Dr Rajiv Desai

FEAR

March 6, 2013 by Dr Rajiv Desai

FEAR:

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Prologue:

I was watching movie “Jaws” in a theater with friends in Mumbai 30 years ago. In one scene, a deserted wrecked ship is being explored under water by divers and suddenly the shark makes appearance with frightening music and my whole body just jerked for a second. My friends were laughing and said that I am very fearful. Well, now they know that I am not fearful as I took all powerful media & politicians head-on. But that jerk of my body was an instantaneous response to advent of potential threat. That is fear and that is natural. If I were to pinpoint one pervasive emotion in society today, it would be fear. Fear is not a new emotion. Throughout history, it has marked societies and even mobilized them, whether they were facing down plagues or the threat of nuclear annihilation. Since the 1980s, society at large has bolted frantically from one panic to the next. Fear of crime reduced us to wrecks, but before long we were also howling about deadly diseases, drug abusers, online pedophiles, avian flu, teens gone wild, mad cows, anthrax, immigrants, environmental collapse, and—let us not forget—terrorists. Greatest weapon of terrorists is fear playing on irrational emotions of public. We need to understand power of asymmetric threats using easily available bomb-making products. People all around are fearful of almost everything. They fear police. They fear losing their job. They fear losing their house. They fear their city or town government. And they fear the mother of them all – fear of continuing life without enough money to maintain their current lifestyle. Most people rationalize these fears as normal because everyone has them. We are trained from a very early age to act out of fear. We fear our teacher’s wrath, so we do our homework. We fear clergymen, for they decide if we go to heaven or hell, so we say all the right prayers. We fear older children who may bully us so we cross the street to avoid them. Men fear death as children fear to go in the dark. The oldest and the strongest emotion of mankind is fear.

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Are you a human or a mouse? No matter how you answer, you experience fear the same way in your brain. The pictures below show fearful mouse and fearful child. The same amygdala in brain is activated.

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Read the story below to understand the havoc created by fear:

1595 people died in car accidents following 9/11 attack as out of fear, people switched from planes to cars for their travel in the year following 9/11 attack. All these deaths could have been avoided had people were not fearful of plane hijack by terrorists.

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Expression and experience of fear:

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The maturation of the human mind from primeval animal to reasoning being is an enigmatic but fascinating story. As the first tools began to be used to facilitate everyday prehistoric life and humankind began to hunt in organized groups, spoken language was developed, agriculture was invented, discoveries were made, and humans transformed themselves in a slow but constantly accelerating pace toward the modern age. Yet though we now live in nearly artificial societies surrounded by technology and manmade artifacts to the extent that we hardly realize our thorough separation from nature, we still maintain unconscious, primal instincts that act to preserve us. Arguably the most powerful of these instincts is fear. For the great majority of our existence, we lived in small hunter-gatherer groups, facing dangerous predators and prey alike – even other humans – and kept a well-developed sense of fear to help us remember which elements of the world to avoid. The reason for fear as an ingrained trait is simple and obvious – it helps us to survive, by injecting us with memories and chemicals so that we can recognize and avoid danger – although its process is complex. Since fear can play a direct role in life-and-death struggles, it’s not surprising to find that the brain contains elaborate machinery dedicated to its routines. Since most humans in modern society no longer regularly need a fight-or-flee reaction from predators and hazardous living conditions, they seem to have developed an instinctual need to keep their minds and abilities sharp via frightening films and novels, thrill rides, and negative newscasts. The instinct of fear is necessary as a survival trait, and its current form is a compelling study of how our world is reflected in our entertainment by creating, programming, and exploiting fear which nurtures a constant state of alarm, thereby we run the risks of dulling our own protective senses. 

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Rational v/s irrational fear:

Fear is a primal instinct that served us as cave dwellers and today. It keeps us alive, because if we survive a bad experience, we never forget how to avoid it in the future. Our most vivid memories are born in Fear. Adrenaline etches them into our brains. Nothing makes us more uncomfortable than fear. And, we have so many: fear of pain, disease, injury, failure, not being accepted, missing an opportunity, and being scammed to name a few. There are two types of fear. There are the rational ones, like when I am walking across a street and there is a truck coming my way. If I walk in front of the truck I will surely get hurt or die. That is a real danger and I should avoid it. Then there are irrational ones. It is the things that we make up in our minds, like making a speech in front of a thousand people. If I go to a game park and I am taking a walk and all of a sudden I see a lion running towards me, how will my body react? My heart will beat faster. My hands will become sweaty. I will feel nervous. This is my brain telling my body that it is in danger and that I should get ready to flee or fight (In this instance I hope I will flee). Now, just before I am about to make that speech in front of a thousand people, how does my body react? My heart starts to beat very fast. My hands get sweaty and I am nervous…exactly like as if I had seen a lion running towards me. In this instance it is my brain telling my body that I am in physical danger and my body gets ready to flee or flight again. Only, this time, my brain was lying to my body. I am not in physical danger. So it is an irrational fear.

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Fear is difficult to describe in scientific terms due to the subjective nature of the experience of fear. Dependent upon the experiencer’s past encounter with threatening, fearful, and or anxious situations generally will determine what she/he may describe as a fearful or anxious event. People respond differently to threatening situations. The type of threat that is perceived by the individual and the learned social responses to fearful situations could effect how an individual responds to a given threat. According to Rachman, there are three main components to fear and they do not always correspond with each other. It is therefore important, when discussing fear, to identify which component of fear is being described. The three components of fear are described as “the subjective experience of apprehension, associated psychophysiological changes, and attempts to avoid or escape from fearful situations”. An individual’s ability to control a possible threatening situation will have an impact on her/his experience of fear. According to Rachman (1990), “the ability to cope with threats varies with age, and these changes tend to be reflected in the distribution of fears”. In the human experience of dying and death, if the individual feels that she/he has no control over dying, death, and what happens after death then it would be expected that there might be some fear associated with the eventuality of this human experience. However, if the individual is prepared to die, has a sense of control over her/his dying, and some insight into what may follow death then dying may not be as fearful.  Psychological research has demonstrated that fear can be acquired either through a conditioning process or by vicarious experiences. The conditioning theories postulate that fear is a learned response “occurring to signals (conditioned stimuli) that are premonitory of (i.e., have in the past been followed by) situations of injury or pain (unconditional stimuli)” (Mowrer, 1939). Conditioning can cause fear; it also can be used to reduce or extinguish some fears by the use of systematic desensitization. Fears that are acquired vicariously are believed to be developed by observing fear in others. Bandura observed that not only could attitudes and behaviors be developed by observing others but by using the psychological technique of modeling other people’s appropriate behavior, fearful attitudes and behaviors can be changed. Additionally, there is some research offering theories that fear can also be acquired through the absorption of threatening information. According to Rachman (1990), “fears can be generated by information that is slightly or not at all threatening but which is misinterpreted by the recipient as being threatening”. As an example, information regarding how painful some terminal illnesses are can cause fear of the process of dying. However, the provision of positive information regarding the advantages and uses of pain killers, can have a positive effect on reducing an individual’s fear of the process of dying. Although these theories have not been sufficiently researched they do appear to offer a plausible explanation to the acquisition and overcoming of some fears.

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What is emotion?

Griffiths (1997) proposed that the term ‘emotion’ is scientifically redundant, as we refer to so many different processes and components when we refer to emotion; perhaps the term should be replaced with the specific process of the emotional experience we refer to, such as appraisal, motivational aspects, valence, intensity and so forth. However, with emotion touching practically every aspect of our lives, and the relevance of phenomenological research becoming apparent, emotion may now be a problem to which we can contribute many important and interesting insights. Extensive qualitative research conducted by Gilbert (2001) suggests that emotions refer to feelings, sensations, drivers, personally meaningful experiences; something that comes ‘from within ourselves’ (Gilbert, 2001, p.9) and that which makes us truly human. These descriptors lack clarity yet aim at describing something which is innate to human experience. We come to realize that emotions may be culturally defined and socially constrained. Emotions and feelings are seen as overlapping concepts. Feelings are “red herrings”, products of the conscious mind, labels given to unconscious emotions whereas emotions are distinct patterns of behaviors of neurons. Emotions can exist of conscious experiences as well as physiological & neurological reactions and voluntary & involuntary behaviors. Feelings are seen as intentional as they are not just directed at one’s body and its physiological changes, but also at the world beyond the body. Nesse & Ellsworth (2009) state that different emotional states may correspond to the adaptive challenges encountered in different situations. This certainly follows from Ellis and Newton’s proposal of emotion as a self-motivated activity of the individual; however Nesse and Ellsworth approach emotion from an evolutionary perspective. They place functional significance of emotions in individual lives, and also place emphasis on intensity of emotions felt and valence as essential properties of emotional experience. This research highlights some intrinsic properties of emotion including the autonomous nature of the self-organizational process, and emotion can be interpreted as essential to sense-making for the individual. Research has shown that the amygdala is an essential structure involved in emotion elicitation (LeDoux, 2000). Other research has shown that the prefrontal cortical structures are involved in physiological emotional response (Damasio, 1999) as well as affective feelings. The components of fear go beyond feelings and emotions. It is also the specific memory of the emotion. After a frightful experience, one can remember the logical reasons for the experience (e.g. the time and place) but one will also “feel” the memory, and his body will react as such (i.e. increased heart and respiration rate, sweating). In one recent case, after a near drowning incident, the victim could not only vividly remember each detail, but when doing so, his body reacted as though he were reliving the experience. These feelings of memory are stored in an almond shaped structure in the brain known as the amygdala.  

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Positive and negative emotions:

The emotions expressed by humans can be divided into two broad categories. We can regard them as polarized, as opposite of each other, or we could just say that there is a dividing line where one type of emotions change into the other type of emotions. We can call the two types of emotions Positive and Negative. That is not so much as value judgment as it is a description of the main action of each group. Judging either as “good” or “bad” isn’t very helpful. Negative emotions express an attempt or intention to ‘Exclude’. Strengthening one’s own position at the expense of others. Keeping bad stuff away, destroying what is perceived as a threat. Negative emotions are fueled by an underlying fear of the unknown, a fear of the actions of others, and a need to control them or stop them to avoid being harmed. Positive emotions express an attempt or an intention to ‘Include’. Taking the whole into consideration. Working on learning more viewpoints, interacting more with others, enjoying making things better. Positive emotions are fueled by an underlying desire for enjoyment and unity. Negative emotions are, for example: apathy, grief, fear, hatred, shame, blame, regret, resentment, anger, hostility. Positive emotions are, for example: interest, enthusiasm, boredom, laughter, empathy, action, curiosity. The negative emotions are useful as motivation for moving away from what one doesn’t want. The positive emotions are useful as motivation for moving towards what one does want.

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Some psychologists such as John B. Watson, Robert Plutchik, and Paul Ekman have suggested that there is only a small set of basic or innate emotions and that fear is one of them. This hypothesized set includes such emotions as joy, sadness, and anger.

Fear is one of the crucial evolutionary mechanisms for individual survival.

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Fear is one of the most interesting emotions that a person could have. Although it’s an emotion, it triggers a physical response more intense than almost any other emotion a person could have. When a person becomes scared or is fearful, their heart generally starts to race, they may start to sweat, and their breathing often becomes heavier. Not to mention that your hands may suddenly feel very clammy and you may also feel as though every goose bump on your body is visible from your head to your toes. But what is fear and what causes it? Why do we sometimes know that it’s just a tree banging against the door and other times we’re convinced that someone’s trying to break into the house? Fear is one of the most interesting emotions that a person could have. Fear, like any other emotion that we have, is a signal that the brain has sent that we are in danger. It begins with an outside stimulus, such as the tree banging against the door, and this stimulus triggers the fight-or-flight response in the brain. There are a million stimuli that could trigger the fear reaction and one of the most interesting things about fear is that for every person, there are a million different things that they fear. And although these stimuli may be different for every person, the reaction in the brain is the same.

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Fear is one of the most basic human emotions. It is programmed into the nervous system and works like an instinct. From the time we’re infants, we are equipped with the survival instincts necessary to respond with fear when we sense danger or feel unsafe. Fear helps protect us. It makes us alert to danger and prepares us to deal with it. Feeling afraid is very natural — and helpful — in some situations. Fear can be like a warning, a signal that cautions us to be careful. Sometimes fear is triggered by something that is startling or unexpected (like a loud noise), even if it’s not actually dangerous. That’s because the fear reaction is activated instantly — a few seconds faster than the thinking part of the brain can process or evaluate what’s happening. As soon as the brain gets enough information to realize there’s no danger (“Oh, it’s just a balloon bursting — whew!”), it turns off the fear reaction. All this can happen in seconds.

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When we sense danger, the brain reacts instantly, sending signals that activate the nervous system. This causes physical responses, such as a faster heartbeat, rapid breathing, and an increase in blood pressure. Blood pumps to muscle groups to prepare the body for physical action (such as running or fighting). Skin sweats to keep the body cool. Some people might notice sensations in the stomach, head, chest, legs, or hands. These physical sensations of fear can be mild or strong. This response is known as “fight or flight” because that is exactly what the body is preparing itself to do: fight off the danger or run fast to get away. The body stays in this state of fight-flight until the brain receives an “all clear” message and turns off the response.

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Fight-flight response (vide infra):

The fight-or-flight response (also called the acute stress response) was first described by Walter Bradford Cannon. His theory states that animals react to threats with a general discharge of the sympathetic nervous system, priming the animal for fighting or fleeing. This response was later recognized as the first stage of a general adaptation syndrome that regulates stress responses among vertebrates and other organisms. Though Cannon, who first proposed the idea of fight-or-flight, provided considerable evidence of these responses in various animals, it subsequently became apparent that his theory of response was too simplistic. Animals respond to threats in many complex ways. Rats, for instance, try to escape when threatened, but will fight when cornered. Some animals stand perfectly still so that predators will not see them. Many animals freeze or play dead when touched in the hope that the predator will lose interest. Others have more exotic self-protection methods. Some species of fish change color swiftly, to camouflage themselves. These responses are triggered by the sympathetic nervous system, but, in order to fit the model of fight or flight, the idea of flight must be broadened to include escaping capture either in a physical or sensory way. Thus, flight can be disappearing to another location or just disappearing in place. And often both fight and flight are combined in a given situation. The fight or flight actions also have polarity – the individual can either fight or flee against something that is threatening, such as a hungry lion, or fight for or fly towards something that is needed, such as the safety of the shore from a raging river. A threat from another animal does not always result in immediate fight or flight. There may be a period of heightened awareness, during which each animal interprets behavioral signals from the other. Signs such as paling, piloerection, immobility, sounds, and body language communicate the status and intentions of each animal. There may be a sort of negotiation, after which fight or flight may ensue, but which might also result in playing, mating, or nothing at all. An example of this is kittens playing: each kitten shows the signs of sympathetic arousal, but they never inflict real damage. In humans, during fight or flight response in prehistoric times, fight was manifested in aggressive, combative behavior and flight was manifested by fleeing potentially threatening situations, such as being confronted by a predator. In current times, these responses persist, but fight and flight responses have assumed a wider range of behaviors. For example, the fight response may be manifested in angry, argumentative behavior, and the flight response may be manifested through social withdrawal, substance abuse, and even television viewing. Males and females tend to deal with stressful situations differently. Males are more likely to respond to an emergency situation with aggression (fight), while females are more likely to flee (flight), turn to others for help, or attempt to defuse the situation – ‘tend and befriend’. During stressful times, a mother is especially likely to show protective responses toward her offspring and affiliate with others for shared social responses to threat.

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The four defensive strategies are noted against danger, namely, escape, aggression, freezing, and submission; and these are deployed to varying degrees in different types of responses (anger, fear, anxiety, panic etc), in accordance with their utility. These responses are generated by amygdala and its connections with cortex, thalamus and other sub-cortical areas in the brain (vide infra).

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Definition of fear:

Fear is an intense aversion to or apprehension of a person, place, activity, event, or object that causes emotional distress and often avoidance behavior. Fear is an emotion induced by a perceived threat which causes entities to quickly pull away from it and usually hide. It is a basic survival mechanism occurring in response to a specific stimulus, such as pain or the threat of danger. In short, fear is the ability to recognize danger leading to an urge to confront it or flee from it (also known as the fight-or-flight response) but in extreme cases of fear (horror and terror) a freeze or paralysis response is possible. It is worth noting that fear almost always relates to future events, such as worsening of a situation, or continuation of a situation that is unacceptable. Fear can also be an instant reaction to something presently happening. All people have an instinctual response to potential danger, which is in fact important to the survival of all species. The reactions elicited from fear are seen through advantages in evolution. Fear can be a manipulating and controlling factor in an individual’s life. Fear is high only if the observed risk and seriousness both are high and is low if one or the other of the seen risk or seriousness is low.

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Fear includes

1. Imminent danger,
2. Personal security or pain is threatened,
3. Concern for a future specific unpleasant event,
4. Perceived loss of safety.

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The purpose of fear is to protect us from danger. There are several unlearned triggers for fear, including:

■something hurling rapidly toward you, such as a truck racing toward you

■sudden loss of support, such as the floor giving way,

■The threat of physical pain,

Also, there are any number of learned triggers for fear, such as receiving a letter from the IRS, being called to the principal’s office, or entering a dark room. People also fear losing control, humiliation, shame, or insignificance. The common theme is avoiding threats. 

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Physical Reactions:

Fear causes a variety of reactions depending on the intensity, timing, and coping options available. The reactions include:

■Freezing in place and feeling terror if we can’t do anything to avoid the immediate danger.

■Running or escaping from the immediate danger,

■Sharply focusing our attention and mobilizing us to act to reduce or eliminate the danger when we can take effective action to cope with the threat, or

■Panic, including shortness of breath, racing heartbeat, and the inability to focus on anything but worrying about the feared future event,

■Fighting to destroy the object of our fear.

Fear also often causes cold hands, deeper and more rapid breathing, increased heart rate, increased blood pressure, sweating, dry mouth, and trembling or tightening of the muscles, especially in the arms and legs.  

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Fear is a chain reaction in the brain that starts with a stressful stimulus and ends with the release of chemicals that cause a racing heart, fast breathing and energized muscles, among other things, also known as the fight-or-flight response. The stimulus could be a spider, a knife at your throat, an auditorium full of people waiting for you to speak or the sudden thud of your front door against the door frame. The brain is a profoundly complex organ. More than 100 billion nerve cells comprise an intricate network of communications that is the starting point of everything we sense, think and do. Some of these communications lead to conscious thought and action, while others produce autonomic responses. The fear response is almost entirely autonomic: We don’t consciously trigger it or even know what’s going on until it has run its course. Because cells in the brain are constantly transferring information and triggering responses, there are dozens of areas of the brain at least peripherally involved in fear. Fear often manifests itself by the impulse to escape or run away. Various nuances of fear include dismay, anxiety, worry, shyness, fright, alarm, horror, terror, or panic-all forms of fear to one degree or another.

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Fear is something that is in everyone. All of us experience fear at some point or another It is like an emotion that has already been with us since thousands of years ago. Why then is fear a useful emotion? Fear helps us to know when to fight or take a flight. Enough, often when we experience danger, our mind will tell us if we should fight or flee from that situation. Fear acts like an instinct, which will tell us what our next move should or could be. Fear also allows us to be humble. When we know who we’re going up against, there is a sense or a feeling of fear. Especially when we’re facing our authorities. Like when a worker is talking to his employer. Fear also helps us to learn from our mistakes. When we make a mistake and have to face the consequences (which is often unpleasant), we will feel fear. When being put in the same situation again, we will think twice about our actions. By thinking twice in the situation to not make the same mistakes again, we can imply that fear is present. Because of the fear of the consequences that we have, it lets us carry out the tasks as accurately as possible. Fear is also needed for us to take necessary risks that will allow us to go further. Without fear, we will not take ricks without careful consideration. That situation would seem very superficial and mundane. However, if we fear too much, it would not be beneficial to us at all. We will be too scared to take any risks. If a businessman wants to start or open up a business and he does not take the risk, he would not have started at all. Business is like a game of risk. There is no confirmed profitable business. At the same time, if we do not have fear at all, we will become rebellious towards future threats, which might even cause one’s failure.

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Fear may be therapy, redirected through safe mediums such as literature and film, but fear can also be exercised, via thrill rides and haunted houses. Both are highly popular attractions, and both have a timeless quality to them; they do not reflect the outlooks of the age except by becoming more extreme. In a Psychology Today article, Eric Minton adds that “the biggest common denominator is that the two feed on the same basic fear: loss of control. Once a coaster takes off, passengers can do nothing but sit or, on some rides stand, and scream.” Both attractions also share the appeal for fear that frightening films and literature do, in that “no matter how precarious a roller coaster or alarming a haunted house may appear, it must be totally safe” (Minton). Fear is channeled here as well, with the conscious realization of danger without consequence. The fear response is activated without the existence of true threat. However, this modern human tendency to redirect fear has resulted in a tendency to create fear where there should be none, or generate far worse fear from mundane circumstances than would be warranted. We worry about our jobs, world events, relationships, automotive mechanical failure, computer crashes, and other difficulties that are stressful but not directly life-threatening. According to Ernest Becker, “man’s fears are fashioned out of the ways in which he perceives the world.” Animals know what to fear by instinct, “but an animal who has no instinct (man) has no programmed fears”. Since fear is designed to protect us from harm, we absorb information where possible to learn what may be detrimental to our well-being and “allow the fear system to take control in threatening situations and prevent our conscious awareness from reigning. This may have been an optimal design for predator-rich environments in which survival was a minute-by-minute question, but it is not a good adaptation for modern environments in which the stressors can be job performance reviews” (Johnson and Selim).

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Fear Conditioning (vide infra):

Fear conditioning is a particularly efficient form of classical conditioning. It is a quick and long lasting mechanism for acquiring and storing information about harmful or potentially harmful stimuli and situations. It is an ancient evolutionary solution to self-defense that has been observed in species as diverse fruit flies, fish, baboons and humans. Once a fear trigger is learned, the response will remain the same indefinitely and resist efforts to extinguish it. The bias is toward action; it is better to react immediately to a false alarm than to ignore a real threat. Both fear and anxiety are provoked by danger. Fear is the response to a specific and immediate danger. Anxiety results from a non-specific concern or threat. Today many threats are psychological rather than physical, but the same primitive impulse often takes hold. Fear describes a specific and sudden danger to your physical well-being. When fear passes, we feel relief and often exhilaration. Our emotional brains react immediately to defend against a possible threat, and then later we can comprehend the situation more fully and decide on the best action to take.

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Fear biologically:

In a biological sense fear is related to death. For the human organism all emotions can be said to be reactions to what Jeffrey Gray calls “reinforcing events,” i.e., rewards and punishments, or the removal of such rewards and punishments. Fear, as all emotions do, depends on what our perception is in relation to these “reinforcing events.” A fearful response is an indication that the perceiver believes that his well-being is in danger, and that he is threatened by death or injury, which can lead to death indirectly. Biologically fear is a warning signal that death, injury or destruction is imminent, and it is designed to cause the perceiver to avoid the dangerous situation. Fear, psychologically, is also a warning, and it basically functions to prevent the possibility of personality disintegration. A victim of fear perceives a threat to his identity which he experiences as a loss of control. According to Arno Karlen it is “a traditional Western fear that any loss of individual or social control will start a snowballing loss of controls in general,” and such an effect in itself is sufficient to arouse more fear and complicate the situation for the victim. That is, fear is capable of generating more fear, and a victim of fear can find himself in a nightmare of his own making if he allows his imagination to get out of hand and does not successfully reimpose control on the situation. Once the victim perceives himself in control, he must maintain that control until the situation stabilizes. If his control falters, he will enter a vicious cycle of control and loss of control, and thereby facilitate the start of a panic reaction.

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Fear stimuli:

There are two basic kinds of fear stimuli. The first is environmental (external) and poses a direct physical threat to the perceiver. The second is strictly psychological (internal) and poses no direct physical threat. For obvious reasons the first is a rational fear and the second is an irrational fear. Rational fears can be overcome by physical retaliation or escape, whereas irrational fears such as those aroused by horror stories can be successfully overcome only by conscious and rational control. Carl Jung claims that “it is just man’s turning away from instinct–his opposing himself to instinct–that creates consciousness.” Consequently, the method for controlling irrational fear is to avoid further instinctual reactions and to concentrate on rationalizing. However, in a panic situation the victim automatically acts instinctually rather than rationally, and instead of remedying his problem and dispelling his fear he acts in a non-rational way that is likely to end catastrophically. Though the principle of rational control is plausible enough, the fact that the type of fear aroused by a horror story [or horror film] is irrational fear makes the victim’s task difficult. The conscious-rational side of the human mind is diametrically opposed to, and inconsistent with, the unconscious-irrational side of the mind. The unconscious influences the behavior of the conscious, but a person cannot directly understand his unconscious mind. According to the personality theories of both Sigmund Freud and Carl Jung, an integrated personality depends on a balanced interaction between the conscious and the unconscious sides of the mind. Jung’s analytical theory details two parts of the unconscious which he calls “personal” and “collective.” Irrational fear, which is the type of fear produced by horror fiction, has its source in both of Jung’s portions of the unconscious mind.  

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Exploiting Vulnerability:

Fear is such a powerful emotion that it is often exploited through fear-mongering. Unneeded, ineffective, or overpriced insurance policies, safety equipment, automobile undercoating, protection services, defensive actions, medications, and military expenditures are willingly purchased by people who are intimidated by a wide range of doomsayers. Terrorism is so effective because fear is so powerful. The fear of humiliation is strong and is a form of control often exploited by people as diverse as childhood playmates, advertisers, sales people, the boss, and tyrants.

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Paths of Fear:

Events that can trigger our fear or anxiety are common and frequent occurrences. How we respond to those provocations and the choices we make critically affect our peace of mind, well being, and our lives. The following figure illustrates choices we have and paths we can take to either prolong or resolve our fears.

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Each colored elliptical bubble represents a state of being that represents the way you are now. The labels on the arrows represent actions or events and the arrows show paths into or out of each state. You are at one place on this chart for one particular relationship or interaction at any particular time. Other people are likely to be in other places on the chart.

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Horror & terror:

Terror is usually described as the feeling of dread and anticipation that precedes the horrifying experience. By contrast, horror is the feeling of revulsion that usually occurs after something frightening is seen, heard, or otherwise experienced. It is the feeling one gets after coming to an awful realization or experiencing a deeply unpleasant occurrence. In other words, horror is more related to being shocked or scared (being horrified), while terror is more related to being anxious or fearful.  At the highest levels, terror and panic overwhelm people, causing them to make irrational choices. While terror is an apprehension of impending danger, horror is a sickening and painful experience. Horror is the emotion, which lays the foundations for the amygdala to sense the backgrounds of painful events. The amygdala remember the images, sounds, words and situations, which accompanied the horror of injury, ridicule, social rejection, loss of loved ones, or career failure. Subsequently, the detection of any related signals trigger fear, often without the person knowing the cause of her fear. Horror has also been defined as a combination of terror and revulsion. Horror and terror stem mainly from movies and literature. Horror is the feeling you get after seeing something violent and disturbing, while terror is the apprehension before something bad happens. To increase horrific feelings in the audience, plots often involve the supernatural, serial murderers, disease/virus outbreak, and surrealism. Themes involved to induce horror and terror include gore, werewolves, villains, torture, ghosts, curses, satanism, demons, vicious animals, vampires, cannibals, haunted houses, and zombies. The definition of what was once called a horror movie has changed over the years. Examples are The Silence of the Lambs and Seven. Horror is considered horror when there is an over the top amount of bloodshed and gore whereas thriller/terror is considered to be more along the route of mindgames, exemplified by the feeling of nervousness as a character is walking down a dark alley.

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Common fears:

According to surveys, some of the most common fears are of ghosts, the existence of evil powers, cockroaches, spiders, snakes, heights, water, enclosed spaces, tunnels, bridges, needles, social rejection, failure, examinations and public speaking. In a test of what people fear the most; Bill Tancer analyzed the most frequent online search queries that involved the phrase, “fear of…”. This follows the assumption that people tend to seek information on the issues that concern them the most. His top ten list of fears consisted of flying, heights, clowns, intimacy, death, rejection, people, snakes, failure, and driving. One of the most common fears in humans is the fear of public speaking. People may be comfortable speaking inside a room but when it becomes public speaking, fear enters in the form of suspicion that whether the words uttered are correct or incorrect because there are many to judge it. Another common fear can be of pain, or of someone damaging a person. Fear of pain in a plausible situation brings flinching, or cringing.

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Nearly all fears have a scientific name, such as triskaidekaphobia, the fear of the number 13. In the classic Christmas television special, “A Charlie Brown Christmas,” Charlie Brown had pantophobia, the fear of everything. Other common fears include:

• ailurophobia (fear of cats)
• didaskaleinophobia (fear of going to school)
• entomophobia (fear of insects)
• glossophobia (fear of speaking)
• myctophobia (fear of darkness)
• ophidiaphobia (fear of snakes)
• xenophobia (fear of strangers or foreigners)
• zoophobia (fear of animals) 

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Fear Statistics:

Fear and Worry Statistics	Data
Percent of things feared that will never take place	60 %
Percent of things feared that happened in the past and can’t be changed	30 %
Percent of things feared that are considered to be insignificant issues	90 %
Percent of things feared in relation to health that will not happen	88 %

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About 19.2 million American adults ages 18 and over, or some 8.7 percent of people in this age group in a given year, have some type of specific phobia, or extreme fear. And between 9 percent and 20 percent of Americans say they avoid going to the dentist because of anxiety or fear, according to WebMD. Westefeld reported on a survey of mostly college-age students in 2006 in which 73 percent of participants had “a little bit” or “moderate” fear of weather.

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There’s no such thing as “the friendly skies” for the 25 million or so people in the United States who suffer from some form of flying fear. Such fears range from just a bit of anxiety to an extreme flying phobia called aviophobia that can keep a person off airplanes at any cost. Like other phobias, reason plays little role in calming such crash fears. For instance, the lifetime odds of dying in an air travel accident are 1-in-20,000 compared with 1-in-100 for an auto accident and 1-in-5 from heart disease (based on 2001 statistics).

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In a 2005 Gallup poll (U.S.A.), a national sample of adolescents between the ages of 13 and 17 were asked what they feared the most. The question was open ended and participants were able to say whatever they wanted. The top ten fears were, in order: terrorist attacks, spiders, death, being a failure, war, heights, criminal or gang violence, being alone, the future, and nuclear war.

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Most of these basic fears are carried into adulthood. Other common fears include public speaking, going to the dentist, pain, cancer and snakes.

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Top 10 fears among people:

This list of fears below, listed in order, is based on data taken from Google (and other popular search engines) and indicates the types of fear people are most looking for information on. So it’s not as ‘scientific’ as a Gallop poll but nevertheless this short-list of most common fears does reflect the level of concern that millions of men and women have right now.

01. Fear of flying
02. Fear of public speaking
03. Fear of heights
04. Fear of the dark
05. Fear of intimacy
06. Fear of death
07. Fear of failure
08. Fear of rejection
09. Fear of spiders
10. Fear of commitment                                            

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Top 10 Bizarre fears and phobia:

1. Ablutophobia – The Fear of Washing, Bathing, or Cleaning:

 Ablutophobia is a phobia that results in a persistent, abnormal, and unwarranted fear of washing yourself. It is most commonly found in women and children. Most patients don’t fear water, just when there is intent to clean. It is important to note that many children dislike baths, so ablutophobia is generally not diagnosed in children unless it persists for more than six months. Like all phobias, ablutophobia is often linked to a traumatic past event. It can be serious, as a lack of hygiene can lead to social displacement and disease.

2. Caligynephobia – The Fear of Beautiful Women:

 Caligynephobia is a form of gynophobia, which is the fear of all women. However, caligynephobia is directed towards good looking females. It can be an extremely disruptive social phobia, depending on the level of damage. The symptoms include rapid breathing, shortness of breath, irregular heartbeat, nausea, sweating, panic attacks, and feelings of dread. There can also be individualized specific responses to this phobia. Caligynephobia can manifest itself in adolescent children, adult men, and women, but is most often viewed in men.

3. Anglophobia – The Fear of the England or the English Culture:

 Anglophobia is a phobia that includes the fear of the English. The term is also inaccurately used to discriminate against English people. Anglophobia is a true disorder that has historic routes. A 2005 study by Hussain and Millar of the Department of Politics at the University of Glasgow found that the condition has decreased in prevalence since the introduction of devolution. Having an English friend or direct contact with the English greatly reduces the chances of suffering from Anglophobia.

4. Spectrophobia – The Fear of Specters or Ghosts:

Spectrophobia is a specific phobia that involves an intense fear of ghosts and aspirations known as specters. Most adults will admit to being a bit afraid of ghosts, but people with spectrophobia feel that ghosts and specters are powerful black magic phantoms who can steal souls and even lives. Like most phobias, people who suffer from spectrophobia usually have experienced some sort of mental or physical trauma in their life. This experience then becomes associated with specters, ghosts, or apparitions. The symptoms of this phobia can range from a mild uncomfortable feeling to full blown anxiety or panic attacks. It is a rare disorder that is usually self-diagnosed, as the individual realizes the fear is interfering with their ability to function.

5. Dendrophobia – The Fear of Trees:

Dendrophobia is a very common phobia surrounding the fear of trees or the forest. One of the most complicated factors when dealing with dendrophobia is that the patients often times don’t reveal the disorder, in fear of ridicule and joking. Individuals with this phobia become occupied with the thought that a “dead fear” is linked to the dense trees. They might feel trapped or experience a sense of strangulation. Dendrophobia causes anxiety and intense panic attacks. Avoiding trees can often be a difficult task. Many documented cases have patients referring to forests and tree land as “the darkness” and “evil.”

6. Chorophobia – The Fear of Dancing:

Chorophobia is defined as the irrational fear of dancing. It is often times based around the individual’s unwillingness to become aroused or excited. This phobia surrounds social problems, such as the fear of embarrassment or large crowds. The disorder can become disabling. The real problem ensues when the individual is forced into a dancing situation. A good treatment method is personal therapy and some people use hypnosis. Many sufferers take to hiring a personal trainer to improve their dancing skills.

 7. Homichlophobia – The Fear of Fog:

Homichlophobia is an exaggerated or irrational fear of fog. This disorder causes extreme panic in all patients. Individuals will take extreme avoidance measures towards fog, locating themselves in geographical areas that don’t receive much precipitation. They have extreme imaginations and create horrible visions surrounding the mist and fog. One commonly reported symptom is tunnel vision and crazy feelings of dread. It is a widespread phobia and has been reported in over 67 countries.

8. Cypridophobia – The Fear of Prostitutes or Venereal Disease:

Cypridophobia is an irrational fear of venereal disease. The phobia has been around for generations and the name originates from Cyprus and is a Greek word for Venus. It surrounds the fear of gaining a deadly venereal disease. It is a serious disorder and the patients often experience feelings of panic, terror, dread, rapid heartbeat, trembling, anxiety, and can become ill and often faint. The phobia helps fuel bipolar personalities. Patients often suffer from sleep disorders and depression as the phobia expands and greatly damages social behavior. Cypridophobia can often lead to a complete withdrawal from sexual intercourse and isolation from the opposite sex. It is a serious disorder that is commonly seen all over the world.

9. Nyctophobia – The Fear of the Dark:

Nyctophobia is a disabling disease characterized by a frenzied fear of the darkness. The phobia is generally related to children, but many adults experience it. It is extremely disruptive and incapacitating in adults and almost always leads to hospitalization. Patients experience an uncontrollable fear triggered by the mind’s perception of what could happen and is waiting in the dark. It seems to be based around mental-recall of past horrifying events. There is little known about the pathological background and emotional aspects of nyctophobia. However, scary movies, television shows, and ghost stories can manifest the phobia in children. Patients suffer from various physical, emotional, and mental reactions to the phobia, including chest pain, discomfort, choking, smothering sensations, vertigo, and feelings of unreality, sweating, and shaking. Individuals suffering from nyctophobia have a hard time sleeping.

10. Methyphobia – The Fear of Alcohol:

Methyphobia is an intense and irrational fear of alcohol. People suffering from this phobia fear the consequences of alcohol consumption and in many instances they avoid everyone who drinks. They will also avoid any situation where alcohol is present, including weddings, holidays, and family gatherings. Methyphobia can directly lead to many social disorders. People suffering from this phobia often times have experienced a real life trauma related to alcohol consumption. It could be parental abuse, personal damage, or many other causes. There is a wide spectrum of symptoms when dealing with methyphobia. Some individuals might lightly perspire and feel uncomfortable around alcohol, while others might have serious anxiety and panic attacks. Some other symptoms include dry mouth, numbness, dizziness, trembling, rapid heartbeat, feeling out of control, trapped, or utter doom.

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Harrowing Heights (acrophobia):

If you get nervous when standing on a rooftop or looking up at a tall building, you’re not alone. Fear of heights is one of the most common phobias (followed by public speaking) with an estimated 3 percent to 5 percent of the population suffering so-called acrophobia. While scientists had thought such phobia was the result of an irrational fear to normal stimuli, new research is suggesting otherwise. In the study, published in the journal Proceedings of the Royal Society B, participants had to judge the height of a building when standing at ground level and when atop the building. Compared with participants who scored lowest on an acrophobia test, those most afraid of heights judged the building to be about 10 feet (3 meters) higher at ground level and 40 feet (12 meters) taller from the top of the building. So the building actually seems taller to acrophobics, it seems.

