The Perils of Living Defensively

The primary causes of both physical and mental health risks are threats and other stressful situations. Inadequate responses to stressful situations maintain individuals in chronic defensive reactivity to life. Approximately eighty percent of physical and emotional symptoms that prompt individuals to visit general practitioners are directly associated with cumulative stress and distress. The nature and origins of stress and distress, and the consequences of prolonged stress and distress, are described in this section because it is important to understand them. While the focus of this paper in on thriving in life, we all have physical and psychological challenges and threats which activate our defenses.

When threats and dangerous consequences associated with careless behaviors are real, the self-defense system becomes crucial to our well-being. Thriving also depends on the resolution of threats, and subsequent freedom from our own defenses when threats are resolved. When psychological resolution to threats and distressing experiences fails to happen, individuals live in a self-defensive orientation to life that prolongs stress and distress unnecessarily. The resulting dysregulated emotional self-defense system attacks the mind and body in much the same way as a dysregulated immune system attacks cells through an auto-immune response.

The Origins of Stress and Distress

Research has shown that stress has two main origins: physical threats and psychological threats. While physical threats are often more intense, psychological threats are usually much more prevalent. Physical threats can include depletion of one’s physical/emotional resources, and perceived or actual physical danger. Psychological threats mainly result from perceived obstructions to our needs for emotional security, belonging and control of our lives. Stress is a psychosomatic response with both physical and psychological components, regardless of whether the origin is mainly physical or psychological.

The most common psychological threats have a social context that can result in anticipated or perceived criticism and rejection by others, loneliness and expectation of failures. Persistent perceived or real social threats can result in a state of sustained social anxiety. Also, sustained defensive reactivity can lead to a state of hopelessness experienced as sadness and depression. Persons with high physical threats may not have high social stress, but those with high social stress often have high physical stress due to the depletion of emotional resources.

Stress can be both situational (acute) and cumulative (chronic). Sally Dickerson at UCLA and Margaret Kemeny at the University of California, San Francisco conducted an extensive analysis of over 200 laboratory studies on situational stress measured by changes in stress hormone levels. They found that challenging tasks are most stressful for individuals when they are accompanied by the threat of social evaluation and by the perception that they have no control over the outcome. Both conditions amplify each other. Being subject to the potential criticism of others is threatening enough when evaluations turn out to be primarily positive, but highly stressful when social evaluations are basically negative.

It is easy to see that these momentary stressors could become chronic in environments that consistently provoke self-defense. The resulting defensive strategies are usually directed at avoiding such situations. This is the case with social anxiety, where limited interaction with others allows sufferers to avoid the perceptions of social evaluations.

After decades spent studying chronic stress in humans and other primates, Robert Sapolsky at Stanford University has concluded that the most frequent origin of cumulative stress and distress is relational, or comes from lack of positive interactions and connections with others that frustrate the need for belonging. He has observed that the most powerful relational stressor is social isolation and loneliness, particularly if it is imposed by others through criticism and rejection.

The healthy alternative to social stress is for individuals to receive adequate care from and connections with others, equipping them to become care-givers themselves. The stages of attachment, care-giving, friendship, pair-bonding and altruism are the social-developmental path to security and resilience. Disruption of this sequence leaves individuals alone and vulnerable to stress from both interpersonal and other life challenges.

Sapolsky maintains that the other main stressor is lack of predictability and control over our selves and lives. Lack of predictability and control usually occurs when individuals are exposed to environments in which they are unable to anticipate their experiences. A sense of lack of control often results when individuals stay focused on goals that remain obstructed over time by challenges and setbacks. Another source of stress is situations in which individuals are consistently coerced by others to behave in ways that they perceive to be inconsistent with their own goals and well-being.

Also, individuals experience a lack of control when they are either over or under-committed to responsibilities in their lives. When over-committed, people find themselves stressed by depletion of physical and mental energy, and threats to their self esteem from imagined or real failure to complete all of their commitments. When under-committed, people find themselves consistently experiencing the negative consequences that result from irresponsibility. Part IV of this paper describes self-determinism; the collective strategies for exercising control over ones- self and one’s life.

