Regulating defensive survival circuits through cognitive demand via large-scale network reorganization

Here we propose a neural framework for understanding the cognitive regulation of emotion which can serve as a heuristic framework for guiding hypotheses to improve treatment of fear-related disorders. We discuss evidence showing that cognitively demanding tasks induce a reorganization between large-scale networks. Specifically, they reduce activation in the amygdala, a key structure of the salience/defensive survival network. The notion that increasing cognitive demand may benefit treatment of fear-related disorders provides a mechanistic account of already existing techniques, such as Tetris, EMDR, and cognitive reappraisal. Future research should reveal whether systematically increasing cognitive demand leads to a stronger reorganization between the central-executive control network and the salience/defensive survival network and thereby a reduction in fear and anxiety-related symptoms.