell yourself about your experience -- to see that the stories you consider unequivocal reality are merely your interpretation of your experience. You end up considering other, less catastrophic stories about your experience. In other words, when your heart races and your palms sweat, you learn to tell yourself, "It doesn't mean I'm having a heart attack/going crazy/[insert extreme, neurotic response here]. It just means I'm experiencing a particular cluster of physiological responses to which the genetic roulette wheel has inconveniently deemed I'll be predisposed, responses that in no way imply I'm facing any real danger."
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