Antonio Damasio in his book “Descartes’ Error” describes very clearly and lucidly the unfortunate case of Phineas Gage, who suffered a very serious brain injury when a 3 ½ foot long, 1/2 inch diameter steel bar was explosively pushed through his left cheekbone piercing the base of the skull and exiting through the top of his head. The crucial thing about Gage’s story for the therapist is not the physical injury, but the profound change in personality and behaviour that took place following the insult to his brain. Gage changed from a highly competent railway engineer, making complex and highly responsible decisions on a daily basis to a boorish ill tempered, ill-mannered man who made consistently bad decisions for the rest of his life. Damasio makes careful and considered analysis of the medical notes provided by Harlow, the physician who tended to him, and our subsequent knowledge of Gage’s life story and makes the observation that Gage had become, “a child in his intellectual capacity and manifestations, he has the animal passions of a strongman… The strongest admonitions from Harlow himself failed to return our survivor to good behaviour”.
There can be little clearer description of the disconnection between a well formed intellect and a powerful emotional basis. Gage’s most unfortunate accident and miserable subsequent life gives us a clue to the power and importance of the bond between the prefrontal cortex, the limbic system and primitive brain, a bond that I describe in terms of a horse and a rider. It is this bond that seems to me be helpful for understanding how and why human beings behave the way they do.
Jonathan Haidt provided me with the idea of the rider and horse from his book, “the righteous mind: why good people are divided by politics and religion”. He states quite explicitly that he “chose an elephant rather than a horse because elephants are so much bigger – and smarter – than horses.” In my opinion this part of the human brain has not developed to be smarter, but merely to be more successful in survival. It is the development of the rider (prefrontal cortex, PFC) that created smartness, though as we see the world over, having a prefrontal cortex does not necessarily make us wise!
Now while I can understand his reasoning about the elephant being bigger and smarter, it is more difficult for people to associate themselves with an elephant and understand what it might be like to ride one. Nor is the elephant renowned for its skittishness and ability to be spooked by the smallest things. I prefer the horse as it is a very threatminded creature that spooks easily, lives in the here and now and reacts quickly when threatened with anger or fear and these reactions are also characteristic of human beings in danger or under stress.
He goes on to say,
“automatic processes run the human mind, just as they have been running animal minds for 500 million years, so they’re very good at what they do, like software that has been improved through thousands of product cycles. When human beings evolved the capacity for language and reasoning at some point in the last million years, the brain did not rewire itself to hand over the reins to a new and experienced charioteer. Rather, the rider (language-based reasoning) evolved because it did something useful for the elephant.
The rider can do several useful things. It can see further into the future (because we can examine alternative scenarios in our heads) and therefore it can help the elephant make better decisions in the present. It can, learn new skills and master new technologies, which can be deployed to help the elephant reach its goals and sidestep disasters. And, most important, the rider acts as a spokesman for the elephant, even though it doesn’t necessarily know what the elephant is really thinking…. Once human beings developed language and began to use it to gossip about each other, became extremely valuable for elephants to carry around on their backs a full-time public relations firm.”
Haidt also makes another very important point when he said that he stopped thinking about emotion versus cognition and started thinking about intuition versus reasoning. To me, his allusion to intuition is a reference to what most people might call “gut feeling”. An automatic emotional response driven by millions of years of successful evolution that enables the creature experiencing it to have a better chance of survival.
The horse and the rider metaphor is important as it recognises those times when people are struggling with anxiety and depression. Let me explain, the people I work with often complain of not feeling like themselves anymore. Questions like, “why am I like this?” or statements like, “I don’t feel in control of myself any more” are frequent, confusion about not being “me” anymore is often expressed.
I provide the horse and rider analogy in these sort of terms:
Do you remember a time before all this began when you were well? What were you like? Sometimes the person is able to describe themselves, at times when they were feeling competent and together, feeling comfortable inside their own skin, knowing who they are and being able to behave in ways that makes sense to them. Sometimes I have to encourage them to describe how they were with prompts and detailed questions about what their life was like before they started to struggle with their misery. Then I describe the horse as emotional, physically powerful, threatminded, spooking at the smallest things, scared or angry, wanting to hide away from “danger” and generally avoidant. Many people recognise themselves but say that it is not them and that they don’t understand why they are now like this.
I then describe the rider as the rational, logical and pragmatic person who is sat on the back of the horse. When the person is well and enjoying life the horse and rider work well together, the join between them is seamless and both are happy and comfortable with their role in the person’s life. Indeed, together as horse and rider they could win the Grand National (or perhaps that should be the “Grand Notional!”).
However, when the person becomes stressed, depressed, traumatised, bullied, suffers loss or some other setback in life the control tends to move from a balanced point between the horse and rider to a point where the horse is slightly more dominant and thus the characteristics of the horse begin to take over and the person becomes more avoidant in many aspects of their life. They may feel reluctant and anxious about going to work, seeing friends, spending time with intimates, the horse is driving a loss of confidence in the person’s abilities simply through its desire to avoid situations that may involve risk (no matter how small) of any kind. The rider begins to feel a sense of loss of control as this reluctance to engage is experienced. The immediate consequence of this is a sense of feeling out of control and the rider tries to grip the horse more tightly, which as every horse rider knows, makes the horse go faster, creating a vicious circle.
