Resources and Learning  Article 

Chaos or calm – how to rewire your stress response 

An article by Carrie Demers MD – Yoga International Magazine 
Remember the tale “The Lady or the Tiger?” As it ends, the hero is standing before two identical doors: one conceals a beautiful maiden; the other, a ferocious tiger. The hero must open one of these doors—the choice is his—but he has no way of knowing which will bring forth the lady and which will release the tiger. 
I’m sometimes reminded of this story when a patient is describing one of the symptoms of chronic stress: headaches, indigestion, ulcers, tight muscles, high blood pressure, or some combination of these. When I point out that the symptom is stress-related, the patient seems resigned—stress is such a constant in most people’s lives that all the doors seem to have tigers lurking behind them. Most of the people who find their way to my office know the fight-or-flight response is hardwired into our nervous system and many have come to accept a constant feeling of tension as normal, even inevitable. 
It isn’t. Like the hero in the story, we have a choice. There is another door, another response to the challenges of everyday living that is also hardwired into our nervous system. And unlike the hero, whose destiny rests with chance, we can discover which door is which. A general understanding of the nervous system and how it responds to stress, coupled with training in three fundamental yoga techniques, make it possible for us to distinguish one door from the other. Practicing these techniques gives us the power to choose the lady while leaving the door that unleashes the tiger firmly closed. 


The problem is that for many of us the fight-or-flight response rarely switches off, and stress hormones wash through the body almost continuously. 
The source of our stress is psychological rather than physical—a perception that something crucial to us is threatened. 
Fear of the unknown, major changes in our circumstances, uncertainty about the future, our negative attitudes—all these are sources of stress. Today we worry more about our jobs, our relationships, or getting stuck in traffic than we do about fighting off a wild animal, but even though the perceived threat is psychological, it still triggers the archaic survival response. 
The upshot is that our bodies are in a constant state of tension, ready to fight or flee, and this causes a host of physical problems. You can see what some of these are if you look again at what happens when adrenaline courses through the body: elevated blood pressure, rapid shallow breathing, high blood sugar, and indigestion. What is more, adrenaline makes our platelets stickier, so our blood will clot quickly if we are wounded. This increases our chances of surviving a physical injury—but chronically sticky platelets are more apt to clot and create blockages in our arteries. And this sets the stage for a heart attack or a stroke. 
The damage doesn’t end there. When we are constantly in fight-or-flight mode, the adrenal cortex begins to secrete cortisol, a steroid whose job is to help us adapt to a prolonged emergency by ensuring that we have enough fuel. Cortisol acts on the liver and muscle tissues, causing them to synthesize sugars (glucose) and fats and release them into the bloodstream. From the body’s viewpoint, this is a reasonable response—dumping fat and sugar into the blood will help us survive a shipwreck, for example. But when this fuel is not metabolized in response to prolonged physical duress, disease results. Excess sugar in the bloodstream leads to diabetes, and excess fat to high cholesterol/high triglycerides. Both conditions boost our chances of developing heart disease. 
The steroids cortisol and cortisone quell inflammation in autoimmune diseases and asthma, and so are useful when used infrequently and for brief periods, but their constant presence in the bloodstream suppresses immune function. This causes the white blood cells—those hardy defenders against bacteria, viruses, cancer cells, fungi, and other harmful microorganisms—to become sluggish. And this makes us more prone to disease, especially cancer and chronic infections like Lyme disease, hepatitis, and the Epstein-Barr virus. 
Sounds grim, doesn’t it? It is. It’s a tiger. A chronically activated sympathetic nervous system keeps the body under constant pressure. If we ignore early warning symptoms—tight shoulders, digestive upset, recurring headaches, an increasing tendency to lose our temper or become easily upset—sooner or later the tiger will tear us up. But we can make another choice. The autonomic nervous system has another component, the parasympathetic nervous system. Rather than living under the tyranny of a ramped-up sympathetic nervous system, we can learn to trigger the parasympathetic system, the rest-and-digest response, instead.Just as the fight-or-flight response automatically kicks in at the threat of danger, the rest-and-digest response automatically responds to our sense of equilibrium. 
Just as the fight-or-flight response automatically kicks in at the threat of danger, the rest-and-digest response automatically responds to our sense of equilibrium. When it is activated, the heart rate drops, blood pressure falls, and respiration slows and deepens. Blood flow to the core of the body is reestablished—this promotes good digestion, supports the immune system, and infuses us with a sense of well-being. 
We unconsciously achieve this state on vacation, in the throes of a hearty laugh, or in deep sleep. It feels good, and it offers a much needed respite from the hectic pace we set for ourselves. But we have come to accept stress as the norm and to expect the feeling of relaxed well-being to come about only sporadically—and so it does. We release the tiger a dozen times a day, even though the other door is also there in every moment. Once we learn to open it at will, we can override the harmful habit of triggering our stress response by activating the rest-and-digest component of our nervous system instead. 


