5. Temperament & Anxiety - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Born that Way, Temperamental Challenges in Relationships and Therapy
Chapter 5: TEMPERAMENT & ANXIETY
by Ronald Mah





An individual cannot control the activities and reactions of other individuals and the context entirely.  As a result, his or her needs may or may not be well met.  Anxiety becomes a normal and necessary part of managing life challenges.  An individual who develops in nurturing and supportive circumstances has generally positive experiences managing anxiety and managing life demands that precipitate anxiety.  The infant and child deal with daily anxieties in the initial context of parental caregiving.  Poorly supported, anxiety can grow out of hand and interfere with healthy functioning.  The therapist would find poor parenting triggered Aliya's greater anxiety if they explore her developmental experiences.  Born with high emotional reactivity, she had a greater than average need for soothing.  Unfortunately, her parents had a lower than average ability to provide her nurturing support.  Panic attacks, social or school anxiety, various phobias, obsessive-compulsive disorder, posttraumatic stress disorder, and generalized anxiety disorder are clinical labels used when anxiety becomes disruptive to normal life.  However, so-called garden variety anxiety can be significantly intrusive to individuals in many aspects of their lives, including the couple's relationship.

Henig described the anxiety and activity in the brain and Kagan's comments.  "In the brain, these thoughts can often be traced to overreactivity in the amygdala, a small site in the middle of the brain that, among its many other functions, responds to novelty and threat.  When the amygdala works as it should, it orchestrates a physiological response to changes in the environment.  That response includes heightened memory for emotional experiences and the familiar chest pounding of fight or flight.  But in people born with a particular brain circuitry, the kind seen in Kagan's high-reactive study subjects, the amygdala is hyperreactive, prickly as a haywire motion-detector light that turns on when nothing's moving but the rain.  Other physiological changes exist in children with this temperament, many of them also related to hyperreactivity in the amygdala.  They have a tendency to more activity in the right hemisphere, the half of the brain associated with negative mood and anxiety; greater increases in heart rate and pupil dilation in response to stress; and on occasion higher levels of the stress hormones cortisol and norepinephrine.  But having all the earmarks of anxiety in the brain does not always translate into a subjective experience of anxiety.  'The brain state does not make it a disorder,' Kagan told me. 'The brain state exists, and the statement 'I'm anxious,' exists, and the correlation is imperfect.'  Two people can experience the same level of anxiety, he said, but one who has interesting work to distract her from the jittery feelings might do fine, while another who has just lost his job spends all day at home fretting and might be quicker to reach a point where the thrum becomes overwhelming.  It's all in the context, the interpretation, the ability to divert your attention from the knot in your gut.  These variations also happen when someone grows up from an anxious infant to someone either fretful or tranquil.  One aim of Kagan's and Fox's longitudinal studies is to watch how the life stories of these high-strung babies unfold." (Henig, 2009).

The infant is preset to react more intensely to stimuli.  Subsequently, the quality and quantity of nurturing and support the infant receives and to what degree is able to internalize for self-nurturing and self-support determine the degree of experienced anxiety as an adult.  The individual's initial relative reactivity is a function of the arousability of motor, affective, and sensory response systems.  Reactivity can be gauged according to

ones sensitivity to cues that evoke positive or negative emotional states);

intensity (low or high arousal or energy or the reaction));

duration (time to baseline, falling reactivity or soothability;

prototypical situations that elicit reactivity (novel-familiar; social-non-social);

reward-punishment or threat;

threshold (response evoked by low stimulation-high stimulation) (Teglasi et al., 2004,page 10-11).

In addition, activity and emotionality are two important dimensions of reactivity.  On the other hand, self-regulation is made up of processes that modulate (increase or decrease) reactivity.  These include flexibility and adaptability, shifting focus of attention, ability to inhibit oneself, and ability to seek or avoid stimulation that is triggering.  Self-regulation moderates reactivity, including regulating stress reactions and maintaining optimal arousal.  Activating mechanisms to regulate reactivity may be relatively automatic to taking concerted effort.  The ability to automatically and successfully self-regulate varies significantly from person to person.  High reactive individuals with limited effective self-regulation mechanisms have to spend greater energy to modulate high emotions, resist being distracted, and restrain high activity.  Aliya and Charlie have difficulty self-regulating while Samuel tends to self-regulate effectively more automatically.