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Public speaking:

Does the thought of speaking in front of an audience color your face a bright red, send sweat pouring from your pores and bring a sick feeling to your gut? Those are just a few of the signs of social phobia (vide infra), which affects about 15 million American adults, according to the National Institute of Mental Health. And it’s not limited to public speaking: Those affected can get the sweats over eating or drinking in front of others, or a general anxiety when around almost anyone other than family members. The fear begins in childhood or adolescence, usually around the age of 13.

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How to conquer Public Speaking fear:

11 Hidden causes of Public Speaking fear:

1. Thinking that public speaking is inherently stressful (it’s not).
2. Thinking you need to be brilliant or perfect to succeed (you don’t).
3. Trying to impart too much information or cover too many points in a short presentation.
4. Having the wrong purpose in mind (to get rather than to give/contribute).
5. Trying to please everyone (this is unrealistic).
6. Trying to emulate other speakers (very difficult) rather than simply being yourself (very easy).
7. Failing to be personally revealing and humble.
8. Being fearful of potential negative outcomes (they almost never occur and even when they do, you can use them to your advantage).
9. Trying to control the wrong things (e.g., the behavior of your audience).
10. Spending too much time over-preparing (instead of developing confidence and trust in your natural ability to succeed).
11. Thinking your audience will be as critical of your performance as you might be.

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10 Key Principles always keep in mind:

1—Speaking in Public is not inherently stressful

2—You don’t have to be brilliant or perfect to succeed

3—All you need is two or three main points

4—You also need a Purpose that is right for the task

5—The Best Way to succeed is not to consider yourself a Public Speaker!

6—Humility and Humor can go a long way

7—When you speak in public, nothing “Bad” can ever happen!

8—You don’t have to control the behavior of your Audience

9—In general, the more you prepare, the worse you will do

10–Your Audience truly wants you to succeed

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Claustrophobia:

Claustrophobia (from Latin claustrum “a shut in place” and Greek phóbos, “fear”) is the fear of having no escape and being closed in small spaces or rooms. One study conducted by University of Wisconsin-Madison’s neurology department revealed that anywhere from 2-5% of the world population is affected by severe claustrophobia, but only a small percentage of these people receive some kind of treatment for the disorder. It can be the result of many situations or stimuli, including elevators crowded to capacity, windowless rooms, and even tight-necked clothing. Claustrophobia develops as the mind makes the association that small spaces psychologically translate to some imminent danger. This typically occurs as a result of a traumatic past experience (such as being trapped in a dark, small space and thinking that there is no way out because the mind is not fully developed enough to realize there is a way out) or from another unpleasant experience occurring later on in life involving confined spaces. These two causes of claustrophobia both reject the common misconception that claustrophobia is a genetic disorder. In fact claustrophobia is a conditioned response to a stimulus. It results from when an individual associates a tremendous amount of anxiety and a panic attack with a confined space. That event, the confined space, serves as a trigger or the stimulus, which is programmed into the brain. Because that stimulus is programmed into the brain, so is the response, which in this case, is a tremendous amount of anxiety. As a result, the confined space consistently triggers the same anxious response. Magnetic resonance imaging, or the MRI, has been attributed to the onset of claustrophobia. Since a patient has to be put into the center of a magnet to optimize imaging, the patient finds themselves in a narrow tube for an extended period of time. In a study involving claustrophobia and the MRI, it was reported that 13% of patients experienced a panic attack during the procedure. The procedure has been linked not only to the triggering of ‘preexisting’ claustrophobia, but also to the onset in some people. In fact, estimates say that anywhere from 4–20% of patients refuse to go through with the scan for precisely the reason of getting panic attack during MRI. One study estimates that this percentage could be as high as 37% of all MRI recipients. The average MRI takes around 50 minutes; this is more than enough time to evoke extreme fear and anxiety in a severely claustrophobic patient.

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Absence of fear (aphobia):

A classical situation is when a child is attacked by a predatory animal (or an armed human), and a parent starts an all-out fight against the much stronger attacker, totally neglecting his or her personal safety. This mechanism is present among many species, most notably when a mother behaves fearlessly towards much stronger opposition in order to save her offspring. Ethnomusicologist Joseph Jordania uses the term aphobia for the temporary loss of fear, induced by the release of neurochemicals in the brain which leads to a specific altered state of consciousness. Jordania calls this state the battle trance. According to him, aphobia supersedes the individual’s instinctive fear for selfish survival and well-being, when more evolutionarily important subjects than that individual’s own life are in danger. These can be the life of a child, family members, or members of a soldier’s unit. Sometimes saving unknown humans or animals can also trigger the temporary loss of fear. Strong religious feelings can also induce aphobia (for example, when martyrs sacrifice themselves without the feeling of fear or pain). Jordania suggested that battle trance and associated loss of fear and pain (known as analgesia) were designed in the course of evolution by forces of natural selection as a survival mechanism, as individual hominids were too weak to stand against the formidable African ground predators after they descended from the relatively safe trees to the ground. The state of battle trance, which can be induced by rhythmic drumming, singing, dancing, body painting, and the use of certain substances, allowed them to lose their individuality, obtain collective identity, and to fight together as a unit without feeling fear and pain, neglecting their personal safety for the evolutionarily more important reason. Unlike the feel of pain, which can be fully absent in some human conditions, there is no such condition as congenital absence of fear (although psychopaths are known to have a much lessened feeling of fear).   

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Facial Expression of fear:

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The facial expression of fear has these distinctive features as seen in the photo below:

Fear expressions send a danger warning to those close by. Screaming also sends a danger warning.

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Evolution of facial expression of fear:

According to modern evolutionary theory, different emotions evolved at different times. Primal emotions, such as fear, are associated with ancient parts of the brain and presumably evolved among our premammal ancestors. Filial emotions, such as a human mother’s love for her offspring, seem to have evolved among early mammals. Social emotions, such as guilt and pride, evolved among social primates. Sometimes, a more recently evolved part of the brain moderates an older part of the brain, such as when the cortex moderates the amygdala’s fear response. Evolutionary psychologists consider human emotions to be best adapted to the life our ancestors led in nomadic foraging bands. One important observation Darwin made was that even in individuals who were born blind, body and facial expressions displayed are similar to those of anyone else. The ideas found in his book on universality of emotions were intended to go against Sir Charles Bell’s 1844 claim that human facial muscles were created to give them the unique ability to express emotions. The main purpose of Darwin’s work was to support the theory of evolution by demonstrating that emotions in humans and other animals are similar. Most of the similarities he found were between species closely related, but he found some similarities between distantly related species as well. He proposed the idea that emotional states are adaptive, and therefore only those able to express certain emotions passed on their characteristics. Paul Ekman is most noted in this field for conducting research involving facial expressions of emotions. His work provided data to back up Darwin’s ideas about universality of facial expressions, even across cultures. He conducted research by showing photographs exhibiting expressions of basic emotion to people and asking them to identify what emotion was being expressed. Ekman noted that while universal expressions do not necessarily prove Darwin’s theory that they evolved; they do provide strong evidence of the possibility. He mentioned the similarities between human expressions and those of other primates, as well as an overall universality of certain expressions to back up Darwin’s ideas. The expressions of emotion that Ekman noted as most universal based on research are: anger, fear, disgust, sadness, and enjoyment. A common view is that facial expressions initially served a non-communicative adaptive function. Thus, the widened eyes in the facial expression of fear have been shown to increase the visual field and the speed of moving the eyes which helps finding and following threats. The wrinkled nose and mouth of the facial expression of disgust limit the intake of foul-smelling and possibly dangerous air and particles. Later, such reactions, which could be observed by other members of the group, increasingly become more distinctive and exaggerated in order to fulfill a primarily socially communicative function. This communicative function can dramatically or subtly influence the behavior of other members in the group. Thus, rhesus monkeys or human infants can learn to fear potential dangers based on only the facial expressions of fear of other group members or parents. Seeing fear expressions increases the tendency for flight responses while seeing anger expressions increases the tendency for fight responses. Classical conditioning studies have found that it is easier to create a pairing between a negative stimuli and anger/fear expressions than between a negative stimuli and a happiness expression.

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Neurobiologically the same neurocircuitry that has been implicated in fear/anxiety responses in humans is readily activated by stimuli that are not intrinsically threatening, but may convey information regarding the presence of threat in the environment or about the fearful emotional state of others. Responses in the amygdala are readily elicited by photographs of facial expressions, especially those of fear (Breiter et al, 1996a; Davis and Whalen, 2001; Fitzgerald et al, 2006; Morris et al, 1996; Vuilleumier and Pourtois, 2007; Whalen et al, 2001), even when presented below conscious awareness (Morris et al, 1998; Whalen et al, 1998, 2004). Emotional facial expressions have also been associated with activation in the dACC, rACC, medial frontal gyrus, and insular cortex (Fitzgerald et al, 2006; Gorno-Tempini et al, 2001; Morris et al, 1996; Phillips et al, 1997, 2004; Sabatini et al, 2009; Sprengelmeyer et al, 1998). Brain responses to the relatively ambiguous facial expression of surprise have been shown, in some studies, to depend on the extent to which individual subjects interpreted these expressions as positive or negative; more negative interpretations were associated with greater amygdala and lower ventral medial prefrontal cortex activation (Kim et al, 2003). These findings are consistent with the notion that the amygdala and medial prefrontal cortex are reciprocally modulated (e.g., Garcia et al, 1999). Furthermore, the experimental manipulation of the context in which surprise facial expressions are presented alters brain activation patterns in a similar way: surprise expressions associated with a negative context elicited more amygdala activation than those associated with a positive context (Kim et al, 2004). These amygdala activations were positively correlated with activation in the dACC (Kim et al, 2004). [fear neurobiology vide infra]

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Fear signals in nature:

Biologists have long known of fear factors in nature — chemical signals released by a distressed individual, either deliberately or inadvertently, that end up inciting similar displays of fear or agitation in recipients. Ants disturbed in their nest produce alarm pheromones that rally colony defenses. If air is blown over the cage of a rat as it receives an electric shock to the foot, rodents downwind of the jolting event react with a full-blown stress response, as if they, too, had been shocked.  Karl von Frisch, the legendary Austrian honeybee researcher, discovered in the 1930s that the skin of an injured minnow oozed into the water a substance he called Schreckstoff (“fright stuff”), which prompted other minnows in the vicinity to immediately flee the site of obvious antiminnow intentions. This year, researchers finally isolated from the mucus of fish skin the active ingredient of Schreckstoff: chains of sugars called chondroitins that are very potent at repelling fish. Injured plants also release alarm signals through air and soil that can be construed as evidence of vegetal despair, or at least a reminder that no life form likes being eaten, even by vegans. In human studies, the sweat of frightened people has been shown to cause anxiety and heightened vigilance, and even to enhance cognitive performance on tests.  Birds, by contrast, were thought to express their fear by freezing, swooping or screeching, and they were considered to have little if any sense of smell, a misconception thought to date back to poorly designed experiments by the naturalist and artist John James Audubon in the 19th century. Deseada Parejo, a biologist at the Arid Zones Experimental Research Station in Almería, Spain, was studying family dynamics behavior in Eurasian rollers — spectacular jay-size birds with long, slender tails and the Cray-Pas colors of parakeets. On removing one of the nestlings for a standard check of size and weight, she practically jumped at its horror-film response: The tiny chick gaped its mouth wide and vomited up a big dose of sticky orange liquid, enough to fill half a teaspoon. Dr. Parejo touched a second chick, a third, a sixth, and got the same expulsory retort. “I have worked with many other bird species,” she said, “but I never found anything similar to this vomiting behavior before.” Not only that: The fluid had a distinctive, evolving odor. In the current issue of Biology Letters, Dr. Parejo and her colleagues describe their study of this noteworthy aroma, which they designate the roller nestlings’ “smell of fear.” The researchers said that the reflux reflex might well serve as a defense mechanism — helping to repel nest predators like snakes and rodents. The new findings add to the growing evidence that many animals can smell one another’s fear, including species not known for their bloodhound powers. Birds and humans in particular were long thought to rely on vision and hearing rather than smell when sizing up the world and its ambient threats. Yet recent research reveals that birds have a nose for news after all, that people are deeply affected by odors in ways they often are not consciously aware of, and that one class of odor likely to impinge on both humans and birds is the scent of a fellow’s despair.

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Classification of fears:

There are only five basic fears, out of which almost all of our other so-called fears are manufactured. Those five basic fears are:

1. Extinction – fear of annihilation, of ceasing to exist. This is a more fundamental way to express it than just calling it the “fear of death”. The idea of no longer being arouses a primary existential anxiety in all normal humans. Consider that panicky feeling you get when you look over the edge of a high building.

2.Mutilation – fear of losing any part of our precious bodily structure; the thought of having our body’s boundaries invaded, or of losing the integrity of any organ, body part, or natural function. For example, anxiety about animals, such as bugs, spiders, snakes, and other creepy things arises from fear of mutilation.

3. Loss of Autonomy – fear of being immobilized, paralyzed, restricted, enveloped, overwhelmed, entrapped, imprisoned, smothered, or controlled by circumstances. In a physical form, it’s sometimes known as claustrophobia, but it also extends to social interactions and relationships.

4. Separation – fear of abandonment, rejection, and loss of connectedness – of becoming a non-person – not wanted, respected, or valued by anyone else. The “silent treatment,” when imposed by a group, can have a devastating psychological effect on the targeted person.

5. Ego-death – fear of humiliation, shame, or any other mechanism of profound self-disapproval that threatens the loss of integrity of the Self; fear of the shattering or disintegration of one’s constructed sense of lovability, capability, and worthiness.

Think about the various common labels we put on our fears. Start with the easy ones: fear of heights or falling is basically fear of extinction (possibly accompanied by significant mutilation, but that’s sort of secondary). Fear of failure? Read it as fear of ego-death. Fear of rejection? It’s fear of separation, and probably also fear of ego-death. The terror many people have at the idea of having to speak in public is basically fear of ego-death. Fear of intimacy, or “fear of commitment” is basically fear of losing one’s autonomy. Some other emotions we know by various popular names are also expressions of these primary fears. If you track them down to their most basic levels, the basic fears show through. Jealousy, for example, is an expression of the fear of separation, or devaluation: “She’ll value him more than she values me.” At the extreme, it can express the fear of ego-death: “I’ll be a worthless person.” Envy works the same way. Shame and guilt express the fear – or the actual condition – of separation and even ego-death. The same is true for embarrassment and humiliation.

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Fear is also classified as external fear, internal fear and subconscious fear:

External Fear:

Usually caused by a specific event in your past, external fears are caused by something outside of you. This is when someone fears something specific like flying, spiders or the number 13. It is only triggered under specific instances when you encounter what it is that frightens you. Because of the trigger, these fears are easily recognized. Most of these fears are caused by some traumatic event in the past. For instance, if you got bit by a spider at a young age, you might develop a phobia about them. Your experience taught you to avoid them.

Internal Fear:

Like external fears, these fears are also triggered by events outside of you. However, internal fears are not specific to any circumstance and are due to internal emotions. This can make these fears difficult to recognize. Internal fears manifest as fear of failure, fear of success, fear of rejection, lack of self worth and doubt. Having a fear of failure can stop someone from starting their own business, asking a person out on a date or starting a new hobby. All of these are different circumstances affected by one fear. Internal fears are dangerous because it can make you think that this fear is just who you are. If you miss it, these fears can really hold you back in life.

Subconscious Fear:

Other fears are so internal to use that we develop beliefs around them. Subconscious fear is similar to internal fears except subconscious fears are believed to be a part of who we really are. Subconscious fears develop into limiting beliefs.

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In medical practice, we encounter three entirely different types of fear:

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Causes of fear:

There are some basic causes of fear. Depending on our emotions and psychological makeup, we will react accordingly. These categories are broad, and many different situations may fit under each. What causes fear? Why do people often react differently when frightful situations arise? The answer has to do with human emotions. The better we understand our emotions, the more equipped we are to handle various circumstances that may arise. Many programs to the problem of handling fear have been suggested. Some people have been able to employ these programs successfully. Others have not. For many, these strategies seem to work temporarily, but eventually the problem of fear returns. There are three basic causes of fear. These are: the possibility of harm, the possibility of frustration (the failure to achieve), and the possibility of not surviving. Any of these fears may be caused by real or imagined threats.

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In the real world, fear can be acquired by a frightening traumatic accident. For example, if a child falls into a well and struggles to get out, he or she may develop a fear of wells, heights (acrophobia), enclosed spaces (claustrophobia), or water (aquaphobia). There are studies looking at areas of the brain that are affected in relation to fear. When looking at these areas (amygdala), it was proposed that a person learns to fear regardless of whether they themselves have experienced trauma, or if they have observed the fear in others. In a study completed by Andreas Olsson, Katherine I. Nearing and Elizabeth A. Phelps the amygdala were affected both when subjects observed someone else being submitted to an aversive event, knowing that the same treatment awaited themselves, and when subjects were subsequently placed in a fear-provoking situation. This suggests that fear can develop in both conditions, not just simply from personal history. The creation of fear is affected by cultural influences and historical experience, especially during childhood or after serious accident happened. For example, in the early 20th century, many Americans feared polio, a disease that cripples the body part it affects, leaving that body part immobilized for the rest of one’s life. There are also consistent cross-cultural differences in how people respond to fear. Display rules affect how likely people are to show the facial expression of fear and other emotions. Although fear is learned, the capacity to fear is part of human nature. Many studies have found that certain fears (e.g. animals, heights) are much more common than others (e.g. flowers, clouds). These fears are also easier to induce in the laboratory. This phenomenon is known as preparedness. Because early humans that were quick to fear dangerous situations were more likely to survive and reproduce, preparedness is theorized to be a genetic effect that is the result of natural selection.

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What causes fear varies from person to person depending upon childhood experiences and personality. It’s possible that fear of some animals is inborn in all mammals. But more often a parent’s fear will rub off on the child. A child is bitten by a dog, scratched by a cat or stung by a wasp can grow up with a fear of that animal or insect. Sometimes a horror movie can trigger this fear. As with other phobias, what causes fear of dental work could be a previous traumatic experience. It could also occur from a rough or unpleasant dentist, a fear of the needle for freezing or the dread of having something done in your head. It could also be the fear of confinement in a chair. More than 50% of North Americans dislike dental procedures. When the fear progresses to avoiding the dentist altogether, it is a phobia and you need help. What causes fear of blood is often other family members who fear this too. Children often internalize this fear from their parents and siblings.

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Conditioned (learned) fear and unconditioned (innate) fear:

Fear can broadly be characterized into two types. Conditioned fear is the process by which an insignificant and otherwise harmless stimulus becomes, by association, a sign of danger. The association between an innocuous stimulus and a fear response can easily be induced by classical conditioning, in which the stimulus is repeatedly associated with something scary, until the stimulus itself is feared. In contrast, unconditioned fear is not learnt, but, rather, is ‘instinctive’, and can be regarded as an evolutionary relic – we sometimes fear what our ancestors feared. A great deal of time and effort has gone into attempts to determine whether the human emotional response to a certain stimulus is a primary (innate) or a secondary (learned or acquired) response. For example, is the fear of snakes innate or learned? Some psychologists have said ”innate” and pointed to the fact that chimpanzees raised in the laboratory are innately afraid of snakes (Hebb, 1946). Others have shown that children under two years of age often seem to have no fear of snakes. Neither of these arguments is very persuasive however: That chimpanzees are innately afraid of snakes doesn’t mean that humans are; and that a fear develops after infancy does not mean that it is learned. Indeed, only two stimuli seem to elicit fear in a newborn: a loud noise and a sudden loss of support. Innate and learned fears are at opposite ends of a continuum of associability. The distinction between conditioned associative fears and innate non-associative fears may need even more modulation. Natural and experimental observations of the onset of different fears are best understood as being on a continuum with many gradations. At one end no traumatic experience is needed for the fear to develop, in the middle only a little unpleasant learning, and at the other end a great deal of aversive association. Different situations thus have different valencies for attracting fear. At the purely innate extreme of the continuum are defensive reactions which are so potent or prepared that they appear without any traumatic experience at all. Examples are neonates’ startle response (Moro reflex) to loud noise, and eye blinking when objects approach the eye rapidly. They are completely non-associative. Slightly away from the purely innate end of the continuum lie fears of other situations that are largely but not completely innate (latent, potent, prepared, and mainly non-associative). Such fears may remain dormant if individuals have no traumatic experience of the relevant situation, yet manifest quickly and persistently after subjects have undergone minimal vicarious or direct trauma in the situation. That even a biological defense such as snake fear requires some (albeit minimal) associative conditioning to become manifest is revealed in Mineka’s classic studies of laboratory-reared rhesus (vide infra).   

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Is fear learned or innate?

The ability to survive is one of the greatest determining factors to whether or not an individual will pass on their genetic information. Naturally, because trial and error in interactions with potentially dangerous predators, such as snakes and spiders, could lead to rather deadly results, innate abilities to detect, orient, and learn about such dangers are extremely plausible and may have resulted from evolutionary selective pressures. In terms of the evolution of survival mechanisms, the ability to recognize recurring threats within the environment and learn to act in an appropriate manner toward them would be a favorable trait that would spread through the population, perhaps via genetics or social learning. A properly functioning mechanism of detection and learning fear for recurrent threats in infancy would serve a great benefit in preventing premature mortality, while over-exaggerated fear of threats could otherwise produce a harmful dysfunction in later life that we term as being a phobia. By determining the predictors and patterns early on that lead to severe phobic anxieties, it may be possible to produce interventions, treatment, and counseling to prevent their emergence. All humans universally experience and express the emotion of fear as a signal of danger during certain situations that may be a potential threat to survival (LeDoux, 1996; Marks, 1987). Humans probably experienced numerous environmental threats throughout evolutionary history and would have benefited from the ability effectively to protect themselves from these experiences. Fear of snakes and spiders, which are both considered to be common threats to survival in early human history, were not thought to be innate characteristics in human and nonhuman primates but learned; which later on proved to be flawed conclusion. Early studies of Watson and Rayner (1920) demonstrated that fear can indeed be learned through conditioning, but threat relevant stimuli appear to more readily become objects of fear, supported by increasing evidence that fear arises from the presence of evolutionary psychological mechanisms which provide the ability to rapidly detect, attend to, and learn about predators (Rakison & Derringer, 2008, Öhman & Mineka, 2001). Evidence of fear prevalence and response to snakes in non-human primates, comparable to humans, would suggest evolutionarily relevant explanations behind the development of fear perhaps related to genetic variation or differences in learning associations with predatory stimuli. Rhesus monkeys raised in the wild show strong fear responses to snakes, unlike their captive counterparts. Lab monkeys, found to not show initial fear responses to snakes, were easily able to learn fear of snakes through observations of live and videotaped wild monkeys demonstrating fear responses to not only live, but toy snakes (Cook & Mineka, 1990). However, these monkeys were not capable such substantial fear conditioning for nonthreatening stimuli, like flowers and toy rabbits, though could still be trained to implement both these, as well as the predatory stimuli, as conditioned signals for food. This research supports constrained selective learning of fear with evolutionary threats. Rakison and Derringer (2008) found evidence that human infants may possess evolved spider and snake detection mechanisms, based on perceptual templates, which may have aided in our early ancestors’ abilities to learn about and avoid these predators to ensure survival. In this study, preferential looking and habituation paradigms were used with 5-month-old infants to assess the perceptual template structures for spiders. It was demonstrated that infants showed preference to attending to schematic images of spiders, compared to template spiders with features reconfigured or completely scrambled, but did not show this preference with another biological, but non-threat-relevant stimuli, specifically a flower. It was also found that when infants were habituated to real colored static images of spiders, they generalized the real spiders to the schematic template but not the reconfigured and scrambled images, indicating that the perceptual preference for the schematic spider was not the product of a simple shape preference.  

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Evolutionary perspective:

From an evolutionary psychology perspective, different fears may be different adaptations that have been useful in our evolutionary past. They may have developed during different time periods. Some fears, such as fear of heights, may be common to all mammals and developed during the mesozoic period. Other fears, such as fear of snakes, may be common to all simians and developed during the cenozoic time period. Still others, such as fear of mice and insects, may be unique to humans and developed during the paleolithic and neolithic time periods (when mice and insects become important carriers of infectious diseases and harmful for crops and stored foods). An evolutionary view can help explain otherwise puzzling features of anxiety by suggesting new and testable hypotheses about its function, and a search for relevant evidence. To take an example, stranger fear arises worldwide in infants at about six months of age. In trying to explain this, Marks when writing Fears, Phobias, and Rituals (1987) reasoned that a fear that is so transcultural is likely to be adaptive. At age six months, babies start to crawl away from mother and encounter strangers more often. Were strangers especially dangerous to infants in our recent evolutionary past? A search for relevant evidence found much that was emerging. Infanticide by strangers turned out to be so common that it is a strong selective force in primates as well as other species (Hrdy 1977). Abundant documentation also emerged that even today human infants are far more likely to be killed or abused by strangers than by familiars (Daly and Wilson 1989).

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Fear in amygdala as an evolutionary survival mechanism:

During the early beginnings of life, nature developed the amygdala as special purpose organs in the brain to remember and respond to danger signals. They become sensitive to sensory signals, which accompanied past painful events. Such sensitivity in the amygdala of animals has been extensively verified. In typical experiments, a rat is exposed to a painful foot shock accompanied by a sound. Later, when the sound alone is heard, its amygdala will fire fear signals. Such painful experiences were seen to develop “speed dial (LTP) circuits,” which later responded instantly to the related sound signal. The organs became over sensitive to such signals. As essential as the vertebrae, these organs were early components of the brains of fishes, amphibians, reptiles, birds and mammals. As the primary defense response mechanism, the amygdala recognized danger patterns and impelled animals to fight, freeze, or escape. Over millions of years, nature has assembled in the amygdala a memory for harmful events. On recognizing signals of such events, the amygdala instinctively responds by triggering fear. So, most people have an inherited fear of falling, of being suffocated in enclosed spaces, of drowning in water and of being attacked by rats, cockroaches, or snakes. Even stage fright and a fear of public speaking originate from an instinctive fear of becoming a focus of attention of predators. The fear responses of the amygdala for such events are often accompanied by the startle response (vide infra). The assumption that fear is a learned avoidance reaction to potentially dangerous situations is gradually being questioned. Recent studies show that fear may be a genetically determined function of the nervous system. This hypothesis receives support from an evolutionary point of view. The ability to detect and anticipate dangerous situations seems to be crucial for survival, and individual learning might not be entirely quick enough to ensure survival chances. Moreover, even potentially dangerous stimuli might be rare and thus impossible to learn – leading an individual into danger when the stimulus is encountered for the first time.

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Studies that support that fear is innate:

Study 1) Some studies show that humans might be genetically predisposed to fear certain harmful things like spiders, snakes and rats — animals that once posed a real danger to human beings because they were poisonous or carried disease. Fear of snakes, for example, has been found in people who have never even been in the presence of a snake. This makes sense if you think about fear as an evolutionary instinct embedded in the human consciousness. The idea is also supported by scientific research. Psychologist Martin Seligman performed a classical conditioning experiment in which he showed subjects pictures of certain objects and then administered an electric shock. The idea was to create a phobia (an intense, irrational fear) of the object in the picture. When the picture was of something like a spider or a snake, it took only two to four shocks to establish a phobia. When the picture was of something like a flower or a tree, it took a lot more shocks to get a real fear going.

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Study 2) The neurocircuitry for fear is genetically encoded in the mammalian brain. Panksepp writes: “The emotional experience of fear appears to arise from a conjunction of neural processes that prompt animals to hide (freeze) if danger is distant or inescapable, or to flee when danger is close but can be avoided.” The concept of genetically determined, innate neurocircuitry for fear can be demonstrated with a loss-of-function experiment using knockout mice. Such mice are engineered to lack the activity of one or more genes. Knockout mice contain the same, artificially introduced mutation in every cell, abolishing the activity of a preselected gene. The resulting mutant phenotype (appearance, biochemical characteristics, behavior etc.) may provide some indication of the gene’s normal role in the mouse, and by extrapolation, in human beings. Knockout mouse models are widely used to study human diseases caused by the loss of gene function. Researchers Chong Chen et. al knocked out just one copy of a particular gene and created a knock-out mouse with unusual characteristics related to fear. In Animals in Translation: Using the Mysteries of Autism to Decode Animal Behavior (2005), Temple Grandin and Catherine Johnson recount how researchers “discovered that they hadn’t just knocked out some aspect of learning; they’d also knocked out fear. A normal mouse, with a normal amount of fear, does not fight to the death. He fights until he’s beaten, or sees he’s going to lose, and then he yields. Fear keeps him alive. The knockout mice were almost fearless, and they fought to the death.” Grandin and Johnson write: “The researchers would come to the lab first thing in the morning and find dead mice in the cages. Their backs were broken and there was blood everywhere.”

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Study 3) Many animals have innate fears. Panksepp writes: “External stimuli that have consistently threatened the survival of a species during evolutionary history often develop the ability to unconditionally arouse brain fear systems.” For example, laboratory rats that have never before encountered a cat or ferret exhibit “increased freezing and inhibition of other motivated behaviors” when the odor of a cat or ferret is introduced into their environment. Panksepp notes that the fear response is species-specific.  

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Study 4) Evolutionarily speaking, early humans who were capable of surviving the dangers of an uncivilized society adapted accordingly. And the same can be said of the common fear of certain animals, such as spiders and snakes: The ancestors of modern humans were either abnormally lucky or extraordinarily capable of detecting and deterring the threat of, for example, a poisonous snake. Psychologists Vanessa LoBue and Judy DeLoache were able to show this phenomenon by examining the ability of adults and children to pinpoint snakes among other nonthreatening objects in pictures. “We wanted to know whether preschool children, who have much less experience with natural threats than adults, would detect the presence of snakes as quickly as their parents,” LoBue explained. “If there is an evolved tendency in humans for the rapid detection of snakes, it should appear in young children as well as their elders.” Preschool children and their parents were shown nine color photographs on a computer screen and were asked to find either the single snake among eight flowers, frogs or caterpillars, or the single nonthreatening item among eight snakes. As the study surprisingly shows, parents and their children identified snakes more rapidly than they detected the other stimuli, despite the gap in age and experience. LoBue and DeLoache also found that both children and adults who don’t fear snakes are just as good at quickly identifying them as children and adults who do fear snakes, indicating that there may be a universal human ability to visually detect snakes whether there is or is not a fear factor based on a learned bias or experience. LoBue and DeLoache explain that their study does not prove an innate fear of snakes; only that humans, including young children, seem to have an innate ability to quickly identify a snake from among other things. Babies detect snakes quickly – and then learn to be afraid of them really quickly, she said. One of their previous studies indicated that humans also have a profound ability to identify spiders from among non-threatening flora and fauna. Lobue has also shown that people are very good at quickly detecting threats of many types, including aggressive facial expressions. In one Swedish study, scientists showed volunteers images of snakes, spiders, flowers and mushrooms while giving them a small electric shock.  The volunteers learnt to associate an electric shock with all the images – but the effect lasted a lot longer with snakes and spiders. Also discussed earlier, another U.S. study found that monkeys raised in a laboratory are not afraid of snakes, but will learn to fear snakes more quickly than they learn to fear rabbits or flowers.

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Study 5) Research like the type conducted by David Rakison of Carnegie-Mellon University and Jaime Derringer of the University of Minnesota seems to contradict the idea that fears of snakes and spiders are (at least predominantly) culturally developed. They showed pictures of spiders to five-month old infants and measured the amount of time they spent fixated on them vs. pictures of other objects. The infants spent an average of 7-8 seconds longer looking at the spider pictures, an indication that the spiders were more interesting to the newborns, at a time when they seemingly could not have learned the significance of a spider through cultural or environmental processes. Similar research has been conducted in the past with spiders and snakes, with similar results, although not with humans of such a young age. So what does this mean? Do we have inborn fears of snakes and spiders? Well, perhaps we are not born with a fear of spiders, but maybe with a predisposition toward viewing snakes and spiders in a different way than we would a cat or a flower. The evolutionary viewpoint is that a predisposition toward certain fears that would increase the chances of survival would be passed on. Sure, most snakes and spiders we encounter today aren’t harmful, but in the environment where our evolutionary ancestors dwelled (Africa) there were more harmful varieties, as well as little medical ability to manage a poisoning. Thus, an encounter with a snake or spider was something to be feared, and those that had a healthy fear would be more likely to survive, reproduce, and propagate their genetic information. Rakison and Derringer suggest that a genotype that increases the chances of survival by only 5% would be widespread throughout a population in 20-30 generations. Natural selection is likely to favor people who stay away from potentially dangerous animals, they say. 

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Fear of Spiders can develop before birth by transfer of information from mother to offspring about predation risk:

Now researchers have proven that unborn crickets can gain a fear of spiders based on their mother’s harrowing experiences. Scientists put pregnant crickets into terrariums containing a wolf spider. The spiders’ fangs were covered with wax so the spiders could stalk but not kill the pregnant crickets. After the crickets laid their eggs, the researchers compared the behavior of the offspring with offspring whose mothers hadn’t been exposed to spiders. The differences were dramatic, the scientists said. The newborn crickets whose mothers had been exposed to a spider were 113 percent more likely to seek shelter and stay there. They were also more likely to freeze when they encountered spider silk or feces —a behavior that could prevent them from being detected by a nearby spider. Overall, these newborns had better survival rates than other newborn crickets, eaten by the wolf spiders for the sake of science. The results of the cricket test suggest that “the transfer of information from mother to offspring about predation risk, in the absence of any parental care, may be more common than one might think,” said Jonathan Storm of the University of South Carolina Upstate in Spartanburg. Scientists aren’t sure how the fear is passed down, but they speculate that stressful events like predator attacks trigger the release of a hormone in the mother that influences the development of the embryo. 

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Study showing that fear is not innate:

Parents pass on ‘irrational fear’ of spiders and snakes to their children:

Experts at Rutgers University in Newark showed seven-month-old babies two videos side by side – one of a snake and another of a non-threatening animal. At the same time, the babies were played a recording of either a fearful human voice or a happy one. The infants spent more time looking at the snake videos when listening to the fearful voices, but showed no signs of fear themselves, the researchers report in the journal Current Directions in Psychological Science. The study challenges the theory that snake and spider phobias are innate.

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In a nutshell, after assessing all studies, I conclude that fear of snake in primates is evolutionarily hardwired in brain for survival as healthy fear would make species more likely to survive, reproduce, and propagate their genetic information and natural selection is likely to favor those who stay away from potentially dangerous animals. This innate fear may not manifest all the time and remains concealed till an organism encounters snake. That is why monkeys raised in a laboratory are not afraid of snakes, but will learn to fear snakes more quickly than they learn to fear rabbits or flowers.   

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Fear vis-à-vis anxiety:

In a book Godin differentiates between fear and anxiety. Fear is something that presents a clear and present danger to our life.  Anxiety is something we often call “fear”, when it’s really just exaggerated worry about a worst-case outcome of some future event. In almost every case, that worry is irrational.

 Accidentally stepping on a cobra = fear

 Avoiding hiking through… well, wherever cobras live because you may step on a cobra = anxiety

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Scientists generally define fear as a negative emotional state triggered by the presence of a stimulus (the snake) that has the potential to cause harm, and anxiety as a negative emotional state in which the threat is not present but anticipated. We sometimes confuse the two: When someone says he is afraid he will fail an exam or get caught stealing or cheating, he should, by the definitions above, be saying he is anxious instead. You are taking a walk in the woods ― pleasant, invigorating, the sun shining through the leaves. Suddenly, a rattlesnake appears at your feet. You experience something at that moment. You freeze, your heart rate shoots up and you begin to sweat ― a quick, automatic sequence of physical reactions. That reaction is fear. Human anxiety is greatly amplified by our ability to imagine the future, and our place in it. A week later, you are taking the same walk again. Sunshine, pleasure, but no rattlesnake. Still, you are worried that you will encounter one. The experience of walking through the woods is fraught with worry. You are anxious. This simple distinction between anxiety and fear is an important one in the task of defining and treating of anxiety disorders, which affect many millions of people and account for more visits to mental health professionals each year than any of the other broad categories of psychiatric disorder. 

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Anxiety (also called angst or worry) is a psychological and physiological state characterized by somatic, emotional, cognitive, and behavioral components. It is the displeasing feeling of fear and concern. Anxiety is a generalized mood that can occur without an identifiable triggering stimulus. As such, it is distinguished from fear, which is an appropriate cognitive and emotional response to a perceived threat. Additionally, fear is related to the specific behaviors of escape and avoidance, whereas anxiety is related to situations perceived as uncontrollable or unavoidable.  Another view defines anxiety as “a future-oriented mood state in which one is ready or prepared to attempt to cope with upcoming negative events,” suggesting that it is a distinction between future and present dangers which divides anxiety and fear. In a 2011 review of the literature, fear and anxiety were said to be differentiated in four domains:

 (1) Duration of emotional experience,

 (2) Temporal focus,

(3) Specificity of the threat, and

(4) Motivated direction.