I use a variety of natural therapies in my medical practice, but the basic treatments are drawn from yoga—stretching, breathing, relaxation, and meditation—and these techniques are especially effective when it comes to managing stress. You already know from personal experience that aerobic exercise is excellent for dissipating stress-created tension, and that sugar, caffeine, and spicy food contribute to jangling your nervous system and shortening your temper. You are probably also familiar with the relaxing effects of practicing yoga postures—they teach us to move and stretch our tense, strained bodies and to focus on the breath. But do you know that breathing slowly and deeply is the easiest way to activate the rest-and-digest system? That is one reason yoga classes are so popular—they soothe frazzled nerves and quiet anxious minds. But yoga also works at an even deeper level: it reestablishes healthy breathing patterns, teaches us to relax consciously and systematically, and gives us the opportunity to explore the inner workings of our minds through meditation. These techniques—both separately and in combination—nourish and strengthen the parasympathetic nervous system so that the relax-and-digest response becomes our normal mode. The fight-or-flight response is then reserved for emergencies, as nature intended. So let’s take a look at some ways we can open Door Number Two. 


Of all the processes regulated by the autonomic nervous system (heart rate, blood pressure, secretion of gastric juices, peristalsis, body temperature, etc.), only breathing can be controlled consciously. And in doing so, we stimulate the branch of the vagus nerve that innervates the diaphragm (which carries a message to the other vagus branches and the brain) to activate the entire rest-and-digest response. This is why the first step in reversing our chronic stress response is to learn to breathe again the way we were born to breathe. 
If you haven’t been trained in diaphragmatic breathing, find an experienced teacher and practice every day until it once again becomes a habit. Then, as you develop the skill of breathing from the diaphragm in the course of your daily activities, you will begin to experience your breath as a barometer for the nervous system. As long as you are breathing deeply and from the diaphragm, you will find that you can access a feeling of calm and balance even when you are confronted with an unpleasant situation. And you will also notice that if you allow your breath to become shallow by breathing from your chest, anxiety creeps in, your muscles tighten, and your mind begins to race and spin. When this agitated breathing is prolonged, it creates an unsettled and defensive outlook on life. Once you know this from your own experience, you can make a different choice. 


When you are first learning to meditate, the mind will wander away from the object of meditation to dwell on some other thought. This will happen again and again. Your job is to gently and repeatedly bring your attention back to your object of meditation, and to do it patiently, without judgment. Sometimes it may seem as if the distracting thoughts are like movie images projected onto a personal viewing screen in your mind. And some may be strange and wild. But you are in the rest-and-digest mode, and as strange as they are, your projections don’t trigger the fight-or-flight response. The ability to simply observe them is evidence that they aren’t you. And the ability to distinguish between the inner observer in you and the chaotic jumble in your mind means that you can respond with equanimity, rather than react and flood your body with stress hormones. 
The more we practice meditation, the more we will be able to discriminate between what is real and what is not—between what is truly life-threatening and what is just a habitual overreaction. And once we begin to see that almost everything that triggers our sympathetic nervous system is merely a habitual overreaction, we can begin to make different choices. Instead of reacting to an unpleasant event, we can cushion the jarring effect on our nervous system by observing it in the same way that we observe our mental chatter in meditation and by consciously breathing from the diaphragm. 
This is likely to prove challenging in the beginning. When your spouse or a coworker snaps at you, you may find yourself halfway into an angry retort before you notice that you have switched to chest breathing. Then you need to remind yourself to breathe from the diaphragm and to find a neutral vantage point. But this skill comes with time, particularly when you are sitting for meditation regularly, practicing diaphragmatic breathing, and punctuating your day with a systematic relaxation practice. And as you choose to activate your rest-and-digest response consciously and continuously, you will find yourself in fight-or-flight mode only when your car skids on a patch of ice or the cat knocks over a candle and sets the curtains on fire. Your health will improve, to say nothing of your outlook on life. You have learned to choose the right door. 
Carrie Demers, MD – Himalayan Institute 

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