Aliya finds maintaining her equilibrium amidst all the family chaos to be exhausting.  This experience for her and others with high reactivity can divert resources from acquiring more involved academic and social abilities.  "Executive functions or (meta-cognitive skills) serve to orchestrate basic processes of working memory, attention, and inhibitory (effortful) control as a means of planning and implementing goal-directed strategies toward desired outcomes (Lyon & Krasnegor, 1996; Zelazo, Carter, Reznick, & Frye, 1997).  Inhibitory or effortful control is a key component of executive cognition, and its development relates to individuality in attentional self-regulation (Posner & Rothbart, 1998; Ruff & Rothbart, 1996).  Moreover, positive emotional experiences, in reciprocal relation with working memory and attention, enhance the organization of higher-order cognitive structures that aid self-regulation (Fischer, Shaver, & Carnochan, 1990), whereas negative emotional experiences disrupt higher-order information processing (Matthews & Wells, 1999; Mogg & Bradley, 1999).  Thus, the development of increasingly complex competencies is built on increasing automatically of lower-level self-regulatory functions and increasing development of metacognitive skills that organize automatic and effortful self-regulatory processes" (Teglasi et al., 2004,page 12).

An individual such as Samuel or Charlie who share ADHD (along with Charlie having other learning disabilities) has difficulties processing information.  Because of memory or attention issues such an individual is more likely to have problems developing learning how to self-regulate in academic and social areas.  The individual will have additional energy stress if he or she has to also regulate for high negative emotional reactivity or distractibility.  Through childhood, adolescence, and into adulthood increasing inadequacies in social competence as well as learning may become more and more anxiety provoking.  Self-awareness of consistent failures over time exacerbates distress anticipating problems managing complex social dynamics such as the couple relationship.  High emotional reactivity clearly can lead to tremendous anxiety and significant dysfunctionality in life.  It would seem to be counter-productive to be so sensitively wired.  What would be the benefit of such extreme temperament?  While the reactive sensitivity could be highly distressing to the individual, it may be beneficial to the group or the species.  With some hyper-vigilant members to scan the horizon for potential threats and then give the alarm for the group, overall survival can be improved.  Species including human species in more primate environments are served by the non-voluntary hypersensitivity of a subset of the group.

For modern challenges, caution, introspection, and the capacity to work alone which are consequences of or intrinsic to certain temperamental traits can be beneficial.  "Kagan has observed that the high-reactives in his sample tend to avoid the traditional hazards of adolescence.  Because they are more restrained than their wilder peers, he says, high-reactive kids are less likely to experiment with drugs, to get pregnant or to drive recklessly" (Henig, 2009).  An individual with a highly reactive temperament who is not so extreme that he or she becomes dysfunctional tends to be conscientious and very well to obsessively well-prepared.  This better to over prepared individual is less likely to forget important details.  An individual who worries a lot may be more meticulous and attentive as a co-worker and a friend.  "Kagan told me that in the 40 years he worked at Harvard, he hired at least 200 research assistants, 'and I always looked for high-reactives.  They're compulsive, they don't make errors, they're careful when they're coding data.'  He said he would bet that when the United States sends people up in space, the steely, brave astronauts were low-reactive as infants, and the mission-control people down on the ground, doing the detail work that keeps the craft aloft, were high-reactive" (Henig, 2009).

Anxious temperament can create an inner-directed individual who provides benefits to society in his or her work.  An anxious individual seeks to anticipate not just dangers to self but also to society.  More likely to contemplate the meaning of life and society, internal exploration and examination can lead to artist expression, music, literature, scientific discovery, philosophy, spiritual exploration, and other advances and depth.  "'Our culture has this illusion that anxiety is toxic,' Kagan said.  But without inner-directed people who prefer solitude, where would we get the writers and artists and scientists and computer programmers who make society hum?  Kagan likes to point out that T. S. Eliot suffered from anxiety, and that biographies indicate that he was a typical high-reactive baby.  'That line 'I will show you fear in a handful of dust' — he couldn't have written that without feeling the tension and dysphoria he did,' Kagan said" (Henig, 2009).  Nevertheless, while society may benefit from have a subset of members with anxious or reactive temperaments, such a member often suffers the temperaments without appreciation.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
phone: (510) 614-5641
fax: (510) 889-6553
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