Fear is defined as short lived, present focused, geared towards a specific threat, and facilitating escape from threat; while anxiety is defined as long acting, future focused, broadly focused towards a diffuse threat, and promoting caution while approaching a potential threat. While most everyone has an experience with anxiety at some point in their lives, as it is a common reaction to real or perceived threats of all kinds, most do not develop long-term problems with anxiety. When someone does develop chronic or severe problems with anxiety, such problems are usually classified as being one or more of the specific types of Anxiety Disorders. Anxiety takes several forms: phobia, social anxiety, obsessive-compulsive, and post-traumatic stress. Although panic attacks are not experienced by every person who suffers from anxiety, they are a common symptom.

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Fear should be distinguished from the emotion anxiety, which typically occurs without any certain or immediate external threat. Fear is frequently related to the specific behaviors of escape and avoidance, whereas anxiety is the result of threats which are perceived to be uncontrollable or unavoidable. Fear is good. It’s evolutionary. It activates our sympathetic nervous system. It keeps us alive. Anxiety is bad. It keeps us from doing interesting and/or fun stuff. It keeps us paralyzed. It forces us to always take the safe route. It forces us to sacrifice that which makes us unique individuals in the name of security. It kills our ability to create. It destroys our ability to make our own dent in the universe.

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Fear = a feeling of doom, unease, or apprehensiveness in response to imminent danger.

Anxiety =a feeling of doom, unease, or apprehensiveness when no danger is imminently present.

Anxiety, therefore, is the same feeling as fear, but there is no danger to react to. With no specific threat, the anxiety is a free-floating, vague feeling. That’s why it can be difficult to pinpoint and treat.

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Are fear and anxiety just different labels of the same emotion, or are they separate and distinct, different from each other as night is from day? According to Reber (1985), fear is “an emotional state in the presence or anticipation of a dangerous or noxious stimulus and is usually characterized by an internal, subjective experience of extreme agitation, a desire to flee or to attack and by a variety of sympathetic reactions”. Anxiety, on the other hand, can be defined as “a fusion of fear with the anticipation of future evil…a continuous fear of low intensity…a feeling of threat, especially of a fearsome threat, without the person being able to say what he (or she) thinks threatens”. Although, the answer to this question is not straightforward, it can be argued that fear is an individual’s reaction to a somewhat clear and present danger, whereas anxiety is a reaction to an anticipated or imagined situation or event.

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There is much correlation between the emotional states of fear. Anxiety, distress, and fear are closely related negative emotional states associated with physical or psychological harm. These three emotions can be differentiated by the temporal relationship between the feeling and the potential threat. Anxiety is characterized by the anticipation of being harmed in the future, where as fear is characterized as the anticipation of being harmed in the present. Distress is characterized by the awareness of being harmed at this particular moment. The three emotions can diffuse into one single diffuse state.

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Anxiety and belief:

A very good example of fear and anxiety is narrated in a seminar on the Power of False Beliefs. At the beginning of the session, teacher would bring in a box wrapped with duct tape and UPS stickers. He told the group this box was just shipped in containing 1000 spiders. He had them close their eyes as he slowly peeled off the tape. He described the exiting of the spiders and their exodus around the room. At least 2/3rds of the students would squirm, squeal and move around in anxiety. He described the spiders for several minutes and then allowed them to open their eyes. He then explained there had never been any spiders. He asked them to think logically: “How could I have found that many spiders? Who would have sold them to me? Why would I want to do that to anyone?”  Yet, even as he sought to dissuade them from their arachnophobia, people were still squirming and showing their nervousness. The belief that spiders were present and dangerous was more powerful than the spiders. Anxiety is meaningless without belief.

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Panic:

Panic is a sudden sensation of fear which is so strong as to dominate or prevent reason and logical thinking, replacing it with overwhelming feelings of anxiety and frantic agitation consistent with an animalistic fight-or-flight reaction. Panic may occur singularly in individuals or manifest suddenly in large groups as mass panic (closely related to herd behavior). Prehistoric men used mass panic as a technique when hunting animals, especially ruminants. Herds reacting to unusually strong sounds or unfamiliar visual effects were directed towards cliffs, where they eventually jumped to their deaths when cornered. Humans are also vulnerable to panic and it is often considered infectious, in the sense one person’s panic may easily spread to other people nearby and soon the entire group acts irrationally, but people also have the ability to prevent and/or control their own and others’ panic by disciplined thinking or training (such as disaster drills). Architects and city planners try to accommodate the symptoms of panic, such as herd behavior, during design and planning, often using simulations to determine the best way to lead people to a safe exit and prevent congestion (stampedes). The most effective methods are often non-intuitive. A tall column, approximately 1 ft (300 mm) in diameter, placed in front of the door exit at a precisely calculated distance, may speed up the evacuation of a large room by up to 30%, as the obstacle divides the congestion well ahead of the choke point. Many highly publicized cases of deadly panic occurred during massive public events. The layout of Mecca was extensively redesigned by Saudi authorities in an attempt to eliminate frequent stampedes, which kill an average of 250 pilgrims every year. Football stadiums have seen deadly crowd rushes and stampedes, such as at Hillsborough stadium in Sheffield, England, in 1989 when 96 people were killed in a deadly crush. India is a house of panic where countless people have died in stampede at temples, bridges, staircases and festivals.

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Panic attack:

Panic attacks are periods of intense fear or apprehension that are of sudden onset and of variable duration of minutes to hours. In panic attack, a person suffers from brief attacks of intense terror and apprehension, often marked by trembling, shaking, confusion, dizziness, nausea, or difficulty breathing. Panic attacks usually begin abruptly, may reach a peak within 10 minutes, but may continue for much longer if the sufferer had the attack triggered by a situation from which they are not able to escape. It can be triggered by stress, fear, or even exercise; the specific cause is not always apparent. In panic attacks that continue unabated, and are triggered by a situation from which the sufferer desires to escape, some sufferers may make frantic efforts to escape, which may be violent if others attempt to contain the sufferer. Some panic attacks can subside on their own over the next several hours. Often, those afflicted will experience significant anticipatory anxiety and limited symptom attacks in between attacks, in situations where attacks have previously occurred. The effects of a panic attack vary. Some, notably first-time sufferers, may call for emergency services. Many who experience a panic attack, mostly for the first time, fear they are having a heart attack or a nervous breakdown. Experiencing a panic attack has been said to be one of the most intensely frightening, upsetting and uncomfortable experiences of a person’s life and may take days to initially recover from.

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Panic disorder:

Repeated panic attacks are considered a symptom of panic disorder. People who have repeated persistent attacks or feel severe anxiety about having another attack are said to have panic disorder. Panic disorder is strikingly different from other types of anxiety disorders in that panic attacks are often sudden and unprovoked. This disorder is fairly common; 2.7 percent of Americans above 18 have it, which makes it more common than bipolar disorder, schizophrenia and obsessive compulsive disorder. Usually, panic disorder strikes people in their twenties, but children can suffer from it as well. Twice as many women develop panic disorder as men. In addition to recurrent unexpected panic attacks, a diagnosis of panic disorder requires that said attacks have chronic consequences: either worry over the attacks’ potential implications, persistent fear of future attacks, or significant changes in behavior related to the attacks. Accordingly, those suffering from panic disorder experience symptoms even outside specific panic episodes. Often, normal changes in heartbeat are noticed by a panic sufferer, leading them to think something is wrong with their heart or they are about to have another panic attack. In some cases, a heightened awareness (hypervigilance) of body functioning occurs during panic attacks, wherein any perceived physiological change is interpreted as a possible life-threatening illness (i.e., extreme hypochondriasis).

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A panic attack is a response of the sympathetic nervous system (SNS). The most common symptoms may include trembling, dyspnea (shortness of breath), heart palpitations, chest pain (or chest tightness), hot flashes, cold flashes, burning sensations (particularly in the facial or neck area), sweating, nausea, dizziness (or slight vertigo), light-headedness, hyperventilation, paresthesias (tingling sensations), sensations of choking or smothering, difficulty moving and derealization. These physical symptoms are interpreted with alarm in people prone to panic attacks. This results in increased anxiety, and forms a positive feedback loop. While the various symptoms of a panic attack may cause the person to feel that their body is failing, it is in fact protecting itself from harm. The various symptoms of a panic attack can be understood as follows. First, there is frequently (but not always) the sudden onset of fear with little provoking stimulus. This leads to a release of adrenaline (epinephrine) which brings about the so-called fight-or-flight response wherein the person’s body prepares for strenuous physical activity. This leads to an increased heart rate (tachycardia), rapid breathing (hyperventilation) which may be perceived as shortness of breath (dyspnea), and sweating (which increases grip and aids heat loss). Because strenuous activity rarely ensues, the hyperventilation leads to a drop in carbon dioxide levels in the lungs and then in the blood. This leads to shifts in blood pH (respiratory alkalosis or hypocapnia), which in turn can lead to many other symptoms, such as tingling or numbness, dizziness, burning and lightheadedness. Moreover, the release of adrenaline during a panic attack causes vasoconstriction resulting in slightly less blood flow to the head which causes dizziness and lightheadedness. A panic attack can cause blood sugar to be drawn away from the brain and towards the major muscles. It is also possible for the person experiencing such an attack to feel as though they are unable to catch their breath, and they begin to take deeper breaths, which also acts to decrease carbon dioxide levels in the blood.

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Role of carbon dioxide:

Carbon dioxide inhalation is capable of inducing panic symptoms in patients with panic disorder but not in normal subjects. In the clinical laboratory, inhalation of 5% carbon dioxide was found to potentiate a rapid increase in ventilation before the panic (ventilation is mediated by receptors that sense carbon dioxide mediated pH change in brain stem). These results have suggested that patients with panic disorder may have very sensitive brain stem carbon dioxide receptors, i.e., “suffocation alarm mechanisms.”

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Put simply, a panic attack is a fear reaction minus any obvious danger to the person experiencing the attack. Physiologically, a panic attack works much the same way fear does. Normally after the onset of fear, your parasympathetic nervous system quickly kicks in to calm your body down by lowering your heart rate and blood pressure. But that does not happen during a panic attack. For some unknown reason, the parasympathetic system doesn’t work properly during an attack, which leaves you to face disturbingly prolonged bodily panic. The fear reaction has advantages in life-threatening situations. All that adrenaline and those juiced muscles could help you escape an attacker or swim to safety. But during a panic attack, when no apparent danger exists, that fear reaction seems completely uncalled for and out of place. For this reason, people who have panic attacks often think they’re going insane. That, be assured, is definitely not the case. 

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Biological Perspective of fear, anxiety and panic:

The basic premise of the biological or physiological explanation for the occurrence of fear and anxiety is that problems with brain functioning lead to anxiety disorders. For example, current research indicates that generalized anxiety disorder is caused by excessive neurological activity in the area of the brain that is responsible for emotional arousal, and this increased level of arousal is experienced as anxiety. This excessive neurological activity is thought to stem from the fact that certain inhibitory neurons whose purpose is to reduce neurological activity are not functioning properly. The neurotransmitter that is released by the inhibitory neurons is known as GABA (gamma-aminobutyric acid). It is believed that low levels of GABA result in the failure to inhibit the activity (neural transmission) of other neurons, which leads to a high level of neurological activity in the areas of the brain that are responsible for arousal, and this high level of activity is experienced as anxiety. One class of drugs that are quite effective at ameliorating the dysphoric symptoms associated with fear and anxiety states are the benzodiazepines. Benzodiazepines reduce anxiety because they directly increase the likelihood that GABA will bind to the receptors of those neurons that are to be inhibited. This, in turn, increases the effectiveness GABA, thereby reducing neural activity, which subsequently decreases one’s level of anxiety. Panic disorder, which is an anxiety state, is generally characterized by brief and intense spontaneous anxiety, is now thought to occur in individuals who have overly sensitive respiratory control centers in the brain stem. Current research has shown that in these individuals, even a relatively minor reduction in oxygen intake will result in the feeling that the person is beginning to suffocate, and it is this feeling of suffocation that leads to panic. It has been found that antidepressant drugs (SSRI) which increase the level of serotonin at the synapses are effective in controlling panic attacks. This is because serotonin acts as an inhibitory neurotransmitter in the respiratory control centers of the brain, thus reducing neurological activity, which in turn reduces its level of sensitivity.

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Phobias:

A phobia means persistent, abnormal, and irrational fear of a specific thing or situation that compels one to avoid it, despite the awareness and reassurance that it is not dangerous. A phobia is, when used in the context of clinical psychology, a type of anxiety disorder, usually defined as a persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding, typically disproportional to the actual danger posed, often being recognized as irrational. In the event the phobia cannot be avoided entirely, the sufferer will endure the situation or object with marked distress and significant interference in social or occupational activities. Phobias tend to run in families, can be influenced by culture and parenting style, and can be triggered by life events.

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The single largest category of anxiety disorder is that of phobic disorders, which includes all cases in which fear and anxiety is triggered by a specific stimulus or situation. Between 5% and 12% of the population worldwide suffer from phobic disorders. Phobias are a common form of anxiety disorders. Phobias are largely underreported, probably because many phobia sufferers find ways to avoid the situations of which they are phobic. Therefore, statistics that estimate how many people suffer from phobias vary widely. An American study by the National Institute of Mental Health (NIMH) found that between 8.7% and 18.1% of Americans suffer from phobias. Broken down by age and gender, the study found that phobias were the most common mental illness among women in all age groups and the second most common illness among men older than 25. Between 4% and 10% of all children experience specific phobias during their lives, and social phobias occur in 1% to 3% of children and adolescents. However, social phobias are more common in girls than in boys. Sufferers typically anticipate terrifying consequences from encountering the object of their fear, which can be anything from an animal to a location to a bodily fluid to a particular situation. Sufferers understand that their fear is not proportional to the actual potential danger but still are overwhelmed by the fear. The average age that phobias begin is about 10 years of age. Women tend to be twice as likely to suffer from a phobia compared to men. If left untreated, a phobia may worsen to the point where the person’s life is seriously affected by the phobia and by attempts to avoid or conceal it, leading to problems with personal health, friends and family, failures in school, and/or lost jobs while struggling to cope. Some of the most common phobias include fears of public speaking or other social situations (social phobia or social anxiety disorder), open spaces (agoraphobia), closed-in spaces (claustrophobia), clowns (coulrophobia), flying (aerophobia), blood, animals (zoophobia), commitment (commitment phobia), driving, spiders (arachnophobia), needles (aichmophobia), snakes (ophidiophobia), math, heights (acrophobia or altophobia), germs (mysophobia), and having dental work done (dentophobia). Fears of midgets, haunted houses, helmets, pickles, and feet are just a few unusual fears/phobias and may be considered weird or strange by some but can be just as debilitating as those phobias that are more common. Agoraphobia often coexists with panic disorder.

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“Normal” fear v/s phobias:

Fear is a natural, if at times unpleasant, emotion caused by something dangerous, by something likely to cause pain, or by some other sort of threat. Fear is a response all of us can relate to – there has been a time in all of our lives when our first instinctual reaction was fear. Many people feel what is felt by somebody with a phobia is simply fear, the same, generally fleeting, emotion that comes and goes quickly. While the emotional and physical responses are similar, there is one major difference between a phobic reaction and simple fear. While fears aren’t always for logical reasons, someone who is afraid of something can logically overcome their fear while someone with a phobia may not be able to overcome what they are afraid of – no matter how illogical that fear maybe. Take for example, speaking in public. The idea of speaking in public is fearful for many people, but people without phobias think their way through the fear. They picture the audience in their underwear, look up at the clock above the audience instead of making eye contact or simply take a deep breath and push their way through it. People with a phobia would never be able to overcome such a fear. Even tricks to alleviate the fear wouldn’t work. The fear they feel is not logical (although the root of the phobia is actually perfectly logical in origin, the sufferer often doesn’t see the logic behind it) and is not something they can trick themselves out of. Someone with a phobia of the dark, for example, also known as Nyctophobia is common in children. While it is understandable for children with vivid imaginations to be afraid of the dark, when the phobia continues into adulthood it can have negative effects on the Nyctophobic’s life. Someone suffering from an illogical, overwhelming fear cannot simply take a deep breath and push through it. Someone afraid of the dark to the point where it becomes a phobia cannot go out in the dark, sleeps with the lights on, and has adverse physical reactions such as a quickened heartbeat or even panic attacks when confronted with the dark. The main difference between fear and phobia is found in how people react to their fear. Someone who is just afraid can use their mind to overcome their fear and can function without letting the fear affect them greatly. People with a phobia cannot overcome their fears on their own, and their fears lead to a debilitating life. Another example would be chrometophobia (also known as chrematophobia), or the fear of money. There is no logical reason to be afraid to handle money, yet there is a phobia out there in which people are too afraid to handle money. Even the idea of spending something of monetary value sends them into a spiral of uncontrollable negative emotions. While fear is understandable, and a normal reaction to many situations in life, a phobia takes fear much farther than is logical. Phobias are crippling and have a negative effect on people’s lives. Furthermore, while fear is something people can overcome on their own, people with phobias aren’t able to just push aside their fear and move on. They are also more common that you might think. According to the American Psychiatric Association, phobias are the number one psychiatric illness in women of any age and the number two in men over 25 years.

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It is normal and even helpful to experience fear in dangerous situations. Fear is an adaptive human response. It serves a protective purpose, activating the automatic “fight-or-flight” response. With our bodies and minds alert and ready for action, we are able to respond quickly and protect ourselves. But with phobias the threat is greatly exaggerated or nonexistent. For example, it is only natural to be afraid of a snarling Doberman, but it is irrational to be terrified of a friendly poodle on a leash, as you might be if you have a dog phobia.

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The difference between normal fear and a phobia
Normal fear	Phobia
Feeling anxious when flying through turbulence or taking off during a storm	Not going to your best friend’s island wedding because you’d have to fly there
Experiencing butterflies when peering down from the top of a skyscraper or climbing a tall ladder	Turning down a great job because it’s on the 10th floor of the office building
Getting nervous when you see a pit bull or a Rottweiler	Steering clear of the park because you might see a dog
Feeling a little queasy when getting a shot or when your blood is being drawn	Avoiding necessary medical treatments or doctor’s checkups because you’re terrified of needles

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The Three Kinds of Phobia:

Hundreds of different phobias have been identified, including phobophobia or fear of phobias. But when talking about phobias, which are a kind of anxiety disorder, experts divide them into three categories:

1. Social phobia: fears other people or social situations such as performance anxiety or fears of embarrassment by scrutiny of others, such as eating in public. Overcoming social phobia is often very difficult without the help of therapy or support groups. Social phobia may be further subdivided into

A) Generalized social phobia (also known as social anxiety disorder or simply social anxiety).

B) Specific social phobia, in which anxiety is triggered only in specific situations. The symptoms may extend to psychosomatic manifestation of physical problems. For example, sufferers of paruresis find it difficult or impossible to urinate in reduced levels of privacy. This goes far beyond mere preference: when the condition triggers, the person physically cannot empty their bladder.

2. Specific phobias: fear of a single specific panic trigger such as spiders, snakes, dogs, water, heights, flying, catching a specific illness, etc. Many people have these fears but to a lesser degree than those who suffer from specific phobias. People with the phobias specifically avoid the entity they fear.

3. Agoraphobia: a generalized fear of leaving home or a small familiar ‘safe’ area, and of possible panic attacks that might follow. It may also be caused by various specific phobias such as fear of open spaces, social embarrassment (social agoraphobia), fear of contamination (fear of germs, possibly complicated by obsessive-compulsive disorder) or PTSD (post traumatic stress disorder) related to a trauma that occurred out of doors.

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These factors may increase your risk of phobias:  

• Your age: Social phobia usually develops early in life, often before age 25. Specific phobias having to do with the environment or personal injury also first appear in childhood — as early as age 5. Fear of tunnels, elevators, bridges, flying, driving and other situational phobias usually develop by the mid-20s.
• Your sex: Phobias affect both sexes, but women and girls are more likely to have specific or social phobias than are men and boys. Women are also more likely to be diagnosed with agoraphobia, but this may be because men tend to hide anxiety or mask it with alcohol. Men and boys may be less likely to seek help for emotional problems than women and girls.
• Your family: If someone in your immediate family has a specific phobia, such as a fear of spiders or snakes, you’re more likely to develop it also.
• A traumatic event: Experiencing a traumatic event, such as being trapped in an elevator or attacked by an animal, may trigger the development of a phobia.

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Symptoms of phobias often involve panic attacks (vide supra).

Emotional signs and symptoms of a phobia:

Feeling of overwhelming anxiety or panic Feeling an intense need to escape Feeling “unreal” or detached from yourself

Fear of losing control or going crazy Feeling like you’re going to die or pass out Knowing that you’re overreacting, but feeling powerless to control your fear

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Complications of phobia:

Although phobias may seem silly to others, they can be devastating to the people who have them, causing problems that extend into and affect many aspects of life.

• Social isolation: People with socially isolating disorders, such as social phobia and agoraphobia, can experience a range of serious consequences. Many have academic, professional and relationship problems. Children with these disorders are at risk of academic difficulties and loneliness and often fail to develop basic social skills.
• Depression: Many of those with phobias have depression as well as other anxiety disorders.
• Substance abuse: The stress of living with a severe phobia often leads to substance abuse.

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Consider treatment for your phobia if:

• It causes intense and disabling fear, anxiety, and panic.
• You recognize that your fear is excessive and unreasonable.
• You avoid certain situations and places because of your phobia.
• Your avoidance interferes with your normal routine or causes significant distress.
• You’ve had the phobia for at least six months.

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Phobophobia:

Phobophobia (from Greek: phobos, “fear”) is a phobia defined as the fear of phobias, or the fear of fear, including intense anxiety and unrealistic & persistent fear of the somatic sensations and the feared phobia ensuing. Phobophobia can also be defined as the fear of phobias or fear of developing a phobia. Phobophobia is related to anxiety disorders and panic attacks directly linked to other types of phobias, such as agoraphobia. When a patient has developed phobophobia, their condition must be diagnosed and treated as part of anxiety disorders. When people experience panic attacks, they are convinced that they are about to die or suffer some extreme calamity in which some kind of action is done by the individual (such as fleeing or screaming). In case of phobophobia, a panic attack might be encountered as the fear that they will in fact experience the calamities of the feared phobia and see it as something inevitable. Also, the nature of the panic is of profound personal significance to the individual, on a similar way phobophobia is related to the individual. This is why panic attacks are closely related to phobophobia. Nevertheless, they can differentiate themselves by the fact that phobophobia is a psychological fear of the phobia itself that intensifies it, while panic attacks are extreme fear of encountering the calamities of an imminent disaster.

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Social anxiety disorder (social phobia):

Social anxiety is a discomfort or a fear when a person is in social interactions that involve a concern about being judged or evaluated by others. It is typically characterized by an intense fear of what others are thinking about them (specifically fear of embarrassment, criticism, or rejection), which results in the individual feeling insecure, and that they are not good enough for other people. The results of this are fear and anxiety within social situations, and the assumption that peers will automatically reject them in the social situations.  Social anxiety disorder describes an intense fear and avoidance of negative public scrutiny, public embarrassment, humiliation, or social interaction. This fear can be specific to particular social situations (such as public speaking [vide supra]) or, more typically, is experienced in most (or all) social interactions. Social anxiety often manifests specific physical symptoms, including blushing, sweating, and difficulty speaking. As with all phobic disorders, those suffering from social anxiety often will attempt to avoid the source of their anxiety; in the case of social anxiety this is particularly problematic, and in severe cases can lead to complete social isolation. A person with social anxiety disorder is afraid that he or she will make mistakes, look bad, and be embarrassed or humiliated in front of others. The fear may be made worse by a lack of social skills or experience in social situations. The anxiety can build into a panic attack. As a result of the fear, the person endures certain social situations in extreme distress or may avoid them altogether. In addition, people with social anxiety disorder often suffer “anticipatory” anxiety — the fear of a situation before it even happens — for days or weeks before the event. In many cases, the person is aware that the fear is unreasonable, yet is unable to overcome it.

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Social phobia is a persistent and irrational fear of situations that may involve scrutiny or judgment by others, such as parties and other social events. When people feel so self-conscious and anxious that it prevents them from speaking up or socializing most of the time, it’s probably more than shyness. It may be an anxiety condition called social phobia. Teens with social phobia are highly anxious in situations like these. Their anxiety may make them avoid everyday social activities and can make social interactions very uncomfortable. People with social phobias fear and avoid situations in which they may be judged by others. It may begin in adolescence and may have to do with overprotective parents or limited social opportunities. Males and females are affected equally with this disorder. Social phobia can affect someone’s life too. With this condition, thoughts and fears about what others think get exaggerated in someone’s mind. The person starts to focus on the embarrassing things that could happen, instead of the good things. This makes a situation seem much worse than it is, and influences a person to avoid the person who has this kind of condition. As the body experiences these physical sensations, the mind goes through emotions like feeling afraid or nervous. People with social phobia are at high risk for alcohol or other drug dependence, because they may come to rely on drinks or drugs to relax in social situations.

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Social anxiety is anxiety (emotional discomfort, fear, apprehension, or worry) about social situations, interactions with others, and being evaluated or scrutinized by other people. The difference between social anxiety and normal apprehension of social situations is that social anxiety involves an intense feeling of fear in social situations and especially situations that are unfamiliar or in which one will be watched or evaluated by others. The feeling of fear is so great that in these types of situations one may be so worried that he feels anxious just thinking about them and will go to great lengths to avoid them. According to the US National Comorbidity Survey, social anxiety is the number one most common anxiety disorder and is also the third most common mental disorder in the U.S. An estimated 19.2 million Americans and counting suffer from social anxiety disorder and it can occur at any time but most often it on-sets in adolescence, early adulthood, or even early childhood. Statistically it is also more common in women than in men.

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People with social anxiety disorder may be afraid of a specific situation, such as speaking in public. However, most people with social anxiety disorder fear more than one social situation. Other situations that commonly provoke anxiety include:

• Eating or drinking in front of others.
• Writing or working in front of others.
• Being the center of attention.
• Interacting with people, including dating or going to parties.
• Asking questions or giving reports in groups.
• Using public toilets.
• Talking on the telephone.

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Fear and Ignorance:

J. Krishna Murthi in his work “The First and Last Freedom” writes that the popular perception about fear and its causes is not what the reality is. Fear can only be caused by the known, and not the unknown. People fear death. But death per se cannot cause fear. In normal circumstances, death cannot be known or perceived. How can we fear something which we have not seen or of whose pain or severity we have had no personal experience? Then what causes fear? Krishnamurthy explains that the fear actually comes from the imagined pain of permanent separation from the near and dear ones and from the cherished possessions, luxuries and life’s enjoyments. It is this perception of separation that is the real cause of fear. Suppose a child who has never heard about or seen a ghost suddenly comes across one. What will happen? It is certain that the child will not run away. Indeed the chances are that he would be glad to find a companion. This is the fearlessness of ignorance. It is for this reason that children all over the world are found much more fearless and bold than adults in general. They have no idea of the all consuming power of fire or electric shock. That is why we often hear of their touching fire or catching electric wires and in the process suffering burns or electric shocks. Then there is also a category of persons who are well aware of the risks involved and yet would play with dangerous situations, things or animals. Snake-charmers daily catch deadly snakes and hunters frequently go on tiger hunts. These things do not frighten them. In fact, they keep searching for their prey and are glad to find them, whereas ordinary persons would shiver at the very thought of fiddling with them. On the other hand, Ignorance too is considered a major cause of fear. Primitive man was completely in the dark about natural phenomena; the eclipses, thunder and lightning, the comets and the like. He feared them, held them in awe and resorted to numerous rites and sacrifices to propitiate these ‘deities’. Later, as he gained knowledge of these phenomena, the fear vanished. Interestingly even as old fears of ghosts and supernatural things are dwindling away, their place is increasingly being taken over by new fears. 

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Fear of detachment:

 The British psychologist Richard Garnett writes in his book “Psychology of Fear” that physical pain is a function of nerves, a nerve reaction to some pain stimulus. But mental-emotional pain arises in a condition of man’s deep attachment to an object. In such a condition, nearness to the object is soothing and comforting. But, conversely, one begins to fear any such person or thing as can separate him from the object. Man is an aggregate of accumulated experiences that act as a bulwark against inner turmoil and disquietude. As long as these psychological and physical experiences are not disturbed they prevent any onset of psychological pain. This being so, man fears all such things as can disturb and deharmonise those experiences. His is thus a phobia of the unknown, a fear of those very experiences which he has accumulated to avoid pain and suffering. In the end, Garnett, too, concludes that this knowledge can at best only alleviate pain; it is not a means to secure freedom from fear.

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Fear v/s respect:

A New York City gang member was asked why he carried a gun. He replied: “Before I had this gun, I didn’t get any respect. Now I do.” Similarly, teachers and parents often belief that if a child obeys them, or says “Yes, Sir/ No, Sir,” it means the child respects them. Several teachers have told me they felt more respected when there was more ‘discipline’ in the classrooms. There is a danger in mislabeling fear as respect. Fear and Respect, surprisingly, are words often used synonymously. For instance, have you not heard of people talking about being ‘god-fearing’ instead of being ‘god-believing’? Fear is a negative feeling coming from a position of weakness. It comes either out of guilt or sheer helplessness. Fear gets exploited everywhere. In the places of work, workshop, with friends and even at home. It is often externally induced and manipulated. Fear terrifies you of consequences and stops you from an action. Fear blocks your mind and hinders free thinking. Fear is demanded by the weak from the weak. Fear comes out of ignorance; not knowing what is in other person’s mind, what is to happen next, what if …… Respect is a positive feeling, comes from a position of strength. It is a natural phenomenon caused in the context of certain observed values which are appealing. It is internal to the person and not prone to external manipulations. You respect a person when you see a person (or an entity) better in some aspect; may be knowledge, power, position, money… be it whatever, it energizes your mind and propels you into action. Respect is commanded by the strong and respect is given by the strong. Respect comes knowledge; knowing you, knowing your choices, knowing others and knowing the world. People can spend their whole lives thinking of ways to earn respect, but unless they do something they will never get it. It is hard for people to get good jobs if they are not respectable.

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Respect, properly defined, is admiration given to another due to his/her accomplishments in some worthwhile endeavor (whether it is programming, humanitarianism, sports, and music, whatever). Respect in one endeavor may not imply respect as a whole–there are many professional athletes, for instance, that you respect for their on-the-field prowess, but you would not want to have them as neighbors. This definition of respect specifically excludes fealty–admiration (or outward admiration, even if one’s personal opinion is different) given to another due to his position of power, authority, or influence. Note that true respect is almost always genuine; whereas fealty may be false. Fealty is a duty to another from a power relationship – it does not have anything to do with ones feelings toward the other person – you owe them duty. Fear is different. Many people in positions of power confuse the two. The schoolyard bully believes that the other kids respect him because he can beat them up; when in reality they fear him (and cannot stand him). Sadly, much of pop culture confuses respect for fear.

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Fear and Gender:

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While men are often more likely to encounter threats to their survival that result in injury and death, women typically report greater fear towards such events. It is theorized that sexual selection created more risk taking tendencies in men, decreasing the extent of their fears, whereas women have favored more cautious strategies. Such caution would not only allow them to provide direct protection for their young, but would furthermore ensure women’s survive, thus prolonging their ability to care for their young. As such, risk taking would be of a greater reproductive cost to women than men. The necessity to avoid risks and reasoning behind it could explain why over three times as many women as men list snakes as their object of most extreme fear or phobia (Fredrikson, Annas, Fischer, & Wik, 1996; Agras, Sylvester, & Oliveau, 1969).

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Female infant more fearful than male infant: a study:

While most would at least flinch at the sight of Aragog, the human-eating spider depicted in “Harry Potter and the Chamber of Secrets,” the everyday spider can cause the same fear in some people. And it turns out; women are four times more likely to fear such arachnids than men. In a study being published in the journal Evolution and Human Behavior, David Rakison of Carnegie Mellon University in Pittsburgh found that 11-month-old girls quickly learned to associate images of spiders and snakes with a fearful facial expression, while baby boys did not. From an evolutionary perspective, this makes sense, as women would have encountered spiders & snakes regularly while gathering food, Rakison speculates. And, he says, the fear factor could keep both moms and their infants safe. Macho men, on the other hand, would have needed to take frequent risks when hunting and so evolutionary pressure to jump at the sight of a spider would be less than beneficial.

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Sex differences in fear reactions in sheep: a study:

In order to assess potential sex differences in fear reactions, 40 rams and 40 ewes were studied using a battery of tests previously designed and validated. Animals were individually confronted with situations classically reported to induce fear in sheep: i.e. isolation from conspecifics, surprise effect and presence of a human. Eight groups were studied, each comprising ten animals of the same sex, breed (Romanov or Ile de-France) and rearing condition (artificially or dam-reared). Males and females of the same breed and rearing condition were tested alternately during the same week (4 days of habituation plus 3 days of tests) in order to prevent fear reactions from being biased by differences in the environment (such as noises, ambient light, etc.) which could influence fear reactions. Twenty-six behavioral items related to fear were recorded. Furthermore, an overall score, based upon those items and reflecting the fear level of each subject in each of the test situations, was calculated. All the significant differences between sexes (P < 0.05) consistently indicate that rams (male sheep) are less fearful than ewes (female sheep). Their overall scores were respectively, 37.0 ± 10.5 vs. 44.0 ± 11.9 (P < 0.01) in the isolation test, 36.1 ± 11.0 vs. 44.9 ± 8.4 (P < 0.001) in the surprise test, 38.5 ± 12.5 vs. 42.5 ± 13.6 (P = 0.06) in the human test (higher scores reflect heightened fearfulness). When subjected to non-social fear-eliciting situations, rams were seen to be less fearful than ewes.

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Gender Differences in Fear as a Function of Situational Context: a study:

The data from the study revealed that females reported more fear than did males, and that males were reported to be more frightening than were females. In other words, fear prevalence is more in females than males but intensity of fear is more in males than females. In stereotypic male-negative and frightening situations, female adults and children reported more fear than did males. For the adolescents, females reported more fear than did males in frightening and stereotypic male-positive situations, and they also tended to report more fear in angry situations. Although adolescent females did not report significantly more fear in male-negative scenarios relative to males, the means for adolescent males and females were in the same direction as they were for the adults and children. These results support much previous literature indicating that females report more fear than do males (cf. Croake et al., 1987; Kirkpatrick, 1984), but extends this literature by indicating that gender differences in the intensity of fear are specific mostly to frightening and stereotypic male-negative situations.

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Gender and age differences in the prevalence of specific fears and phobias: a study:

Point prevalence of specific fears and phobias was determined in 704 respondents of 1000 randomly selected adults aged 18-70 yr. A phobia for lightning, enclosed spaces, darkness, flying, heights, spiders, snakes, injections, dentists and/or injuries was defined if subjects reported a fear that was out of conscious control, interfered with life and lead to the avoidance of the feared object. Fear intensity was assessed using visual analogue scales. A factor analysis generally supported the classification of fears and phobias into: (1) situational phobias (lightning, enclosed spaces, darkness, flying and heights); (2) animal phobias (spiders and snakes); and (3) mutilation phobias (injections, dentists, injuries). Total point prevalence of any specific phobia was 19.9% (26.5% for females and 12.4% for males). In total, 21.2% women and 10.9% men met criteria for any single specific phobia. Multiple phobias were reported by 5.4% of the females and 1.5% of the males. Animal phobia had a prevalence of 12.1% in women and 3.3% in men. Point prevalence of situational phobia was 17.4% in women and 8.5% in men. For mutilation phobia no gender difference was observed, being presented in 3.2% of the women and 2.7% of the men. Women as compared to men gave higher fear ratings for all objects and situations. Inanimate object fears and phobias were more common in older than younger individuals. Animal fears were more intense in younger than in older individuals. Fear of flying increased and fear of injections decreased as a function of age in women but not in men. Thus, specific fears and phobias are heterogeneous with respect to sex and age distribution.

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Gender differences in facial reactions to Fear-relevant stimuli: a study:

The aim of the study was to explore whether females are specifically more facially reactive than males, or whether females are more emotionally reactive in general, as reflected even by non-facial reactions such as autonomic responding and emotional experience. Forty-eight females and 48 males were exposed to pictures of fear-relevant and fear-irrelevant stimuli while EMG activity was detected from the Corrugator supercilii muscle region. Skin conductance responses (SCRs) were measured, and the participants were also required to rate how unpleasant they experienced the stimuli to be. Fear-relevant stimuli evoked a larger corrugator response than fear-irrelevant stimuli, but only for females. Fear-relevant stimuli also elicited larger SCRs and higher ratings of unpleasantness, but these measures were almost identical for females and males. The results are consistent with the hypothesis that females are more facially reactive than males, but not more reactive in other respects.

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Gender differences in reported dental fear and fear of dental pain: a study:

The study found that women were more likely to report global dental fear, global fear of dental pain, and specific fear of dental pain than men, and both women and men were more likely to report ‘dread’ of dental pain than ‘fear’ of dental pain.