An additional powerful source of stress is emotional injuries resulting from traumas and otherwise distressing experiences that continue to affect us until they are resolved. When unresolved, such experiences stay poised to be expressed through defensive reactivity, leaving us with a lingering sense of physical and/or psychological danger. People with many unresolved distressing experiences live fearful rather than thriving lives. Their defensiveness is expressed in their memories, perspectives, and plans. Even if stored distress is repressed from our conscious minds and inhibited from most of our behavior, it is experienced as elevated stress hormones in our bodies.

Most severe traumas result from real or imagined loses in life. This includes loss of security that results from a threat to one's life, and also the loss of a loved one, a significant relationship, life dreams, significant property, and bodily functions. In the majority of cases, even these crises do not result in unresolved traumas. Surprisingly, the lasting impact of traumas is only marginally related to their severity. However, some severe emotionally unresolved traumas do permanently lower person's stress tolerance and raise their temperamental level of defensive reactivity. The ability to resolve severe traumas is largely related to the individual's levels of thriving and defensive reactivity before and after the crisis, and ability to form a beneficial perspective during and after the crisis.

Toxic stress is the sustained whole body response to prolonged stress and distress. It may be largely the effect of unresolved traumas and/or long periods of downward spiral from cumulative stress and distress. This stress is toxic because it overloads the energy usage, interrupts the natural defenses and interferes with the replacement of certain brain cells. It also increases cell aging throughout the body, as measured by such markers as length of telomeres which serve as protective end caps on chromosomes. It is felt throughout the body as anxiety, depression, anger and pain, and compromises the health of almost every major organ and body system.

The Distressed Personality: A Severe Health Liability

Johan Denollet of Tilburg University in the Netherlands discovered a syndrome called the distressed personality that predicts very poor physical health outcomes. The condition is measured by fourteen questions, seven measuring defensive reactivity and seven measuring social isolation. Very high scores in both areas typify the distressed personality, while a high score in only one does not. Many studies have followed the subsequent health of persons with and without this syndrome for years after they had an initial episode of heart failure. Depending on the study, those with distressed personalities had four to six times as many additional episodes of heart failure in the subsequent years in which they were compared
.
Persons with the distressed personality syndrome report significant health problems, but not many psychological problems. This may be due in part to the fact that collectively they are high in self-concealment, not overtly acknowledging the extent of their distress and loneliness to themselves and those in which they have the most contact. Their emotional distress often centers on the fear of being rejected by others and the anger they create as a defense against this fear. They are also more distressed than others about their physical illnesses. Compared to other individuals, they believe their physical illnesses to be more serious, pervasive and consequential.

Measurements of this Type D Personality only correlate marginally with scores on the Beck Depression Inventory, indicating that the syndrome makes a unique contribution to poor mental and physical health outcomes. The solution for the distressed personality is to resolve emotional distress and re-engage constructively with others.

The Basic Feelings of Emotional Self-Defense

The main basic feelings that accompany stress and distress are those associated with the self-defense system: fear, pain and apathy. Anger evolves with fear as a means to control fear, and the people and situations associated with it. The research of Joseph LeDoux has identified the amygdala as the main origin of the fear response in the brain, and the fear response as central to our experiences of distress. Fear and anger direct us to respond to real and perceived threats with avoidance and attack behaviors.

The associations between our fears and specific real or imaginary threats occur and are stored in the limbic system, some unconscious parts of the brain. Once these associations are formed, they resist change. The mind seems to hold to the belief that if something was a threat once it could become a threat again. The brain circuits for fear responses are more automatic and less flexible than for the other parts of our stored experiences. So, stress, fear, sadness and anger can be prolonged after real threats are removed but not resolved psychologically. Resolving fear, anger and sadness often requires intentional psychological work, often focused on forgiveness.

Pain has two main components: physical pain and emotional pain. Each lowers the threshold for the other. Pain from tissue damage and pain from intense fear and sadness have both emotional and physical components. According to Dan Ranney of the University of Waterloo, no differences have been found for the ways that physical pain and emotional pain are represented in the brain.

Even though pain from fear and grief may not seem as localized as pain from tissue damage, it still might be related to cell survival. Emotional pain is mainly thought to occur when the brain is overwhelmed with neuropeptides that signal danger to brain cells. There is now evidence that prolonged exposure to these chemicals is associated with stress-related loss of cells in the hippocampus and other areas of the brain.

