Understanding Executive Function
In addition to situations that are non-routine, the amygdalae react to certain genetically encoded stimuli. For example, if you are walking in the woods, an S-shaped object on the ground will trigger a stress hormone release. In a few thousandths of a second, without will on your part, your hormones shut down the mental autopilot that has been walking you forward and stop you in your tracks. For a moment, you don’t know why: It takes one-tenth of a second for the brain to turn data from the eyes into a usable image. Another tenth of a second is needed to identify the image. If the image turns out to be a vine, you may feel foolish for having overreacted. But if, after backing away, you see a snake, you’ll feel relief, and maybe even a little proud of your performance. But, really, feeling prideful or foolish is neither here nor there. Your amygdalae were just doing their job, which is to be quick—not right.
The opposite is true for Executive Function. Its job, like that of a corporate executive, is to be right—not quick. Even so, a good CEO doesn’t let problems build up. Some say the sign of a good executive is an empty desk. Through deliberate assessment, building a plan of action, and commitment, good Executive Function clears the desk to be ready to deal with what comes next.
It is important to process each issue brought to your attention as it is brought to your attention. In this way, stress from unresolved issues does not build up. With your desk cleared, when your amygdalae bring something to your attention, you are free to fully focus on the matter; then you can resolve it, and return—like any good executive—to an empty desk.
Your Inner CEO’s Executive Suite
Think of your orbitofrontal cortex—that part of the brain directly over your eyes—as your inner CEO’s executive suite. There your inner CEO has a desk. And on the desk, there’s an intercom. It is directly wired to the intercom at your assistant’s desk. Let’s call your personal assistant Amy (short for amygdalae). Amy’s job is to alert your CEO to anything that is non-routine. If the situation calls for action, your CEO builds a plan of action, and commits to it.
Amy isn’t the problem solver, but she’s a great gatekeeper and is very efficient. She sorts through the myriad e-mails, phone calls, and letters that constantly come to your office, not bothering you with these mundane, routine items, knowing that you have better things to do. But when something unusual pops up, something non-routine that only you, the inner CEO, can deal with, she pushes the intercom button: The intercom in your mental office goes off. But unlike an ordinary intercom or a smoke alarm that produces noise, when this intercom goes off, it zaps your CEO with stress hormones. When the stress hormones hit, your inner CEO jumps into action, assesses the situation, builds a plan of action, and commits resources to carrying it out. Commitment automatically signals Amy that the plan is being carried out. This lets her off the hook. So Amy takes her finger off the intercom button and goes back to her gatekeeper role. Your inner CEO takes a break or focuses on whatever is of interest.
So we have Amy, the gatekeeper, ever-vigilant, on the lookout for non-routine situations; the intercom, the alert system, signaling the CEO to situations that require his immediate attention; and the CEO, the executive, the big kahuna, the only one capable of solving the situation by practicing his ABCs, quickly assessing what’s going on, making a plan, and committing to an action. That’s your inner office at work, 24/7.
Consider Amy coming across an ad saying, “Today Only! Your own portable television set, a $129.99 value for just $69.99!” Like any other non-routine situation, the ad gets Amy’s attention: She pushes the intercom, compelling your CEO to take note. In spite of the impulse to hurry to the store and take advantage of the non-routine offer, your CEO may say, “No, I already have one.” With good Executive Function, your CEO makes its commitment and signals Amy to turn off the intercom. Nevertheless, residual hormones—like the noise from Amy’s intercom—are still echoing around the building. They remain an influence for a few seconds. In the case of an exciting opportunity, residual hormones can influence your thinking for a few seconds, tempting you to reconsider. In a risk-assessment situation, residual hormones keep you temporarily on edge. This is a time when impulsivity could get the better of you. But good Executive Function, in spite of the lingering effect, stands fast and does not ruminate; to do so would bring the non-routine matter back into focus, triggering a new round of stress hormones. When the residual hormones are given time to subside, there is a return to homeostasis, which is a state of internal equilibrium.
How does all this relate to the fear of flying? If you were able to fly in the cockpit, anxiety would be easily controlled. Upon sensing something non-routine, a glance at the pilots would provide you with an assessment that there is no problem. Your Executive Function would then be able to correctly decide to take no action. Commitment to that decision would quiet the amygdalae.