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Fear, gender and crime:

Assessing age and gender differences in perceived risk and fear of crime: a study:

Much of the research on fear of crime indicates that women and older persons are highly afraid of crime. These findings, especially older persons’ fear of crime, are widely communicated in the scientific and popular media. This study examines age and gender differences in perceived risk and fear of crime. The data are from telephone interviews of 320 randomly selected residents in a southeastern metropolitan area of the United States. The relationships of age and gender to fear of crime are compared using a National Crime Survey (NCS) measure of fear of crime and 11 alternative indicators of fear of specific offenses. Women reported significantly greater perceived risk and fear of crime than men regardless of how fear of crime was measured and older adults reported the greatest fear of crime when the NCS measure was used but not when the alternative individual measures of fear of crime were used.

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How to explain gender differences in fear of crime: Towards an evolutionary approach: a study:

Employing data from a sample of 610 Dutch high school students and their parents, this study argues in favor of an evolutionary explanation for the fact that women are more fearful of crime than men while they are less often victimized. With respect to a variety of events that involved physical injury, varying from robbery to being involved in a car accident, female respondents were, compared to male respondents, more fearful of every event, judged every single event to be more harmful, and consistently rated their own probability to experience these events in the future as higher. The findings suggest that fear of crime among women does not represent a real higher risk of being victimized, is not primarily linked to the risk of being raped, and is not an isolated phenomenon. Indeed, women seem in general more fearful of all kinds of events that might imply a physical injury. The observed gender differences were not influenced by the degree of traditionality of the family of the respondents as expressed in status differences between the parents, in the division of household tasks, and in having an intact family. The gender differences could neither be explained by a perceived norm that boys must be more risk taking than girls. It is concluded that the observed gender differences may be the result of sexual selection that favored risk-taking and status fights among males, and being cautious and protecting one’s offspring among females.

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Sex differences in the neurobiology of fear conditioning and extinction: a fMRI study:

A substantial literature implicates the amygdala, hippocampus, hypothalamus, medial prefrontal cortex (mPFC) and brain-stem nuclei in the generation of fear responses and in the inhibition and extinction of fear (vide infra). Recent work has suggested that these regions are dysregulated in anxiety disorders. Interestingly, these regions have also been shown to be sexually dimorphic and to activate differentially in healthy men and women under stress and during learning paradigms. Therefore, understanding sex differences could provide some insight into the differences between men and women in the incidence of anxiety disorders. Sex differences in the fear circuitry have been reported in both animal studies and human studies using fear conditioning paradigms. However, these results are inconsistent. Although some studies have reported no sex differences, others have reported that in humans and rodents, males tend to exhibit higher conditioning responses relative to females. As for fear extinction, researchers recently reported data showing that estradiol significantly enhances extinction recall in female rats and in women. Moreover, it has been shown that estradiol facilitated contextual fear extinction via estradiol’s effect on hippocampal long-term potentiation in rats. The modulation of arousal by estradiol is consistent with Goldstein and colleagues’ finding of sex differences in the stress response circuitry of the healthy brain, which shares brain regions with fear circuitry.  Sex differences in the function of the healthy adult brain during a visual stress challenge in a functional magnetic resonance imaging (fMRI) environment has been studied by Goldstein and colleagues. These authors reported that men, compared with women in the late follicular menstrual phase, showed greater blood-oxygenation-level-dependent signal changes in the amygdala, anterior cingulate cortex (ACC), orbitofrontal cortex (OFC), medial prefrontal cortex (mPFC), hippocampus, anterior hypothalamus and periaqueductal gray. These findings were distinct from comparisons of the same women imaged during the early follicular phase, suggesting that circulating sex-steroid hormones partially accounted for sex differences in brain activity in these regions, which is consistent with other fMRI studies using arousing stimuli. Goldstein’s reported BOLD-signal differences were in the same ventral mPFC (vmPFC) region as similar to previous study of the fear circuitry, suggesting anatomical overlap between sex differences in arousal due to stress and fear.   

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Fear and culture:

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Our fears are portrayed through sources such as books, movies. For example, many horror movies and books include characters who fear the antagonist of the plot. Fear is also found in mythological folklore and folklore superstitions. One of the important characteristics of historical and mythical heroes across the cultures is to be fearless in the face of hardship. While there may be “universal fears,” there are also fears that are particular to individuals, communities, regions or even cultures. Someone who grew up in the city probably has a more intense fear of being mugged than someone who has spent most of his life on a farm. People living in South Florida may have a stronger fear of hurricanes than people living in Kansas, and people in Kansas probably have a deeper fear of tornadoes than do people in Vermont. What we fear says a lot about our life experience. There is a phobia called taijin kyofusho that is considered in the psychiatric community (according to the DSM IV) to be a “culturally distinctive phobia in Japan.” Taijin kyofusho is “the fear of offending other persons by an excess of modesty or showing respect.” The intricate social rituals that are part of life in Japan have led to a Japanese-specific fear. The fear of the end and its existence is in other words the fear of death. The fear of death ritualized the lives of our ancestors. These rituals were designed to reduce that fear; they helped collect the cultural ideas that we now have in the present. These rituals also helped preserve the cultural ideas. The results and methods of human existence had been changing at the same time that social formation was changing. One can say that the formation of communities happened because people lived in fear. The result of this fear forced people to unite to fight dangers together rather than fight alone.

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Culture of fear (or climate of fear) is a term used by certain scholars, writers, journalists and politicians who believe that some in society incite fear in the general public to achieve political goals, for example…”The people don’t want war, but they can always be brought to the bidding of the leaders. This is easy. All you have to do is tell them they are being attacked, and denounce the pacifists for lack of patriotism and for exposing the country to danger. It works the same in every country.” – Hermann Göring. The term Islamaphobia is used to describe fears about Islamic terrorism which is usually exaggerated or irrational in nature. The culture of fear has also been used to describe irrational fear in other contexts, such as citizens fearing persons of different ethnic backgrounds, or neighborhood residents fearing retribution if they assist police in identifying criminals. When Franklin D. Roosevelt took the stage and delivered his first inaugural address, he beheld legions of frightened Americans. The year was 1933. A quarter of the nation was unemployed. As he bellowed those now-famous words—the only thing we have to fear is fear itself.  For there’s no doubt that “nameless, unreasoning, unjustified terror which paralyzes needed efforts to convert retreat into advance” seizes the citizenry more tightly today than ever before.  Former National Security Advisor Zbigniew Brzezinski argues that the use of the term War on Terror was intended to generate a culture of fear deliberately because it “obscures reason, intensifies emotions and makes it easier for demagogic politicians to mobilize the public on behalf of the policies they want to pursue”. British academics Gabe Mythen and Sandra Walklate, argue that following terrorist attacks in New York, the Pentagon, Madrid, and London, government agencies developed a discourse of “new terrorism” in a cultural climate of fear and uncertainty. UK researchers argued that this processes reduced notion of public safety and created the simplistic image of a non-white “terroristic other” that has negative consequences for ethnic minority groups in the UK. The dangers of modern life have a stranglehold on people’s imaginations. Sociologists call the phenomenon risk society, describing cultures increasingly preoccupied with threats to safety, both real and perceived. And while the human species is prone to miscalculating risk, there’s more at work here than frazzled modern nerves.

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The Culture of Fear was written in 1999 by Barry Glassner, a sociology professor at the University of Southern California. According to Glassner, three out of four Americans say they feel more fearful today than they did twenty years ago. He explores such questions as: Why do we have so many fears these days? Are we living in exceptionally dangerous times? What he uncovers is that it is our perception of danger than has increased, not our actual level of risk. There are people and organizations in America that actually profit from these fears and so they create them, but there are prices we pay for social panics, including money that is wasted on unnecessary programs and products as well as time and energy spent worrying about these fears. Glassner blames the news media for a great deal of Americans’ fears. The media, he argues, bombards us with sensationalistic stories that are designed to increase ratings, a concept called the media-effects theory. Television news programs, for instance, survive on scares. Stories of crime, drugs, and disaster make up most of the newscasts because that is what gets people to tune in and watch. As stories of crime and disaster increase, so do ratings. Similarly, television newsmagazines such as Dateline, Primetime, or 20/20 commonly report on stories that are statistically nearly impossible to happen, yet they sensationalize one account of an event, letting emotional accounts trump objective information, and getting the general public to panic and fear over the event or subject. News outlets, whether on television or in print, typically exaggerate events and inflate statistics, according to Glassner, and that leads to many of the fears that overcome Americans’ lives.  Other “peddlers of fear” that Glassner discusses are politicians and advocacy groups. In essence, they over exaggerate and inflate statistics and stories to the American people so that their own personal causes and beliefs can benefit. For example, if a politician knows they can get more votes and win a re-election if they get funding for a program benefitting teen moms, he or she will inflate the problem of teenage pregnancy and instill fear in Americans over what would happen if such a program were refused funding. For instance, perhaps teenage pregnancy rates would skyrocket or teen moms on welfare would lose income and starve their children. Korstanje argues that the fear may be politically and culturally manipulated to dissuade citizenry about the implementation of market-oriented policies, otherwise would be widely rejected. In contexts of disasters, nation-states manage the fear not only to provide their citizens with an explanation about the event or blaming some minorities, but also to adjust their previous beliefs. The manipulation of fear is done by means of symbolic instruments as terror movies and the administration ideologies that lead to nationalism. After a disaster, the fear is re-channeled in a climate of euphoria based on patriotism. The fear and evilness are inextricably intertwined.

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The cycle of fear that drives assault weapon sales in the United States:

The cause of gun control in the US is lost unless Americans address the underlying anxiety that makes people feel safer armed. The future of guns in the society may be better understood if we knew more about what they mean to people and why people buy them. Fear is a major factor for many firearm purchases. Recent trends in gun sales suggest that many citizens are becoming more fearful: Gallup poll data suggest that Americans are more fearful, at near-record high levels, about big government, compared to big business or big labor. This fear overlays the long-term public fear of crime and terrorism. Studies show that price increases for semi-automatic assault weapons reflect public moods and fears about social instability. The demand for assault rifles among people who, in many cases, had not previously owned or fired one can be attributed to the popular culture depictions of the weapon in movies, its numerous mentions in national and international news reports, and a paranoid narrative about government control of weapons and losing constitutional freedoms. Decades of research and analysis of news reports show that fear has become a staple of popular culture, ranging from fun to dread. This narrative is repeated as “the discourse of fear” – a pervasive communication or symbolic awareness – and with that comes an expectation that danger and risk are a central feature of everyday life. Weapons in the United States create a paradox that incite a cycle of fear: the more firearms are widely available and are used in crimes and incidents of mass-killing, the more media reports there are about gun crime, and that, in turn, leads people to buy more weapons to feel safe. More guns lead to more violence, more violence lead to more fear, more fear lead to more guns and so vicious cycle of fear promoting violence continues in the United States. The only option is to ban assault weapon and consider amending constitution. No constitution is so sacred that it cannot be amended. Constitutional sanctity cannot be used as a defense of mass murder.  

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Fear and conservatism:

“It’s not that conservative people are more fearful, it’s that fearful people are more conservative”  And that pretty well sums it up. This comes from a study co-authored by Brown University political scientist Rose McDermott. The study is titled:  “Fear as a Disposition and an Emotional State: A Genetic and Environmental Approach to Out-Group Political Preferences.”  Fearful people are more likely to have conservative attitudes toward “out-groups.” People who are scared of novelty, uncertainty, people they don’t know, and things they don’t understand, are more supportive of policies that provide them with a sense of surety and security.  And this conservative/paranoid attitude gets played to the max with today’s hot button issues — immigration, the war on women, hostility toward minorities, champing at the bit to invade other (i.e. inferior) countries, etc.

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Fear and religion:

If one were to look into religion, they would find that it is filled with different fears that humans have had throughout many centuries. The fears don’t just go on the metaphysical levels (including the problems of life and death) but move onto moral dimensions as well. Death was a boundary to people that is seen as a transition to another world. Religious beliefs around punishment and hell in the afterlife can be very difficult for believers. That world would always be different depending on how each individual lived their lives. The origin of this intangible fear comes from other sources that are not found in the present world. In a sense we can assume that fear was a big influence on things such as morality. Religion tells us to fear God, because it is God who will judge us when we die. When we fear God, the religion that says we must do so also has to be feared, because the religion is the one that claims to have the rulebook that God has written for us. God is all powerful, and if you go against his rules you will not be able to quell your fear of death with the promise of afterlife. God sees and knows you better than you know yourself, so you’d better fear him because there’s no lying to him. Fear God because he will be the one to judge you when you die. Religions teach us not to question them as they are the authority of God himself, and therefore the words he speaks through his books are to be treated as truth. But if any of the rules or stories or rules goes against anything you might feel in your conscience, you have to fear these feelings and push them down.

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Bertrand Russell on religion:

“Religion is based primarily upon fear. It is partly the terror of the unknown and partly as the wish to feel that you have a kind of elder brother who will stand by you in all your troubles and disputes. Fear of the mysterious, fear of defeat, fear of death. Fear is the parent of cruelty, and therefore it is no wonder if cruelty and religion have gone hand in hand. It is because fear is at the basis of those two things. In this world we can now begin a little to understand things, and a little to master them by help of science, which has forced its way step by step against the opposition of all the old precepts. Science can help us to get over this craven fear in which mankind has lived for so many generations. Science can teach us, and I think our own hearts can teach us, no longer to look around for imaginary supports, no longer to invent allies in the sky, but rather to look to our own efforts here below to make this world a fit place to live in, instead of the place that the churches in all these centuries have made it.”

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Religious guilt & fear and Fundamentalism: a study:

Guilt and fear associated with religious beliefs have received little research attention. In a convenience sample of 100 adults, fear of punishment by God was significantly higher for fundamentalists protestants than for liberal protestants, or for those with a personal faith not associated with a religious organization. Feelings of guilt for not living up to their religious ideals were approximately the same for fundamentalist and liberal protestants. The pattern of correlations among well-being, importance of religion, and religious guilt & fear was consistent with the hypothesis that religious guilt & fear contribute to suppressing a positive relationship between subjective well-being and importance of religious faith. 

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Fear of death and religion:

Psychologists have addressed the hypothesis that fear of death motivates religious commitment, and that it may be alleviated by assurances about an afterlife. Empirical research on this topic has been equivocal. According to Kahoe and Dunn, people who are most firm in their faith and attend religious services weekly are the least afraid of dying. A survey of people in various Christian denominations showed a negative correlation between fear of death and religious concern.

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Who is afraid of Death? Religiousness, Spirituality, and Death anxiety in late adulthood: a study:

Data from a sample of predominantly white, Christian men and women born in Northern California in the 1920s (N = 155) were used to test the hypothesis that traditional, church-centered religiousness and de-institutionalized spiritual seeking exemplify distinct, but equally adaptive, ways of approaching fear of death in old age. Although both religiousness and spirituality were related to positive psychosocial functioning (an integrated identity and involvement in everyday activities), only religiousness served as a buffer against the fear of death. This effect was consistent with the greater emphasis on conventionality and acceptance of social norms that characterized individuals high in religiousness. The absence of a relation between spirituality and fear of death reflected the spiritual individual’s emphasis on personal searching, creativity, and the positive use of reminiscence. 

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Thanatophobia:

Thanatophobia, or more commonly known as the fear of death, affects millions of people worldwide. Thanatophobia is the fear of death, dead things, or anything associated with death. What causes fear of death is often just being human. Cats and dogs don’t fear death. But they may fear poisonous snakes. You may fear the pain of death or the uncertainty of what or when it will be. Sometimes a loved one’s pain before dying causes anxiety over dying. What if we do not fear our own death, but we fear the death of a family member or a loved one? Every person with a fear of death is different, so some of the tips below may not work for you, though many might.

Tips to overcome fear of death:

1. Understand that it’s a cycle. People are born, people die, more people are born. Don’t feel like you’re being called out, and that you have to fear it.

2. Know that people won’t forget you. You will continue to be remembered on earth, and your memories will never disappear. Even though people are constantly passing on, the memories they leave behind aren’t, and they are staying in the hearts of those they loved. Don’t feel like as soon as you die, you’ll disappear into oblivion.

3. Talk to someone. It’s good to talk to someone about it so you should find someone you trust, and tell them about your fear. Explain to them why you think you feel this way, and how long you’ve felt like this. It is recommended that you see a therapist if the phobia is extreme.

4. Live life the way you’re supposed to. Don’t waste your lifetime worrying about death. Instead, fill each day with as much joy as possible, and don’t let little things get you down. Go outside, play with friends, or take up a new sport. Just do anything that will take your mind off dying, and put it on living.

5. Don’t worry until you need to. Death is something you shouldn’t worry about but perhaps learn to accept as part of life. Death is not something to worry about even if you have a fatal disease in which the chances of death are high.

6. Be optimistic. It is shown that optimists are less likely to contract heart disease than pessimists. If you think badly of the future, you are likely to die sooner. So don’t worry and you’ll live longer.

7. Realize that there’s hope. The materialist view – that physical reality is the only reality – may not be true. No one knows what happens when you die. Embrace the mystery of the unknown.

8. Death does not equal pain. Although life is a great thing, remember that when you are dead you will not be in pain, or suffering.

9. If you are worried about somebody else dying, it’s okay to worry, but just remember that they are human just like you, and can adapt to changes and overcome situations.

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Can you really scare someone to death?

Take the day of Jan. 17, 1994. That was the day the Northridge earthquake struck Los Angeles. On a normal day in Los Angeles, about five sudden deaths occur; a sudden death is generally defined as a natural death (usually attributable to heart disease) that occurs unexpectedly in someone who hasn’t previously exhibited life-threatening symptoms or conditions. On the day of the earthquake, there were 24 sudden deaths. A few were linked to physical exertion, but most were attributed to the frightful earthquake. While the average age of the people that died that day was fairly high — 68 years — only 42 percent of those people had previously exhibited symptoms of heart disease. How often does this happen?  Cannon attributed the ultimate cause of death to an overactive sympathetic nervous system. Essentially, the sympathetic nervous system activates the fight-or-flight response. But the response is never shut down. Instead, the jolt of adrenaline acts on the heart almost like a large amount of cocaine would — it completely shuts the organ down. At the same time, the fight-or-flight response causes the blood vessels to constrict so that valuable oxygen is cut off from the heart, further compounding the body’s distress. Researchers at Johns Hopkins University studied the effects of the “broken heart syndrome,” in which extreme emotions caused something that looked like a heart failure or heart attack, but that was, in fact, different, because the blood clots and clogged ­arteries­ that cause cardiac conditions were absent. Instead, the heart was just weak from stressful emotions. This work suggests that death could happen in the wake of any shocking emotion, from intense joy at finding out a long-lost son is still alive, to deep anger at the betrayal of a loved one. Hypothetically, that means we’re all at risk. But since millions of us engage in scary movies, haunted houses and rush hour traffic every year, it’s hard to imagine that getting scared to death is a real threat, and so researchers at Johns Hopkins acknowledge that the risk of sudden death from fear or any emotion is low. 

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Could fright explain why people die in police custody?

While neither the American Medical Association nor the American Psychological Association recognize it, the diagnosis of “excited delirium” is sometimes used after death that occurs in the course of arrest or imprisonment. The diagnosis typically results after an obese, often drug-addled person resists police with violence. The adrenaline produced by the fight is thought to cause death. Civil liberty groups, however, cry foul, claiming that the bogus diagnosis is used to cover up unnecessary police brutality and force.

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Fear in childhood:

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Emotional development in infant vis-à-vis fear:

Emotions are distinct feelings or qualities of consciousness, such as joy or sadness that reflect the personal significance of emotion-arousing events. The major types of emotions include fear, sadness, anger, surprise, excitement, guilt, shame, disgust, interest, and happiness. These emotions develop in an orderly sequence over the course of infancy and childhood. Even during the first three or four months of life, infants display behavioral reactions suggestive of emotional states. In the period from 4 to 10 months, new emotional states appear. The crying and resistance infants display at the withdrawal of a favorite toy or at the interruption of an interesting activity can be termed anger. One-year-old infants are capable of displaying sadness in response to the prolonged absence of a parent. Infants begin displaying signs of the emotion of fear by their fourth to sixth month; a fearful response to novelty—i.e., to events that are moderately discrepant from the infant’s knowledge—can be observed as early as four months. If an infant at that age hears a voice speaking sentences but there is no face present, he may show a fearful facial expression and begin to cry. By 7 to 10 months of age, an infant may cry when approached by an unfamiliar person, a phenomenon called stranger anxiety. A month or two later the infant may cry when his mother leaves him in an unfamiliar place; this phenomenon is called separation anxiety. It is no accident that both stranger and separation anxiety first appear about the time the child becomes able to recall past events. If an infant is unable to remember that his mother had been present after she leaves the room, he will experience no feeling of unfamiliarity when she is gone. However, if he is able to recall the mother’s prior presence and cannot understand why she is no longer with him, that discrepancy can lead to anxiety. Thus, the appearances of stranger and separation anxiety are dependent on the improvement in memorial ability. These emotions in young infants may not be identical to similar emotional states that occur in older children or adolescents, who experience complex cognitions in concert with emotion; these are missing in the young infant.

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Child’s world is magical and menacing—full of mysteries and dangers, real and imaginary, that most of us forget as adults. In one survey of a thousand children, 90 percent had some specific phobia between the ages of 2 and 14. In another study, 43 percent of children between the ages of 6 and 12 had “many fears and worries.” Most of these anxieties are not associated with psychiatric disorders or psychopathology. It can be difficult to decide when a child’s fears are so serious that they need treatment. The categories used for adult anxiety disorders, like most adult psychiatric diagnoses, are inadequate when applied to the constantly growing and changing bodies & minds of children. Fears that are normal at one age become incapacitating a few years later; and chronological age is not decisive, since different children have different rates of development. Most of these fears are mild and transient. Fear becomes a problem only if it interferes with activities normal at a given age, and in most cases it presents a mental health problem only if this situation lasts at least a month. By one estimate, 8 percent of boys and 11 percent of girls have clinically significant anxiety of some kind before the age of 18. A survey in the province of Ontario, Canada found that 6 percent of children aged 4 to 6 and 2.5 percent of children aged 12 to 15 might be in need of treatment for fears and anxieties. Perhaps 2 to 3 percent of children at some time have enough fear of school to worry their parents and teachers. Researchers have never agreed on how to classify children’s fears.

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Fears are common in childhood. More than 50 percent of children experience normal phobias, which is the fear of a specific object, or more general worries, called anxieties, before they are 18 years old. For adults it may be helpful to distinguish between rational fears, such as fear of snakes or guns, which are survival mechanisms and serve to protect a person from danger; and irrational fears, or phobias, which cannot be traced to any reasonable cause. Most children have some fears. Fears are normal, and can be a good thing. For example, children need to know they should not run into a street. They need to know not to play with knives. A little fear is good, but too much fear is a problem. So is too little fear. A child with too much fear may not want to leave the house. A child with not enough fear may get into a stranger’s car. Children’s personalities also will influence their fears. One child may be scared of more things than another child. Some children are braver, while others are more shy and fearful. Many childhood fears fall somewhere between the rational and irrational, occurring in phases as the child or adolescent is exposed to new experiences and as both cognitive reasoning and the capacity for imagination develop. Whether a child’s fear is considered normal generally depends on his or her age, background, and most importantly on how much it interferes with his or her normal daily activities. Fear of water may be considered normal in a child who has never learned how to swim, but it might be considered abnormal in the adolescent son of a coastal fisherman.

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Which of my child’s fears are normal?

According to the Child Anxiety Network, the following fears are extremely common and considered normal:

• 0-2 years – Loud noises, strangers, separation from parents, large objects.
• 3-6 years – Imaginary things such as ghosts, monsters, the dark, sleeping alone, strange noises.
• 7-16 years – More realistic fears such as injury, illness, snakes & spiders, teachers, doctors, school performance, death, and natural disasters.

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In older adolescents, common fears include anxiety about school achievement, social rejection and related worries, and sexual anxieties, including dating and sexually transmitted diseases, especially human immunodeficiency virus (HIV). Symptoms in adolescents and teens include anger, avoidance, and denial of the fear, and panic reactions, such as sweating, trembling, fast heartbeat, and rapid breathing.

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Reasons of childhood fears:

Explanations for children’s fears and anxieties are disputed. Clearly, innate temperament is important. Some fears are nearly universal and appear to be survival mechanisms: fear of darkness, strangers, snakes, heights, loud noises, being stared at. The question is, why do most children succeed in outgrowing or coping with fears and some do not? A few seem to be temperamentally shy. Studies have shown that the 15 percent of children who have the highest resting heart rates at age 2 are also more likely to develop unusual fears at age 5 to 7 — fears of television violence, kidnappers, or going to the bathroom alone at night. Temperamentally susceptible children are apparently more likely to become fearful when they have older brothers and sisters.  Panic attacks are another source of children’s fears. Probably they are not just a heightened form of ordinary anxiety but have a distinct biological source, possibly a chemical imbalance in the nervous or endocrine system. A sudden assault of heart palpitations, chest pain, breathlessness, nausea, and sweating, with an accompanying sense of impending doom, provides a powerful motive for avoiding the place or situation in which it occurs. This anticipatory anxiety—fear of fear itself—may cause multiple anxieties and phobias. Twenty-five to 50 percent of adult patients with panic attacks say they began before the age of 20, and about 20 percent of adult patients with panic attacks had school phobia or separation anxiety as children.

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The most significant factors in overcoming fear are identifying the fear, developing a sense of control over the feared environment, and envisioning alternatives to the feared negative outcomes. Forcing children to perform activities they are afraid to do destroys, rather than builds, autonomy and self-confidence. If a child refuses to do something or explicitly voices fear, those feelings should be taken seriously and explored through questions and discussion. Parents can ask the child or adolescent what change can be made to accommodate the fear in order to make him or her feel more in control. Some research suggests that reading scary picture books functions as a courage-building tool for children and helps them face their fears in a controlled environment; they are free to turn the page or to remind themselves that the monster is not real. Horror stories or movies may serve the same purpose for teens but not for children who cannot exercise the same level of choice by leaving the theater and should not be exposed to disturbing movies.

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Childhood phobias:

A childhood phobia is an exaggerated, intense fear “that is out of proportion to any real fear” found in children. It is often characterized by a preoccupation with a particular object, class of objects, or situation that one fears. A phobic reaction is twofold—the first part being the “intense irrational fear’ and the second part being “avoidance.” According to Child and Adolescent Mental Health, approximately 5 percent of children suffer from specific phobias and 15 percent seek treatment for anxiety-related problems.

Common childhood Phobias:

1. Fear of Abandonment:

From infancy a child can feel whether or not his mother cares for him. As a child grows and develops, he or she will need continued guidance until they reach adulthood. When a child’s discipline is directed at the child himself instead of his misbehavior, the child feels as if his relationship with his parents is at risk. Phrases like “Ugh, you’re killing me,” “I’ll give you up for adoption.” or “I could just kill myself,” are especially harmful. These phrases can make the child unstable and overly anxious when left alone. The child perceives that he is unloved and blames himself for the rejection.

2. Fear of Animals:

The fear of animals most often occurs in the third year of life. In some cases, the fear has logical origins such as a traumatic experience with a large seemly furious dog. In others however, the fear is less rational. When a child fears small seemingly harmless animals like bunny rabbits and kittens, it is often due to the child relating the animal to something “scary” they have seen elsewhere.

3. Fear of Darkness:

One of the first fears that a child can acquire is a fear of darkness. Because a child lacks the coordination and knowledge of an adult they often allow themselves to imagine goblins and ghosts hidden in the depths of darkness surrounding him.

4. Fear of Strangers:

 The fear of develops within the first six to ten months. It is characterized by crying or whimpering when introduced to unfamiliar people.

5. Nightmares or Night Terrors:

Nightmares “represent the fulfillment of forbidden, repressed, or rejected wishes.” Dreams may consist of aggressive monsters, sexual stirrings, or something unexpected.

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Childhood fears, such as fear of the dark, of monsters or of being left alone, are common, and most children outgrow them. But if your child has a persistent, excessive fear that’s limiting his or her ability to function in daily life, talk to your doctor.

To help your child cope with fears:

• Talk openly about fears. Don’t trivialize the problem or belittle your child for being afraid. Instead, let your child know that you’re there to listen, and to help.
• Don’t reinforce phobias. Instead, take advantage of opportunities to help children overcome their fears. If your child is afraid of the neighbor’s friendly dog, for example, don’t go out of your way to avoid the animal. Instead, help your child cope when confronted with the dog. For example, you might offer to be your child’s home base, waiting and offering support while your child steps a little closer to the dog and then returns to you for safety. Over time, encourage your child to keep closing the distance.
• Pursue positive approaches. Help your child learn to breathe deeply and repeat positive statements such as “I can do this” when facing something scary. Your child also may benefit from rating the fear on a scale of 1 to 10. Recognizing that the fear rates only a 5 on the scale, for example, may help your child see the feeling as being less overwhelming.

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Persistent fear and anxiety can affect young children’s learning and development: 

Ensuring that young children have safe, secure environments in which to grow, learn, and develop healthy brains and bodies is not only good for the children themselves but also builds a strong foundation for a thriving, prosperous society. Science shows that early exposure to cir­cumstances that produce persistent fear and chronic anxiety can have lifelong consequences by disrupting the developing architecture of the brain. Unfortunately, many young children are ex­posed to such circumstances. While some of these experiences are one-time events and others may reoccur or persist over time, all of them have the potential to affect how children learn, solve prob­lems, and relate to others. The emergence and course of typical childhood fears are different from the fears and anxiety elicited by traumatic situations such as physical or sexual abuse or exposure to violence. Early exposure to extremely fearful events affects the developing brain, particularly in those areas in­volved in emotions and learning. A large and grow­ing body of research, including animal studies as well as recent neuroimaging studies of human adults, has revealed groundbreaking insights into the brain circuitry that underlies how we learn to be afraid and how we come to associate a specif­ic event or experience with negative outcomes. Two extensively studied structures located deep in the brain—the amygdala and the hippocampus— are involved in fear conditioning. The amygdala detects whether a stimulus, person, or event is threatening and the hippocampus links the fear response to the context in which the aversive stim­ulus or threatening event occurred.  Studies also show that both the amygdala and the hippocam­pus play an important role in how the body then responds to this threat. Elevated stress hormones such as cortisol have been shown to affect the growth and performance of the hippocampus and the activity of the amygdala in rodents and non-human primates, and early and persistent activa­tion of the stress response system adversely affect young children’s learning and development. Children who have had chronic and intense fearful experiences often lose the capacity to differentiate between threat and safety.   

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Fear as motivator:

Fear as motivator in children:

A child without a healthy fear of his parents is a child without brakes facing life’s hilly terrain of temptation. Running into the road, taking the family money off the dresser, lying to teachers, bullying a smaller child are a few examples of a child who has not received a traditional dose of “do what I say, or else”. The “or else” is left to the imagination but the parent is obliged to dispense a significant consequence that puts feat into the heart of the child not to do it again. Fear worked and still does work in preventing a child from doing something he thinks the parent would consider wrong and motivates him to do something right he would not do on his own. Fear of parents and other authority figures helps each of us to channel our energies into socially approved thoughts and behavior. Fear is a basic emotion. It has existed throughout human history in many forms. Eliminating all forms of fear as a motivator is detrimental to the overall development of the individual. The child without fear of his parents wastes much time testing the limits. This leads to defiant disrespect of the parents and other authority figures. Not using fear to discipline a child removes the best motivator, a stick, from our traditional arsenal of the carrot and the stick. A child who has no fear of his parents will have to be bribed to be motivated. The carrots (material rewards) have to be constantly upgraded to retain any level of motivation. On the other hand fear of punishment only costs the time and energy to show the child you mean business. Once the fear of disobeying the parent is firmly established it maintains its effectiveness with minimal effort.

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Many people would agree that fear is one of the most powerful motivators of human behavior. Fear is a primitive instinct that we are born with. It keeps humans and animals alive. If you experience something horrible once and survive it, you will do everything possible in the future avoid it. If, for instance, you had driven under the influence of alcohol and got into a car accident you would never do such a thing again. Because you would fear that you will lose your life the next time around. This fear motivates you to become a better and more responsible driver. Our most intense recollections are borne in fear. The trauma engraves them into our memories. Humans have so many fears that we have stored away in our brains. We all have a fear of hurt, sickness, life threatening diseases, disappointment, inability to succeed, not being accepted by society and just not being the person we think we have to be. This motivates us to comply with society’s image of what a person should be and how we should act. This motivates us to do well in school and to make our parents and teachers proud. Fear takes everybody out of their comfort zone, which is why we have this penetrating fear of fear itself.  Fear of injury makes us buckle our seat-belts. Fear of failure makes us study or work harder. The fear of a accident will help motivate you to drive safely and to wear a seat belt. People can also use fear to motivate others. If a teacher said he will call students parents home because he didn’t do work can motivate the student to do his works. If a student doesn’t do his work he will suffer the consequence. Fear can be a good motivator because if people don’t do what they are fear of fear will take control of them.

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Does this fear actually cause an employee to do anything productive?

Fear can be a warning that you need to avoid something. In the case of the scary coworker, fear can motivate you to give them a wide berth. In that case fear can help you avoid an unwanted situation, but the constant fear of not meeting expectations, or losing a job, can often be a self fulfilling prophecy. According to psychologists, no one can thrive on negative emotions alone. Studies of emotion and performance show that your positive emotions need to outnumber the negative for you to be able to perform your best. In fact, your ratio of positive to negative emotions has to be between 3:1 and 5:1 for optimal performance. So in the case where fear is a warning signal, it can be helpful if you listen to it, but constant fear does not produce people’s best work. So as a manager, being a source of fear for your employees is not a successful strategy. It is equally unsuccessful to know that the people who work for you are scared and not do anything to alleviate it.

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Motivated by Fear: Exploring how negative feedback influences performance:

Fear can be a strong motivator. People who are afraid of living in poverty may be motivated to pursue any career option in order to avoid financial destitution. In a similar way, individuals who are afraid that they may develop specific health-related problems may work tirelessly to maintain optimal physical condition. Fear often has been linked to motivation, both positively and negatively. Until recently, however, few studies examined how fear of failure affects activity-related performance. Jocelyn J. Bélanger of the University of Maryland sought to determine how negative feedback on specific tasks affected motivation in individuals fearful of failure (obsessive) and those who were passionate about their activity but less worried about setbacks (harmonious). In a series of experiments, Bélanger found that individuals who are passionate about achieving their goal perform differently based on their style of commitment. In particular, those with obsessive passion responded with positive motivation to negative/failure cues while those with harmonious passion saw no change in performance. In fact, the harmonious passion participants maintained the same level of performance throughout the experiments, regardless of whether they received success or failure feedback. “Obsessive passion, associated with defensiveness, predicts performance aimed at avoiding failure, whereas harmonious passion, associated with a secure self-concept, predicts stable performance,” Bélanger said. These findings suggest that fear works as a motivator for individuals with obsessive passion. Bélanger believes that people who feel their sense of self is threatened by failure of goal attainment may unconsciously respond to that threat by increasing their performance. However, those who have harmonious passion traits are less threatened and view the feedback, positive or negative, merely as information needed to continue the process of attaining their goals. The results of this study offer valuable information that could be used for the development of goal-attainment strategies in the professional, academic, and sports arenas, and could help clinicians better understand an individual’s reaction to goal-achievement outcomes.

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Rewards are a much better motivator; fear can only get you to do the minimum required:

The expectation of rewards, which could be financial or personal, motivates one to perform at the highest of one’s capacity. And when you actually see the rewards, your motivation is justified, and feeds itself.  Fear, on the other hand, can get one to the minimum required to avoid whatever is being feared. This kind of motivation does not produce the best of results.  Studies in psychology show that the motivation effects of fears and stress is a bell shaped curve, motivation and success increases up to a point and once a threshold is reached, they fall drastically. You wouldn’t see a threshold point with rewards, as an expected reward is achieved; one finds more energy and motivation to perform better.

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Importance of fear:

If we couldn’t be afraid, we wouldn’t survive for long. We’d be walking into oncoming traffic, stepping off of rooftops and carelessly handling poisonous snakes. We’d be hanging out with people who have open tuberculosis. In humans and in all animals, the purpose of fear is to promote survival. In the course of human evolution, the people who feared the right things survived to pass on their genes. In passing on their genes, the trait of fear and the response to it were selected as beneficial to the race.

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 It may seem that fear is an undesirable emotion and while most people don’t enjoy being scared, fear is a very important emotion. It keeps us from doing dangerous things, such as walking out into traffic or taking a hot dish out of the stove. Humans also have the advantage of hearing about things and seeing things that we have never experienced for ourselves. We may fear these situations even though we have never experienced them for ourselves. This is why many people are terrified to board an airplane even though they have never been in a plane crash, or even on a plane for that matter! These are non-conditioned fears, meaning that they are common fears that many people have, and for very good reason. It only takes one plane crash to end your life and while not common, they are certainly not unheard of either. However, there are also conditioned fears, which are specific to one person and usually, because of a very specific reason. For example, a person may have had a bad fall off their bike when they were five and were too terrified to ever get on a bike again because they associate the action with the fear memory. Conditioned fears can also come from things that you may have never experienced. A child may find common house spiders and bugs very interesting but when they see their mother constantly becoming stressed and panicked every time she sees one, they begin to associate spiders with this reaction. Over time, they may become just as frightened of spiders as their parent is simply because they’ve seen the stimuli linked to the response so many times.