It is difficult to know which comes first, the horse taking more control to avoid the fear or the rider feeling out of control and losing confidence. Either way the result is that the horse transmits its fear to the rider and the rider transmits their loss of confidence in themselves to the horse creating a feedback loop in which the rider is clinging to the horse tighter and tighter making the horse go faster and faster (panic attacks).
Like most ways of helping ourselves to manage our psychological processes, the answer is simple but not easy. Relaxing on the back of a runaway horse would not be easy, trying to let go and allow yourself to be overwhelmed by your anxiety is not easy either but very necessary for a change of behaviour.
Fortunately, there are another ways of taking control back from the horse that is by the use of reason and also by taking control breathing. The rider is a very new phenomenon in terms of evolution. The rider only appeared a few hundred thousand years ago but in that short period of time since it has transformed its environment, from one of almost constant physical threat to a rather benign environment in which the vast majority of threats are intellectual and not physical. Unfortunately, the horse continues to respond to any threat and can only respond in one way which is a profoundly physical response arousal and preparation to run or fight. (For a comprehensive view this see my online lecture at https://stream.liv.ac.uk/a9r9u78k ) of the purpose of those “symptoms”.
It is very simple, but not easy, to change what we think to something that we desire, what is wanted, away from paying attention to that which is not wanted. We are threat-minded creatures we evolved to notice threat, for if we failed to notice threat it was more than possible, in prehistoric times, that we would die or be seriously injured, which amounted to the same thing. In today’s world threats are largely intellectual, they are unlikely to kill us. For example, losing a job or a relationship may be devastating emotionally and intellectually but it is not life-threatening. Yet even the idea of these things occurring produces significant levels of anxiety and stress and this is because the horse is reacting to what has been imagined, something that may or may not occur in the future. However, the horse, our primitive self, cannot take the chance that this is not real and thus responds in the only way it knows how through physical arousal in preparation for running of fighting.
It is our imagination that causes so much damage and produces so many stress responses. Therefore the logical and rational way to change this is to change the way we think and in order to do that we have to overcome millions of years of evolution that has produced a very sophisticated survival machine upon which we self-aware creatures are now precariously sat. It is really important to begin to think about what is wanted and move towards the safety of a preferred future rather than try to run away from a perceived danger. To illustrate this, I use the story of Little red Riding:
The story of Little Red Riding Hood is a great metaphor for how life works. The story goes something like this:
Little Red Riding Hood (LRRH) goes into her grandmother’s cottage to see Grandma as she is not well.. LRRH goes upstairs to Grandma’s bedroom to talk to Grandma and goes to give her a kiss. LRRH realises that it is a wolf in the bed and not Grandma! she screams and runs out of the cottage through the forest to get away from the wolf.
Now there are a number of crucial observations to make about this little story that relate to Solution Focused thinking.
1) Is LRRH running away from the wolf or running toward safety. In SF we look for what is wanted (or the place of safety), we try not to run away from what is not wanted but move toward what is wanted?
2) Which way is LRRH looking as she runs through the forest? Many would say that she is looking back to see where the wolf is but this doesn’t help! Why? well, when we look back we slow down and worse still we are more likely to run into something unseen (like a tree trunk) that is in front of us. So, SF encourages to look where we are going and think about what we are heading for.
3) what is LRRH thinking about as she runs through the forest – thinking about the wolf and its teeth doesn’t take her anywhere – except to terrify her. So, thinking about what is wanted takes her in the direction she wants to go is less anxiety making and a step in the direction she wants to go.
Next time you are anxious or struggling think about LRRH and consider which way would be helpful to you to look and what would be helpful to think about to take you where you want to go.
There is a second option however, there is one system in the body which the intellect and the primitive self both control, and that is the system of breathing. It is the only system in the body that is controlled by both the horse and the rider. When the horse becomes aroused it increases the rate of breathing in order to get more oxygen around the body and we begin to pant. Breathing becomes fast and shallow. However, it is well known that if we can slow breathing down in these situations by taking a long slow deep breath in and exhaling slowly our arousal tends to reduce.
There are many exercises that include breathing as a fundamental part of helping to relax. In any stressful situation, unless you’re about to be mugged by a hyena run over by a bus, taking a deep breath slowing everything down, pausing if you can and describing to yourself what is actually happening, helps to reduce anxiety.
This is helpful, but only helps to reduce the anxiety in the moment, the key going forward is to learn to breathe in a more controlled manner and to begin to think about what is wanted and creating in your imagination picture of the future that is preferred. What is even better is to create that future in detail and rehearse that picture as often as you can.
Which would you prefer, a world full of past fears or a future full of hope?
Haidt, Jonathan. (2013) The Righteous Mind: Why Good People are Divided by Politics and Religion. Penguin Books Ltd. Kindle Edition.