“A man’s body and his mind, with the utmost reverence to both I speak it, are exactly like a jerkin, and a jerkin’s lining; rumple the one, you rumple the other” (Laurence Sterne).
When we experience intolerable anxiety our minds and bodies react in a variety of ways.
We may feel overwhelmed, like we’re losing control, become easily angered, irritable and frustrated.
We might begin to feel bad about ourselves.
Physically we can experience unpleasant symptoms.
We may be troubled by headaches, stomach pains, nausea, chest pain or rapid heartbeat.
We can experience unexpected aches and pains.
We might experience sweating, a dry mouth or difficulty swallowing.
Sometimes people are unaware that they are clenching their jaws and grinding their teeth, perhaps in sleep.
Insomnia can be common.
We become more prone to frequent colds and infections.
Libido can diminish and we may be constantly tired and lacking in energy.
Socially, we can become difficult to live with.
Sometimes we become snappy and temperamental; at others we may withdraw socially and find it easier to hide away.
Sometimes people around us will notice our anxieties and realise that maybe something is wrong.
Commonly, lawyers will carry on as normal and do their best to contain uncomfortable emotions.
We’re used to keeping a stiff upper lip.
In order to look after our clients, we must first look after ourselves.
Any sign of weakness could be seen as a chink in the armour and might work to our professional or tactical disadvantage.
Andrew kept things to himself.
The pressure built up until he was forced to admit, after some probing by the GP, that things were not as he would wish them.
In addition to the physical discomfort, what troubled him more was the loss of the sense of control both emotionally and in his thinking.
He was alarmed when he experienced his ‘thoughts scrambling’ in court.
Neuro acting and reacting
The cognitive changes that are brought about by cerebral processes in situations of extreme stress are remarkably complex.
Part of the neurological sequence goes something like this.
Neuromodulator hormones are released in the peripheral and central nervous system during stress.
These ‘turn on’ our heart and muscles and ‘turn off’ the stomach to prepare for flight or fight responses.
At the same time the brain may turn on a structure called the amygdala and then turn off the prefrontal cortex (a higher cognitive centre.)
This allows posterior cortical and subcortical structures to control our behaviour.
The amygdala is known to be central for the expression of emotion and the formation of associations between stimuli and emotions.
The prefrontal cortex inhibits inappropriate responses or distractions and allows us to plan and organise effectively.
High levels of the neuromodulators exert opposite actions on these brain regions.
Stimulation during periods of stress activates the amygdala and improve memory consolidation.
During stress the amygdala also induces increased hormone release in the prefrontal cortex.
However, in contrast to the facilitative actions in subcortical structures, high levels of hormonal release in the prefrontal cortex results in cognitive dysfunction.
Exposure to mild to moderate uncontrollable stress impairs prefrontal cortical function.
Sometimes a person then feels they have no control over the stress.
Simple routine functions can be performed quite satisfactorily, but anything requiring complex thought and imagination becomes difficult or impossible .
These two ways of reacting to stress can be both useful and unuseful.
If I’m in immediate physical danger then the instinctive flight or fight response will help me to survive or avoid harm.
But it doesn’t help when there’s no actual physical danger and I need my prefrontal cortex to regulate appropriate thinking and acting …
 Arnsten, A. F. T. (1998) Neuroscience: The Biology of Being Frazzled, Science, 280, 1711-1712.
(This is an edited excerpt from my book A Lawyer’s Guide to Wellbeing and Managing Stress published by ARK Group in 2015.)