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What would it be like to live in a world in which everything you imagined became true? Your world was once like that. Until around three, children experience imagination as though it were real. Psychological theorist Peter Fonagy calls this state—in which imagination and perception are experienced as if they were the same—“psychic equivalence.”
Think of a four-year-old and a two-year-old playing together. The older child says, “Let’s pretend we are in the jungle. There are lions and tigers. They are going to try to catch us and eat us. Look. There’s one! He's after us! Run!”
To pretend, a child must be aware enough of his mental processes to sense a difference between what he imagines and what he perceives. Aware of "making them up," the older child knows the predators are not real. The younger child also made the animals up. But, not yet aware of his mental processes, the lions and tigers in his mind are as threatening as a real predator would be to his older playmate. Terrified, he runs for his mother to save his life.
When my daughter was very young, she told me she couldn’t sleep because of a panther in the closet. I told her there was no panther. She was sure it was there. I searched the closet as she watched. I told her, "See, no panther." She insisted it was still there. She got out of bed and we searched the closet together. But, when back in bed she said, “It’s still there.” Finally—and I don’t know where this idea came from—I said, “Would you like the panther to snuggle up with you in bed?” She smiled. “That would be fine,” she replied.
To me, the panther was imaginary. To her, the panther was real. In the closet, it was threatening. In her arms, warm and cuddly, it comforted her. She fell asleep. Such is the psychic equivalence world of a child.
Around the age of three, we begin to observe and to think about our own mental processes. This ability, called metacognition or reflective function, allows us to distinguish imagination from perception. It allows us to recognize that what is held in the mind may be different than what is real in the environment. As an adult, stress can disable reflective function. When it does, the adult regresses instantly—but unknowingly—to childlike psychic equivalence.
Healthy executive function deals with probability. To estimate the outcome of a course of action, executive function must produce an internal mental representation of the external physical environment together with its risks and rewards. In addition to navigating the environment, to deal well with other people, we must generate a workable internal representation of what is in their mind.
In psychic equivalence, as the mind shifts from perception to imagination, it no longer produces an accurate representation of the environment. We stop experiencing what is in the mind as a representation of the physical environment. We mistakenly experience our distorted mental representation of the environment as the physical environment.
When stress hormones cause psychic equivalence during flight, what we fear might happen is experienced as happening. For example, fear that the plane might fall is transformed by psychic equivalence into terror that the plane is actually falling out of the sky.
When planning to fly, thoughts of crashing may enter the mind. To some, crashing is too improbable to merit serious consideration. Others, though, cannot set thoughts aside based on improbability. To set such thoughts aside, safety must be absolute; the outcome must be certain; otherwise, they must be in control or able to escape. Though driving is less safe physically, it feels safer emotionally; it offers a feeling of control at the wheel. If there is an accident, escape seems possible. The person can imagine walking away from a car crash. But, not a plane crash.
With images of his own plane crashing firmly in mind, the amygdala releases stress hormones. Though the person is making these images up, when stress hormones have shut reflective function down, these scenes are experienced - not as conjecture - but as what is sure to happen.
The phobic flier's expectation based on psychic equivalence is very different from expectation based on probability. To accurately represent probability, imagine a highway billboard divided up into forty-five million squares, one millimeter by one millimeter. One of the squares is blacked out to represent the crash That square is surrounded by 44,999,999 unmarked squares. One blacked out square surrounded by 44,999,999 unmarked squares is an accurate mental representation of what a person should expect when they consider taking a flight. (Details at this blog at Psychology Today.
The anxious person's mental representation of a one-hundred percent probability of disaster triggers the release of stress hormones. The hormones force the person to remain focused on what is visualized. This, in turn, triggers the release of more stress hormones. If reflective function is vulnerable, this vicious cycle quickly causes psychic equivalence. Every vividly imagined threat - like the panther in the closet - is experienced as life-threatening.
Arousal, fear, and danger are different. Normal response to arousal is curiosity. Fear develops only if some threat is identified. But, in PTSD and in phobia, the three are welded together. If psychic equivalence takes place as arousal, fear, and belief there is danger are being experienced simultaneously, the three fuse together. Thereafter, arousal automatically triggers fear, and fear is automatically accepted as proof life-threatening danger exists. Thus, when stress hormones are released by thoughts of flying, the mind is led directly to mortal danger. The person “just knows” that if they fly, their plane will crash. Comments posted by an anxious flier on the www.fearofflyingmessageboard.com are an example.