But in the passenger section, information is limited. When a noise or motion triggers a stress hormone release, an anxious flier may not have enough information to be sure there is no problem. Without a good assessment, no plan—either of action or inaction—can be built. With no plan, no commitment can be made. And with no commitment, no signal can be sent to the amygdalae to discontinue stress hormone release.
Probability versus Possibility
A good CEO recognizes that every course of action—or inaction—involves some level of uncertainty. Your Executive Function, if it is to serve you well, must accept that there are no guarantees. When a good CEO builds a plan, the plan is based not on certainty but on what can be reasonably expected. The next step is to commit—not in the naïve “nothing bad can ever happen” sense, but in the mature acceptance that this commitment, like any other, could work out badly. If the plan carries a high risk of failure, Executive Function may wisely decide to not take the risk. But if the risk of failure is exceptionally low, it is dismissed as not worth consideration.
Impaired Executive Function doesn’t like probability. It wants certainty. Make no mistake, if an outcome were certain, what need would there be for Executive Function? In other words, if the score of the Super Bowl had been established before the kickoff, there would be no need for quarterbacks.
As it looks for certainty, impaired Executive Function misses the big picture. It fixates instead on the small—in fact, minuscule—picture. It brushes aside what is by far the most likely outcome—that the plane will arrive just fine—and focuses instead on the tiny possibility of disaster. Though a fatality occurs once in twenty-some million flights, when Executive Function is impaired, its logic seems to be, if something is possible, it can happen. If it can happen, it can happen to me. At that point, the disaster becomes personal; the thought of being in a plane that is crashing triggers the release of stress hormones. Stress hormones, because they force Executive Function to focus on what the amygdalae are responding to, compel impaired Executive Function to view images of personal disaster, which make it appear that any plan of action will result in disaster. Seeing disaster as the only possibility, the second ABC step—building a plan of action—comes to a halt. With no plan to commit to, no signal can be sent to quiet the amygdalae. Stress hormones continue, fixation on disaster continues; no relief comes until the person decides to abandon the plan. Professors George Loewenstein and Jennifer Lerner summarize the process, saying “As the intensity of immediate emotions intensifies, they progressively take control of decision making and override rational decision making.”
Here is an example of impaired Executive Function. This dialogue is from the SOAR Chat. To maintain her privacy, her name has been changed to Jeanette. She is not a client. She was unable to deal with two decisions: her flight, and whether or not to enroll in SOAR. The following are dialogues from two different chat sessions.
FIRST CHAT SESSION
Jeanette. Every time I feel I’m making progress, I get worse again. It is a horrible feeling to let fear take over your life. My flight is supposed to be in June, but I am procrastinating and haven’t bought the tickets yet. I’m so afraid to get my tickets. If I give up at the last minute, I won’t get my money back, and I’ll miss work on unpaid vacation. I’m always like that when it comes to making big decisions. I am starting to think that my main fear is turbulence even though there are millions of things in my head right now. I know that once I buy the tickets, then I will be anxious about packing, walking at the airport, boarding, etc.
Captain Tom Bunn. Jeanette, we were just talking about how the amygdalae, the part of the brain that triggers stress hormones, has a job to do. Not unlike the smoke alarm in your home, whenever anything non-routine is picked up, they alert you. The smoke alarm with noise. The amygdala with stress hormones. Then you do your ABCs. A. You assess what the alarm means. B. You build a plan. C. You commit to the plan. Commitment resets the amygdalae. The stress hormones stop. The feelings, which are caused by stress hormones, go away.
Jeanette. I wish I had a capacity and power to control the feelings. I know that half of what I feel is part of my imagination. I have this fear of being inside the plane and trying to get out and it is too late. I always make everything too complicated. I tend to do that with other issues, too. I started imagining how nice it would be to drive to another place closer instead of flying overseas, and I felt my anxiety level drop when I took the idea of flying out of my head. But I get so depressed for feeling I am a failure and a disappointment to the loved ones anxious to see me.
