Friday November 10, 2017

#FearlessSquad

Earthquakes, mass shootings, Zika virus… The world can feel like a pretty scary place sometimes, especially when we are feeling vulnerable in our personal lives. In fact, we are hardwired to experience fear, and if we didn’t know fear, we would be in serious trouble (same with pain). When does fear serve us? And when does it become maladaptive and increase risk for mental health problems?

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Fear is essentially a signal of anticipation from our brains that we are in danger and our security is in peril. This worked great when we were cave dwellers and our physical safety was under constant threat from marauding predators or warrior tribes. In the absence of such jeopardy, the fear signal can actually become dysfunctional and increase risk for a range of anxiety related disorders.

1.

Fear and the Amygdala. The amygdala is an almond shaped structure – one in each hemisphere of the brain – that is associated with fear, but it is really the seat of anticipation. When we perceive threat, the amygdala sets off a cascade of signals that prime us to react – our pulse quickens, muscles tense, and pupils dilate even before the conscious part of our brains have figured out if we need to be scared. This is why we jump when we are startled for example.

2.

Lifesaving or Life threatening? The fear response can be lifesaving by prompting us to jump out of the way of an oncoming train or run away from fire. The trouble comes when we can’t tamp down the amygdala response. This leads to unbridled fear, which, in turn, leads to unbearable anxiety. Whether we calm down or develop anxiety disorders is largely a function of how we activate the more analytical parts of our brains. Do we tell ourselves that lions and tigers are lurking everywhere or do we calm ourselves down by recognizing that we can cope with what is before us?

3.

Physical survival to psychological threat. Today, for most of us (although unfortunately not all), we live with much greater physical security and have many fewer survival threats day to day. The irony is that the amygdala is primed to anticipate threats. Without physical threats, we have more time to engage in cognitive worry. Thus, fear becomes interwoven into psychological and emotional threats. This can take us for a ride because our brains are programmed for flight-fight-or-freeze responses to fear and these responses don’t really work for psychological and emotional threats.

4.

Wary hypervigilance and risk for mental disorders. In today’s world of social media and instantaneous news, we are bombarded with bad news everywhere and all the time. The result is often an amygdala that is juiced-up to flip us into a fight, flight or freeze response at a much lower threshold than would be ideal. If we are not good at engaging our analytic thinking to calm ourselves, we will be at increased risk for developing psychological disorders like social anxiety, hypochondriasis, post-traumatic stress disorder, insomnia, and phobia.

5.

Courage is not the absence of fear. Strength and courage are valorized in our society and showing fear is often considered weak. But in fact, courageous behavior can only occur when we acknowledge and accept that we feel afraid. Trying to suppress or ignore feelings of fear is not a long-term solution. We can run but we cannot hide from fear. That strategy is likely to intensify our fears over time and transmute the adaptive signal to maladaptive emotional states.

 

Acknowledging our psychological and emotional fears and engaging cognitive strategies that help us calm an overactive amygdala is one of the most effective ways to reduce risk for anxiety related disorders. The more primitive reflexes of fight, flight or freeze don’t work so well for psychological fears. One effective strategy is reminding ourselves of the social support and the loving relationships we have. That’s our #FearlessSquad. Brain imaging shows that having a #FearlessSquad and intentional engaging this squad when we are fearful literally makes the amygdala less apt to freak out.

As Mandy Gonzalez says in her newly released song Fearless, “when the fear’s the only thing that’s real, I let you in and I begin to feel fearless.”

Kathleen M. Pike, PhD - Is Professor of Psychology & Director of the Mental Health Program at CUMC kmp2@cumc.columbia.edu