I’m an engineer. I usually don't believe in the idea that someone can predict the future, however, my fear overdrives my logic and I now think my intuition is saving me from death. A few days before the flight, I can see/feel what's going to happen. I'm going to be on a flight that'll crash. Things trigger me thinking that I'm going to be on a flight that'll crash. It can be anything that pops up on my phone, an article, etc. For example, the TV show "Why Planes Crash.” I know this show comes on a lot, but I think, 'Oh, am I seeing this because my plane is going to crash?” I understand these stories and TV shows are out there, but for some reason before my flights, they take on a whole new meaning.
Over one-hundred years ago, two Harvard psychologists, John Dodson and Robert Yerkes, found high levels of stress hormone cause some mental processes to shut down. One of the vulnerable processes is reflective function, defined by Fonagy and his associates in Affect Regulation, Mentalization, and the Development of the Self, as looking inward at ones own mental processing. Reflective function examines our take on reality. It senses the difference between imagination and perception. The physical eye perceives grass as green. The mind’s eye can imagine grass of any color. Ordinarily, we sense differences between perception and imagination. When stress hormones force reflective function off line, we slide—completely unknowingly—into psychic equivalence. Imagination by the mind's eye is mistaken for perception by the physical eye.
I have a rational, logical thinking mind 99.99% of the time. I understand how to take in my surroundings and know I'm safe, how a plane works, etc, but my emotions get a hold of me and make me think so irrationally and make myself believe it before and during a flight.
Not everyone possesses strong reflective function. Persons with well-developed reflective function look inward, are aware of mental processes, know their "take" on reality is fallible, and understand a constant critique is needed if what is "in here" in the mind is to accurately represent what is "out there" in the world around them. Strong reflective function, according to Fonagy, is a “hard-won developmental acquisition” that “grows out of interpersonal experience.” If ones reflective function is robust, psychic equivalence occurs only when stress hormone levels are quite high.
If a person who looks inward less, reflective function is weaker and more vulnerable to stress hormones. When free of stress, the person does not mistake imagination for perception. But, when reflective function is not a person's strong suit, the distinction between imagination and perception is lost with a relatively slight increase in stress hormone level.
From the point of view of someone observing them, the person don't just slide into psychic equivalence; it is like a switch has flipped. A moment ago, they made sense. Now they are saying things that are off the wall with no awareness of the distortion.
Waiting in the boarding area, I met the captain. He smelled of cigarette smoke. Smoking is a heart attack risk. He's going to have a heart attack and die on my flight.
From their own point of view, their "take" on reality is infallible. They are simply right. If others see it another way, they are wrong. With self-reflection completely absence, they are unaware that they are in a state of psychic equivalence.
Fonagy suggests that people with good self esteem may have as many negative thoughts about themselves as people with poor self-esteem. The difference in self-esteem may be due to how easily psychic equivalence takes place. When a negative self-image thought comes to mind, it triggers stress hormones. If reflective function is weak, psychic equivalence causes acceptance of the negative thought as fact. On the other hand, a person not prone to psychic equivalence would regard the thought as merely conjecture.
If we apply this dynamic to flying, an anxious flier may have no more thoughts of crashing than a confident flier. The pivotal difference is the strength of their reflective function. When the thought “what if something goes wrong with my plane” releases stress hormones, weak reflective function collapses; psychic equivalence transforms concern into catastrophe. The catastrophic thinking typical of phobia may be due to weak reflective function. When weak reflective function fades, what others dismiss as highly improbably is seen as likely. What others consider a slight possibility feels seriously threatening. If reflective function is highly vulnerable to stress hormones, instead of fading, it collapses. Psychic equivalence becomes total, and translates the mere thought of disaster—no matter how remote—into certain disaster.
If a person who usually doesn’t wish me a safe flight, wishes me a safe flight—I know this sounds weird—but in my head I'm wondering why are they saying it this time and not all the other times. Illogical/irrational, I know. It sounds crazy to me too, but days before a flight, I guess I'm not thinking rationally.
The person who falls precipitously into psychic equivalence has “panthers in closets” everywhere. When imagination masquerades as reality, life can be a waking nightmare. “Psychic equivalence,” says Fonagy, “can cause intense distress, since the projection of fantasy to the outside world can be terrifying."
Psychic equivalence causes flying to be experienced by anxious fliers as one life-threatening event after another. During takeoff, it causes the belief that the pilots can’t get enough power for the plane to get off the ground. Once in the air, the plane seems to be going up too steeply and thus may fall back to the ground. When engine power is reduced during routine noise abatement, the engines seem to have failed. Light-headedness as the rate of climb is reduced triggers belief that the plane is falling.
Psychic equivalence can make a stress-induced increase in heart activity equal a heart attack. A stress hormone produced urge to breathe faster that is possible may be experienced as suffocation. Changes in self-awareness are experienced as being of control or of going crazy.
And probably the worst, I think that if I get over my fear of flying that I've given the flight permission to go wrong.
