Every so often I meet a patient for the first time where I am challenged to how best to work with them. Usually, it may be because they are quite young – in their teens – or they may have some mild intellectual impairment which means I must modify the materials I use to demonstrate some of the concepts I believe are important to discuss, such as arousal and anxiety.
This happened last week when I met a teenager for the first session where my task was to work with his social anxiety.
As it turns out, my seeking ways to explain to him and his family the concept of the stress response, including the biology of the flight and freeze threat response, led me to Adele, the pop singer.
For fear of flying and other disorders of vigilance and avoidance, preparation such claustrophobia, acrophobia (fear of heights) and so on, my re-purposing of a YouTube video featuring Adele might be useful.
There’s a video now available which features Adele and Graham Norton of the BBC where the singer impersonates herself as a nanny called Jenny. She has joined other impersonators who actually are very good singers who front cover bands entertaining others at functions singing Adele’s hits. In the original YouTube video officially released by the BBC in November 2015, we see a version of events which are very entertaining. Adele has undergone some makeup prosthetics (chin and nose) and it is quite some fun waiting for the impersonators to catch on to “Jenny’s” true identity.
But in mid-December, an extended version was released and it is a much more satisfying video to watch.
The original, with a still shot below, has garnered over 42 million views at the time of writing.
However, this unofficial version which may be removed for copyright reasons has about 400,000 hits at the time of writing and hopefully when you read this article is still up, below. Watch it in its entirety then come back to this article so you can see why I am writing about it, and what you can learn.
Quite the emotional experience, wasn’t it, to watch her fans and emulators be surprised and then delighted for what will be an event they will never forget, especially now that it has been recorded by the BBC and is on YouTube.
So, in what way might this video be useful in working with anxious patients?
One of the important aspects of the work I do is guide patients to understand the biology of the fear/threat response and why it feels the way it does, and causes them to act the way they do. The idea behind this is to de-emphasise the “fear of fear” response and to be more accepting of the normality of the response itself, especially when it is to things the patient knows shouldn’t bring it on: “I know all the safety statistics about flying (or elevators or tunnels, etc.) but I still can’t help myself”.
The idea is to present patients with information about what goes on “under the hood”, so to speak, when our threat response systems are activated. Unless we have trained very hard to react differently, we are likely to continue to react to things in our environment we have learnt elicits a threat response. When we get better at reacting faster to lesser stimuli, it feels as if we’re getting worse over time not better.
The four automatic threat responses
I have previously written about the four characteristic automatic threat responses: flight, freeze, fight and appease. All of these bring on automatic bodily shifts in preparation for dealing with perceived threats. When the perception is strong and rapid, there is very little time for the thinking part of the brain – the pre-frontal cortex – to do its job of finding rational solutions. Instead, older parts of the brain (in evolutionary terms) which we share with other mammals kicks in, and relays messages to those parts of the body and brain enabling those four automatic responses to activate swiftly.
You can see a number of those responses activate in the “Jenny/Adele” video I have linked to.
Let me go through the responses, so you can see that these responses can be elicited not so much when a threat is perceived but also when an unexpected event occurs – “OMG, I cant believe it – it’s actually Adele” – which takes us utterly by surprise and is a significant test of reality!
Things to look for in the Jenny/Adele video
- If you watch the video again (the extended version) the first person shown twigging it’s actually Adele on stage is an Adele impersonator by the name of Talullah Windmill (Facebook page link). While her neighbour on her right keeps denying it’s Adele, many people on the YouTube pages have described Talullah’s reaction as “classic” and one of the most memorable parts of the prank video. The sequence of stills below starts at 6:25 into the YouTube video, where the reaction changes from an expectant smile to one of “hold on a minute – something’s not quite right”, below:
- But then in just a quick moment, it becomes apparent – remember, these impersonators have studied Adele’s voice and mannerisms to the nth degree – that Talullah has twigged it’s Adele onstage. Notice below that in an instant she reaches across to the woman to her left with her arm. It’s such an abrupt unexpected action, that her companion’s gaze is distracted away from Adele on stage, to looking down at the arm which is reaching across her. Talullah’s automatic reaction is similar to that of the car driver reaching out with their arm across their passenger in an emergency break, when both hands should be on the wheel.
- I call this the Indiana Jones reaction, after a scene in one of the later films in the series when Indie’s son is about to run ahead of him into likely danger, and Indie reflexively reaches out to pull him back. Think about this for a moment. What possible evolutionary significance is there in reaching out having recognised it’s Adele on stage? And doing it in a way that causes your neighbour to shift their gaze to you?
Clearly, none. Or so it would appear…
But there is an advantage in steeling yourself, frozen in disbelief, when your reality is being sorely tested. This is not the time to go running around in circles, panicked, perhaps putting yourself in real danger. No, what we are witnessing is a momentary loss of composure when a new reality emerges. Talullah knows Adele’s voice so well – and the real Adele is singing like the real Adele – that whatever blindness she and the other impersonators had to Adele’s heavily made up appearance can not be sustained. Adele’s voice breaks through Talullah’s role as an Adele impersonator watching other impersonators and the video beautifully captures this moment, as I hope I have in the screenshot above. This is why so many commenters praise this moment as the one they like watching over and over again.
It’s also why those YouTube videos of talent show competitors surprising the judges and the audiences garner so many hits – we see assumptions smashed (think Paul Potts and Susan Boyle) when our realities are tested and adjusted. If you look at the judges and the audiences in those videos you see very classic open mouth, suck in air, moments of disbelief, as you can see in the still of judge Amanda Holden during the singing of a performance-anxious Jamie Pugh (2009), below:
- These are very stereotypical behaviours that cut through any role playing and we get to see an honest expression of wonderment. As a new reality is assessed and accepted, behaviour changes and in the case of Talullah, she can embrace the moment even while the other impersonators are still trying to work out what’s going in, as shown below:
Next to her, another Adele impersonator, with a very good voice herself, has overcome her apparent anger at being fooled (go back to the video and keep an eye on her range of emotional expressions) and is now overwhelmed with emotion at being in the presence of someone she so admires.
What does this all mean?
Freezing, when we reset our measures of reality, seems to be very hardwired into humans, as well as other mammals we share certain areas of brain real estate with. It can save us from being panicked and running into a pack of predators, and it can serve to buy us time while we work out what’s really going on.
It can occur under all manner of threats, both physically (“what was that noise, movement, sight…?”) and psychologically (“I can’t really believe this is happening to me…”).
My task, as an anxiety specialist, is to assist patients and performers I work with understand this important part of human behaviour and prepare for it. This requires practice and rehearsal and a set of tools such as diaphragmatic breathing, focusing strategies and cognitive restructuring – what you say to yourself that better suits the task – so as to reduce the delay before you take action and reboot your performance, such as we see in the Adele video where at 5:30mins she seems to miss her cue to start singing.
This in stage magician terms, is a misdirection, and it also occurred earlier when Adele feigned being ill, perhaps from stage fright. This of course only accentuates the false belief that it’s not Adele on stage, but an impersonator – “the real Adele would never miss her cue” – and it reinforces the surprise when the reveal actually occurs.
If what you’ve read appeals and you’d like to discuss with me how I could assist in your own anxiety issues, email me <firstname.lastname@example.org> or ring +61 413 040 747.