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The Benefits of Fear:

Most people avoid fear especially when it comes to issues that surround relationships, health, job and so forth. In today’s competitive world where we live in fear of the unknown, it makes sense to seek ways to accept the fear and challenge it head on. For instance, fear of driving is reasonable if you had a horrible experience involving an automobile. The main benefits of fear are as follows:

 1. Reduces risk of accidents:

 Fear of driving is common and affects people of different ages. Some people fear driving in particular areas, for instance in busy highways or in terrains, while others have had bad experience involving car accidents. Either way, fear of driving unquestionably lowers your chance of being involved in an accident.

 2. Fear is rational:

 If you are on your way to work and suddenly you have a strange feeling or fear –never ignore it. According to psychiatrists, our senses often pick up stuff that we have no control of, things that we feel through instinct and intuition. Ignoring such a feeling and danger will always remain at your peril. In other words, you should always respect and acknowledge fear.

3. Coping mechanism:

 Although unknown to many, fear is a coping mechanism of some sort. It is important to ensure you never ignore all that surrounds your life.

4. Keeps you on the edge:

 They say that fear always keeps you on your toes, ready to pounce or flee. Overconfidence and complacency can lead you nowhere – a road that has no sign posts.

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Harms of fear:

Long Term Effects of fear:
A persistent lack of escape routes from danger lead to the insistent fear signals of anxiety, which raise heart rate and blood pressure over time. Such conditions are believed to lead to heart palpitations, fatigue, nausea, chest pain, shortness of breath, stomach aches, or headaches. Escalating fear signals trigger panic attacks, which have indications similar to the symptoms of heart attacks. Anxiety over the years has been linked to health issues, including arthritis, migraines, allergies, stomach ulcers and thyroid disease.

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Fear as an Outdated Response:
While physical danger was ever present in the primitive world, it is less relevant today. Unfortunately, while justified by a tiger in the vicinity, fear responses are unsuitable and unhealthy for a person facing career problems. The possibility of dismissal from work requires a calm and collected reaction. Fear triggers images of unpaid bills and sets off tightness in your chest, which serve no useful purpose. If a solution to the problem was available to you, you would immediately know it. Worry and anxiety set off by fear rarely find solutions, but affect your health. Except for avoiding sudden physical injury, fear is an irrelevant animal response. The cause of such fear is a primitive neural signal from the amygdala, which can be stilled through the practice of self awareness.

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Can fear & anxiety cause high blood pressure?

Anxiety doesn’t cause long-term high blood pressure (hypertension). But episodes of anxiety can cause dramatic, temporary spikes in your blood pressure.  If these temporary episodes occur frequently, such as every day, they can cause damage to your blood vessels, heart and kidneys, as can chronic high blood pressure. In addition, when you have anxiety you’re more likely to resort to other unhealthy habits that can increase your blood pressure, such as:

• Smoking
• Drinking alcoholic beverages
• Overeating

Some medications to treat anxiety, such as selective serotonin reuptake inhibitors (SSRIs), also can increase your blood pressure.

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Can fear cause low blood pressure?

Occasionally severe fear can cause vaso-vagal attack resulting in low blood pressure. We have seen medical/nursing student collapsing after seeing splash of blood in operation theatre.

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Fear mongering:

Fear mongering is the use of fear to influence the opinions and actions of others towards some specific end. The feared object or subject is sometimes exaggerated, and the pattern of fear mongering is usually one of repetition, in order to continuously reinforce the intended effects of this tactic, sometimes in the form of a vicious circle. The fear-mongering classic occurred during the 1988 presidential campaign ad featuring a frightening mug-shot of convict Willie Horton. Bush’s opponent, Massachusetts governor Michael Dukakis, had a two-digit lead in the polls prior to the ad. Then the pro-Bush National Security PAC began running the Horton ad which used Horton as an example of Dukakis on Crime. The story the ad told was true — that under a Dukakis program granting weekend furloughs to convicts, convicted murderer Willie Horton was released but did not return. On April 3, 1987 in Oxon Hill, Maryland, Horton twice raped a local woman after pistol-whipping, knifing, binding, and gagging her fiancé. What the ad did not say was that Dukakis had not created the furlough program and that 99 percent of furloughed prisoners returned to jail without any problems. Images of the menacing Horton haunted the campaign. Bush strategists later bankrolled their own ads showing convicts passing through a revolving turnstile and again bringing up Willie Horton. Dukakis’ lead vanished. Willie Horton, as Bush campaign adviser Lee Atwater had predicted, became a household name, and Bush easily won the election.

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Appeal to fear:

An appeal to fear is a fallacy in which a person attempts to create support for an idea by using deception and propaganda in attempts to increase fear and prejudice toward a competitor. The appeal to fear is common in marketing and politics. This fallacy has the following argument form: Either P or Q is true. Q is frightening. Therefore, P is true. The argument is invalid. The appeal to emotion is used in exploiting existing fears to create support for the speaker’s proposal, namely P. Also, often the false dilemma fallacy is involved, suggesting Q is the proposed idea’s sole alternative.

 Examples are:

“If you continue to drink, you will die early as your father did.”

“If you cannot graduate from high school, you will live in poverty for the rest of your life.”

“Voting for him is the same as voting for the terrorists.”

“If you tell a lie, then no one will ever believe what you say again.”  

“If you hold your breath for a long time, you will die.”

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Fear appeal in marketing:

Fear appeals have been used successfully to increase advertising’s effect on consumer interest, recall, persuasiveness, and behavior change. An appeal is the motive to which an ad is directed. Its purpose is to move the audience toward a goal set by the advertiser. Fear appeals are commonly used in many types of marketing communications, e.g., the marketing of products, services, social causes, and ideas. The basic message is “if you don’t do this (buy, vote, believe, support, learn, etc.), some particular dire consequences will occur” (Glascoff, 2000). That is, advertisers invoke fear by identifying the negative results of not using the product or the negative results of engaging in unsafe behavior. In general, however, fear appeals are effective in increasing ad interest, involvement, recall, and persuasiveness (LaTour, Snipes, and Bliss, 1996). “Fear appeals are one of the most frequently used motivators to get people to help themselves” (Bagozzi and Moore, 1994). In fact, fear appeals have grown in popularity because advertisers have found them to increase ad interest and persuasiveness (LaTour, Snipes, and Bliss, 1996). Evidence also suggests that individuals “better remember and more frequently recall ads that portray fear than they do warm or upbeat ads or ads with no emotional content” (Snipes, LaTour, and Bliss, 1999). A fear appeal is composed of three main concepts: fear, threat, and perceived efficacy. “Fear is a negatively valenced emotion that is usually accompanied by heightened physiological arousal. Threat is an external stimulus that creates a perception in message receivers that they are susceptible to some negative situation or outcome. And, perceived efficacy is a person’s belief that message recommendations can be implemented and will effectively reduce the threat depicted in the message.” (Gore et al., 1998) Witte and Allen (2000) have concluded that fear appeals are most effective when they contain both high levels of threat and high levels of efficacy. That is, the message needs to contain (1) a meaningful threat or important problem and (2) the specific directed actions that an individual can take to reduce the threat or problem. The individual needs to perceive that there is a way to address the threat and that he or she is capable of performing that behavior. (Eckart, 2011; Jones, 2010; Lennon and Rentfro, 2010) In addition, Cauberghe, De Pelsmacker, Janssens, and Dens (2009) state, “Message involvement is a full mediator between evoked fear, perceived threat, and efficacy perception on the one hand, and attitudes towards the message and behavioral intention to accept the message on the other.”  Fear appeals have been used for many products, services, ideas, and causes. Some examples include smoking, dental hygiene, personal safety, pregnancy warnings, child abuse, AIDS prevention, safe driving practices, insurance, financial security, sun exposure, climate change, food additives, social embarrassment, motorcycle helmets, anti-drug abuse, immunization, smoke detectors, cell phones, safe sex, stress, and regular health exams. Fear appeals are often used in marketing and social policy, as a method of persuasion. Fear is an effective tool to change attitudes, which are moderated by the motivation and ability to process the fear message. Fear appeals are nonmonotonic, meaning that the level of persuasion does not increase in proportion to the amount of fear that is used. A study of public service messages on AIDS found that if the messages were too aggressive or fearful, they were rejected by the subject; a moderate amount of fear is the most effective attitude changer. Others argue that it is not the level of fear that is decisive changing attitudes via the persuasion process. Rather, as long as a scare-tactics message includes a recommendation to cope with the fear, it can work.

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Management of fear:

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The figure below shows steps to be taken by an individual to eliminate fear:

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How to conquer most fears:

The trick to conquering most fears of course lies in the mind. But, isn’t that where fear came from in the first place? Of course it is, and that’s exactly the first place to start. But, before you try to conquer fear the first thing required is a strong desire to overcome your inner most fears. Here are several ways to fight fear before it begins to take control of your life.

1. Face your fears in small doses:

One way to rid yourself of some of your fears is to meet them head on. If you’re suffering from an internal fear embrace the fear and learn to love yourself. Love is the opposite emotion of fear, and is also a very powerful. Have the courage to face your fear in small healthy doses. After a while the level of fear you face will be determined by your emotional outlook. The more you learn to face your fears the less fearful these thoughts become.

2. Talk with other people:

Sometimes a fresh new outlook on your situation can be very helpful. Listening and also taking about your fears and worries brings these emotions out into the open. No longer are they “hidden” from view, but are now open for discussion. The ability to voice your opinions “out loud” on these destructive emotions are very therapeutic when it comes to the subconscious mind and the ego. This verbal communication is sometimes all which is needed for some of these fears to be swept under the emotional rug. New ideas on how to deal with certain fears can also be obtained from listening to others who are in the same emotional boat.

3. Write about your fears:

Another way to get your fears out in the open is to write about them. As you write down these fears in a poem or even in a fiction based story you begin to understand these emotions in a different light. Even written affirmations such as: I will fear nothing today, or fear will not rule my emotions, can sometimes also help to re-program the subconscious mind. Dealing with your fears creatively is a lot easier than experiencing them in real life. Who knows what the mind can do when creativity and the intellect begin to productively work together.

4. Accept your fear:

Acceptance is the key to most emotional problems in life. The ability to recognize and accept things as they are sometimes provides a new mental outlook on the situation. Maybe with some fears all that’s needed is to accept that they actually exist. Don’t keep your inner feelings inside the mind to deal with on a mental basis, put them out into the universe and see what happens to them when they’re released. Maybe they’re just hanging around until they’re acknowledged and dealt with. Accept them for what they are, and move on with your life.

5. Reprogram the mind:

The third dimensional mind is a super computer which excels in problem solving; so make good use of it. Learn to be mentally aware of your thoughts, and filter out the bad thoughts the moment they enter the mind. Don’t let fear have time to duplicate itself in the mind. Immediately throw out these destructive thought patterns as soon as they enter the mind. Listen to the thoughts which enter the mind. Most of these thoughts are about regrets from the past, or worries about the future. Both of these thoughts seem to dominate the mind, and both types of these thoughts are also useless. We can’t change what was done in the past, and we also can’t change the future by worrying about it. If your mind still wants to work overtime, then provide it with some brand new material to think about. When thoughts of fear enter the mind replace them with creative thoughts, or positive thought patterns. After a lot of mental work your mind will begin to filter the thoughts which dominate it; now you’re cooking with oil. With the ability to recognize destructive thoughts the subconscious and the ego are recognized for what they are. Most of these fear thoughts are all about our personal self preservation, which is our number one fear.

Now that you’ve learned to recognize, face, and understand your fears, most of them seem like a distant shadow from the past. The rest of your life waits as you begin to see the world in a new light. Your perception is now clear and precise as the future begins to embrace your inner most feelings, and also your personal desires.

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How to start overcoming fear right now:

 1. Awareness: Before you can begin overcoming fear, you have to know that they are causing havoc in your life. It’s easy to get so attached to your thoughts and feelings that you think they are all that exist, which couldn’t be further from the truth.

2. Identify: Get specific about what exactly you’re afraid of. Look at the pictures you have in your head about the situation. What is happening in them? What are you really scared of? Become an observer of your inner space.

 3. Curiosity: While curiosity may have killed the cat, it certainly won’t do you any harm when investigating your fears. Get curious about what thoughts generate your fear, where do you feel the fear, and how do you react to it? Again, be an observer of what is going on.

4. The Now: What are you lacking right now? When you center yourself in the now, you realize that everything is how it is. You naturally accept what is. Tapping into the now can be as simple as feeling your body and breath.

5. EFT: EFT is short for Emotional Freedom Techniques. You use your fingertips to tap meridian points on your body while thinking of a fear you have and it alleviates and sometimes gets rid of the fear altogether. Simple, yet extremely powerful.

 6. Sedona Method: Another simple system to overcoming fear is the Sedona method. It consists of asking a few simple questions while focusing on your fear.

 7. The Work: The Work is very similar to the Sedona method in that it asks questions.

8. Hypnosis: With hypnosis, you can program the right thoughts into your mind and eliminate negative beliefs. This doesn’t work for everyone, but it might for you.

 9. Gratitude: Whenever you feel fear, switch it over to what you are grateful for instead. If you’re afraid of public speaking, be grateful for the opportunity to communicate with so many people, and that they are there to genuinely listen to what you have to say.

 10. Journaling: Getting your fears down on paper is important, because trying to think them through never works. You get caught in endless loops of negativity that only lead you further down the rabbit hole, and make your life miserable.

 11. Talk: No-brainer advice, but how often do we hold the negative in because we are afraid of how others might react, or because of some other reason? Talking helps, but don’t throw a pity party for yourself.

 12. Therapy: If you can find a good therapist, therapy can be highly beneficial, even life-changing. Finding the right therapist for you can be hard. Listen to your heart and choose someone who resonates with you.

 13. NLP: NLP is short for Neuro-Linguistic Programming.

 14. Life Coach: Do you have a fear of success, or a fear of failure? A good life coach can help you examine what you truly want from life, and where your fears come from.

 15. Read: Reading a good book on your specific fear can open new doors on how you can get rid of it. You can read a lot of motivational and inspirational work on and around the topic.

 16. Take Action: Fears are just fears and they are created by your imagination to make reality seem scarier than it is. When you take action and face your fears, they become weaker, because you realize that reality isn’t nearly as bad as your imagination.

 17. Watch: Watching a movie or a documentary can be as enlightening as reading a book. Sometimes it’s nice to distract yourself from your fear, but if you really want to, you can find dozens of movies on the fear you’re dealing with.

 18. Diet: Did you know that the food you eat can have a dramatic impact on how you feel? All the sugars, additives, sweeteners, and other chemicals in our foods have a surprisingly powerful effect in getting our body out of balance. Stick to a clean diet that suits you.

 19. Positivity: Whenever fear strikes, flip it over. Instead of thinking of something bad that can happen, think of something positive. What’s a positive outcome to your fear? If you’re thinking about public speaking, imagine yourself being wildly successful instead of failing horribly.

 20. Perspective: Overcoming fear is all about putting your negative thoughts in perspective. We tend to focus too much on the negative, so by looking at all the options, you often realize that you’re making a big deal of nothing. There are so many things that can happen that it’s impossible for you to predict.

 21. Surrender: Surrendering to what is powerful, because as long as we try to change what is, we are in war with reality.

 22. Your Story: We all tell ourselves a story about our fear. If I’m afraid that no one will like my writing, I tell myself a story (in my head) about how I’ll fail horribly, people will laugh at me, or even worse, no one will read what I have to say.

 23. Release Control: We want control and predictability, even though it’s impossible to get. Where we don’t have control, we experience fear. But is it possible to ever have control? Even if you can swim, you can drown. A professional guitar player can still make mistakes and butcher a gig. Give up the illusion of control, and you’re free.

 24. Help: Be kind to others. If you’re shy, focus on helping people instead of being self-conscious about how you look or sound when you talk. Flip it on other people and make yourself feel good.

 25. Meaning:  We all go through things for a reason. That includes the fears we have. When you look back at the challenges and fears in your life, you will see that more often than not, they delivered exactly the message you needed at that time.

 26. Model: Find someone who had fears similar to what you have, but managed to get rid of it. Get in touch with them, ask them how they did it, and learn to use their strategies in your own life.

 27. Pray: Prayer is very similar to meditation. In the end, it doesn’t matter what you choose, as long as it works for you.

 28. Worst Watch: What’s the worst that could happen? If you’re afraid of public speaking, imagine yourself on a stage with everyone laughing at you. How do you feel afterward? You’re still alive, aren’t you? Life goes on.

 29. Yoga: Energy can get trapped in your body. When you do Yoga and breathe, that energy can be released. Sometimes you release parts of your fears, or you might even find that you’ve dropped a few fears without even noticing after a few months of Yoga.

 30. Ask: Your feelings are there to tell you something, ask what the purpose of them is.

 31. Understand Failure: When you realize that failure is not the end of the world, you become free. Failure is just a stepping stone to success. And most of our fears are fear of failure, shame, or somehow not living up to the standards society has put up for us.

 32. Explore Your Roots: What is the root of your fear? This may require some meditation. Look inside and ask yourself when the fear started. If you’re afraid of public failure for example, when did it happen? Where you shamed in public when you were younger?

 33. Breathe: Your breath can set you free. It can anchor you in the now and help you vanquish and overcome your most pervasive fears. It’s one of the simplest and most powerful ways of overcoming fear.

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Treatment of panic attack:

How can people overcome panic attacks? They have three effective options: antidepressants, anti-anxiety drugs and psychological therapy. Panic disorder can be effectively treated with a variety of interventions including psychological therapies and medication with the evidence that cognitive behavioral therapy has the longest duration of effect, followed by specific selective serotonin reuptake inhibitors. Medication and therapy are about equally effective — they work between 60 percent and 90 percent of the time. SSRI antidepressants help prevent panic attacks for many people. SSRI stands for selective serotonin reuptake inhibiters. Essentially, SSRI antidepressants increase the amount of serotonin in your brain. They usually take effect two to four weeks after the patient begins taking them. Tricyclic antidepressants also treat panic disorder. These antidepressants increase the amount of norepinephrine in the brain. But these antidepressants cause more negative side effects than SSRIs. Both of these kinds of antidepressants are safe to take for years, but they should be gradually tapered off, not stopped suddenly. If antidepressants don’t work, low doses of benzodiazepines alleviate anxiety, agitation, and fear by their actions on receptors located in the amygdala, orbitofrontal cortex, and insula. Administration of benzodiazepines during a panic attack may result in complete relief from symptoms in as little as ten or fifteen minutes. Benzodiazepines do not treat the source of the underlying fear but rather offer rapid-onset relief from the immediate symptoms. A benzodiazepine increases the activity of the neurotransmitter GABA, which reduces anxiety. Another drug carbamazepine also facilitates GABA activity and reduces fear. Unlike antidepressants, anti-anxiety drugs work almost immediately, but they are usually best to only take for a few weeks to a few months. They quickly cause a dependency, which means that if you stop taking them cold turkey, episodes of intense anxiety might ensue. For this reason, doctors generally recommend that patients taper off anti-anxiety medications if they decide to stop using them. The third option is psychological therapy, which can be used as an alternative to or in conjunction with medication. Cognitive behavioral therapy has proved helpful for people trying to overcome panic attacks. For prevention, 30 minutes a day of physical exercise is recommended, as well as healthy nutrition and sleeping habits. A back rub during a panic attack can help if the person has problems breathing well.

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Measured Breathing during panic attack:

In the great majority of cases hyperventilation is involved so that re-establishing an even, measured diaphragmatic breathing pattern is appropriate, effective and rapid way to stop the attack. Regular breathing helps to re-balance the oxygen and CO2 levels in the blood. David D. Burns has some useful breathing exercises for those suffering from anxiety. One such breathing exercise is a 5-2-5 count. Using the stomach (or diaphragm) – and not the chest – you inhale (feel your stomach come out, as opposed to your chest expanding) for 5 seconds. As you reach the maximal point at inhalation, hold your breath for 2 seconds. Then slowly exhale, over 5 seconds. Repeat this cycle twice, and then breathe ‘normally’ for 5 cycles (1 cycle = 1 inhale + 1 exhale). The point is to focus on the breathing, and relax the heart-rate. Regular diaphragmatic breathing may also be achieved by extending the outbreath either by counting or even humming. Although breathing into a paper bag was a common traditional recommendation for attempting short-term treatment of the symptoms of an acute panic attack, it has more recently been criticized as inferior to measured breathing, even potentially worsening the panic attack, and possibly posing reducing needed blood oxygen. While the paper bag technique increases needed carbon dioxide and so reduces symptoms, it may at the same time excessively lower oxygen levels in the blood stream. To make matters worse, several studies now show a link between panic attacks and the abrupt increase in CO2 from the paper bag method, so that use of the paper bag method itself may worsen feelings of panic in patients who might otherwise use measured breathing techniques with success.

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Treatment of phobias: An overview:

Various methods are claimed to treat phobias. Their proposed benefits may vary from person to person. Some therapists use virtual reality or imagery exercise to desensitize patients to the feared entity. These are parts of systematic desensitization therapy. Cognitive behavioral therapy (CBT) can be beneficial. Cognitive behavioral therapy allows the patient to challenge dysfunctional thoughts or beliefs by being mindful of their own feelings with the aim that the patient will realize their fear is irrational. CBT may be conducted in a group setting. Gradual desensitization treatment and CBT are often successful, provided the patient is willing to endure some discomfort.  In one clinical trial, 90% of patients were observed with no longer having a phobic reaction after successful CBT treatment. CBT is also an effective treatment for phobias in children and adolescents, and it has been adapted to be appropriate for use with this age. One example of a CBT program targeted towards children is the Coping Cat. This treatment program can be used with children between the ages of 7 and 13 to treat social phobia. This program works to decrease negative thinking, increase problem solving, and to provide a functional coping outlook in the child. Another CBT program was developed by Ann Marie Albano to treat social phobia in adolescents. This program has five stages: Psychoeducation, Skill Building, Problem Solving, Exposure, and Generalization & Maintenance. Psycho education focuses on identifying and understanding symptoms. Skill Building focuses on learning cognitive restructuring, social skills, and problem solving skills. Problem Solving focuses on identifying problems and using a proactive approach to solving them. Exposure involves exposing the adolescent to social situations in a hierarchical approach. Finally, Generalization & Maintenance involves practicing the skills learned. Eye Movement Desensitization and Reprocessing (EMDR) has been demonstrated in peer-reviewed clinical trials to be effective in treating some phobias. Mainly used to treat Post-traumatic stress disorder, EMDR has been demonstrated as effective in easing phobia symptoms following a specific trauma, such as a fear of dogs following a dog bite. Hypnotherapy coupled with Neuro-linguistic programming can also be used to help remove the associations that trigger a phobic reaction. However, lack of research and scientific testing compromises its status as an effective treatment. Antidepressant medications such SSRIs, MAOIs may be helpful in some cases of phobia. Benzodiazepines may be useful in acute treatment of severe symptoms but the risk benefit ratio is against their long-term use in phobic disorders. There are also new pharmacological approaches, which target learning and memory processes that occur during psychotherapy. For example, it has been shown that glucocorticoids can enhance extinction-based psychotherapy. Emotional Freedom Technique, a psychotherapeutic alternative medicine tool, also considered to be pseudoscience by the mainstream medicine, is allegedly useful.  Another method psychologists and psychiatrists use to treat patients with extreme phobias is prolonged exposure. Prolonged exposure is used in psychotherapy when the person with the phobia is exposed to the object of their fear over a long period of time. This technique is only tested when a person has overcome avoidance of or escapes from the phobic object or situation. People with slight distress from their phobias usually do not need prolonged exposure to their fear. For children and adolescents, one of the most effective treatments for specific phobias is participant modeling and reinforced practice. In this treatment method, the therapist models for the child how they should respond to their fears and then encourages the child to practice this behavior and reinforces their efforts. These treatment options are not mutually exclusive. Often a therapist will suggest multiple treatments.

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Cognitive behavioral therapy (CBT) has been found to significantly decrease phobic symptoms by helping the phobia sufferer change his or her way of thinking. Cognitive-behavioral therapy adds a cognitive approach to more traditional behavioral therapy. It teaches individuals how to change their thoughts, behaviors, and attitudes, while providing techniques to lessen anxiety, such as deep breathing, muscle relaxation, and refocusing. CBT uses three techniques to accomplish this goal:

 •Didactic component: This phase involves educating the individual about phobias and treatment and helps to set up positive expectations for therapy and promote the cooperation of the person with a phobia.

 •Cognitive component: It helps to identify the thoughts and assumptions that influence the person’s behavior, particularly those that may predispose him or her to being phobic.

 •Behavioral component: This employs behavior-modifying techniques to teach the individual with a phobia more effective strategies for dealing with problems.

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Simple phobias, in children or adults, can usually be eliminated by exposure to the feared object in imagination or (preferably) in reality, backed by reassurance, persuasion, and instruction from a therapist or parent. This technique is most closely identified with behavioral learning theory, but even therapists who doubt the behavioral explanation of phobias—it is usually hard to find evidence of classical conditioning—admit that the best way to defeat fears is to face them. More than 50 different terms are used for various types of exposure treatment. It is unclear whether these differ fundamentally or which ones work best for which patients.

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Systemic Desensitization:

Systematic desensitization is a type of behavioral therapy used in the field of psychology to help effectively overcome phobias and other anxiety disorders. More specifically, it is a type of Pavlovian therapy / classical conditioning therapy developed by a South African psychiatrist, Joseph Wolpe. The behaviorists involved in classical conditioning techniques believe that the response of phobic fear is a reflex acquired to non-dangerous stimuli. The normal fear to a dangerous stimulus, such as a poisonous snake, has unfortunately been generalized over to non-poisonous ones as well. If the person were to be exposed to the non-dangerous stimulus time after time without any harm being experienced, the phobic response would gradually extinguish itself. This behavioral therapy is called desensitization (also known as graduated exposure therapy), in which people are gradually exposed to the frightening object or event until they become used to it and their physical symptoms decrease. This counter-conditioning is most often used in a systematic way to very gradually introduce the feared stimulus in a step-by-step fashion known as systematic desensitization. For example, someone who is afraid of snakes might first be shown a photo of a snake. Once the person can look at a photo without anxiety, he might then be shown a video of a snake. Each step is repeated until the symptoms of fear (such as pounding heart and sweating palms) disappear. Eventually, the person might reach the point where he can actually touch a live snake. Three-fourths of affected people are significantly improved with this type of treatment. Many therapists now use cognitive behavioral therapy techniques that often incorporate exposure hierarchies as a means of desensitizing patients to fear-based stimuli.

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Exposure therapy:

Exposure therapy is a technique in behavior therapy intended to treat anxiety disorders and involves the exposure to the feared object or context without any danger in order to overcome their anxiety. Procedurally it is similar to the fear extinction paradigm in rodent work. Numerous studies have demonstrated its effectiveness in the treatment of anxiety disorders such as PTSD and specific phobias.

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Flooding:

 One simple form of exposure treatment is that of flooding, where the person is immersed in the fear reflex until the fear itself fades away. The key is keeping the patients in the feared situation long enough that they can see that none of the dreaded consequences they fear actually come to pass. Phobias by definition are irrational fears, and these phobias can get in the way of everyday life. For example, a person with a phobia of cars would have a hard time crossing the street or even walking around town. For some reason this person has developed the belief that all cars are dangerous and need to be avoided. Often, a person who has developed a phobia of a particular thing or situation will go to extreme lengths to avoid that situation. As long as they avoid exposure to the thing that they fear, they have no way of knowing that it can’t hurt them. So flooding is necessary to overcome such phobia. Some phobic reactions are so strong that flooding must be done through one’s imagining the phobic stimulus, rather than engaging the phobic stimulus itself.

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Modeling:

Systematic desensitization can be paired with modeling, and application suggested by social learning theorists. In modeling, the patient observes others (the “model(s)”) in the presence of the phobic stimulus who are responding with relaxation rather that fear. In this way, the patient is encouraged to imitate the model(s) and thereby relieve their phobia.

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Hypnosis:

Hypnosis can also set you free of fears and phobias. In mild cases, where a person recognizes the triggers but would like help controlling their reaction, posthypnotic suggestions can help them control their breathing, slow their heart rate, and achieve a relaxed state of mind. This permits them to deal with the problem in a calm and rational manner. More severe cases are often the result of a traumatic childhood event. Most of the time the event can no longer be recalled by the conscious mind, but is still retained in the subconscious. In these cases, the Hypnotherapist will often apply age regression. Age regression is one of the most powerful tool available to the Hypnotherapist. With it he can guide the person back in time, and help them reexamine the event that initially triggered the fear from an objective point of view. Once the cause is revealed, the fear of losing control is eliminated.

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Several drugs are used to treat specific phobias by controlling symptoms and helping to prevent panic attacks. These include anti-anxiety drugs (benzodiazepines) such as alprazolam, lorazepam, clonazepam or diazepam. Beta blockers medications such as propranolol appear to work well in the treatment of circumscribed social phobia, when anxiety gets in the way of performance, such as public speaking. These drugs block sympathetic system response (blocking the effects that adrenaline on the body); reduce over-stimulation, thereby controlling the physical symptoms of anxiety. In addition, some antidepressants may be effective when used together with cognitive-behavioral therapy. These include the monoamine oxidase inhibitors (MAO inhibitors) phenelzine and tranylcypromine, as well as selective serotonin reuptake inhibitors (SSRIs) like fluoxetine, paroxetine, sertraline, citalopram, escitalopram and fluvoxamine.

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In all types of phobias, symptoms may be eased by lifestyle changes, such as the following:

• eliminating caffeine
• cutting down on alcohol
• eating a good diet
• getting plenty of exercise
• getting good sleep
• reducing stress
• avoiding some over-the-counter cold medicines, and other stimulants

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Therapy of claustrophobia:

Cognitive therapy is a widely accepted form of treatment for claustrophobia. Cognitive therapy would attempt to convince a claustrophobic patient that elevators are not dangerous but are, in fact, very useful in getting you where you would like to go faster. A study conducted by S.J. Rachman shows that cognitive therapy decreased fear and negative thoughts/connotations by an average of around 30% in claustrophobic patients tested, proving it to be a reasonably effective method. Virtual reality (VR) distraction could reduce claustrophobia symptoms during a mock magnetic resonance imaging (MRI) brain scan. Virtual Reality (VR) allows a third option of exposure therapy in a virtual setting that is safer, less embarrassing, and less costly than reproducing the real world situations. Besides situations can be created that are difficult to find in real life and it’s more realistic than imagining the danger. Already some experiments have proven VR to be a useful tool in treating specific phobias such as fear of heights, fear of spiders, fear of flying and claustrophobia, as well as agoraphobia. However most research that is done on VR exposure consists of single case studies and controlled group studies are necessary to support the conclusions of case studies. Research in this area is still in its infancy, but is progressing rapidly. To take Virtual Reality (graded) Exposure (VRE) from the experimental lab and into the daily practice of psychologists more research is needed.  

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Treatment of social phobia:

Behavioral treatment appears to have long-lasting benefits.

• Cognitive behavioral therapy helps you understand and change the thoughts that are causing your condition, as well as learn to recognize and replace panic-causing thoughts.
• Systematic desensitization or exposure therapy may be used to treat phobias. You are asked to relax, then imagine the things that cause the anxiety, working from the least fearful to the most fearful. Gradual exposure to the real-life situation has also been used with success to help people overcome their fears.
• Social skills training may involve social contact in a group therapy situation to practice social skills. Role playing and modeling are techniques used to help you become more comfortable relating to others in a social situation.

Social phobia is not an abnormal condition. Many people suffer with social phobia and it is treatable. If you have unusually high anxiety and fear about social situations, talk openly with your doctor about treatment. If this condition is untreated, this may lead to depression, drug or alcohol problems, school or work problems, and poor quality of life.

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Treatment of children having fear:

When children’s fears persist beyond the age when they are appropriate, they can begin to interfere with their daily lives. Typically, children who experience this type of irrational fear, or phobia, should get treatment from a psychologist. Treatments for childhood fears and anxieties include school counseling, psychodynamic, cognitive, and behavioral therapies, family therapy, and drugs. Many children need these treatments in combination simultaneously or successively. The most popular and effective treatment for phobias is behavior therapy, which approaches the phobia as an undesirable behavior to be unlearned. Most often it takes the form of desensitization, a technique by which the fearful person is exposed to the feared stimulus in an extremely mild form and then with gradually increasing degrees of intensity. For example, a child who fears dogs may first be asked to look at pictures of dogs, then perhaps play with a stuffed dog or view a dog from afar, ultimately getting to the point when she is able to pet and play with dogs. Some of the drugs used in treating adult anxiety disorders are also helpful to children. Phobias respond to treatment by medication, including anti-anxiety drugs and selective serotonin reuptake inhibitors (SSRIs). The beta-blockers (propranolol and others) have been used safely in children; they relieve physical symptoms of anxiety by suppressing activity in the sympathetic nervous system. All these drugs, of course, have side effects and dangers. Prescribing them for children requires even more caution than prescribing them for adults. Drugs are usually not the first choice in treating children and should never be the only treatment. One study has found that the antidepressant imipramine (used to treat panic attacks and agoraphobia in adults) is more effective than a placebo in children who refuse to go to school. Forty-five children participated in the experiment; after six weeks, 70 percent of those taking imipramine and 44 percent of those taking a placebo were able to return to school. Medication is especially helpful for social phobia, where it can help the child overcome her aversion to social interaction sufficiently to work with a therapist. When agoraphobia accompanies panic attacks, it also responds to cognitive-behavioral treatment for panic disorder, often in conjunction with anti-anxiety and antidepressant medications similar to those prescribed for other phobias. Before, during, and after exposure to the source of fear, the child can begin to imagine controlling the environment and his own reactions in other ways. Creative visualization, for example, imagining a switch the child can use to control his fear when visiting the doctor or dentist, can sometimes be effective. A comforting ritual, a familiar object, or thoughts of a beloved person can be used as a good luck charm before embarking on a scary trip or performing a task such as speaking in class or sleeping alone. Relaxation techniques can also be taught to older children.

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Fear-extinction Medication: cycloserine:

Scientists have learned that inhibiting a protein called NMDA (N-methyl D-asparate) in the amygdala inhibits fear extinction. They reasoned, then, that stimulating that protein might stimulate fear extinction. Studies show that the antibiotic D-cycloserine (well-known for treating tuberculosis) might be helpful in fear extinction by assisting the action of NMDA. This type of approach would be beneficial when paired with behavioral therapies that attempt to create fear-extinction memories. The idea is not to replace exposure therapy, but to speed it up. This hypothesis was played out in a study on rats who had been conditioned to associate a bright light with a foot shock. When the light was presented repeatedly without the shock, the rats who had been injected with D-cycloserine unlearned their fear much faster than those who were going the natural route. The antibiotic also achieved results in a study of people with a fear of heights. Following virtual-reality sessions designed to expose individuals to heights in a safe environment, the people who had been given the antibiotic exposed themselves to heights in the real world twice as often as the subjects who did not receive the drug. This type of research is very promising for people who are under the control of debilitating phobias and anxiety disorders.

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New memory for fear extinction: scientific studies:

Study-1)

Overcoming Fear: fear extinction by creating new memories:

Studies have shown that rats with damaged amygdala will walk right up to cats. Most of us aren’t too keen on the prospect of going at our amygdala with an ice pick, though. So scientists are exploring other ways to overcome fear. Scientist Mark Barad of UCLA performed an experiment in which he and his team combined a noise with an electric shock. They would play the tone and then immediately apply a shock to the metal floor of the rats’ cage. It was classical conditioning, and it didn’t take long for the rats to brace themselves for the shock as soon as they heard the sound. At that point, their amygdala paired the sound with the shock, and the sound created a fear response. The researchers then began the process of fear-extinction training, in which they made the sound but did not apply the shock. After hearing the sound very often without the shock, the rats stopped fearing the noise. Fear extinction involves creating a conditioned response that counters the conditioned fear response. While studies situate the amygdala as the location of fear memories formed by conditioning, scientists theorize that fear-extinction memories form in the amygdala but then are transferred to the medial prefrontal cortex (mPFC) for storage. The new memory created by fear extinction resides in the mPFC and attempts to override the fear memory triggered in the amygdala. Most behavioral therapies for fear extinction focus on exposure. For instance, therapy for a person with a fear of snakes might involve visiting a snake farm repeatedly and taking small steps toward touching one. First, the person might get within 10 feet of the snake and see that nothing terrible happens. Then he might get within 5 feet of the snake. When nothing terrible happens within 5 feet of the snake, he might get close enough to touch it. This process continues until new, fear-extinction memories are formed — memories that say “snakes are not going to harm you” and serves to contradict the fear of snakes that lives in the amygdala. The fear still exists, but the idea is to override it with the new memory.