SECOND CHAT SESSION
Jeanette. Today my stress level is huge. I booked my tickets yesterday and that already made my heart race.
Captain Tom Bunn. Jeanette, what comes to mind as the problem?
Jeanette. Oh, Captain Tom, I could stay here forever listing you all my fears. Turbulence is a big thing. Worried about bad weather. The fact of being on a plane for nine hours. I don’t see me standing nine hours without feeling sick. But I have neglected flying for three years and I haven’t seen my parents that long due to this awful fear. I blame it on myself. I cry every day and I put pressure on myself. But what if the weather is bad and we are already up in the air?
Captain Tom Bunn. Jeanette, the weather forecast has to be okay. And if there is any chance at all that it might go bad, you have to have an alternate airport specified.
Jeanette. Sometimes I feel it is out of the pilot’s hands when it comes to Mother Nature, like in a storm, and it gets me so anxious to imagine the possibility of having a massive turbulence, etc. The feeling is so intense and getting stronger over the years that the fear took control over my life.
Captain Tom Bunn. Jeanette, of course you can imagine the possibility of massive turbulence. So can I. But, I can do it without stress hormone release. I can teach you to do that, too. One way we control these feelings is we tap into the Social Engagement System. It is a system that shuts down stress hormone production in certain interpersonal situations. We teach the amygdalae to link each thing that happens on a flight—or that you imagine could happen on a flight—with something the amygdalae regard as benign. We want to teach the amygdalae to regard being on the plane as being alone with someone you are profoundly secure with. Recalling such a moment shuts down the release of stress hormones. By shutting down the release of hormones, we control the feelings. The other way we control feelings is to teach your high-level thinking, called Executive Function, to recognize the difference between what can go wrong, and what could go wrong, and what will go wrong. What you are contemplating is extremely unlikely, and your Executive Function needs to be able to base decisions on what is by far the most likely outcome instead of expectation of a most unlikely outcome.
Jeanette. I think that training could be almost impossible in a person so fearful like myself. I can’t even stand up without my legs shaking. I get stuck in my seat. I don’t get up to use the restroom. I don’t eat and I stay staring at everybody waiting for something to happen. I get so scared that I feel—I know it is silly—that if I get up I won’t feel the ground below my feet.
Jeanette’s remarks show, that for emotional control, she is dependent upon the Mobilization System. She knows only one way to control fear and anxiety, and that is to always be able to escape. The very idea that her feelings could be controlled in some other way is unthinkable. She needs her feet on the ground. To her, security means being able to go toward what is interesting or desirable—she would like to see her family again—and being able to move away from anything that frightens her (in this case, being on the plane). The two things, confinement on the plane to reach her family and escape from the plane to stop anxiety, are in direct conflict.
Psychological Fixation
Though impaired Executive Function can become fixed on physical disaster, for many anxious fliers, the fixation is on psychological disaster: claustrophobia, high anxiety, or panic. Such folks have panic at times in day-to-day life. When they do, they seek relief by getting away from where they are. The relief that comes with this action causes a gross misunderstanding. Because the amygdalae stop releasing stress hormones when commitment to an action is taken, panic stops immediately upon commitment to escape. Ironically, the panic would stop just as quickly if the person made a commitment to stay put. As has been pointed out, it is commitment that ends the release of stress hormones, whether it is to escape or to hold one’s ground.
Notice that panic stops not when arriving at a safe haven but upon leaving to go there. Logically, if it feels unsafe here, there should be no reason to feel safe until well away from here. The fact that panic is relieved at the moment escape is initiated shows us that commitment to action, not completion of the action, ends stress hormone release. The belief that panic can be stopped only by escape causes fear of being any place where escape is not instantly available. It could be an elevator. It could be a bridge. It could be a tunnel. It could be a multilane highway with no immediate exit. It could, for some, even be speed, and the awareness that it would take a moving vehicle several seconds to stop and let them off. It could be the insecurity of another person in control of the vehicle; will he respond instantly if the person insists she wants to get off? And, even if escape is not blocked by a physical barrier, it can be blocked by a psychological barrier: embarrassment. Some clients have said they cannot go to church because, if the need to escape arose, they could not leave because of embarrassment. Even if sitting in the back row, someone—and perhaps several people—would notice.