The apathy response is the mind’s automatic attempt to control overwhelming stress, fear and grief by shielding it from emotional disintegration. This is accomplished by partially disconnecting the awareness of feelings from the experiences in which they are created without significantly diminishing the associated biological stress reactions. But this “disassociation” results in thoughts and feelings of hopelessness, and other characteristics of sadness and depression. It also suppresses many biological systems, restricting energy and movement, even to the point of physical and emotional immobilization.

One potential result of long-term apathy and emotional dissociation is inexplicable rage. Even though the individual is partially shielded from the awareness of intense feelings of fear and anger, and has those feelings disconnected from the experiences to which they were originally connected, his stored emotional experiences are primed for distressing events to happen again. When something similar to the original experiences triggers the fear and anger response, the resulting thoughts and feelings are often directed at the individual or situation that is present.

The autonomic nervous system directly regulates both stress and defensive feelings, and it is highly influenced by the mind. This is further evidence of the psychosomatic nature of the self-defense system. Most people think of stress as primarily physical, and distress as primarily psychological because stress is measured by biological reactions, and distress by clinical observation and self-report. Actually, they are both manifest through prolonged over-arousal of the autonomic nervous system. Prolonged fear, anger and sadness produces chronic stress, and prolonged stress produces chronic distress. Both can be maintained by highly limiting beliefs.

The autonomic nervous system is supposed to keep a certain balance, providing moderate levels of arousal to most body organs and systems when energy is needed, and calming them afterward when rest and reflection are needed. Too much time and effort spent in overly demanding or threatening life situations, and in defensive mode without rest and reflection when needed, causes us to become inefficient, unhealthy, confused and distressed.

Playing With Predators

Researchers have made very precise observations and descriptions of behavior, brain activity and hormonal activity of animals in various stages of threats, particularly in response to the proximity and attack of predators. Human defensive reactions to both physical and psychological threats seemed to researchers to be remarkably similar to those of animals in the presence of predators. However, it didn't seem humane or practical to try to subject humans to predators as a source of threat, and conduct a lot of measurements to see how they respond. But some crafty researchers figured out how to do it, and got permission from their ethics committees. My clever name for this experimental design is the predator game.

The predator game works by placing each subject, represented as a little person on a computer screen, in a maze with a predator and monitoring their brain activity. When captured on the computer by the predator, the subject gets a moderate but painful shock. If that was all there was to the experiment, it would just be an exercise in cruelty. Because the researchers were able to make functional MRI images of the brains of the subjects in real time, the results were very instructive.

At first, the predator is so incompetent that it is easy for an alert subject to avoid being shocked. Under this condition, subjects are quite competent in navigating the maze. Subjects respond to the incompetent predator with sufficient sympathetic nervous system arousal to be alert and avoid being shocked. Their biological indicators of stress are mildly elevated, but other indicators showed that their planning and problem-solving abilities seem completely intact. To many participants the game is enjoyable. If they do get a shock they exhibit little distress because they still feel in control.

This zone of mild sympathetic arousal and tolerable stress is where most people make constructive changes in their lives that produce significant personal growth and achievements. Any real personal change presents a threat sufficient to place most individuals in the condition of mild to moderate stress. Optimistic, confident self-actualizing individuals frequently place themselves in the zone of tolerable stress to meet challenging goals in their lives.

At some point the predator becomes so skilled that it requires all of the subject's attention to avoid being “caught” and shocked. When attacked by the skilled predator, the brain fear responses (amydala) are elevated, as is the brain response in the pre-frontal cortex to regulate the fear down to a reasonable level. Planning and problem-solving functions are intact, but diminished in effectiveness. At this point increasing stress erodes the mental resources of participants. The more focused people become on sources of stress and distress the poorer their choices become.

Finally the predator becomes so skilled that the subject cannot escape, and the subject gets repeated painful shocks. When attacked by the very skilled predator, the fear response is very high and unregulated by the pre-frontal cortex. Planning and problem-solving are overwhelmed. This is a typical response to severe threat that leaves individuals distressed and confused with no apparent means of escape.

