Fear

Is fear real or are we in fear of fear itself after all? Many people suffer from a fear of something that is preventing them from being what they want to be and constraining their potential impact. They have a fear of aiming high, fear of failure, a fear of being themselves and many others. 

Dr. Kerry Ressler’s lab at Yerkes Research Center is focused studying signs of fear and advanced treatments for fear-based disorders, such as Post-traumatic Stress Disorder and Panic Disorder.  Ressler says (4.11) that, although fear is healthy in the sense that it plays an important role in keeping us safe it is also often triggered by events that have nothing to do with our safety and, in many situations, we experience unnecessary fear and it plays an enormous role in preventing us from enjoying our daily lives and pursuing things that could dramatically improve our lives. 

The new neuroscience of understanding emotion and fear can help us to inhibit and transcend the fear in our daily lives. Fear lives in a part of the brain called the amygdala. The amygdala is hyper activated when a fear stimulus has occurred. This can be seen in MRI scans and it’s the same in almost all animals. If you are hiking through a remote area and you see a snake it instantly triggers a fear response. Your heart starts beating more rapidly and you breathe more heavily. This is a fight or flight response. However, when you realize that it was just a stick the fear goes away. The problem is that this fight or flight response is unnecessarily triggered on a daily basis in modern-day life for many people. There are triggers in our lives that activate this basic primitive reflex before we can control it. 

We also know that some people seem to have more trouble controlling their fears and the way they respond to them than others. What is different in people that have this response compared to people that don’t have this response? Ressler focuses specifically on PTSD. His research is focused on answering the question, why do some people seem to be more sensitive to PTSD after a traumatic experience than others? We think of PTSD as something that combat veterans suffer from but in fact anyone can suffer from it if they have experienced something traumatic. However, some people are more susceptable than others and suffer more than others. We know that there is a “differential sensitivity”. Ressler says that this is partly due to a combination of genetics and past experiences. He estimates that genetics contributes approximately 30 to 40% of the response. Research done by Binder and Bradley found that increasing rates of child abuse are associated with increasing rates of ptsd symptoms following an adult trauma. Research also found that the results were more pronounced if the subjects had certain genes activated and, therefore, showed that both elements played a role in the fear response mechanism – hence supporting the notion of a “differential sensitivity”.  They found that the response is also dependent on the number of traumas. 

The question is, how do we inhibit fear so we can get on with our lives? Ressler says that there is a “consolidation of fear”. He says that memories do not become permanent immediately. An example of this is that after a head injury or a seizure people will often have a period of amnesia. This tells us that new memories are not formed immediately. The memories are in a transient state before they become permanent. 

How can we interfere with chronic fear and PTSD and learning to inhibit them? This doesn’t mean giving ourselves permanent amnesia but rather an ability to remember the trauma in a way that doesn’t interfere with our daily lives? People that experienced PTSD after a trauma and experience multiple nightmares and memories and flashbacks seem to sensitize the experience (meaning that it seems that every time they have the experience it gets worse and worse). In contrast, people that recover tend to inhibit their fear – an action known as “extinction”. This is a term invented by Pavlov in the late 1800s when he conducted an experiment where he would open a door in order to give food to a dog. The dog would salivate in anticipation. Pavlov did this several times until he eventually only needed to open the door in order to trigger the salvation from the dog. Pavlov also discovered fear conditioning. He repeated the same experiment with an animal where he provided a mild shock at the same time as he rang a bell. After repeating it several times he could induce the stress in the animal just by ringing the bell and not using the shock. He also found that if he exposed the animal to the bell many times without any reinforcement (not using the shock) the animal would eventually lose its fear. Ressler says that the new science is showing us that this is a new “learning” process (meaning that you are not erasing or forgetting the memory but learning to associate the memory with a different scenario). This extinction process caused the fear to diminish with repeated exposure. He says that therapy that has produced the best results for people that have fear disorders and people that have ptsd. 

How does extinction process work? “Fear consolidation” is when a sound, smell, or other trigger is associated with a bad event and has become so closely associated with the bad event that the sound or smell alone will trigger fear. Extinction works by decoupling past bad memories from the trigger that causes us to recall them and, in turn, trigger the fear (fight or flight) response in the amygdala in our brain. If we hear the sound many times without the bad event happening we eventually “learn” that the sound doesn’t automatically mean that the bad event is happening now or is about to happen so the fear response is inhibited.

Ressler says that there was an experiment conducted where people that were afraid of heights were put into a virtual reality environment where they had to go up 19 floors, walk out onto a catwalk, hold onto the bars and look down at the lobby. They got nauseous and started sweating and had to take off the virtual reality helmet. The research showed that after 6-8 sessions (approx 1 hr each with this therapy) their fear diminished significantly. This has been replicated in other experiments relating to social anxiety, obsessive compulsive disorder, ptsd and panic. 

The conclusion to draw from this research is that we can take one big step forward to buy simply understanding the association between certain triggers and the event that is creating fear. If we change the association from something bad to something good we will eventually diminish and possibly eliminate the fear reaction. 

Next article in this series: “Consciousness”

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