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Study-2)

Erase fear: learn new while retrieving fear memory:

Researchers have developed a method to determine whether an acquired fear response is susceptible to modification. By doing so, they have revealed the circumstances under which an acquired fear response can be eradicated. In order to measure whether a person actually learnt something new, the researchers used a measure for Prediction Error — in other words, the discrepancy between a person’s anticipation of what is going to happen and what actually happens. Fear responses can only be erased when people learn something new while retrieving the fear memory. This is the conclusion of a study conducted by scientists from the University of Amsterdam (UvA) and published in the journal Science. One major finding of research lab is that when participants were given propranolol, a beta blocker, while retrieving a specific fear memory, the acquired fear response was shown to be totally erased a day or month later. The researchers repeatedly found that the fear did not come back, despite the use of techniques specifically aimed to make it return. This indicates that the fear memory was either fully eradicated, or could no longer be accessed. One crucial finding was that while participants could still remember the association with the fear, that particular memory no longer triggered the former fear response.

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Control of fear-new study: training visual cortex:

A new study by UF researchers has found a different region of the brain to help control anxiety or fear. This means people could have more control over their anxiety disorders or phobias. Other therapies exist to help with anxiety disorders and phobias, but this discovery could lead to a new type of treatment. Future research would test what happens when people can control the way they look at something fearful. The treatment would train the visual response. Researchers have worked on the study for 15 years, and they just got the sense to isolate the visual cortex and test it. For the experiment, 21 undergraduate participants looked at silent and loud shapes on a screen. The loud shapes were followed by an unpleasant, high static noise. The silent shape was a safety cue and the loud shape was a threat cue. The brainwave reactions in their visual cortices showed the participants learned to fear the loud shapes. When both of the shapes appeared on the screen, the participants ignored the safety cue and focused only on the threat. 

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Neurobiology of fear:

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Researchers disagree over the nature and cause of fear.

What’s scarier, a deadly snake slithering across your path during a hike or watching a 1,000-point drop in the stock market? Although both may instill fear, researchers disagree over the nature and cause of this very powerful emotion. “When you see the stock market fall 1,000 points, that’s the same as seeing a snake,” says Joseph LeDoux, professor of neuroscience and psychology the Center for the Neuroscience of Fear and Anxiety based at New York University. “Fear is the response to the immediate stimuli. The empty feeling in your gut, the racing of your heart, palms sweating, the nervousness—that’s your brain responding in a preprogrammed way to a very specific threat.” LeDoux adds: “Since our brains are programmed to be similar in structure, we can assume that what I experience when I’m threatened is something similar to what you experience.” Fear even affects different species in similar ways. “We come into the world knowing how to be afraid, because our brains have evolved to deal with nature,” LeDoux says, noting that the brains of rats and humans respond in similar ways to threats, even though the threat itself might be completely different. Other researchers find fear to be a vastly personal experience. Whereas some people become terrified watching a scary film, others may be more afraid to walk back to their cars in a dark parking lot after the movie ends. If you ask a group of people to catalogue the things that make them afraid, you are likely to get a very different list from each person, says Michael Lewis, director of the Institute for the Study of Child Development at Robert Wood Johnson Medical School in New Brunswick, N.J. “Introspectively, we can agree that fears of an IRS [Internal Revenue Service] audit or mugging may feel the same,” he says. “The problem is we don’t have a good physiological measure of fear or any emotion.” He notes that the behavior of people around us may influence our responses to threatening situations. “We learn to become fearful through experience with the fear event, or learning from those people around us like our parents, our siblings, our colleagues,” Lewis says. “Fear has a certain contagious feature to it, so the fear in others can elicit fear in ourselves. It’s conditioning, like Pavlov and the salivating dog.”

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What happens in fearful rats?

Neuroscientists have determined that the memory of a fear stimulus triggers dramatic changes in the vital signs of rats. In a series of conditioned-response experiments, rats are first exposed to a painful shock accompanied by a tone. Whenever the tone is repeated, the rats immediately stop dead in their tracks. Blood pressure shoots up within three seconds, and heart rate peaks within five seconds. After 20 seconds, increased levels of stress hormones like corticosterone flood the body, and highly oxygenated and fuel-charged blood is pumped into the muscles to prime them for action.

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Different fear behaviors:

In the 1980s Caroline and Robert Blanchard, working together at the University of Hawaii, carried out a pioneering study on the natural history of fear. They put wild rats in cages and then brought cats gradually closer to them. At each stage, they carefully observed how the rats reacted. Researchers found that the rats responded to each kind of threat with a distinct set of behaviors. The first kind of behavior is a reaction to a potential threat, in which a predator isn’t visible but there is good reason to worry that it might be nearby. A rat might walk into a meadow that looks free of predators, for example, but that reeks of fresh cat urine. In such a case, a rat will generally explore the meadow cautiously, assessing the risk of staying there. A second, more concrete type of threat arises if a rat spots a cat at the other side of the meadow. The rat will freeze and then make a choice about what to do next. It may slink away, or it may remain immobile in hopes that the cat will eventually wander away without noticing it. Finally, the most active threat: The cat glances over, notices something, and walks toward the rat to investigate. At this point, the rat will flee if it has an escape route. If the cat gets close, the rat will choose either to fight or to run for its life. 

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Fear and brain:

Fear is a chain reaction in the brain that starts with a stressful stimulus and ends with the release of chemicals that cause a racing heart, fast breathing and energized muscles, among other things, also known as the fight-or-flight response. The stimulus could be a spider, a knife at your throat, an auditorium full of people waiting for you to speak or the sudden thud of your front door against the door frame. The brain is a profoundly complex organ. More than 100 billion nerve cells comprise an intricate network of communications that is the starting point of everything we sense, think and do. Some of these communications lead to conscious thought and action, while others produce autonomic responses. The fear response is almost entirely autonomic: We don’t consciously trigger it or even know what’s going on until it has run its course. The physiological response to a fear stimulus starts in the brain. The brain triggers the release of certain chemicals that cause the “fight or flight” response in human beings. This response is characterized by rapid heart rate, rapid breathing, flexed muscles, and an automatic focus on reacting physically. Once the chemicals released in the blood stream start to work, we are hardly aware of what is happening to us physically. We are simply in a reactive state controlled by the autonomic nervous system. All we want to do is run away from the fear agent or attack it directly.

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Because cells in the brain are constantly transferring information and triggering responses, there are dozens of areas of the brain at least peripherally involved in fear. But research has discovered that certain parts of the brain play central roles in the process: Specific parts of the brain work together to trigger our reactions to fear stimuli. These include:

•  Thalamus – decides where to send incoming sensory data (from eyes, ears, mouth, skin)
• Sensory cortex – interprets sensory data
• Hippocampus – stores and retrieves conscious memories; processes sets of stimuli to establish context
• Amygdala – decodes emotions; determines possible threat; stores fear memories
• Hypothalamus – activates “fight or flight” response

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There are many different parts of the brain that play a part in triggering the fear response however, research has shown that there are 5 main parts in the brain that participate in the fear response. These are: the thalamus, which is the part of the brain that will determine where to send incoming sensory data, such as from the eyes, skin, or mouth; the sensory cortex, which reads the sensory data; the hippocampus, which stores memories and is able to retrieve them later. The hippocampus also creates stimuli so that context can be established. This means that if the door is banging against door frame at night, the hippocampus will be able to determine that it’s a very windy night and that you noticed the tree branch was loose last time. This will lead to the conclusion that there’s nothing to be afraid of because it’s just a tree branch. The amygdale then will interpret the emotion, identify possible threats, and then will store that fear into the brain’s fear memory. The hypothalamus then will activate the fight-or-flight response, which will determine whether you run or stay to protect yourself. This may seem like a very basic course of events that takes place in the brain but there are actually two different routes that your body can take to trigger the fear response.

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Fear roads:

The figure above shows that the process of creating fear takes place in the brain and is entirely unconscious. There are two paths involved in the fear response: The low road is quick and messy, while the high road takes more time and delivers a more precise interpretation of events. Both processes are happening simultaneously. 

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When the brain creates the fear response, there are two different paths that are taken. The first road is called the low road and while it’s short and sweet, it can also be quite messy without the high road, which is the other path the brain takes in the fear response. The idea behind the low road is “take no chances.” If the front door to your home is suddenly knocking against the frame, it could be the wind. It could also be a burglar trying to get in. It’s far less dangerous to assume it’s a burglar and have it turn out to be the wind than to assume it’s the wind and have it turn out to be a burglar. The low road shoots first and asks questions later. The low road takes the fastest and easiest way to get you out of danger and the theory behind this is that the signal is telling the brain to ‘take no chances.’ With the low road, the body comes into contact with a stimulus, such as the door banging against the frame, and sends this information to the thalamus. The thalamus at this point doesn’t know whether or not the stimulus is actually a danger and so just passes the signal on to the hypothalamus, telling it to initiate the fight-or-flight response. The low road, while fast, doesn’t take any other possibilities into consideration and if this was the only response in the brain, would leave you acting irrationally most of the time. That’s why signals from stimulus also follow a high road.

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The high road in the brain follows a much more logical and rational path. Instead of simply sensing the stimuli and initiating the fear response, the brain will look at all the options and decide whether or not the stimulus actually needs to be feared. Once you have seen (or heard, or felt) the stimulus, your brain will still send it to the thalamus, just as it does with the low road. However, the thalamus will send it to the sensory cortex, which it does not do along the path of the low road. The sensory cortex then determines that there’s more than one possible explanation for the stimulus and the sensory cortex will then send the signal along to the hippocampus. The hippocampus then puts the stimulus into context by determining if it recognizes the stimulus from fear memory and if so, also determining what the stimulus meant at that time. The hippocampus also takes into consideration surrounding stimuli to determine if these could also be related to the original stimuli that stimulated the response in the first place. If the original stimuli were something banging against the door frame, the hippocampus could also determine that there are other stimuli such as the sound of wind blowing or the sound of raindrops against the window. The hippocampus is really the integral part of the high road because it is the area that brings reason and rationale into the situation and it doesn’t act suddenly. Once the hippocampus determines that there is no cause for fear, it will send this message to the amygdala and this will in turn, send the message to the hypothalamus to shut off the fight-or-flight response.

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Fear – The Startle Response:
Fear begins with the startle response. It is the fastest response (20 milliseconds) of the mind to danger through a direct amygdala fear pathway as reported by Joseph E. LeDoux (low road). He identified a second route (300 milliseconds) through the reasoning processes of the cortex, which can proceed to still a sudden onset of fear (high road). Mere movements, sounds or images can trigger the fearful startle response (low road). The reflex is present from birth. When a newborn senses a possibility of falling, his back arches and his arms and legs flail out. Doctors test the reflex to be sure of an infant’s nervous system by simulating a sense of falling by allowing its head to drop slightly. The startle signal from the amygdala activates the sympathetic system, which heightens emotional arousal. Later, the cortical signals may energize the parasympathetic system, dampening down emotional tension. Unthinking fear set off by the startle response may be stilled by the reasoned cortical signals, such as when a coiled snake is identified to be just a garden hose.

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Even though there are two different paths that can be taken by the brain when we encounter fearful stimuli, they both start at the same time. When we first hear the door banging, we both become fearful and start to think about reasons at the same time. However, the low road is much shorter and takes much less time for the brain to process than the high road. This is the reason why when we first hear the door banging, we panic. We may freeze for a second or two and then decide to check the door to see if it is a tree branch, with no fear that there will be a burglar at the door. In both cases however, the signal of the stimuli still ends up at the hypothalamus, the part that triggers the fight-or-flight response. This is also an extremely important part of the fear process because it is this decision that really could save your life in a dangerous situation.

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The fight-or-flight response is as fascinating as it is important. Once the hypothalamus receives the signal, two systems will become activated. These are the sympathetic nervous system and the adrenal-cortical system. The sympathetic nervous system is the part that causes your body to physically react the way it does when you feel as though you may be in danger. Your heart speeds up, your muscles become tense and you feel very alert. Your blood pressure will begin to rise and you will start to think about acting. This is why when you feel as though you are in danger, you begin to think of ways to get out of it – and very quickly! This physical reaction is caused to stress hormones that the sympathetic nervous system sends out when it is activated.

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The other system that’s activated during the fight-or-flight response is the adrenal-cortical system and it is this system that starts to get the body prepared to deal with danger. This system is activated by the hypothalamus which releases the hormone corticotropin-factor (CPF) into the pituitary gland, which ultimately activates the adrenal-cortical system. The pituitary gland then releases the hormone adrenocorticotropic (ACTH) hormone. This hormone races through the bloodstream and activates the secretion of 30 more different hormones. These hormones get the body ready to deal with the danger. Once these hormones are released, several changes start to occur in the body. Not only do your heart rate and blood pressure increase but your pupils will also dilate so that they’ll be able to take in as much light as possible; the veins in the skin will tighten up so that they can send more blood to the major muscles, which is why some people become cold when they are especially scared. Your blood sugar level will also rise and the muscles will tense up, which is when goose bumps become present. Other muscles however will relax so that you can take more air into your lungs and systems such as the immune and digestion system, will also shut down so that the body can give energy to the other systems that need it. Also when you’re very scared, you will most likely be unable to concentrate on small things because your brain and body will be so focused on getting out of the dangerous situation. All of these physical responses are the body’s way of preparing you for fight-or-flight and it’s an instinct that every animal has.

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The sudden flood of epinephrine, norepinephrine and dozens of other hormones causes changes in the body that include:

• heart rate and blood pressure increase
• pupils dilate to take in as much light as possible
• veins in skin constrict to send more blood to major muscle groups (responsible for the “chill” sometimes associated with fear — less blood in the skin to keep it warm)
• blood-glucose level increases
• muscles tense up, energized by adrenaline and glucose (responsible for goose bumps — when tiny muscles attached to each hair on surface of skin tense up, the hairs are forced upright, pulling skin with them)
• smooth muscle relaxes in order to allow more oxygen into the lungs
• nonessential systems (like digestion and immune system) shut down to allow more energy for emergency functions
• trouble focusing on small tasks (brain is directed to focus only on big picture in order to determine where threat is coming from)

­All of these physical responses are intended to help you survive a dangerous situation by preparing you to either run for your life or fight for your life (thus the term “fight or flight”). Fear — and the fight-or-flight response in particular — is an instinct that every animal possesses.

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Cannon recognized as useful in situations in which “fight or flight” are the adaptive responses (Cannon, 1929). Cannon noted the functions of many of these components. Epinephrine acts on platelet beta receptors to enhance clotting and on the liver to release glucose. Cardiovascular changes speed blood circulation. Circulation patterns change so that less blood goes to the skin and gut, and more to the muscles. Hyperventilation raises oxygen import and carbon dioxide export. Sweating cools the body and makes it slippery. A sense of imminent doom galvanizes preventive action and forestalls dawdling. These components form a reliable constellation in the anxiety/panic response, which is partly mediated by adrenergic receptors (a proximate explanation). They act together to increase fitness in the face of danger (the evolutionary explanation that is needed in addition to the proximate one). These aspects of anxiety and panic are largely similar whether cued by heights, animals, thunderstorms, darkness, public places, separation, or social scrutiny. Their similarity reflects the value of this defense against a wide array of threats.

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Amygdala and fear:

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Neurobiology of fear responses: the role of the amygdala:

Evidence from many different laboratories using a variety of experimental techniques and animal species indicates that the amygdala plays a crucial role in conditioned fear and anxiety, as well as attention. Work by Weiskrantz and others (Weiskrantz 1956, Zola Morgan et al1991) demonstrated that the loss of fear in monkeys with temporal lobe lesions results from damage to the amygdala, a heterogeneous group of nuclei buried deep within the temporal lobes. Indeed, a recent study confirms that selective excitotoxic damage to amygdala neurons results in a fear reduction similar to that observed by Kluver & Bucy (Meunier et al 1999). Numerous other studies have demonstrated reduced fear (“taming”) after amygdala damage in several mammalian species including rats, cats, rabbits, dogs, and humans (Goddard 1964). Moreover, both electrical stimulation of the amygdala and amygdaloid seizures are associated with autonomic and behavioral changes characteristic of fear (Davis 1992, Gloor 1960). Hence, consensus has emerged from these studies that the amygdaloid complex has an indispensable role in the regulation of fear. Many amygdaloid projection areas are critically involved in specific signs used to measure fear and anxiety. Electrical stimulation of the amygdala elicits a pattern of behaviors that mimic natural or conditioned fear. Lesions of the amygdala block innate or conditioned fear, as well as various measures of attention, and local infusions of drugs into the amygdala have anxiolytic effects in several behavioral tests. N-methyl-D-aspartate (NMDA) receptors in the amygdala may be important in the acquisition of conditioned fear, whereas non-NMDA receptors are important for the expression of conditioned fear. The peptide corticotropin-releasing hormone appears to be especially important in fear or anxiety and may act within the amygdala to orchestrate parts of the fear reaction. Finally, the amygdala may be a critical site of plasticity that mediates both the acquisition and extinction of conditioned fear. A better understanding of brain systems that inhibit the amygdala and of the role of the amygdala’s very high levels of peptides (cf. Gray 1989) may eventually lead to the development of more effective pharmacological strategies for treating clinical anxiety disorders.  

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The table below shows inputs from various brain areas into amygdala:

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Human amygdala role in fear: various studies:

In recent years several investigators have revealed an important role for the human amygdala in fear conditioning (Davidson & Irwin 1999). For example, a patient with bilateral amygdala pathology associated with the rare genetic disorder, Urbach-Wiethe disease, does not exhibit Pavlovian fear conditioning to either visual or auditory cues paired with loud noise (Bechara et al 1995). Patients who have received a unilateral amygdalectomy for the treatment of epilepsy also have deficits in auditory fear conditioning (LaBar et al 1995), and patients with amygdala damage fail to recognize fear in facial expressions (Adolphs et al 1995, 1999; Young et al 1995). Functional neuroimaging has supported these lesion studies by revealing amygdala activation to visual or vocal expressions of fear (Morris et al 1996, Phillips et al 1997, Whalen et al 1998) and during Pavlovian fear conditioning (Buchel et al 1999, LaBar et al 1998). Thus, the neural mechanisms of fear conditioning appear to exhibit homology across several mammalian species and amygdala is a center of fear conditioning in humans as well as non-human animals.

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Fear in the amygdala:

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The figure below shows pathways to the amygdala vis-à-vis conditioned and unconditioned stimuli:

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The amygdala is the name of the collection of nuclei found in the anterior portions of the temporal lobes in the brains of primates. The amygdala receives projections from frontal cortex, association cortex, temporal lobe, thalamus, olfactory system and other parts of the limbic system. In return, it sends its efferent to frontal and prefrontal cortex, orbitifrontal cortex, hypothalmus, hippocampus, as well as brain stem nuclei. In the amygdala region alone, there is much controversy surrounding the nuclear subgroups, resulting in classifications that range between 5 and 22 different groups within the amygdala itself. Despite all of this, there are four main groups that have been universally agreed upon. These are the Basolateral, Lateral, Central, and Basomedial nuclei. The amygdala is considered to be the key component to the limbic system, a term that has also been regarded with much recent controversy by researchers in the field of emotions. One of the biggest surprises from LeDoux’s work is that there may be no such thing as the limbic system – a brain structure that has been supposed to underlie emotion and motivation. “All students are taught about the limbic system,” LeDoux said, “but in my opinion, it’s no longer a valid concept.”  Reasons for his assertion centers around the investigations of the mechanisms by which the amygdala processes information regarding threats and fear. The classic model of the limbic system encompasses the hippocampus, the amygdala, and a few other small structures. These structures supposedly receive sensory input from the outside world – sight, smell, hearing, touch, and taste, as well as from the viscera. When these sensations are integrated in the limbic system, emotional experiences are thought to occur. While the fear circuit does indeed appear to incorporate the amygdala; the hippocampus and the other limbic structures are not involved. They are bypassed in the fear circuit (low road). But fear and its emotional memories are not the only things controlled by the amygdala. The amygdala has up to 22 distinct regions and only two so far have been clearly implicated in fear. The flight and fear responses may be obtained from the rostral regions of the amygdala, including the lateral nucleus, the periamygdaloid area, and the central nucleus. Defense or aggressive reactions could be obtained from the medial and caudal aspects of the amygdala. These reactions have been observed by the selective stimulation of amygdaloid nuclei in laboratory animals.  

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Scientific evidence of fear circuit in amygdala:

Through the usage of fear conditioned rats in laboratory settings, researchers have been able to effectively map out the “fear circuit”. The fear circuit is stimulated in rats by means of placing the animals in metal boxes and subjecting them to foot-shocks associated with an auditory signal. This method effectively conditions the rats to fear both the metal boxes in which they had experienced pain and the corresponding auditory signal. After experiencing these stimuli, the rats, when exposed to the auditory signal, react with fear. The same fear is expressed when placed inside of the conditioning box, whether or not foot-shocks were applied. Through these experiments, it has been determined that the amygdala is required for both the fear circuit and the memory of fear (conditioned fear) associated with stimuli. These determinations were made through selective lesions of the auditory pathway through to the amygdala. Only when selective lesions were made on the amygdala, did the laboratory animals not respond to the frightening stimuli. Learning and responding to stimuli that warn of danger involves neural pathways that send information about the outside world to the amygdala, which in turn, determines the significance of the stimulus and triggers emotional responses like freezing or fleeing as well as changes in the inner workings of the body’s organs and glands.   

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The figure below shows connections between amygdala and hypothalamic & brainstem areas:

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The brain structure that is the center of most neurobiological events associated with fear is the amygdala, located behind the pituitary gland. The role of the amygdala in fear is best understood as part of a circuitry of fear learning. It is essential for proper adaptation to stress and specific modulation of emotional learning and memory. In the presence of a threatening stimulus, the amygdala generates the secretion of hormones that influence fear and aggression. Once response to the stimulus in the form of fear or aggression commences, the amygdala may elicit the release of hormones into the body to put the person into a state of alertness, in which they are ready to move, run, fight, etc. This defensive response is generally referred to in physiology as the fight-or-flight response regulated by the hypothalamus. Once the person is in safe mode, meaning that there are no longer any potential threats surrounding them, the amygdala will send this information to the medial prefrontal cortex (mPFC) where it is stored for similar future situations. The storing of memory in the mPFC is known as memory consolidation. This is in addition to the memory stored in amygdala. Some of the hormones involved during the state of fight-or-flight include epinephrine, norepinephrine and cortisol. Epinephrine regulates heart rate and metabolism as well as dilating blood vessels and air passages. Norepinephrine increases heart rate, blood flow to skeletal muscles and the release of glucose from energy stores. Cortisol increases blood sugar and helps with metabolism.

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Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval:

‘New’ memories are initially labile and sensitive to disruption before being consolidated into stable long-term memories.  Much evidence indicates that this consolidation involves the synthesis of new proteins in neurons. The lateral and basal nuclei of the amygdala (LBA) are believed to be a site of memory storage in fear learning. Infusion of the protein synthesis inhibitor anisomycin into the LBA shortly after training prevents consolidation of fear memories.  Researchers have shown that consolidated fear memories, when reactivated during retrieval, return to a labile state in which infusion of anisomycin shortly after memory reactivation produces amnesia on later tests, regardless of whether reactivation was performed 1 or 14 days after conditioning. The same treatment with anisomycin, in the absence of memory reactivation, left memory intact. Consistent with a time-limited role for protein synthesis production in consolidation, delay of the infusion until six hours after memory reactivation produced no amnesia. The data shows that consolidated fear memories, when reactivated, return to a labile state that requires de novo protein synthesis for reconsolidation. These findings are not predicted by traditional theories of memory consolidation.

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Fear and memories:

Recent research shows that when something bad happens to you, part of your brain begins thinking independently, storing its own memories so it can save you next time. That worked fine a million years ago. Anyone who has been through a traumatic event (car accident) will recognize the sudden physical response of fear and it’s often debilitating persistence in memory. The feeling of fear, like all emotions, is something that happens to the body and the mind. Few memories are as easily triggered and as hard to shake as those in which we are confronted with an immediate threat. For people who have undergone serious trauma, including war veterans and rape survivors, memories of fear can sometimes play a dominant role in shaping personality, a condition we now call post-traumatic stress disorder.  Unraveling the mystery of how the mind experiences fear— perhaps the most primal and enduring of all the emotions— turns out to be one of the most interesting and instructive quests in the annals of recent neuroscience. Research shows that fear plays tricks with our memory and our perception of reality; and that the fear systems in the brain have their own perceptual channels and their own dedicated circuitry for storing traumatic memories. As scientists have mapped the path of fear through the brain, they have begun to explore ways to lessen its hold on the psyche, to prevent that car accident from keeping us off the road months later.  It seems intuitive to us that we would remember vividly the details of a frightening event like a car accident.  

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Put a rat in a cage, play a tone, and simultaneously deliver a shock to the animal. After a few rounds of tone and shock, the rat starts to fear the tone even if it’s not accompanied by the shock. The fear reaction— noticeable because the rat freezes in place— has been observed in species as diverse as pigeons, rabbits, baboons, and humans. It is called a conditioned response. The rat has an unconditioned innate fear of shocks, but it can be conditioned to be afraid of tones if the two are associated with each other. Conditioned fear is easy: Fruit flies, marine snails, even lizards can be trained to display defensive behavior in response to threatening stimuli, along the lines of the tone and shock experiments. Conditioned fear turns out to be one of the most essential techniques that natural selection stumbled across to increase the survival odds of organisms in an unpredictable environment. When researcher removed the amygdala, the rats failed to learn. In brain anatomy terms, the declarative memory is laid down by the hippocampus, a long, curved ridge located next to the amygdala. The emotional memory of a threat, on the other hand, is mediated by the amygdala itself. Some brain scientists believe that our fear systems are prepared to learn about threats— snakes, spiders, or heights— that have been major obstacles to survival over the millions of years it has taken the modern brain to evolve, which explains why it is easier to develop phobias about snakes than about threats that are statistically much more likely to kill you, such as electricity. Some scientists believe the amygdala doesn’t have its own discrete storage system for emotionally charged memories but rather marks memories created by other brain systems as being somehow emotionally significant. The trouble with emotional memories is that they can be very difficult to eradicate. The brain seems to be wired to prevent the deliberate overriding of fear responses. Although there are extensive neural pathways from the amygdala to the neocortex, the paths running the reverse direction are sparse. Our brains seem to have been designed to allow the fear system to take control in threatening situations and prevent our conscious awareness from reigning. This may have been an optimal design for predator-rich environments in which survival was a minute-by-minute question, but it is not a good adaptation for modern environments in which the stressors can be job performance reviews. The amygdala may be looking out for your best interests by preserving a memory of that nighttime car accident, but if the result is an inability to drive after dark, the fear circuitry has gone too far. Because the low-road memories are so tenacious, one question neuroscience is now wrestling with is how to subdue the amygdala when those memories hurt the organism.

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Brain activity predicts Long-Term Fear Memory: a study:

During a fearful experience, particular changes in brain activity patterns may predict whether a long-term fear memory is formed, according to researchers at the University of Amsterdam (UvA). Until now, there was no way of predicting fear memory. Researchers also found it unclear whether the particular information stored in the long-term memory occurred at the time of fear or after the event. While under magnetic resonance brain imaging (MRI), participants looked at neutral pictures of faces and houses, some of which were followed by a small electric shock — momentarily painful, but not enough to hurt the person or cause any long-term damage. When images were paired with these small electric shocks, the researchers believed that this forced the subjects to form fear memories. The subjects showed fear responses when the pictures were paired with electric shocks. This fear response can be measured in the brain, but is also made evident from increased pupil dilation. After a few weeks, the participants came back to the lab and were shown the same images. Brain activity and pupil diameter were once again measured. The extent to which the pupil dilated when shown images previously followed by a shock was considered an outward sign of a fear memory. In order to analyze the fMRI data, researchers compared the patterns of brain activity taken while participants viewed the images. When pictures that had nothing in common (such as houses and faces) were tied to an electric response, there was an increase in neural pattern similarity. This pattern did not occur when the images were not linked to a fearful response. The extent to which this occurred was an indication of fear memory formation: the stronger the response during learning, the stronger the fear response would be in the long term. 

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Fear and Pain Experiences: 

Over a lifetime, the amygdala builds an additional sensitivity to pain experiences. Pain may have been caused by physical injury, painful confrontations, loss of loved ones, loss of social status, or through social rejection. Mirror neurons also trigger pain within us, on seeing the painful experiences of others. Whenever such pain has been experienced, the amygdala stores memories of the related sensory signals. Fear can be triggered by the fleeting image of an angry face. People suffer fears of failing, of being ridiculed, of the loss of loved ones. If a person suffered trauma, when left alone as a child, she may fear loneliness.

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Training amygdala:

The contrast is between taking action and being stuck, frozen in fear, headed toward despondency, unable to control your life. There’s an interesting experiment along these lines: You have a rat that goes into a chamber A, tone goes off, and he gets a shock, and he freezes with the fear response. The next day he goes into chamber B, the tone goes off, and he freezes. But if he takes a step, the tone stops. Eventually he learns that he has to crawl across the chamber to eliminate the tone completely. So by taking that action, he’s able to prevent fear from existing in his life. In order for the rat to do this, he’s got to throw a switch in the amygdala. Normally, the fear response goes from the lateral nucleus to the central nucleus and then out of the amygdala. In order for the rat to take a step, the stimulus has to go not to the central nucleus but to the basal nucleus, and then out to the parts of the brain that are involved in active behavior. In other words, the amygdala wants to associate the memory with the freezing response, but it can be trained to associate it with something less debilitating.  Extrapolating from this experiment towards humans, you can train your amygdala to take action to prevent fear rather than live life hopelessly in fear.

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Amygdala and reason:

Because the fear response can play a direct role in life-and-death struggles, it’s not surprising to find that the brain contains elaborate machinery dedicated to its routines. The fact that the amygdala’s basic architecture reappears in so many species is testimony to its evolutionary importance: Natural selection generally doesn’t tinker with components that have proved essential to basic survival. Of course, the persistence of the low road in a world where predators are largely nonexistent may no longer be adaptive, but that’s the trade-off of human culture. Evolution made our brains so smart that we ended up building environments that made some of our mental resources obsolete. No matter how calculating and erudite the neocortex becomes, it can’t simply switch off the amygdala. In that sense, you can see the battles between these different regions as a re-enactment of Freud’s clash between man’s civilized superego and his primal id. There is great elegance in the way this system has evolved, with its complex mix of instinct and learning. Like all emotions, the fear circuitry steers the organism toward desirable states— away from predators or other threats— without knowing that much in advance about the world that the organism will actually inhabit. We are not slaves to our emotions, but they are hardly at our beck and call either. They propel us in directions that our rational minds don’t always understand— fear most of all. The amygdala, like the heart in Pascal’s famous phrase, has reasons of which reason knows nothing.

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Amygdala override cortex:

Fear is “an unpleasant emotional state characterized by anticipation of pain or great distress and accompanied by heightened autonomic activity especially involving the nervous system…the state or habit of feeling agitation or dismay…something that is the object of apprehension or alarm” (Merriam-Webster, 2002). Fear evolved as a mechanism to protect humans from life-threatening situations. As such, nothing is more important than survival and the evolutionary primacy of the brain’s fear circuitry. Matter-of-fact, the brain’s fear circuitry is more powerful than the brain’s reasoning faculties. According to Begley, Underwood, Wolffe, Smalley, and Interlandi (2007), “The amygdala sprouts a profusion of connections to higher brain regions – neurons that carry one-way traffic from amygdala to neo-cortex. Fewer connections run from the cortex to the amygdala, however. That allows the amygdala to override the products of the logical, thoughtful cortex, but not vice versa. So although it is sometimes possible to think yourself out of fear (‘I know that dark shape in the alley is just a trash can’), it takes great effort and persistence. Instead, fear tends to override reason, as the amygdala hobbles our logic and reasoning circuits. That makes fear ‘far, far more important than reason.” Due to this circuitry, fear is more powerful than reason. Fear can sometimes be evoked easily and absurdly for reasons that live in mankind’s evolutionary past. For example, reacting to a nonexistent threat, such as a snake that is really a stick, is not as dangerous as the other way around – failing to respond to the actual threat of a snake. The brain seems to be wired to flinch first and ask questions second. As a consequence, fear can be easily and untruthfully sparked in such a way that is irrational and not subject to reason. (Begley, et al., 2007; Maren, 2008)

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Great men became great because they have trained their cerebral cortex to override amygdala and therefore their reason overrides fear. Mahatma Gandhi and Nelson Mandela are great because they have overrode fear by reason, the fear of rising against white-government, the fear of rising against occupation by colonial rulers, the fear of rising against slave-makers. How cortex inhibits (overrides) fear in amygdala is discussed later on.

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Why do people get scared when they watch scary movies?  

In humans, there is a portion of our brain called amygdala, an almond shaped neural structure in the anterior portion of the temporal lobe that plays an important role in our emotional behavior. The human amygdala is very primitive and it is not very discriminatory. While the portion of your brain that governs reason and reality is always on top of things (cerebral cortex), the amygdala does not distinguish between something that is imagined and something that is real (low road, fast response). If you have ever been to a 3D movie and took off your glasses you will see people ducking and dodging and shielding their faces from things on the screen that their amygdala perceives as threatening. At the same time you will hear them joyously squealing and laughing at their own, almost uncontrollable actions. In an instant their amygdala causes a reaction while their reasoning instantly shrugs it off and rationalizes the reaction as inappropriate and thus funny or enjoyable (or maybe even relieved to know that they cannot, in reality, be harmed). Everyone reacts differently to given situations. Some people are just bored by horror movies while others cannot bring themselves to see one. On the other hand, a combat veteran for example, whose amygdala has been over-conditioned may not bat an eye at the sight of Jason lunging out of the big screen with an axe, but he may find the idea of viewing a war movie absolutely unbearable. Why? Because he has been conditioned to dismiss irrational threats that many of the rest of us fear; yet he remains sensitive to the sights and sounds of what he has painfully come to recognize (forever perhaps) as truly and indisputably life-threatening events.

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Blockade of NMDA Receptors in the Amygdala prevents Latent Inhibition of Fear-Conditioning:

The association between a conditioned stimulus (CS) and an unconditioned stimulus (US) in fear-conditioning depends on N-methyl-d-aspartate (NMDA) receptors in the basolateral amygdala complex (BLA). Latent inhibition (LI) is the retardation in learning due to nonreinforced presentation of the prospective CS before conditioning. Disruption of LI in rats is an animal model of schizophrenia, reflecting the deficits of schizophrenic patients in neglecting irrelevant information. Researchers investigated whether the BLA is involved in LI of fear-potentiated startle. Infusions of the NMDA receptor antagonist d,l-2-amino-5-phosphonopentanoic acid (AP-5; 12.5 nmoles) into the BLA before preexposure of rats to the neutral stimulus prevent LI of fear-conditioning. Researchers also demonstrated by the same method that a complex of thalamic nuclei, comprising the medial part of the medial geniculate nucleus, the posterior intralaminar nucleus, and the suprageniculate nucleus, is involved in fear-conditioning, but not in LI. This suggests that the presentation of an innocuous stimulus during preexposure leads to an NMDA receptor-dependent change of neurotransmission in the BLA, but not in the thalamus. Their data show that the BLA but not the thalamus regulates in LI of fear-potentiated startle. Furthermore, it supports the hypothesis that the inability of schizophrenic patients to ignore irrelevant stimuli may be caused by hypofunction of the glutamatergic transmission in the brain and suggests an involvement of the amygdala in the neuropathology of schizophrenia.

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Besides amygdala, what is the role of other brain regions in fear?

A large volume of experimental work has examined the neurocircuitry associated with fear responses, mainly in rodents, using primarily fear conditioning, inhibitory avoidance, and fear-potentiated startle models. Key components of fear circuitry including the amygdala (and its subnuclei), nucleus accumbens (including bed nucleus of stria terminalis BNST), hippocampus, ventromedial hypothalamus, periaqueductal gray, a number of brain stem nuclei, thalamic nuclei, insular cortex, and some prefrontal regions (mainly infralimbic cortex) have been identified in these studies. These regions have their respective roles in the various components of fear processing such as the perception of threat or of unconditioned stimuli, the pairing of an unconditioned stimulus and conditioned response (learning/conditioning), the execution of efferent components of fear response, and the modulation of fear responses through potentiation, contextual modulation, or extinction. Some key findings from animal literature, such as the central role of amygdaloid nuclei in the acquisition of fear conditioning and expression of fear responses, the involvement of the hippocampus in contextual processing, and the importance of the infralimbic cortex in extinction recall, have been replicated across different studies and laboratories. These basic components of fear circuitry are well preserved across species and likely support similar functions in humans. Animal work using in vivo electrophysiological recording, tracing and lesions/reversible inactivation techniques was indispensable in acquiring this knowledge.

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The figure below shows structures other than amygdala activated during fear:

The figure above shows magnetic resonance images (sagittal slices) showing the structures of interest in fear: (a) the hippocampus and the amygdala; (b) the dorsal anterior cingulate cortex (dACC) and the rostral anterior cingulate cortex (rACC); and (c) the insular cortex. Another fMRI study found that several brain structures other than the amygdala have also been observed to be activated when individuals are presented with fearful vs. neutral faces, namely the occipitocerebellar regions including the fusiform gyrus and the inferior parietal / superior temporal gyri. Interestingly, fearful eyes, brows and mouth seem to separately reproduce these brain responses.