The very thought of restrictions triggers anxiety. In time, the thought of being any place where escape is not instantly available may cause feelings of panic. Thus, knowing they cannot get off the plane, the very thought of being on the plane can bring them to the edge of panic. I can no longer count the number of people who have told me they cannot bear to look up in the sky because they might see an airplane, and have the thought of being unable to instantly escape from it.
Believing panic could last until able to get off the plane, an anxious flier may fear that a long flight could mean being in a state of panic for hours. Like fixation on an image of physical disaster, fixation on images of psychological disaster can keep Executive Function from doing its job.
What else can prevent your inner CEO from doing its ABCs? Some inner CEOs can build a good plan of action but not be able to commit to it. High probability that the plan will succeed may not be enough. Some CEOs cannot commit unless the desired outcome seems certain. Amy keeps her finger pressed on the intercom button waiting to hear the CEO has made a commitment. The CEO can’t decide. This goes on and on. Finally, when the noise from the intercom becomes intolerable, the CEO falls apart. Incapacitated in his office, no one can signal Amy to stop, so her finger stays on the intercom. In other words, when a person’s Executive Function cannot produce a commitment, stress hormones keep building up, and the buildup causes Executive Function to collapse. Control reverts to the Mobilization System. This primitive system, having but one solution, demands escape. If escape if blocked, no regulation of stress hormones is possible; the result is panic.
Though some anxious fliers must have immediate escape, others can maintain themselves as long as the flight is making progress. They calm themselves by keeping the goal—getting off the plane at the destination—in mind. Emotions are controlled as long as there is “light at the end of the tunnel” and the progress toward the end of the tunnel is constant. They run into trouble when, for example, the plane goes into a holding pattern, or there is an indefinite delay before takeoff. If there is any pause in progress, the plan is thrown into doubt, and the image in their mind of being able to get off the plane disappears. Success seems no longer guaranteed. Commitment to the plan comes undone. When commitment is lost, stress hormones return.
A similar example is being on an elevator, and just when you expect the door to open, nothing happens. The image of being stuck replaces the expectation of being able to get out. So many anxious fliers say, “I don’t know what to expect.” Some check the weather constantly in an effort to find out what to expect. It is as if the ability to be calm depends upon the ability to expect—and to hold in one’s mind—the desired outcome.
Panic: Multiple Stress Hormone Release
The amygdalae, located in the brain just behind the eyes, receive incoming visual data directly. Think of this as the front door. Images coming in the front door, because they come from your eye, are limited by reality. But the amygdalae have a back door, too, and through the back door images from the mind’s eye enter. These images are not limited by reality. Much of what is presented to the amygdalae by the mind’s eye is imagination. Yet, the amygdalae—in determining whether to react and release stress hormones or ignore the situation and release none—make no distinction between the images from reality and the images from your imagination.
First, let’s consider reality. Unless you’re a first responder or a spy or a soldier in the midst of battle, life does not present one life-threatening situation after another. For most of us, threats coming into the amygdalae through the front door are rare. What comes in the front door is limited to what is actually going on. But what about the mind’s eye? Threats coming into the amygdalae through the back door are limited by nothing other than the limits of your creative imagination. Amygdalae exposure to reality rarely causes panic. But amygdalae exposure to what comes in through the back door from your imagination can. Panic is a back door problem, which is to say it is a mind’s eye problem, which is to say it is a particular kind of imagination problem, one in which a person accepts what is imagined as if it were real.
Whether triggered by your physical eye or your mind’s eye, a single non-routine image is only a single source of stress hormones. A single source does not cause panic. Instead, it only alerts Executive Function; your CEO assesses the non-routine situation and determines its strategy.
Though an armed assailant is a serious threat, it is only one source of stress hormones. When facing a threat that is real, arousal goes no higher than two, on a scale of zero to ten. But when the assailant leaves, the person’s focus is no longer constrained by the emergency. The person can imagine “what if” things had been different. For example, what if the assailant had pulled the trigger? Even though it’s conjecture, the image nonetheless causes the amygdalae to release stress hormones. If your CEO cannot adequately explain why the thief did not shoot, imagination can run wild and produce a whole series of images about being shot, rushed to a hospital, living or dying, and so on. Each image produces a shot of stress hormones. Multiple shots of stress hormones can cause arousal to skyrocket and overwhelm Executive Function. If Executive Function collapses, the person has no ability to stop stress hormone production. The amygdalae may drive arousal even higher. The result may be panic or dissociation. Consider this series:
Thought A: “What if I had done something different?”
