Beyond the False Alarm: Rethinking Anxiety with Joseph LeDoux's Research
Recently, I rewatched a video I had saved featuring the work of neuroscientist Joseph LeDoux. His research challenges many of the core ideas we were taught about fear, anxiety, and the amygdala’s role in therapy.
This isn’t new research. But I find value in returning to older material to test my assumptions, revisit what I’ve internalized, and ask whether it still aligns with what I know today. Sometimes, that process reveals small shifts that make a big difference in how I practice.
As I watched, I found myself asking: What does this change about how I speak to clients?
If you're interested in the full breakdown, I’ve linked my detailed notes [here]. But what struck me most was this central distinction:
Fear and anxiety are not the same — and the amygdala doesn’t create the feeling of fear.
Fear is a survival response. It is fast, automatic, and driven by the amygdala. It prepares the body to freeze, flee, or fight in response to immediate danger. Anxiety, on the other hand, is constructed. It emerges from how the cortex interprets, predicts, and assigns meaning to possible threats, often in the absence of actual danger.
That difference matters.
Many therapy frameworks still rely on outdated models that frame the amygdala as the emotional center and the cortex as the rational override. But this binary oversimplifies how emotions actually work. It can lead us to misunderstand anxiety as purely reactive or irrational, rather than recognizing it as a complex experience shaped by both bodily responses and higher-level meaning-making. In doing so, we risk minimizing the depth and nuance of what our clients are truly feeling.
How This Shows Up in the Therapy Room
Example 1: Jumping to Cognition Too Soon
A client describes racing thoughts, chest tightness, and dread about an upcoming meeting.
A common therapeutic response might be, “Let’s challenge the thought. What’s the evidence that something will go wrong?”
But if their nervous system is still in a survival state, this can feel invalidating. The client may not yet be in a state where reflection is possible. LeDoux reminds us that these sensations aren’t just thoughts gone wild — they’re survival responses, and safety has to come first.
Therapeutic shift: Start with grounding or co-regulation before moving into cognitive work.
Example 2: Misunderstanding Anxiety as Irrational
A teenager avoids driving after being involved in a car accident. Their therapist says, “Logically, you know it’s safe now. Your fear isn’t rational.”
But the amygdala isn’t interested in logic. It’s responding to cues of past danger. Anxiety often makes sense when we understand how survival circuits, memory, and prediction interact.
Therapeutic shift: Normalize the body’s response, then gently explore what meaning the client has made of the experience.
Here Are Three Examples from My Office Where I’ve Started to Use This Info Immediately
Example 1: “It’s just a false alarm.”
What it sounds like: “You’re reacting like you’re in danger, but you’re not.”
What it might imply:
Your nervous system is mistaken
You should ignore your body's reaction
What I took from LeDoux:
The reaction isn’t “false” — it’s fast. The amygdala is responding the way it learned to in past situations that felt dangerous. Even if the current situation is different, the body still reacts based on old patterns it hasn't had a chance to update yet.
The new way I’ll frame it:
“Your body responded before your brain had a chance to catch up. That’s not a mistake — it’s part of how you’ve learned to stay safe. Let’s work with that.”
Example 2: “Let’s reframe the thought.”
What it sounds like: “If we change how you think, we can change how you feel.”
What it might imply:
The problem is in your mindset
Logic will override anxiety
What I took from LeDoux:
By the time a person notices the anxiety, the body has already launched into a response. The cortex is playing catch-up, trying to make sense of the signal. Thought work can help, but only after the nervous system is regulated enough to receive it.
A new way I’ll frame it:
“Let’s notice what your body is doing before we go into meaning-making. That might give us more clarity about what kind of support you actually need.”
Example 3: “We can train your brain not to be afraid.”
What it sounds like: “If you face the fear enough times, it’ll go away.”
What it might imply:
Pushing through discomfort = healing
Fear is the problem
What I took from LeDoux:
Fear memories don’t disappear they can be updated, layered, or softened by new learning. Avoidance isn’t always resistance. It’s often a strategy developed to survive. That deserves respect, not erasure.
A new way I’ll frame it:
“We’re not trying to delete this reaction. We’re creating space for new experiences that feel safe enough to matter.”
What This Reframing Allows For:
We stop treating survival responses as something to override
We pair somatic and cognitive tools more intentionally
We get clearer about where emotional safety fits in our sequencing
LeDoux’s work doesn’t give us a new script; it gives us a better lens.
For me, it’s been an invitation to stay curious, slow down, and ask different questions.
I always strive to improve my work with anxious clients, and this workshop prompted me to think about it so much that I wanted to share my insights.
Who am I?
Kristen McClure.
I am a therapist with 30 years of experience who loves learning and connecting with the community.
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Thanks for Reading.
Important to recognize that an inexact assessment of a threat, an “ over-reaction” to a perceived threat is not a “mistake.” It is a survival advantage. If I over-react to a perceived threat and am wrong in my assessment, well, I might get embarrassed. But if I UNDER-REACT to a perceived threat and am wrong, I may be DEAD! It is to our advantage then to “activate” in response to a stimulus with which we have some stored experience just in case our current assessments are incomplete, faulty, a bad match.
It is important to let clients know that they are not being stupid, broken or weak. This is how we survive! Knowing that we are always making rapid”best guesses” about the threat potential in a stimulus based on the stored associated memories of similar stimuli is generally a good bet for survival! These are not mistakes but are based on stored learned data and best guesses.
Also helpful to teach our clients about sympathetic nervous system activation and that the production of “anxiety” comes first from an assessment, then a threat or no threat message to the SNS. If a yes to possible threat, the SNS activates and what we “feel” aka anxiety is telling the body what to do- go towards something beneficial or get away from something not. Since seeking safety is a primary directive, there must be no shame attached to the body working the way it is designed. One must know the process though to understand why my body is doing what it is doing. I find that literally NONE of the many people I have worked with at any level of care have any idea whatsoever about how this works. The default position is “ If I feel it, it must be real. “
I find it illuminating if they can identify the stimulus and the best matching stored memories surrounding similar or matching stimuli . If there are any salient matching features of a current stimulus associated in memory with threat, one will automatically activate. It makes sense. That function is to protect me, to keep me safe but it may not be enough of a match for me to sustain the SNS activation.
Then, teaching clients down-regulation skills is useful and helps to give clients the skills to manage their threat response systems without shame or feeling broken. But without recognizing that the SNS response is tied to a stored memory of a stimulus, that we cannot unring that bell and unremember that stored memory, trying to override it alone is not particularly helpful. Forgetting the stored salient features about an encounter with a bear is not a survival advantage!
The therapeutic & cognitive intervention is to ID the stimulus activating the SNS, noting that it is not a particularly good match. For example, that large mammal with dark fur ( matching salient stimuli) is a dog, not a scary bear like I saw once in a place like this & I can stand down. We don’t activate willy nilly. There is ALWAYS a reason. It is that very cautious matching function of stimuli and experience trying to keep me safe. We are not broken for SNS activation by choosing to be wrong and alive rather than wrong and dead. The more bundled memories attached to that stimulus, the larger the SNS activation. It makes sense.