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Hippocampus:

After a situation which incites fear occurs, the amygdala and hippocampus record the event through synaptic plasticity. The stimulation to the hippocampus will cause the individual to remember many details surrounding the situation. Plasticity and memory formation in the amygdala are generated by activation of the neurons in the region. Experimental data supports the notion that synaptic plasiticity of the neurons leading to the lateral amygdala occurs with fear conditioning. In some cases, this forms permanent fear responses such as post-traumatic stress disorder (PTSD) or a phobia. MRI and fMRI scans have shown that the amygdala in individuals diagnosed with such disorders including bipolar or panic disorder is larger and wired for a higher level of fear. The hippocampus plays a vital role in Pavlovian fear conditioning. Combining more sophisticated behavioral analysis with lesion and pharmacological techniques have cleared up some of the confusion that resulted from the initial studies in this area. These studies indicate that the hippocampus normally mediates the acquisition and consolidation of a memory for the conditioning context. Other structures, presumably the neocortex, store this memory once hippocampal consolidation is complete. When hippocampal damage occurs before learning, these very same cortical structures may compensate for its loss. We are learning more about which neurotransmitter systems and which cellular plasticity mechanisms are employed by the hippocampus in fear conditioning. Undoubtedly, these mechanisms will prove important in other learning systems. More importantly, however, these systems well may prove to be the very systems whose dysfunction underlies fear and anxiety disorders.

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Periaqueductal grey:

In a related process, another responsibility of the amygdala is the suppression of the periaqueductal gray. The periaqueductal gray is another major structure involved in the interpretation of fear. It is a large structure in the midbrain, consisting of small to medium neurons surrounding the aqueduct of Silvus, otherwise known as the cerebral aqueduct. The periaqueductal gray is thought to be involved in protection and defensive reactions, notably distress calls and affective defense. Affective defense is characterized, for example, in cats by unsheathing of claws, baring of teeth, hissing, piloerection, paw striking, and arching of the back. When selectively electrically stimulated, the amygdala suppresses these behaviors and causes freezing. Freezing is a robust index of learned fear.

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Fear-neuro-circuit:

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Panksepp describes a “major fear circuit” in the brain located within the lateral and central parts of the amygdala in the lobus temporalis, the periaquaeductal grey (PAG) of the diencephalon and mesencephalon, and as “output-generating” parts the brain stem and the medulla. Fear leads to reactions that are both behavioral and physiological. Behavioral reactions include either a “freeze”, “flight”, or “fight” response. Underlying physiological processes include an increase in heart rate, muscular tension, sweating, etc., and, most important, a response of the adrenal gland via the pituitary-hypothalamus-adrenal-axis (HHN) which leads to the release of cortisol. The cortisol level rises as a consequence of the production of corticotropin releasing hormone and ACTH. Thus in many experiments the assessment of changes in cortisol levels is used as an indicator of potentially experienced fear. In a study by Hubert & de Jong-Meyer male subjects showed an increase in cortisol levels (measured from saliva) while they were watching a horror film. Kirschbaum & Hellhammer found similar results. In contrast, Hubert, Möller, & de Jong-Meyer showed that subjects experienced an increase in cortisol levels in response to a funny movie. They speculate that every kind of affective arousal and change of mood, positive as well as negative, could be linked to cortisol secretion. Scientist from Zurich studies show that the hormone oxytocin related to stress and sex reduces activity in brain fear center. So you can say that cortisol is related to fear genesis and oxytocin is related to fear extinction.

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What about connections between cerebral cortex and amygdala?

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Pre-frontal cortex (PFC) does regulate fear arising from amygdala: a study on rats:

For years scientists have believed that the so-called “hub” of fear lies in a peanut-sized part of the brain called the amygdala. The amygdala assesses whether a situation is dangerous, then fires signals to other parts of the brain. This triggers the release of hormones, including cortisol, which causes reactions like sweating and a tensing of the muscles. Now Quirk and others have taken a closer look at another region of the brain — the prefrontal cortex — where they believe one’s sense of safety is generated. To analyze this region, Quirk and his student Mohammed Milad trained rats to fear a tone by following the sound with an electric shock to their feet. Rats conditioned to fear the tone froze at the sound in anticipation of pain. Next the team reconditioned some of the rats using the same tone followed by no electric shocks. Over time most of these rats no longer froze when they heard the tone. In another set of rats, Quirk and Milad did not retrain the animals so they would no longer fear the tone, but instead electrically stimulated neurons in the prefrontal cortex of the rats’ brains. Quirk says the rats whose brains had been stimulated “acted like they had never been conditioned to fear the tone at all,” — even when the tone was repeatedly followed by shocks. “We know that fear is not erased — it’s always there,” says Quirk. “Instead there seems to be a system that actively inhibits the response. That’s what we’ve discovered.” What happens, Quirk believes, is when the brain senses conditions similar to ones that previously produced fear; the prefrontal cortex assesses the situation and if all seems OK, sends what he calls an “all clear” signal to the brain’s fear center. This signal reins in the fear response that would otherwise emanate from the amygdala. The ‘all clear’ signal is likely based on the context of the situation. “If I yell ‘Fire!’ in a movie theater, people may run, but if I yell ‘Fire!’ in an outside county fair, people are a lot less likely to feel afraid and react,” explains Michael Bouton, a psychologist at the University of Vermont. It’s this soothing signal that people with anxiety disorders may have trouble accessing. And just as Quirk was able to electrically stimulate the “all clear” signal in rats, he hopes the same can be done in people using magnetic pulses. Rats and people are a big leap apart, he admits, but those working with human anxiety disorders say the research is promising.

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Overcoming Fear: Whether to Freeze, Flee, or Fight? Cortex role in differential fear response:

Fear can make you run and hide, it can motivate you to take action, and it can freeze you dead in your tracks. In a 2010 study published in Neuron, scientists in Italy at the European Molecular Biology Laboratory (EMBL) and Glaxo Smith Kline in Verona identified that a specific type of neurons in the amygdala determine how mice react to a frightening stimulus. Their findings revealed that deciding whether or not to freeze when you are faced with fear is a much more complex task for our brains than was formerly realized. The scientists found that when they inhibited certain neurons in the amygdala of mice they were able to switch the response to fear from a passive stance to a more active one. Do human beings have the same response? Can we consciously condition ourselves to be more active and less passive in the face of fear? I believe the answer is yes. “When we inhibited these neurons, I was not surprised to see that the mice stopped freezing because that is what the amygdala was thought to do. But we were very surprised when they did a lot of other things instead, like rearing and other risk-assessment behaviors,” says Cornelius Gross, who led the research at EMBL, “it seemed that we were not blocking the fear, but just changing their responses from a passive to an active coping strategy. That is not at all what this part of the amygdala was thought to do.” Much to their surprise, the researchers found that the change from a passive to an active fear response was accompanied by the activation of large parts of the outer layer of the cerebrum called “the cortex.” Blocking this activation of the cortex could reinstate freezing behavior and flip the fear switch back to being passive. This finding stumped many scientists who study fear circuitry, because the amygdala was thought to control fear via the brainstem, not the cortex. Humans also show freezing and risk-assessment behaviors in response to fear. Understanding how to switch from passive to more active fear coping strategies is key to adapting to the stress and unpredictability of modern life, the scientists say.

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Laurel Edmundson explains that “studies of neuronal activity in the brain have suggested that the prefrontal cortex, a cognitive and emotional learning center that helps interpret sensory stimuli, is responsible for the conscious assessment of danger. After passing through the amygdala, sensory information is sent on to the cortex. There, the frightening stimulus is examined in detail to determine whether or not a real threat exists. Based on this information, the amygdala will be signaled either to perpetuate the physical response or to abort it. Because the amygdala is aroused before the cortex can accurately assess the situation, an individual will experience the physical effects of fear even in the case of a false alarm.”

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In addition to understanding the processes by which fear memories are established and expressed, there is considerable interest in the mechanisms by which fear memories are inhibited. Understanding fear reduction has important clinical implications for treating disorders of fear and anxiety, such as posttraumatic stress disorder and panic disorder. There is considerable evidence implicating the prefrontal cortex (PFC) in emotional processes (Davidson & Irwin 1999), and there is an emerging, but complicated, literature suggesting a role for the PFC in the inhibition of conditional fear. For example, PFC lesions have been reported to attenuate extinction of fear under some conditions (Morgan & LeDoux 1995,

Morgan et al 1993). However, others have not found an effect of PFC lesions on extinction (Gewirtz et al 1997). Recently, Quirk and colleagues reported that PFC lesions do not affect the acquisition or extinction of conditional fear per se, but either impair consolidation or affect the contextual modulation of the extinction memory (Quirk et al 2000). One paradigm that has been adopted to study fear reduction is conditioned inhibition. A number of brain structures known to be important for excitatory fear conditioning, including the amygdala, perirhinal cortex, and medial geniculate nucleus, do not appear to be involved in conditioned inhibition of fear (Falls et al1997, Falls & Davis 1995, Heldt & Falls 1998). Moreover, the PFC does not appear to be required for conditioned inhibition (Gewirtz et al 1997, Vouimba et al 2000), although recordings of prefrontal cortical activity reveal that there is an amygdala dependent reduction of spike firing to a conditioned inhibitor (Garcia et al 1999).Thus, the neural substrates underlying the inhibition of fear remains elusive.

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fMRI and amygdala modulation by anterior cingulate cortex (rACC):

More recently, researchers have used functional magnetic resonance imaging (fMRI) to show that the rostral anterior cingulate cortex (rACC) modulates activity in the amygdala, effectively acting as an ‘on-off’ switch. Joy Hirsch and her colleagues at Columbia University used a variant of the Stroop test, which involves presenting words for colors, which are printed in a color that differs from that of the meaning of the word (e.g. green). This discrepancy leads to a delay in the processing of the visual information, increasing the reaction time taken to perform the task. Instead of using words, Hirsch’s team presented participants in their experiments with photographs of happy or scared faces with the word ‘HAPPY’ or ‘FEAR’ written across them. It was found that the amygdala was activated before the rACC when the participants were presented with a happy face with the word ‘FEAR’ printed across it. Soon afterwards, though, the activity in the amygdala would be reduced. That is, initially, the amygdala processes the word ‘FEAR’, but, soon afterwards, the rACC processes the happy face, and inhibits activity in the amygdala to reduce the fear response. In contrast, when participants were presented with a photograph of a scared face which had the word ‘FEAR’ written across it, the rACC remained inactive, while activity in the hippocampus persisted for longer.

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A disinhibitory microcircuit for associative fear learning in the auditory cortex:

Researchers show that acquisition of associative fear memories depends on the recruitment of a disinhibitory microcircuit in the mouse auditory cortex. Fear-conditioning-associated disinhibition in auditory cortex is driven by foot-shock-mediated cholinergic activation of layer 1 interneurons, in turn generating inhibition of layer 2/3 parvalbumin-positive interneurons. Importantly, pharmacological or optogenetic block of pyramidal neuron disinhibition abolishes fear learning. Together, these data demonstrate that stimulus convergence in the auditory cortex is necessary for associative fear learning to complex tones, define the circuit elements mediating this convergence and suggest that layer-1-mediated disinhibition is an important mechanism underlying learning and information processing in neocortical circuits.

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The table above shows various brain areas activated/inhibited during various phobia/anxiety disorders as evident in functional neuroimaging study on fear &anxiety disorders.

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Pharmaceutical and emotional stimuli challenge studies for fear state:

Pharmacological challenge studies:

Another way to examine the mediating functional neuroanatomy of fear or anxiety is to use specific pharmacological agents to provoke such states in healthy individuals during PET or fMRI scanning. For example, cholecystokinin-4 (CCK-4) is associated with increases in subjective states of fear and anxiety, as well as increased activation in the amygdala, insular cortex, claustrum, cerebellum, brain stem, and the ACC (Benkelfat et al, 1995; Eser et al, 2009; Javanmard et al, 1999; Schunck et al, 2006). In addition, two studies reported dACC increases during anticipatory anxiety preceding the CCK administration (Eser et al, 2009; Javanmard et al, 1999). It is important to keep in mind, however, that CCK-B receptor agonists like pentagastrin also have direct effects on stress axis stimulation independent of their effects on subjective experience of distress/fear (Abelson et al, 2005, 2008). Procaine administration has been associated with elevated subjective ratings of fear/anxiety, activation of the amygdala, ACC, and insular cortex (Ketter et al, 1996; Servan-Schreiber et al, 1998), and deactivation of neocortical structures (Servan-Schreiber et al, 1998). Furthermore, amygdala activity was positively correlated with subjective reports of anxiety (Ketter et al, 1996; Servan-Schreiber et al, 1998). Interestingly, those subjects who did not have a panic attack in response to procaine had greater activation in the rACC compared with those who did have a panic attack (Servan-Schreiber et al, 1998), consistent with the idea that the rACC may perform a regulatory or inhibitory function (Mayberg, 1997). The alpha-2 adrenergic antagonist yohimbine has likewise been associated with increased normalized blood flow in medial prefrontal cortex, insular cortex, and cerebellum in healthy individuals (Cameron et al, 2000). A major caveat in the interpretation of pharmacological challenge studies, however, is the difficulty in disentangling the effects that are specific to fear induction from the direct effect of a pharmacological agent on regional brain activity and from the non-specific effects of the pharmacological agent.

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Emotional challenge studies:

Over the past two decades, functional neuroimaging studies have shown that a core set of brain regions mediate responses to emotional stimuli in healthy humans. The relevance of these studies to fear/anxiety circuitry is two-fold: (1) A significant number of these emotional activation paradigms utilize stimuli that depict and/or elicit fear, and (2) these studies shed light on more general emotion-generating neurocircuitry. PET and fMRI studies have reported amygdala activation in response to emotionally negative photographs (Britton et al, 2006; Hariri et al, 2002; Irwin et al, 1996; Lane et al, 1997a; Paradiso et al, 1999; Phan et al, 2003b; Reiman et al, 1997; Taylor et al, 1998), odors (Zald and Pardo, 1997) and tastes (Zald et al, 1998). Several studies have reported amygdala activation to positive stimuli as well (Garavan et al, 2001; Hamann and Mao, 2002; Hamann et al, 1999, 2002; Liberzon et al, 2003), which suggests that the amygdala responds more broadly to emotionally arousing and/or salient stimuli (Phan et al, 2004b). Reappraisal of emotionally negative photographs is associated with reduced amygdala activation (Ochsner et al, 2002) and increased ventromedial prefrontal cortex activation (Urry et al, 2006). Finally, amygdala activation during encoding of emotionally arousing stimuli is correlated with the subsequent recollection of those stimuli (Cahill et al, 1996; Dolcos et al, 2004, 2005; Hamann et al, 1999). Medial prefrontal cortex, including the rACC, also activates in response to emotional pictures (Lane et al, 1997a, 1997b; Phan et al, 2003a, 2003b, 2004a; Reiman et al, 1997) and may mediate self-referential processing (Kelley et al, 2002; Lane et al, 1997a; Zysset et al, 2002). Although the medial prefrontal cortex may activate regardless of task or valence, the rACC may be more likely to activate when a cognitive task is performed during scanning (Phan et al, 2002). Ventromedial PFC responses to fear-related images have been negatively associated with cortisol reactivity (Root et al, 2009). The dACC also activates in response to emotional photographs (Britton et al, 2006; Teasdale et al, 1999) and aversive tastes (Zald et al, 1998). Finally, the insular cortex is responsive to aversive stimuli (Phan et al, 2004a), internally generated sadness (Lane et al, 1997b; Reiman et al, 1997) and disgust-related stimuli (Britton et al, 2006).

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Amygdala substitute:

This brain region, known as the bed nuclei, will step in only when the region linked with fear, the amygdala, is not functioning, the researchers say. Previous work by Fanselow and his colleagues showed that rats with damaged amygdala could still form fear memories after many trials. However, they didn’t know which brain region was the one that took over. They suspected the bed nuclei, which are connected to many of the same parts of the brain as the amygdala. To test their theory, they created lesions on rat’s brains, designed to disrupt either the amygdala or the bed nuclei, or both. The rats were then taught to fear a cage that gave them an electric shock. Rats eventually froze up when they were placed in the cage, remembering the shock. However, rats with lesions on both the amygdala and the bed nuclei froze significantly less than rats with lesions on only one of these brain areas. Additionally, rats with single lesions eventually behaved almost like normal rats, while rats with two lesions (one on each the amygdala and bed nuclei) always showed impairment in their fear learning. In a second experiment, the researchers blocked the ability of bed nuclei neurons to make proteins — a process crucial for the formation of memories. For the rats with working amygdala, blocking protein synthesis in the bed nuclei region appeared to have no impact on the ability to form fear memories. But when the rats had damaged amygdala and were unable to form proteins in their bed nuclei, they could not form fear memories. This suggested the bed nuclei step in when, and only when, the amygdala isn’t working.

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Fear vis-à-vis internal & external threats: amygdala is not the only gatekeeper of fear:

Researchers at the University of Iowa show that the human brain has new regions that sense internally derived fear. The finding comes from tests the team conducted of three women with significant damage to the amygdala (shown in the brain scans by red-dashed circles), which registers fear from external dangers. These three women have an extremely rare condition called Urbach-Wiethe disease that has caused extensive damage to the amygdala, an almond-shaped area in the brain long known for its role in fear. They had not felt terror since getting the disease when they were adolescent. These three women with an extremely rare type of brain damage had never felt fear in their adult lives. Snakes and scary movies didn’t do it for them. In fact, they couldn’t even recognize a fearful expression on someone else’s face. The figure below shows MRI scans of these three women who had atrophic damaged amygdala as compared to a normal person having normal amygdala on MRI.

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However when given a hit of carbon dioxide that made them feel like they couldn’t breathe, the women experienced something surprising and novel: They were panicked. Interestingly, the amygdala-damaged patients had no fear leading up to the test, unlike the healthy participants, many who began sweating and whose heart rates rose just before inhaling the carbon dioxide. That, of course, was consistent with the notion that the amygdala detects danger in the external environment and physiologically prepares the organism to confront the threat. Researchers were completely surprised when the patients had a panic attack. By contrast, only three of 12 healthy participants panicked—a rate similar to adults with no history of panic attacks. Notably, none of the three patients with amygdala damage has a history of panic attacks. The higher rate of carbon dioxide-induced panic in the patients suggests that an intact amygdala may normally inhibit panic. This experience challenges the widely held belief that the amygdala is essential for fear. Interestingly, the amygdala-impaired volunteers still didn’t react in the same way as healthy volunteers. Unlike most people, whose heart and perspiration rates rise immediately prior to a repeat of the carbon dioxide experiment, AM and her cohorts never developed an anticipatory response. They could feel fear, but they couldn’t anticipate it. Carbon dioxide changes blood acidity, activating acid-activated chemo receptors in the brain. This study hints that internal threats, like carbon dioxide, are processed differently by the brain than external ones. This study shows there are other ways to get fear besides through the amygdala. Researchers hypothesize that the hypothalamus might be involved, since it can mediate fear response in healthy people. The results also indicate that there could be other pathways for fear in the brain that skirt the amygdala. While external scary stimuli are processed through visual and auditory pathways that fire off signals to the amygdala, CO2 might trigger a response in another part of the brain, such as the brain stem or insular cortex. Thus, CO2 may directly activate extra-amygdalar brain structures that underlie fear and panic. In a paper published in the journal Nature Neuroscience, the UI team provides proof that the amygdala is not the only gatekeeper of fear in the human mind. Other regions— such as the brainstem, diencephalon, or insular cortex—could sense the body’s most primal inner signals of danger when basic survival is threatened. This research says panic, or intense fear, is induced somewhere outside of the amygdala. This could be a fundamental part of explaining why people have panic attacks. Information from the outside world gets filtered through the amygdala in order to generate fear. On the other hand, signs of danger arising from inside the body can provoke a very primal form of fear, even in the absence of a functioning amygdala. If true, the newly discovered pathways could become targets for treating panic attacks, post-traumatic stress syndrome, and other anxiety-related conditions caused by a swirl of internal emotional triggers. 

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Pavlovian Fear Conditioning:

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Pavlovian conditioning is an elemental learning process whose existence has been demonstrated in a wide range of species, both vertebrates and invertebrates. In this basic form of learning, an initially neutral stimulus acquires new behavioral properties due to its pairing in temporal contiguity with an unconditioned stimulus (US). The effects of learning are expressed in the ability of the conditioned stimulus (CS) to elicit motor or physiological reactions adapted to the anticipation of the US and that generally are closely related to the behavior elicited by this stimulus. Fear conditioning not only induces changes in neuronal response in the amygdala, a structure that seems to be specifically involved in fear and emotional learning but these changes also occur in cortical and sub-cortical systems mediating perceptual processing. Fear conditioning induces a form of Neuronal Plasticity in the Amygdala. The initial learning and subsequent behavioral expression of fear are often viewed as independent processes with potentially unique neural substrates. Laboratory animal studies of Pavlovian fear conditioning suggest that the amygdala is important for both forming stimulus associations and for subsequently expressing learned behavioral responses.

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Famous fear conditioning experiment on rats:

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Pavlovian fear conditioning:

Fear conditioning is a behavioral paradigm in which organisms learn to predict aversive events. It is a form of learning in which an aversive stimulus (e.g. an electrical shock) is associated with a particular neutral context (e.g., a room) or neutral stimulus (e.g., a tone), resulting in the expression of fear responses to the originally neutral stimulus or context. This can be done by pairing the neutral stimulus with an aversive stimulus (e.g., a shock, loud noise, or unpleasant odor). Eventually, the neutral stimulus alone can elicit the state of fear. In the vocabulary of classical conditioning, the neutral stimulus or context is the “conditional stimulus” (CS), the aversive stimulus is the “unconditional stimulus” (US), and the fear is the “conditional response” (CR). After repeated pairings, the CS alone comes to elicit a conditioned fear response (e.g., increased freezing, fear-potentiated startle, or skin conductance responses). Pavlovian fear conditioning has been used as a testable and translational, though admittedly simplistic, model of the acquisition of fears that might be relevant to some anxiety disorders like phobias and possibly to some aspects of post-traumatic stress disorder (PTSD). Fear conditioning has been studied in numerous species, from snails to humans. In humans, conditioned fear is often measured with verbal report and galvanic skin response. In other animals, conditioned fear is often measured with freezing (a period of watchful immobility) or fear potentiated startle (the augmentation of the startle reflex by a fearful stimulus). Changes in heart rate, breathing, and muscle responses via electromyography can also be used to measure conditioned fear. Fear conditioning is thought to depend upon an area of the brain called the amygdala. Ablation or deactivating of the amygdala can prevent both the learning and expression of fear. Some types of fear conditioning (e.g. contextual and trace) also involve the hippocampus, an area of the brain believed to receive affective impulses from the amygdala and to integrate those impulses with previously existing information to make it meaningful.

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Pavlovian fear conditioning in humans: an experiment:

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John Watson and Rosalie Rayner’s famous experiment with the infant Albert is an instructive example of the Pavlovian fear conditioning procedure (Watson & Rayner 1920). In this experiment Watson and Rayner set out to condition fear to a white rat by sounding a loud and aversive noise after presenting the rat to “Little Albert.” Before pairing the white rat with noise, the rat did not evoke fear in Albert. Not surprisingly, the loud noise, which Watson generated by striking a hammer on a suspended steel bar, produced a robust fear response in Albert. Upon hearing the noise, Albert “startled violently” and “broke into a sudden crying fit.” After several pairings of the rat and noise Albert came to fear the rat. When Watson presented the rat to Albert after conditioning, Albert fell over, cried, and attempted to crawl away from the animal. In Watson and Rayner’s words, “This was as convincing a case of a completely conditioned fear response as could have been theoretically pictured.” Although this experiment nicely illustrates fear conditioning, it is important to note that this type of experiment would not be acceptable by current ethical standards. Appealing to the semantics of Pavlovian conditioning, Little Albert had learned that an innocuous conditional stimulus (CS; the white rat) predicted the occurrence of a noxious unconditional stimulus (US; the loud noise). Learning was manifest as a conditional response (crying) that, in this case, took the form of the un-conditional response that was elicited by the loud noise prior to conditioning. Watson and Rayner’s experiment with Albert exemplifies the traditional view of Pavlovian conditioning that one stimulus comes to evoke the response of another—the so-called conditioned reflex. However, as Rescorla has powerfully argued, current thinking holds that Pavlovian conditioning involves learning the hierarchical relationships among events (Rescorla 1988). Indeed, Pavlovian conditioning enables organisms to form neural representations of their worlds. Hence, the representation of the relations between aversive or traumatic events and the stimuli that predict them is at the core of Pavlovian fear conditioning. The “little Albert” study, besides being cruel, was badly designed. Watson did not control it carefully to rule out a wide range of possible interpretations.

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Studies of Pavlovian fear conditioning in non-humans have highlighted the importance of the amygdala in the acquisition of fear conditioning (LeDoux, 2000; LeDoux et al, 1990; Pare et al, 2004; Sananes and Davis, 1992). Similarly, functional neuroimaging studies in humans have reported amygdala activation during fear conditioning (Alvarez et al, 2008; Barrett and Armony, 2009; Buchel et al, 1998, 1999; Cheng et al, 2003, 2006; Gottfried and Dolan, 2004; Knight et al, 2004, 2005; LaBar et al, 1998; Milad et al, 2007b; Morris and Dolan, 2004; Pine et al, 2001; Tabbert et al, 2006), even when the CS is presented below perceptual thresholds (Critchley et al, 2002; Knight et al, 2009; Morris et al, 2001) and even when more complex USs are used (Doronbekov et al, 2005; Klucken et al, 2009). In addition, amygdala activity has been associated with skin conductance changes during fear conditioning (Cheng et al, 2006; Furmark et al, 1997; LaBar et al, 1998; Phelps et al, 2001). Interestingly, amygdala activation in humans also has been observed in response to cues following (1) verbal instructions that discriminate between cues that predict shock vs. safety (even though no shock was actually administered) (Phelps et al, 2001), and (2) observational fear learning, whereby participants watch a video of another person experiencing a Pavlovian fear-conditioning paradigm (Olsson et al, 2007). What exactly amygdaloid activation represents in these latter paradigms is not entirely clear. It could suggest for example that: (1) higher order centers that decipher the anticipated predictive value of the cue, or that learn from observation using empathy, convey information to the amygdala, or (2) alternatively, that the human amygdala is less specific in its responses and is more sensitive to contextual modulation in the absence of a US. These interpretations could have potentially different implications for the understanding of the role of the amygdala in anxiety disorders.

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Fear conditioning is also associated with increased activation in the dACC and rACC (Alvarez et al, 2008; Buchel et al, 1998, 1999; Dunsmoor et al, 2007; Klucken et al, 2009; LaBar et al, 1998; Marschner et al, 2008; Milad et al, 2007a, 2007b; Morris and Dolan, 2004; Phelps et al, 2004). Activation in the dACC and rACC also occurs during observational fear learning (Olsson et al, 2007). In addition, dACC activation is positively correlated with differential skin conductance responses (Milad et al, 2007a). Fear conditioning studies (involving both specific CSs and contexts) also commonly report insular cortex activation (Alvarez et al, 2008; Buchel et al, 1999; Buchel et al, 1998; Critchley et al, 2002; Dunsmoor et al, 2007; Gottfried and Dolan, 2004; Klucken et al, 2009; Knight et al, 2009; Marschner et al, 2008; Morris and Dolan, 2004; Phelps et al, 2001, 2004) and hippocampal activation (Alvarez et al, 2008; Buchel et al, 1999; Knight et al, 2004, 2009; Lang et al, 2009; Marschner et al, 2008).

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Fear and neural plasticity:

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Pavlovian fear conditioning has undergone an extensive neurobiological analysis in recent years. This analysis has revealed that the amygdala and hippocampus are critical components of the neural circuitry underlying association formation and contextual processing, respectively, during fear conditioning. Moreover, synaptic plasticity mechanisms, such as LTP, in the hippocampus and amygdala play distinct and critical roles in these processes. Most recently, molecular techniques are beginning to unravel the intracellular cascades that underlie the formation and storage of fear memories. Collectively, these advances yield great promise for understanding the neurobiology of learning and memory, in general, and in understanding the neurobiological basis of disorders of fear and anxiety in humans.

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Amygdala and extinction of fear:

Earlier research has revealed that in animals and humans, the amygdala is involved in the expression of innate fear responses, such as the fear of snakes, along with the formation of new fear memories as a result of experience, such as learning to fear the sound of a siren that predicts an air raid. In the laboratory, the circuits underlying learned fear are typically studied using an experimental paradigm called Pavlovian fear conditioning. In this research model on rats, a neutral stimulus such as the sound of a tone elicited a fear response in the rats after they heard it paired with a noxious or unpleasant stimulus, such as a shock to the feet. However, this conditioned fear response was diminished with repetition of the neutral stimulus in the absence of the noxious stimulus. This phenomenon is known as extinction. This approach is similar to that used to treat human phobias, where the subject is presented with the feared object in the absence of danger. Behavioral studies have demonstrated, however, that extinction training does not completely abolish the initial fear memory, but rather leads to the formation of a new memory that inhibits conditioned fear responses at the level of the amygdala. As such, fear responses can be expressed again when the conditioned stimulus is presented in a context other than the one where extinction training took place. For example, suppose a rat is trained for extinction in a grey box smelling of roses, and later hears the tone again in a different box, with a different smell and appearance. The rat will show no evidence of having been trained for extinction. The tone will evoke as much fear as if the rat had not been trained for extinction. Extinction memory will only be expressed if tested in the same environment where the extinction training occurred, implying that extinction does not erase the initial fear memory but only suppresses it in a context-specific manner. Importantly, it has been found that people with anxiety disorders exhibit an “extinction deficit,” or a failure to “forget.” However, until recently, the mechanisms of extinction have remained unknown. As reported by Nature, researcher has found that clusters of amygdala cells, known as the intercalated (ITC) neurons, play a key role in extinction. This finding indicates that ITC cells inhibit amygdala outputs to the brain stem structures that generate fear responses. Indeed, researchers have shown that when ITC cells are destroyed with a targeted toxin in rats, extinction memory is impeded, mimicking the behavior seen in PTSD.  The significance of this finding derives from earlier results suggesting that PTSD reflects an extinction deficit and that the amygdala is hyperactive in this disorder. As a result, it might be possible to compensate for this abnormality and facilitate extinction with pharmacological interventions that enhance the excitability of ITC cells to inhibit amygdala outputs.

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Cortex and extinction of fear:

Extinction learning occurs when a CS that previously predicted a US no longer does so, and over time, the conditioned response (e.g., freezing or elevated skin conductance responses) decreases. Extinction learning or, more likely, the later recall of this learning involves the ventromedial prefrontal cortex (vmPFC) (Milad and Quirk, 2002; Morgan et al, 1993; Quirk et al, 2000, 2003, 2006) in rodents. Functional neuroimaging studies of healthy humans have reported vmPFC activation during extinction (Barrett and Armony, 2009; Gottfried and Dolan, 2004; Kalisch et al, 2006; Milad et al, 2007b) and the later recall of extinction (Milad et al, 2007b; Phelps et al, 2004). Skin conductance measures of extinction memory are positively correlated with vmPFC activation (Milad et al, 2007b; Phelps et al, 2004) and vmPFC cortical thickness (Milad et al, 2005). Activation of the amygdala and insular cortex also may occur during extinction learning or recall (Gottfried and Dolan, 2004; LaBar et al, 1998; Milad et al, 2007b; Phelps et al, 2004), and greater amygdala responses during extinction have been associated with higher trait anxiety (Barrett and Armony, 2009). Finally, extinction can be modulated by context (i.e., the surroundings in which extinction takes place), and the hippocampus has a role in this process. In rodents, dorsal hippocampal lesions reduce the context-dependence of extinction (Bouton et al, 2006). In a recent fMRI study, hippocampal activation to the CS+ occurred in the extinction context but not in the conditioning context (Kalisch et al, 2006). Hippocampal activation was also positively correlated with vmPFC activation in this study (Kalisch et al, 2006), suggesting that hippocampal–vmPFC interactions may be important for the contextual modulation of extinction.

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Are the Central Nucleus of the Amygdala and the Bed Nucleus of the Stria Terminalis differentially involved in Fear versus Anxiety?

Although there is a close correspondence between fear and anxiety, and the study of fear in animals has been extremely valuable for under-standing the neural basis of anxiety, it is also clear that a richer animal model of human anxiety disorders would include measures of both stimulus-specific fear and something less stimulus specific, more akin to anxiety. Patients with posttraumatic stress syndrome seem to show normal fear reactions but abnormal anxiety measured with the acoustic startle reflex. Studies in rats, also using the startle reflex, indicate that highly processed explicit cue information (lights, tones, touch) activates the central nucleus of the amygdala, which in turn activates hypothalamic and brain stem target areas involved in specific signs of fear. Less explicit information, such as that produced by exposure to a threatening environment or by intraventricular administration of corticotropin-releasing hormone, may activate another part of the extended amygdala, the bed nucleus of the stria terminalis, which also projects to the startle pathway. Because this information may be less specific and of long duration, activation of the bed nucleus of the stria terminalis may mediate anxiety, whereas activation of the central nucleus of the amygdala may mediate stimulus-specific fear.

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The Neurobiology of Conditioned and Unconditioned Fear: A Neurobehavioral System Analysis of the Amygdala in rats:

A neurobehavioral system approach to conditioned and unconditioned fear is presented in this study. By employing reproducible fear behaviors in Pavlovian conditioning and unconditioned fear paradigms, it has been possible to delineate some differences in neural circuitry and cellular biology for conditioned and unconditioned fear. It is suggested that the basolateral complex of the amygdala and the central nucleus of the amygdala are part of the neural circuitry for fear conditioning but not for unconditioned fear to a predator odor. Furthermore, changes in expression of the transcription factor early growth response gene 1 in the lateral nucleus of the amygdala are shown to be important for contextual fear conditioning but not for unconditioned fear to a predator odor. In addition, data suggest that although conditioning to a synthetic predator odor, trimethylthiazoline, has been difficult to demonstrate, conditioning can occur by modifying by the environment.

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Expressing learned, but not innate, fear requires the prefrontal cortex. A new study on rats:

The results suggest that hyperactivity in a region of the prefrontal cortex might contribute to disorders of learned fear in humans, such as post-traumatic stress disorder and other anxiety disorders, say authors Kevin A. Corcoran, PhD, and Gregory Quirk, PhD, of the Ponce School of Medicine in Puerto Rico. Their report appears in The Journal of Neuroscience. While building on previous findings, this study contradicts prior thinking that the amygdala, which plays a central role in emotional learning, is sufficient for processing and expressing fear, and it opens the potential for new avenues of treatment, the researchers say.  This is the first paper demonstrating that a region of the cortex is involved in learned fear but not in innate fear. In their study, Corcoran and Quirk taught rats to associate a 30-second tone with a shock to the foot at the end of the tone. Upon hearing the same tone the next day, rats spent nearly 70 percent of the time of the tone frozen, a typical fear response. In another group of rats, the researchers chemically blocked activity in the prelimbic cortex, which is located near the front of the brain and close to the midline between the two hemispheres. Corcoran and Quirk blocked nerve signals (using the sodium channel blocker tetradotoxin) in the prelimbic subregion of the medial prefrontal cortex (mPFC) of rats during fear learning and expression. These rats spent only 14 percent of the time freezing to the sound of the tone. Yet the rats’ innate, or natural, fears seemed unaffected by blocking the prelimbic cortex; they froze as much in response to seeing a cat or being placed in a large open area as they did to hearing the tone. Furthermore, when the team trained rats with the tone after chemically inactivating the prelimbic cortex, and then tested them drug-free the next day, the rats showed a normal fear response, indicating that inactivating the prelimbic cortex did not prevent them from learning to fear the tone. Inactivation of mPFL reduced freezing to both a tone and a context that had been previously paired with footshock (learned fear) but had no effect on freezing to a cat (innate fear). Inactivation of mPFL before conditioning, however, did not prevent the formation of auditory or contextual fear memories. Thus, activity in mPFC is critical for the expression, but not the acquisition, of learned fears. They suggest that mPFC integrates information from auditory and contextual inputs and regulates expression of fear memories via projections to the basal nucleus of the amygdala. The prelimbic cortex is connected to the amygdala, and, based on their findings, Corcoran and Quirk speculate that “by modulating amygdala activity, the prelimbic cortex is important for determining the circumstances in which it is appropriate to convey learned fears.” In contrast, they propose that fear responses to innate threats are automatic and do not require cortical involvement.