This research illustrates how our minds and brains react to perceived threats. In real life these three points of mild, moderate and severe threats are not discreet but are on a gradual slope of threat appraisal, from minor to catastrophic. For the purpose of discussion and self- awareness, this slope can be represented as four general levels of stress with different levels of autonomic and emotional arousal. The lowest two levels represent parasympathetic dominance, and the highest two levels represent states of higher sympathetic activation.

The lowest level is passive relaxation, a state of physical and mental disengagement not represented in the study but important for mental well-being. This state is described as the relaxation response in the section on managing stress and distress. The next level is the state of active relaxation, a state of calm engagement with tasks. Most research subjects were in or near this state when they were able to play the predator game without any real perception of threat.

The third level is tolerable stress, a state of aroused engagement. When we perceive a mild to moderate threat, our self-defense systems are engaged to the point that we become preoccupied with it until it is resolved. We are exposed to feelings of stress along with other aspects of motivation, but are often able to use both our intuitive and rational abilities to avoid or resolve the threat. This is the level of stress that resourceful individuals appraise to be a viable challenge. It is the condition under which we solve most of our problems in life. The threat is uncomfortable, but the resolution provides relief, control and self satisfaction.

Living primarily in the state of chronic tolerable stress can still exact a destructive toll. Many individuals live in this state by choice or inaction, not realizing that they can choose to live differently. This is like playing with predators. Even if individuals in such situations and conditions can ignore the distress, their bodies are subject to persistent stress hormones and compromises to almost every aspect of their physical health. Preventative measures are based on early recognition and intentional regulation of stress and distress through the practices outlined later, all of which involve the recruitment of the thriving system.

The highest level is toxic stress, a point in threat appraisal where both reactive and rational-reflective abilities are acutely or chronically overwhelmed by stress and distress. At this point, escape from threat seems impossible and our situations seem hopeless. The fear response in the mind and brain rages, and our emotional regulatory responses from the prefrontal cortex are shut down. We are frozen by confusion and indecision from diminished reflective appraisal, compassion for others and problem-solving abilities. This can result over time in a nearly continual response to life through the self-defense system.

Individual Differences in Defensive Reactivity

Some people are rather immune to things that bother others. Different individuals respond to the same difficult challenges in life with different intensities and durations for multiple reasons. The first may be our natural temperaments. The personality research described earlier illustrated that the degree to which individuals differ in their defensive emotional reactivity to potential stressors is rather stable throughout life.

Another reason has to do with how much stress we have accumulated. When we are already stressed, our thresholds are lowered for an additional stressor through a stress accumulation effect. This is the danger in accepting a stressful life as one's condition, choosing lifestyles that keeps a person in a constant state of tolerable or intolerable stress, often by consistently avoiding solving difficult life problems. Tolerable stress is beneficial at times to get things accomplished or to engage in periods of growth or problem-solving, but it destructive as a prolonged state.

Another potential reason for differences in emotional reactivity is the potential effect of traumas. More recent findings verify that some unresolved traumas, particularly in childhood, can be so stressful that they permanently alter an individual's threshold to, intensity of and duration of stress. An outstanding study was conducted using interviews, tests and measures of stress hormones to see the interaction between childhood trauma, current level of depression and response to a mild social stressor. There are a number of standard social stressors that can be used in research that are similar to “one of your worst days at work”. They cause significant elevations in stress hormones for nearly anyone.

Two groups of women were subjected to one of these stressors. One group had reported childhood sexual abuse and current depression, and the other group reported neither. Current depression was an indication of unresolved distressing experiences. Measures of stress hormones administered before and after subjects were exposed to the social stressor were an indication of stress and distress at two points in time. The women in the abused-depressed group responded to the stressor with increases in stress hormone levels on average five times that of the other group. This shows how stress thresholds can be lowered and emotional reactivity elevated for very long periods of time when distressing experiences are unresolved, and individuals literally live defensively.

Even people who place a great value on thriving intentionally can experience unexpected traumas that result in post-traumatic stress that they find difficult to resolve psychologically. New medical therapies for post traumatic stress disorders and severe chronic depression are being tested that can reduce these effects. These include the use of special sugars that provide additional energy to brain cells under immediate traumatic duress, medications that block distress while re-examining traumatic events during psychotherapy, new medications that increase neurotransmitters and neuropeptides, and electrical stimulation of the vegus nerve. The point is, treatment for debilitating trauma is available and improving. At times, minds need to be treated with psychological therapies just as bodies need to be treated with medical therapies.