What can we do? Two things. One is to work on strengthening reflective function. Doing so is a struggle. Remember, Fonagy said reflective function is a “hard-won developmental acquisition”
A. Looking back at your mind when stressed, are you now aware that you then were not critiquing what was in your mind? Can you now see that what you accepted as real may not have been real?
B. Looking back, are you now aware that, though arousal caused an increase in heart rate, the heart rate was considerably lower than when engaging in sports or a workout at the gym, and thus was not a threat?
C. Looking back, are you now aware that arousal caused temporary psychological changes that—regardless of what you thought at the time - did not mean you were going crazy, or losing control?
D. Looking back, are you now aware that your thoughts are fallible, and the belief that your flight would crash was the result of thoughts accepted at face value?
E. At this point, do you recognize that your thoughts, beliefs, fears, and expectations have no effect on a flight, whether it is yours or another person’s?
F. Though arousal is just arousal, it gets so tightly linked to fear and to the belief that there is danger that arousal, fear, and danger feel like the same thing. In your day-to-day living, when arousal occurs, can you notice a moment before it becomes fear? And, can you notice a gap before fear equals danger?
G. Since something awful has happened to someone, sometime, even years ago, psychic equivalence of it happening to them is accepted as if it were - not just a remote possibility - but a probability or a near-certainty if they fly.
I know this is extremely unlikely. I absolutely understand that. But, there are people who have gotten on planes that DID experience an accident or problem, so it IS possible this could be my experience as well.
Recognize the language that justifies psychic equivalence: the words
- "do"
- "did"
- "could"
- "is"
- "all the time"
Anxious fliers legitimize their fear by saying, "Planes do fall out of the sky. They do disappear without a trace. It happens all the time. It could happen to my flight." But using this language, improbability becomes possibility; possibility becomes probability; probability becomes near-certainty; and in some cases near-certainty becomes belief it will happen.
As to the panther, my young daughter could have said, "But, it could happen. Panthers do exist. Animals do escape from the zoo. It happens all the time. If a panther escaped from the zoo, it could hide in my closet."
H. Think of executive function as your "Inner CEO." Your Inner CEO's job is not to determine what could happen. What could happen is irrelevant for two reasons. First, almost anything could happen. Second, no creature can survive if it avoids all activity in which something bad "could" happen. The creature would not be able to eat or to sleep. Some food could cause death. Falling asleep could mean being unaware of danger.
Your Inner CEO's job is skillful prediction. Executive functions exists to predict what is and is not likely to happen, and to determine your behavior accordingly.
Now that you see how excursions into psychic equivalence are incorrectly justified by what could happen, can you give up the notion that what you experienced in psychic equivalence is justified?
I. Psychic equivalence is like temporary schizophrenia. A person suffering from schizophrenia is more likely to recover if they can recognize that what they experienced during a schizophrenic state was self-generated. For example, the voice they hear and believed was some other person's was self-generated.
Similarly, a person who suffers from thoughts of their plane crashing is more likely to recover if they can recognize what they experienced was self-generated.
Now that you know about psychic equivalence, look back and recall a time when you experienced it. Though you could not use your reflective function at that time, you can now. If you can reflect back and see that your take on reality was erroneous in these ways, you increase the likelihood that your reflective function will remain online when stressed in the future.
The ultimate goal is to sense the potential onset of psychic equivalence quickly enough to step outside of it. SOAR was the first fear of flying program to employ arousal control tools based on Cognitive Behavioral Therapy. The most of important of these tools was an understanding of psychic equivalence. At that time, we referred to it as "going into your own movie." Once taught to recognize the onset of psychic equivalence, some clients were able to step out of it. Others - those whose reflective function collapsed quickly - were not able to use this tool. Now, because we are able to inhibit the release of stress hormones when flying, we can protect reflective function well-enough for this tool to be useful in all cases of flight phobia.
Click here to view a video used in the SOAR Course to teach clients about psychic equivalence and how to increase reflective function, though we refer to it as "going into your own movie."
Second, we can reduce stress hormone release, and by doing so, protect reflective function. Identify situations that trigger stress hormone release. Break down the situation into its components. Link each trigger to the memory of an oxytocin-producing experience. Oxytocin inhibits the release of stress hormones.
Link each trigger to the memory of the presence of an attuned, non-judgmental person. This overrides the effects of stress hormones; it slows the heart rate and activates the parasympathetic nervous system.
By inhibiting the release of stress hormones, and by overriding the effects of stress hormones, reflective function is better protected, and may more easily stay online and prevent psychic equivalence. This procedure is used in the SOAR courses. and detailed in the book SOAR: The Breakthrough Treatment for Fear of Flying.