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Early life programming of innate fear and fear learning in adult female rats:

The early rearing environment can impact on emotional reactivity and learning later in life. In this study the effects of neonatal maternal separation (MS) on innate fear and fear learning were assessed in the adult female rat. Pups were subjected to MS (360 min), brief handling (H; 15 min), or animal facility rearing (AFR) on post-natal days 2-14. In the first experiment, innate fear was tested in the open field. No differences between the early rearing groups were observed in unconditioned fear. In the second experiment, separate cohorts were used in a 3-day fear learning paradigm which tested the acquisition (Day 1), expression and extinction (both Day 2) of conditioning to an auditory cue; extinction recall was determined as well (Day 3). Contextual fear conditioning was also assessed prior to cue presentations on Days 2 and 3. Whereas MS attenuated the acquisition and expression of fear conditioning to the cue, H potentiated extinction learning. Cue-induced fear was reduced on Day 3, compared to Day 2, indicating that the recall of extinction learning was evident; however, no early rearing group differences in extinction recall were observed. Similarly, while contextual fear was decreased on Day 3, compared to Day 2, there were no differences between the early rearing groups on either day tested. The present findings of altered cue-conditioned fear learning, in the absence of innate fear changes, lend further support for the important role of the early rearing environment in mediating cognition in adulthood. 

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A treatment for fear conditioning and phobias via the amygdala is the use of glucocorticoids:

 In one study, glucocorticoid receptors in the central nucleus of the amygdala were disrupted in order to better understand the mechanisms of fear and fear conditioning. The glucocorticoid receptors were inhibited using lentiviral vectors containing Cre-recombinase injected into mice. Results of this study showed that disruption of the glucocorticoid receptors prevented conditioned fear behavior. The mice were subjected to auditory cues which caused them to freeze normally. However, a reduction of freezing was observed in the mice that had inhibited glucocorticoid receptors.

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Emotional balance is regulated by Molecular Factors behind fear &stress response:

An organism’s response to stress is one of the key strategies essential to its survival in dealing with environmental factors. A balanced emotional reaction is of particular importance here and is subject to a highly complex molecular regulation system. Corticotropin-releasing hormone (CRH), which is released in the brain and places the organism in a state of alert, is a central molecular factor of the stress response. In addition to its effect as a hormonal messenger substance, it also controls the activity of neurons through binding to its receptors. Many patients with anxiety disorders and depression display an altered hormonal stress response and have increased volumes of CRH in the brain. To investigate the underlying pathological processes, the research team working with Jan Deussing at the Max Planck Institute of Psychiatry carried out studies on the mouse model system. This enabled them to selectively deactivate an important factor, for example the CRH type 1 receptor, in certain cells, and thus establishes the locations where the receptor is normally active and identifies its function.

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The figure below shows section of mouse brain showing CRHR1 receptors: 

 

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Using immunohistochemical methods and a series of transgenic mouse lines, the researchers succeeded in mapping the gene activity of the type 1 CRH receptor in the mouse brain in detail for the first time. Interestingly, a specific activity pattern emerged in different neuron groups which release different neuronal messenger substances. In regions of the forebrain (cortex, hippocampus, thalamus, septum), CRHR1 is detectable in glutamatergic and GABAergic neurons. At the limbic system, these regions are linked and, as the current study shows, trigger fear-inducing behaviour in glutamatergic neurons. In regions of the midbrain (substantia nigra, ventral tegmental area), CRHR1 arises in dopamine-releasing neurons. The functional examination of the mice gave rise to the fairly sensational discovery that the stress hormone CRH actually reduces fear through its receptors in this part of the brain. These neurons demonstrably trigger the direct release of dopamine in regions of the midbrain and hence cause behavior that overcomes fear. With the help of genetic studies on mice, scientists have discovered two opposing neuronal regulatory circuits for the generation and elimination of fear. Both are controlled by the stress-inducing messenger substance corticotropin-releasing hormone (CRH) and its type 1 receptor (CRHR1). The availability of these factors in neurons that release glutamate in brain areas of the limbic system activates a neuronal network which causes anxiety behavior. Conversely, in dopamine-releasing neurons in the mid-brain, these factors give rise to behavior that reduces fear. Because disorders of the stress factors may be observed in many patients with affective illnesses, the scientists suspect that the pathological alteration of the CRHR1-dependent regulatory circuits may be at the root of such emotional maladies. The opposing effects of the fear-generating and fear-eliminating effect of the CRH/CRHR1 (duality of existence) was demonstrated for the first time by this study and prompted the re-evaluation of the use of CRH-receptor antagonists as anxiolytic and antidepressant drugs. The authors speculate that the over-activity of the CRH system in patients with mood disorders is not general but probably limited to certain regulatory circuits in the brain, thus causing imbalanced emotional behavior. The use of CRH-receptor 1 antagonists could be particularly useful in patients in whom one of these systems is out of synchrony.

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Fear and gene: 4 studies:

Study 1)

TRPC5 gene:

In a paper published in Cell, Vadim Bolshakov, director of the Cellular Neurobiology Laboratory at McLean and associate professor of psychiatry at Harvard Medical School, and his colleagues report that mice lacking the transient receptor potential channel 5 (TRPC5) gene showed diminished fear levels in response to stimuli that they normally would fear innately, compared with normal mice. In the study, the researchers looked at the neurons in the amygdala of mice lacking the TRPC5 gene and discovered that they did not fire as well as those in the brains of normal mice. At the same time, neurons in the same region of the brain of the mice missing the TRPC5 gene were not as sensitive to the neuropeptide cholecystokinine, commonly released in the brain during situations of innate fear or anxiety. What researchers found with their work was that the mice who did not have the TRPC5 protein no longer showed fear-related behaviors when faced with situations that would typically cause them anxiety. The mice lacking the gene, for example, would show no fear in exploring places where they normally would fear to tread. The mice also were not as fearful of new social interactions with other mice.

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Study 2)

Stathmin gene:

Little is known about the molecular mechanisms controlling both learned and innate fear. Rutgers geneticist Gleb Shumyatsky has discovered a gene that controls both innate and learned forms of fear. The gene, known as Stathmin or Oncoprotein 18, is highly concentrated in the amygdala, a key region of the brain that deals with fear and anxiety. It was known for some time that the encoding and consolidation of fearful memories can be blocked by inhibiting protein synthesis in the amygdala, but it was not clear which proteins are involved. Recently, however, Gleb Shumyatsky and his colleagues at Rutgers University in New Jersey discovered several genes that are highly expressed in the amygdala, and which appear to be involved in this process. One of these encodes a protein called stathmin (also known as oncoprotein 18), which is now known to be involved in mediating the formation of memories of both conditioned and unconditioned fear. There is a high level of expression of the stathmin gene, and a corresponding high concentration of stathmin protein, in the amygdala, but not in the adjacent hippocampus. Mutant mice lacking the stathmin gene were unable to learn new fears or to act instinctively in a fearful situation, i.e. they had weaker memories of fearful experiences. Shumyatsky, his collaborators and their laboratory colleagues used mice that were deficient in Stathmin and analyzed their anxiety levels by recording their performance in mazes. Mice instinctively avoid open spaces, but the knockout mice showed no fear and consistently explored more open areas than normal mice. Reductions in innate fear behaviors, such as avoiding open spaces as opposed to “safer” areas with less exposure, correlated with the absence of Stathmin. The stathmin knockout mice also showed less anxiety when presented with new mazes to explore or with potentially dangerous situations. Upon further examination, it was observed that mice lacking the stathmin gene had a less dynamic microtubule network than wild type (normal) mice. Memories are formed by the establishment of new synaptic connections, which require a re-arrangement of microtubules. In the absence of the stathmin protein, microtubules aren’t re-arranged so easily, and, as a consequence, the synapses that would normally be modified during memory formation are not as plastic as they should be. So the protein stathmin is essential for the fear response – both the expression of innate fear and the formation of memory for learned fear. Previous studies had shown that the amygdala, a brain structure important for emotional responses, is the place where fear memory is formed. This study, using mice, demonstrated that those that were genetically modified so they would not produce stathmin showed deficits in neural transmission and exhibited decreased memory in fear conditioning and the failure to recognize danger in innately aversive environments. Learned fear develops after conditioning and lasts for life. Researchers have identified stathmin, an inhibitor of microtubule formation, as highly expressed in the lateral nucleus (LA) of the amygdala as well as in the thalamic and cortical structures that send information to the LA about the conditioned (learned fear) and unconditioned stimuli (innate fear). Whole-cell recordings from amygdala slices that are isolated from stathmin knockout mice show deficits in spike-timing-dependent long-term potentiation (LTP). The knockout mice also exhibit decreased memory in amygdala-dependent fear conditioning and fail to recognize danger in innately aversive environments. By contrast, these mice do not show deficits in the water maze, a spatial task dependent on the hippocampus, where stathmin is not normally expressed. Researchers therefore conclude that stathmin is required for the induction of LTP in afferent inputs to the amygdala and is essential in regulating both innate and learned fear. Shumyatsky explained that the earlier research paper described a gene that is expressed in the learned fear circuitry and controls only learned fear but not innate fear. The new paper describes a gene that controls both learned and innate fear. This work therefore emphasizes the importance of local gene expression in the neural circuits responsible for specific behaviors. The evidence that stathmin is important in the regulation of fear suggests that stathmin knockout mice can be used as a model of anxiety states or mental disorders with innate and learned fear components. In the future, these animal models may be used to develop new anti-anxiety drugs.

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Study 3)

FAAH gene:

A research group at the National Institute on Alcohol Abuse and Alcoholism led by Andrew Holmes found that when a specific brain enzyme (fatty acid amide hydrolase, or FAAH) in mice was inhibited, the mice spent less time in a fear state. Taught to associate a distinctive tone with an electrical shock, they quite naturally froze in fear when they heard it. But when they were subsequently exposed to the tone minus the shock, the enzyme-inhibited rodents shrugged off the formerly frightening sound far more quickly than their still-frozen-in-place peers. Hariri conducted a similar study with middle-aged humans, using brain scans to measure amygdala activity as they looked at a series of faces with threatening expressions. Among participants who carried a specific version of the FAAH gene, brain activity decreased rapidly as the test proceeded, with scowls viewed later in the experiment triggering minimal reaction. This suggests that, for at least some people suffering from anxiety disorders, a drug that blocks the FAAH enzyme could bring you back to a middle-of-the-road response.

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Study 4)

Zinc transporter gene:

Zinc transporter 3 is involved in learned fear and extinction, but not in innate fear:

Synaptically released Zn²⁺ is a potential modulator of neurotransmission and synaptic plasticity in fear-conditioning pathways. Zinc transporter 3 (ZnT3) knock-out (KO) mice are well suited to test the role of zinc in learned fear, because ZnT3 is co-localized with synaptic zinc, responsible for its transport to synaptic vesicles, highly enriched in the amygdala-associated neural circuitry, and ZnT3 KO mice lack Zn²⁺ in synaptic vesicles. However, earlier work reported no deficiency in fear memory in ZnT3 KO mice, which is surprising based on the effects of Zn²⁺ on amygdala synaptic plasticity. Researchers therefore reexamined ZnT3 KO mice in various tasks for learned and innate fear. The mutants were deficient in a weak fear-conditioning protocol using single tone–shock pairing but showed normal memory when a stronger, five-pairing protocol was used. ZnT3 KO mice were deficient in memory when a tone was presented as complex auditory information in a discontinuous fashion. Moreover, ZnT3 KO mice showed abnormality in trace fear conditioning and in fear extinction. By contrast, ZnT3 KO mice had normal anxiety. Thus, ZnT3 is involved in associative fear memory and extinction, but not in innate fear, consistent with the role of synaptic zinc in amygdala synaptic plasticity.

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In a nutshell I may say that proteins and trace element zinc under control of genes determine fear memories, fear expression and fear behavior in animals including human. Genes for innate fear (e.g. fear of snake) are evolutionarily hardwired for survival and passed on to next generation. Learned fears are not passed on to next generation but if learned fear is repeatedly conditioned in every successive generation, it would ultimately become innate fear.

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New perspectives on beta-adrenergic mediation of innate and learned fear responses to predator odor:

In the present study, researchers investigated the role of noradrenergic transmission in unconditioned and conditioned responses to predatory threats. First, they examined the effects of systemically injected beta-blockers on unconditioned and contextual conditioned response to cat odor. The centrally acting beta-blocker (propranolol) was able to impair unconditioned responses, as well as the acquisition of the contextual fear to cat odor; however, the peripherally acting (nadolol) was not effective. Next, they examined the neural substrate underlying the noradrenergic modulation of the defensive response to cat odor and focused on the dorsal premammillary nucleus (PMd), because it represents the hypothalamic site most responsive to predatory threats and, at the same time, presents a dense plexus of noradrenergic fibers. They were able to see that propranolol significantly reduced PMd-Fos expression in response to cat odor and that beta-adrenoceptor blockade in the PMd, before cat odor exposure, reduced defensive responses to the cat odor and to the cat odor-related environment. They have also shown that beta-adrenoceptor blockade in the PMd, before the exposure to cat odor-related context, impaired the contextual conditioned responses. Overall, the present results provide convincing evidence suggesting that central noradrenergic mediation is critical for the expression of unconditioned and contextual conditioned antipredatory responses. They have further shown that the PMd appears to be an important locus to mediate these beta-adrenoceptor effects.

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Fatal attraction in rats infected with Toxoplasma gondii:

Researchers tested the hypothesis that the parasite Toxoplasma gondii manipulates the behavior of its intermediate rat host in order to increase its chance of being predated by cats, its feline definitive host, thereby ensuring the completion of its life cycle. Here they report that, although rats have evolved anti–predator avoidance of areas with signs of cat presence, T. gondii’s manipulation appears to alter the rat’s perception of cat predation risk, in some cases turning their innate aversion into an imprudent attraction. The selectivity of such behavioral changes suggests that this ubiquitous parasite subtly alters the brain of its intermediate host to enhance predation rate whilst leaving other behavioral categories and general health intact. This is in contrast to the gross impediments frequently characteristic of many other host–parasite systems. I find this study interesting and disturbing. That means toxoplasma can reduce fear in rats of cats so that rats do not run away from cats but in fact get attracted to cats to be eaten up by cats so that toxoplasma can complete its life cycle for the survival of its species. Extrapolating from this logic, I may say that one species can uninstall fear in another species for its own survival at the cost of survival of another species. Corollary would be that there are thousands of species on the earth, each installed with fear for its own survival but one species may uninstall fear in another species for its own survival.

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Social fear transmission:

Learning fears by observing others: the neural systems of social fear transmission:

Classical fear conditioning has been used as a model paradigm to explain fear learning across species. In this paradigm, the amygdala is known to play a critical role. However, classical fear conditioning requires first-hand experience with an aversive event, which may not be how most fears are acquired in humans. It remains to be determined whether the conditioning model can be extended to indirect forms of learning more common in humans. Here researchers show that fear acquired indirectly through social observation, with no personal experience of the aversive event, engages similar neural mechanisms as fear conditioning. The amygdala was recruited both when subjects observed someone else being submitted to an aversive event, knowing that the same treatment awaited themselves, and when subjects were subsequently placed in an analogous situation. These findings confirm the central role of the amygdala in the acquisition and expression of observational fear learning, and validate the extension of cross-species models of fear conditioning to learning in a human sociocultural context. The study findings also provides new insights into the relationship between learning from, and empathizing with, fearful others. This study suggests that indirectly attained fears may be as powerful as fears originating from direct experiences.

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Anger vis-à-vis fear: [read article “Anger” posted in this website earlier]

Anger and fear are the two sides of the same coin of primitive survival instinct. Anger is associated with fierceness, daring, possessiveness and taking risks. Fear is exactly opposite. The primitive survival instinct is in dual mode, fight or flight; depending on the assessment of circumstances by the organism. This fact substantiates my theory of “Duality of Existence” in living organisms.

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Neurochemistry of fear vis-à-vis anger:

Stress initiates several biological adaptations, including activation of the hypothalamic–pituitary–adrenocortical (HPA) axis. When released into the system, cortisol increases available glucose, boosting the metabolic fuel expended in energy-consuming activities. In addition to such neuroendocrine responses, acute stress also activates immune system responses resulting in release of proinflammatory cytokines giving signal to brain to induce ‘‘sickness behaviors”, which can include reduced eating and drinking, reduced exploratory behavior, and general social withdrawal to promote recovery from stress. Stress may lead to anger and fear, two important emotions. A study was conducted to determine differential biological reaction to stress vis-à-vis anger & fear. The study found that baseline anger and fear were related to greater cortisol and proinflammatory cytokines. However, anger reactions to the stressor were associated with greater stress related increases in cortisol over time but not proinflammatory cytokines. In contrast, fear reactions to the stressor were associated with increases in stress-related proinflammatory cytokines over time and a decrease in cortisol. Although energy is required for both the fight response linked to anger and the flight response linked to fear, based on the current findings, the motivation to withdraw from a fear-inducing threat may be more important and adaptive for people feeling afraid than the availability of additional energy through the release of cortisol. Because increased cortisol would inhibit ‘increases’ in withdrawal linked proinflammatory cytokine production, it may be that a fearful individual sacrifices the additional energy that would be made available by cortisol in exchange for increases in the motivation to withdraw from fear-inducing situations. Anger, a confrontative (combative) emotion, demonstrated an association with increased HPA axis activity in response to the stressors, consistent with the idea that energy resources are needed following confrontative responses to stress. Fear, by contrast, was associated with enhanced proinflammatory cytokine activity, especially IL-6, effects that are consistent with promoting withdrawal which can often follow states of heightened fear.

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Fear vis-à-vis anger studies:

Study 1)

Forty-three subjects were stimulated in the laboratory to “fear” and “anger,” during which physiological reactions were recorded .This landmark study found that no difference in physiological reaction between anger and fear. The physiological response patterns of anger were suggested as being similar to those produced by injections of epinephrine and nor-epinephrine combined, and those of fear as being similar to injections of epinephrine. The patterns obtained for anger and fear argue against the hypothesis that anger is a strong reaction of both the sympathetic and parasympathetic branches of the autonomic nervous systems, whereas fear is but a sympathetic reaction. In fact, in this study, both anger and fear released catecholamines (stress hormones) in blood.

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Study 2)

Another landmark study found that fear and anger have opposite effects on risk perception. Whereas fearful people expressed pessimistic risk estimates and risk-averse choices, angry people expressed optimistic risk estimates and risk-seeking choices. These opposing patterns emerged for naturally occurring and experimentally induced fear and anger. Moreover, estimates of angry people more closely resembled those of happy people than those of fearful people. So anger & happiness are closely associated as far as optimism is concerned and fear & unhappiness are closely associated with pessimism.

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Study 3)

Study finds Anger is healthier than Fear:

A provocative new study by Jennifer Lerner in the Department of Social and Decision Sciences (SDS) suggests that anger may be a healthier response than fear in situations in which anger is justified. Lerner’s study, published in the journal Biological Psychiatry, found that people who respond to stressful situations with angry facial expressions, rather than fearful expressions, are less likely to suffer such ill effects of stress as high blood pressure and high stress hormone secretion. Analyses of facial expressions revealed that the more fear individuals displayed in response to the stressors, the higher their biological responses to stress. By contrast, the more anger and indignation individuals displayed in response to the same stressors, the lower their responses. Their paper challenges two long-held assumptions: one, that stress elicits undifferentiated negative emotions and as a consequence produces a uniform biological response; and two, that all negative emotions, such as fear and anger, provoke the same psychological and biological reactions. This paper builds on a line of work led by Lerner showing that anger triggers feelings of certainty and control as well as optimistic perceptions of risk. In the past, researchers have assumed that anger can contribute to coronary disease and hypertension. Although a chronically angry, explosive temperament may do just that, justifiable anger in response to short-term frustration appears to be a healthier response than fear. Anger can sometimes be adaptive. When you are in a situation that is maddening and in which anger or indignation are justifiable responses, anger is not bad for you. During the experiment, 92 participants performed mathematical exercises, including counting backwards by seven from 9,095, and counting backwards by 13 from 6,233. To make the exercises more stressful, participants were informed of each mistake they made, and they were urged to go faster by a harassing experimenter. Participants, who also were asked to complete arithmetic problems from an intelligence test, were told these tasks were indicative of general intelligence and that their responses would be compared to other participants’ scores. To ensure that the tasks were creating stress, researchers assessed the participants’ emotional states and measured their stress hormone (i.e., cortisol) level, pulse, heart rate and blood pressure during periods of relaxation as well as immediately following the exercises. Increases in those biological measures were less pronounced in the participants displaying anger and indignation than in the participants displaying fear.   

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Study 4)

Cognitive effects of anger vis-à-vis fear:

Anger makes people think more optimistically. Dangers seem smaller, actions seem less risky, ventures seem more likely to succeed, and unfortunate events seem less likely. Angry people are more likely to make risky decisions, and make more optimistic risk assessments. In inter-group relationships, anger makes people think in more negative and prejudiced terms about outsiders. Anger makes people less trusting, and slower to attribute good qualities to outsiders. When a group is in conflict with a rival group, it will feel more anger if it is the politically stronger group and less anger when it is the weaker. Anger can make a person more desiring of an object to which his anger is tied. In a 2010 Dutch study, test subjects were primed to feel anger or fear by being shown an image of an angry or fearful face, and then were shown an image of a random object. When subjects were made to feel angry, they expressed more desire to possess that object than subjects who had been primed to feel fear.

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Effects of fear and anger on perceived risks of terrorism:

The aftermath of September 11th highlights the need to understand how emotion affects citizens’ responses to risk. It also provides an opportunity to test current theories of such effects. On the basis of appraisal-tendency theory, researchers predicted opposite effects for anger and fear on risk judgments and policy preferences. In a nationally representative sample of Americans (N = 973, ages 13–88), fear increased risk estimates and plans for precautionary measures; anger did the opposite. These patterns emerged with both experimentally induced emotions and naturally occurring ones. Males had less pessimistic risk estimates than did females, emotion differences explaining 60 to 80% of the gender difference. Emotions also predicted diverging public policy preferences. Discussion focuses on and policy implications. A field experiment, using a nationally representative sample and a multimethod approach, found that fear and anger altered beliefs and attitudes regarding matters of national interest. Experiencing more anger triggered more optimistic beliefs; experiencing more fear triggered greater pessimism. These effects held across a range of risks (terror and non-terror related) and with both a verbal response scale and a more analytical probability response scale. Thus, two negative emotions had consistently divergent effects on risk estimates, providing additional evidence for the importance of examining specific emotions, rather than just global moods. Across all risks, males expressed less pessimism than did females. Differences in reported emotion explained 60% to 80% of the variance in these effects. What do terrorists want? They want to create fear in population. As this study shows, fear is associated with pessimism and anger is associated with optimism. Emotionally, best way to tackle terrorism is not be fearful of terrorist activities but rather show justified anger towards terrorism. This anger will bring optimism, certainty and control in our mind to fight terrorism while fear will make us pessimistic, uncertain and yielding to terrorist threats. So anger and not fear is the response to terrorism.

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Assertiveness is ideal compromise between fear and anger:

At one pole of communication stands passivity: not speaking out for fear of adverse consequences. At the other end stands aggressiveness: voicing negative sentiments without restraint or regard for their effect on others. In between passivity and aggression lies the golden mean: asserting one’s thoughts and feelings, wants and needs, while at the same time showing appreciation and respect for the other’s viewpoint. Assertiveness, the ideal compromise between the extremes of passivity (being fearful) and aggression (being angry), is part of our natural endowment–our “universal personality,” as it were. When we first come into the world, and even before we become verbal and can articulate what’s going on inside us, we possess the rudimentary ability to communicate. Innately, we know how and when to smile, to yawn, to express surprise, anger or trepidation and indeed, to convey a broad variety of emotional distress through crying–even wailing (as many a parent can woefully testify). We’re not yet able to employ language to identify our particular frustrations, or consider the likely reactions of our caretakers, but we’re unconstrained in letting our feelings be known.

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Fear vis-à-vis love: [read my article “Matchmaking” posted earlier in this website]:

In the novel concept of ‘fear brain cells’ and ‘comfort brain cells’; fear cells cause increased production of cortisol—the adrenal hormone which, when in excess, feeds the chemistry of energetic depletion, fear, agitation, and anger. The comfort cells, by contrast, produce oxytocin and dopamine—the brain hormones that bring love, compassion, and enlightenment.

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Fear – Cortisol	Love – Oxytocin
Aggression	Anti-stress hormone
Arousal, Anxiety, Feeling stressed-out	Feeling calm and connected, Increased curiosity
Activates addictions	Lessens cravings & addictions
Suppresses libido	Increases sexual receptivity
Associated with depression	Positive feelings
Can be toxic to brain cells	Facilitates learning
Breaks down muscles, bones and joints	Repairs, heals and restores
Weakens immune system	Faster wound healing
Increases pain	Diminishes sense of pain
Clogs arteries, Promotes heart disease and high blood pressure	Lowers blood pressure, Protects against heart disease
Obesity, Diabetes, Osteoporosis

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Remember fear of the partner is the most important sign of abusive relationship and neurochemically, it is proved that fear (cortisol) and love (oxytocin) are contrasting each other. Love and fear are mutually exclusive and therefore never marry a person whom you fear.  

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Psychopaths and fear:

One per cent of the population at large is generally reckoned to be psychopathic – but up to 20 per cent of the prison population is reckoned to be psychopathic. We can’t say that psychopaths are “fearless”, but they do require higher mental stimulation than other individuals. Their threshold for fear is higher than normal, thereby displaying a tendency toward risky behaviors. They might do something extremely risky to attain excitement because they lack the ability to feel as fearful as we do. When confronted with frightening stimuli, they may not react the same way that we do.

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Is Fear deficit a harbinger of Future Psychopaths?

One hypothesis on how psychopathy works is that it has to do with a fear deficit. A new study published in the issue of Psychological Science, a journal of the Association for Psychological Science, finds that children with a particular risk factor for psychopathy don’t register fear as quickly as healthy children. Healthy people notice a fearful face faster than they notice a neutral or happy face, but this was not the case in children who scored high on callous unemotionality. In fact, the higher the score, the slower they were to react to a fearful face. The important point here is that the children’s reaction to the face was unconscious. Healthy people are “reacting to a threat even though they’re not aware of it.” That suggests that teaching children to pay attention to faces won’t help solve the underlying problems of psychopathy, because the difference happens before attention comes into play. It’s just going to take a lot more research to figure out what you can do – whether it’s parenting, psychological interventions, or pharmacological therapy. At this point, we just don’t know. The researchers also found that children in the study tended to respond more slowly to faces showing disgust, another threatening emotion – in this case, one that suggests something is toxic or otherwise wrong. Researchers say psychological scientists should consider that psychopathy may not be related just to fearlessness, but to a more general problem with processing threats.

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Deficient Fear Conditioning in Psychopathy: Functional Magnetic Resonance Imaging Studies:

Study 1)

Results of this study revealed both structural and functional abnormalities in the brains of the psychopaths, with scientists finding there was less communication between two key areas of their brains than the other prisoners. The first of these structures, known as the ventromedial prefrontal cortex, is responsible for emotions including empathy and guilt. The second, called the amygdala, controls levels of fear and anxiety. It is thought the lack of communication between these two areas makes it difficult for psychopaths to regulate their social and emotional behavior. 

Study 2)

The healthy controls showed enhanced differential activation in the limbic-prefrontal circuit (amygdala, orbitofrontal cortex, insula, and anterior cingulate) during the acquisition of fear and successful verbal and autonomic conditioning. The psychopaths displayed no significant activity in this circuit and failed to show conditioned skin conductance and emotional valence ratings, although contingency and arousal ratings were normal. This dissociation of emotional and cognitive processing may be the neural basis of the lack of anticipation of aversive events in criminal psychopaths. This study also shows both structural and functional differences in the brains of people diagnosed with psychopathy. Brains of psychopaths have ‘broken links’ between parts responsible for empathy and guilt. MRI scan can determine if someone is a psychopath.  

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 Psychopathic brain and fear: Do criminal psychopaths enjoy other people’s fear or just not notice it?

For years, researchers and psychiatrists have understood that psychopaths respond differently to external stimuli, and they have theorized that this abnormal response is rooted in the brain. The idea is that psychopaths process information differently than non-psychopaths, and numerous scientific studies using functional MRI (fMRI) to visualize brain activity have backed this up. In 2003, a study presented at a conference in Britain showed that when “normal” people lie, there is increased activity in the frontal lobe that suggests the experience of guilt and discomfort; but when psychopaths lie, there is no increased brain activity. An earlier study found that when psychopaths viewed emotionally charged words like “rape” or “murder,” the changes in their brain activity was completely different from the changes that occurred when non-psychopaths saw those words. The increased brain activity in the psychopaths wasn’t even in the limbic system, which is where language processing occurs. In 2006, a group of London-based scientists published the results of a study that may offer additional information on the biological basis for psychopathy. It appears that psychopaths may experience the signs of fear in other people in a way that is not comparable to the way most of us experience it. In fact, they may not really experience it at all. The study set out to test the idea that psychopaths don’t experience empathy for other people’s distress — can’t understand, sense or appropriately react to it — because they don’t grasp the signs of that distress. In particular, this study tested the responses of nine “normal” people and six criminal psychopaths to typical facial and vocal signs of fear and sadness. All of the subjects were hooked up fMRI equipment that measured their neurological responses to the stimuli. In this context, “response” typically means increased blood flow and/or increased firing of neurons, the carriers of brain signals. The researchers showed both groups of subjects two different sets of images: one of joyful faces and neutral faces, and one of fearful faces and neutral faces. The neutral faces established a baseline for brain activity. When the non-psychopathic subjects saw a happy face, the fusiform and extrastriate regions of the brain — the areas primarily responsible for processing images of facial expressions — showed increased activity compared to their response to a neutral face. The psychopathic brains also showed increased activity in response to the happy faces, although less of an increase than in the non-psychopathic group. However, whereas the non-psychopathic subjects showed a similar increase in brain activity in response to the distressed faces, the psychopathic subjects did not. In fact, when the psychopaths were shown sad or fearful faces, their brain scans actually showed less neural activity than when they were shown neutral faces. The researchers concluded that in psychopaths, the neural pathways that are supposed to process signs of human distress are either non-functional or work completely differently than those pathways work in the general population. This could explain, at least in part, why psychopaths do not identify with the emotional distress of their victims.

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The moral of the story:

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1.Fear is an instinctual response manifested by a set of behavioral reaction that includes both the expression and the experience of emotion to a potential or actual danger, evolutionarily hardwired as fear circuit in the brain for survival of an organism or species as it protect them from harm. The four defensive strategies noted against danger are namely, escape, aggression, freezing, and submission; fear is associated with freezing, escape or submission while anger is associated with aggression.

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2. An impressive amount of evidence from various human and animal experiments using lesions in amygdala and neuroimaging studies has shown that the center for fear regulation across several mammalian species is amygdala in brain. Recent research shows that amygdala is the center for fear processing mainly from external threats but for internal threats, other brain regions may be involved.

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3. Low road, fast response (20 milliseconds) pathway for fear is mediated by brain through amygdala directly bypassing cortex; and high road, slow response pathway (300 milliseconds) for fear is mediated by brain through cortex, hippocampus and then amygdala for fear. Both pathways are simultaneously activated when fear response is initiated. The low road takes the fastest and easiest way to get you out of danger as the brain wants to ‘take no chances.’  For example, reacting to a nonexistent threat, such as a snake that is really a stick, is not as dangerous as the other way around – failing to respond to the actual threat of a snake. The bias is toward action; it is better to react immediately to a false alarm than to ignore a real threat. However, fear subsides as one learns through high road (cortex) that it is a false threat. For a novel threat (neither innate nor learned), no fear response will occur on first exposure as brain may not recognize novelty as a threat.

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4. Innate fear is a genetically determined function of the nervous system because ability to detect and anticipate dangerous situations seems to be crucial for survival, and individual learning might not be entirely quick enough to ensure survival chances. Moreover, even potentially dangerous stimuli might be rare and thus impossible to learn, leading an individual into danger when the stimulus is encountered for the first time. The innate fear response is species-specific.

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5.Fear of snake in primates is evolutionarily hardwired in brain for survival as healthy fear would make species more likely to survive, reproduce, and propagate their genetic information and natural selection is likely to favor those who stay away from potentially dangerous animals. That is why fear of snake is an innate fear genetically hardwired in brains of humans, monkeys and other primates. This innate fear may not manifest all the time and remains concealed. That is why monkeys raised in laboratory did not show initial fear response to snakes but were easily able to learn fear of snakes through observations of live and videotaped wild monkeys demonstrating fear responses to not only live, but toy snakes. That is why these lab monkeys were not capable of such substantial fear conditioning for other stimuli like flowers and rabbits.     

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6. It is the genes of the neurons of the brain fear circuit that determine fear memories, fear perception and fear expression in the brains of primates. Genes for innate fear (e.g. fear of snake) are evolutionarily hardwired for survival and passed on to next generation. Learned fears are not passed on to next generation but if learned fear is repeatedly conditioned in every successive generation, it would ultimately become innate fear. That means after thousands of years, humans will be genetically hardwired to fear electric shock rather than snakes.  

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7. There are thousands of species on the earth, each installed with fear for its own survival but one species may uninstall fear in another species for its own survival. 

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8. Fear overrides reason because amygdala overrides cortex in brain as nothing is more important than survival but this is especially true for innate fears. Various experiments have shown that cortex can suppress amygdala especially for learned fears. Even though cortex can suppress learned fear in amygdala, many times amygdala override cortex even in learned fear as it is evolutionary hardwired for survival. That is why fear can be easily and untruthfully sparked in such a way that is irrational and not subject to reason. This may have been an optimal design for predator-rich environments in which survival was a minute-by-minute question, but it is not a good adaptation for modern environments in which the stressors can be job performance review, stock market fall or public speaking. Great men became great because they overrode fear by reason. This is accomplished by constantly learning and training cerebral cortex to dominate over amygdala.

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9.There are people and organizations in the world that actually profit from fears and so they create them, and we pay for social panics, including money that is wasted on unnecessary programs and products as well as time and energy spent worrying about these fears. Fear appeals are often used in marketing, politics and social policy, as a method of persuasion. Fear appeal endeavors to persuade a consumer to buy a product/service or to persuade a voter to vote for a politician or to persuade people to change their social attitude. This works by exploiting existing fears in the minds of recipients. Some examples of fear appeal to persuade social change include smoking, dental hygiene, personal safety, pregnancy warnings, child abuse, AIDS prevention, safe driving practices, insurance, financial security, sun exposure, climate change, food additives, social embarrassment, motorcycle helmets, anti-drug abuse, immunization, smoke detectors, cell phones, safe sex, stress, and regular health exams. Advertisers and politicians  invoke fear by identifying the negative results of not using the product or the negative results of not voting for that politician.   

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10. Media bombards us with sensationalistic stories (crime and disaster) that are designed to increase their ratings by exaggerating events, by inflating statistics and by manipulating emotions trumping objectivity; which ultimately lead to many fears that overwhelm our lives.

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11. Normal fear, anxiety, panic and phobia need to be differentiated from each other as each one has a different effect on our lives and some of them do need therapy.

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12. There is a difference between men and women about fear perception & fear expression due to evolutionarily hardwired differential fear circuits in their brains and differential effects of sex hormones on these fear circuits as woman is biologically constructed to bear child in her womb and take care of child after delivery. That is why woman is more fearful and less risk taking than man. Increased cautiousness in a woman would help her with better survival ability and better protection of young child.

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13.Researchers have shown that fear acquired indirectly through social observation, with no personal experience of the aversive event, engages similar neural mechanisms of fear conditioning, which results in social fear transmission. So fear is capable of generating more fear.  

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14. Policies against immigration, women and minorities are formed out of fear of losing dominance, economy and security of the society.

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15. The fear of humiliation is so strong that it becomes a form of control often exploited by people as diverse as childhood playmates, family members, marketing people, boss, and tyrants.

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16. I agree with Bertrand Russell that religious faith is based primarily upon fear (fear of not following God’s words as depicted in sacred texts) and science can help us to get over this craven fear in which mankind has lived for so many generations. 

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17. Fear of death and religion are paradoxically linked; fear of death may motivate religious faith and religious faith may buffer against fear of death.

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18. Fear does act as a motivator to improve performance or behavior but only up to a point of threshold, beyond which, excessive fear worsens performance or behavior. No one can thrive on negative emotion alone for best performance or behavior.

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19. The best way to defeat fear is to face feared object in imagination or (preferably) in reality; backed by reassurance, persuasion, and instruction from a therapist or parent.  

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20. There is a biological basis for psychopathy in the sense that scientific studies using fMRI revealed both structural and functional abnormalities in the brains of the psychopaths resulting in inappropriate fear perception & expression in them and lack of empathy towards other’s fears and distress.  

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21. Even though anger and fear are the two sides of the same coin of primitive survival instinct, various scientific studies show that justified anger is healthier than fear; anger & happiness are closely associated with optimism and fear & unhappiness are closely associated with pessimism; and anger triggers feelings of certainty and control while fear triggers uncertainty and helplessness. 

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22. Total 1595 people died in car accidents following 9/11 attack as out of fear, people switched from planes to cars for their travel in the year following 9/11 attack in the United States. All these deaths could have been avoided had people were not fearful of plane hijack by terrorists. Terrorism is so effective because fear is so powerful. Remember, this is only the tip of the iceberg. You can extrapolate and imagine casualties due to fear worldwide.

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23. When emotions are used logically, anger and not fear is the best response to terrorism.  

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Dr. Rajiv Desai. MD.

March 6, 2013

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Postscript:

People describe good human being as a God fearing person. Those individuals who want to portray themselves as good human beings say that they are God fearing persons. I never feared God. Does that make me a bad guy?