While most distressing experiences get resolved without intentional psychological work, even most horrific traumas, some can linger indefinitely if left unattended. It is certainly possible for individuals to be basically emotionally regulated, and still experience the effects of unresolved distressing experiences. Accepting this condition as our natural state undermines our potential happiness and satisfaction with life.

The effects of temperamentally high defensive reactivity, insecure attachments to caregivers, stress from unsolved problems, stress thresholds lowered by traumas, unresolved betrayals and other distressing experiences can combine and accumulate, throwing individuals into downward spirals. This can even occur in persons who are inclined toward good self-care and choices. But, downward spiraling undermines these personal resources.

Downward Emotional Spirals

The cumulative effects of defensive moods and maladaptive coping responses undermine physical, psychological and social resources. This has been referred to as a downward spiral that operates on negative adaptive cycles. Defending in one moment propels an individual to defend in the next by increasing his defensive reactivity and undermining the personal resources necessary to engage life challenges constructively. This creates self-perpetuating negative moods, and eventually pathologies such as chronic anxiety, depression and hostility. Maladaptive coping responses include experiential avoidance, rumination and blaming. These three self-defeating coping responses often occur together.

Experiential avoidance is the main coping response implicated through research in the maintenance and expansion of anxiety disorders. It is the process of suppressing one’s own negative emotions from conscious awareness, and avoiding people and situations which might trigger them. Through the process of generalization of fear from one situation to others experiential avoidance expands as persons spiral down, restricting them to increasingly narrower interactions with people and life opportunities. In most cases, anxiety disorders have been found to precede depressive mood disorders.

Rumination is the main coping response implicated in the maintenance of depression. Rumination about the past and worry about the future are highly related psychological processes experienced by individuals who are stuck in self-defensive loops without the problem-solving resources and/or will to take constructive action. Negative thoughts and feelings that were once controllable become automatic and intrusive. The individual then experiences the continual rehearsal of unresolved distress and catastrophic appraisal of past and future situations. Research shows that individuals in this downward spiral increasingly isolate themselves from others and become intolerable to those in positions to provide emotional support. We have seen that social isolation is an extremely stressful condition in life associated with serious physical and mental health problems.

Blaming is the main coping response associated with sustained hostility. Blaming is holding persons and situations responsible for anger and other distress that an individual is actually embracing for self-defense. The thoughts that accompany blaming generally sustain anger. Rumination that is driven by anger holds other persons and situations responsible for emotional, physical and other conditions in the person’s life. This happens in large part through negative attributions about the intentions of others. Angry moods then flavor all social interactions, even with persons to whom the anger is not intended. Blame generalizes into a general pessimism and distrust of others.

When spiraling down, challenges which most people can manage become threats. Life themes, beliefs and the thriving and defensive appraisal brain circuits become increasingly limited and dysregulated. The amygdala becomes progressively hypersensitive, overwhelming the ability of the prefrontal cortex to appropriately moderate or inhibit threat appraisal. Perspectives become increasingly negative and narrow, limiting access to psychological resources for problem-solving, emotional resolution and personal growth. The result is failure to thrive.

A meta-analysis of brain imaging studies of persons with diagnosed mood disorders illustrated the brain processes that underlie excessive defensive emotional reactivity and the inability to regulate it. In these studies, persons with mood disorders were found to have limbic structures including the amydala that remained hyperactive under generally low stress situations. Their cognitive-cortical structures including the pre-frontal cortex were hypoactive under both low and high stress conditions. These individuals have spiraled down to a chronic state of defensive reactivity with little cognitive-cortical resources to reflect adaptively in response to any stress.

Failure to thrive has been a recognized pediatric syndrome for many decades. It has been consistently observed in orphans that receive virtually no psychological care. This same condition can exist indefinitely or occur periodically throughout life. Failure to thrive can sometimes be attributed to major unresolved traumas, but is most often associated with the spiraling down into stress and distress associated with living defensively for extended periods of time.