Thought B: “He might have shot me.”
Thought C: “I could be dead right now.”
Thought D: “I might be bleeding to death on the sidewalk.”
Thought E: “What will my family feel when they hear what happened?”
Thought A takes arousal from zero to two. Thought B takes arousal from two to four. Thought C takes arousal from four to six. Thought D takes it from six to eight. At eight, stress hormones cause psychic equivalence to take place, shifting thought E from imagination to actuality. Psychic equivalence, according to psychologist Peter Fonagy, is a state in which imagination is experienced as if it were reality.
Executive Function Overload
Even though takeoff is not a life-threatening situation, the plane makes one noise after another. In turbulence, there is one movement after another. These noises and movements—routine to a crew member’s amygdalae—may be non-routine to a passenger’s amygdalae. When the amygdalae notice an unfamiliar noise, stress hormones are released that focus 100 percent of the inner CEO’s attention on the noise. If the CEO recognizes what the noise is, and understands it is nothing to be concerned about, she knows no action is called for. Her plan, then, is to disregard the noise, and to return to what she was doing before. But, as she is about to commit to her plan to disregard the noise—a commitment that would end stress hormone release—she hears another noise. The amygdalae again release stress hormones. Stress hormones give the inner CEO no choice; they force the inner CEO to focus 100 percent of her attention to this new noise. Her plan to disregard the first noise vanishes from her mind. Since her ABCs had not been completed, and commitment had not been reached, the stress hormones from the first noise continue. Then, before she can reach commitment about the second problem, a third problem is presented.
If this continues—as it can during takeoff or in turbulence—the inner CEO can’t stick with any problem long enough to complete the ABCs. She can’t reach commitment, the point at which stress hormone release would stop. Instead, the stress hormones build to a higher and higher level. The sequence in ordinary turbulence might be:
Thought A: “Oh, no. Turbulence!”
Thought B: “I wonder if it will get worse?”
Thought C: “I don’t know if I can take it!”
Thought D: “I think something is wrong.”
Thought E: “The plane is falling!”
In an actual life-threatening situation, reality limits awareness to one thought. In an imaginary life-threatening situation, an unlimited number of thoughts are possible. Each triggers a stress hormone release. Multiple sources of stress hormones cause high anxiety or panic.
Takeoff is brief. Even though there are several noises and movements, the ordeal is over fairly quickly. Turbulence, though, is a different matter. It can go on for an extended period of time. The description above involves imagination. During any non-routine situation in which there is one motion or noise after another, however, Executive Function can become overloaded. The inner CEO may be unable to reach commitment and signal the amygdalae to cease stress hormone production.
But, even if stress hormone production can be stopped, the hormones already released have a residual effect. After commitment has been reached, it may take one to two minutes for the hormones to wear off. Even if the inner CEO recognizes every motion and every noise, and is able to complete the ABC process and reach the point of commitment every time there is a noise or motion, the residual effect can be formidable. It is possible that the residual effect can be enough, at least over an extended period of time in turbulence, for Executive Function to collapse and accomplish no further ABC steps at all.
Imagine what it would be like at home if you had a dozen smoke alarms. If one went off, you would use your Executive Function. You would assess the situation to see if the toaster was burning toast or if there was a serious fire. But what if, after one smoke alarm went off, another one went off a second later, and another after that until all twelve were blaring? Even if you were sure you were not in physical danger, the noise would be too much. You would just leave. That’s what happens psychologically when Executive Function reacts—even successfully—to one situation after another. The combination of fatigue and residual hormone buildup can cause your inner CEO to collapse. The result would be high anxiety or panic. Fortunately, automatic control via Systematic Inhibition can override or prevent stress hormone release and provide the protection necessary for your inner CEO to continue working.