How Fear Works

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.

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 process looks like this:

The door knocking against the door frame is the stimulus. As soon as you hear the sound and see the motion, your brain sends this sensory data to the thalamus. At this point, the thalamus doesn't know if the signals it's receiving are signs of danger or not, but since they might be, it forwards the information to the amygdala. The amygdala receives the neural impulses and takes action to protect you: It tells the hypothalamus to initiate the fight-or-flight response that could save your life if what you're seeing and hearing turns out to be an intruder.

The high road is much more thoughtful. While the low road is initiating the fear response just in case, the high road is considering all of the options. Is it a burglar, or is it the wind? The long process looks like this:

When your eyes and ears sense the sound and motion of the door, they relay this information to the thalamus. The thalamus sends this information to the sensory cortex, where it is interpreted for meaning. The sensory cortex determines that there is more than one possible interpretation of the data and passes it along to the hippocampus to establish context. The hippocampus asks questions like, "Have I seen this particular stimulus before? If so, what did it mean that time? What other things are going on that might give me clues as to whether this is a burglar or a wind storm?" The hippocampus might pick up on other data being relayed through the high road, like the tapping of branches against a window, a muffled howling sound outside and the clatter of patio furniture flying about. Taking into account this other information, the hippocampus determines that the door action is most likely the result of wind. It sends a message to the amygdala that there is no danger, and the amygdala in turn tells the hypothalamus to shut off the fight-or-flight response.

The sensory data regarding the door -- the stimulus -- is following both paths at the same time. But the high road takes longer than the low road. That's why you have a moment or two of terror before you calm down.

Regardless of which path we're talking about, all roads lead to the hypothalamus. This portion of the brain controls the ancient survival reaction called the fight-or-flight response. In the next section, we'll take a closer look at the fight-or-flight response.

To produce the fight-or-flight response, the hypothalamus activates two systems: the sympathetic nervous system and the adrenal-cortical system. The sympathetic nervous system uses nerve pathways to initiate reactions in the body, and the adrenal-cortical system uses the bloodstream. The combined effects of these two systems are the fight-or-flight response.

When the hypothalamus tells the sympathetic nervous system to kick into gear, the overall effect is that the body speeds up, tenses up and becomes generally very alert. If there's a burglar at the door, you're going to have to take action -- and fast. The sympathetic nervous system sends out impulses to glands and smooth muscles and tells the adrenal medulla to release epinephrine (adrenaline) and norepinephrine (noradrenaline) into the bloodstream. These "stress hormones" cause several changes in the body, including an increase in heart rate and blood pressure.

At the same time, the hypothalamus releases corticotropin-releasing factor (CRF) into the pituitary gland, activating the adrenal-cortical system. The pituitary gland (a major endocrine gland) secretes the hormone ACTH (adrenocorticotropic hormone). ACTH moves through the bloodstream and ultimately arrives at the adrenal cortex, where it activates the release of approximately 30 different hormones that get the body prepared to deal with a threat.

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

­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.

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 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.

During the 19th-century debate surrounding evolution, the "face of fear" -- that wide-eyed, gaping grimace that often accompanies sheer terror -- became a talking point. Why do people make that face when they're terrified? Some said God had given people a way to let others know they were afraid even if they didn't speak the same language. Charles Darwin said it was a result of the instinctive tightening of muscles triggered by an evolved response to fear. To prove his point, he went to the reptile house at the London Zoological Gardens. Trying to remain perfectly calm, he stood as close to the glass as possible while a puff adder lunged toward him on the other side. Every time it happened, he grimaced and jumped back. In his diary, he writes, "My will and reason were powerless against the imagination of a danger which had never been experienced." He concluded that the entire fear response is an ancient instinct that has been untouched by the nuances of modern civilization [ref].

Most of us are no longer fighting (or running) for our lives in the wild, but fear is far from an outdated instinct. It serves the same purpose today as it did when we might run into a lion while carrying water back from the river. Only now, we're carrying a wallet and walking down city streets. The decision not to take that shortcut through the deserted alley at midnight is based on a rational fear that promotes survival. Only the stimuli have changed -- we're in as much danger today as we were hundreds of years ago, and our fear serves to protect us now as it did then.

Darwin had never experienced the bite of a poisonous snake, and yet he reacted to it as if his life were in danger. Most of us have never been anywhere near The Plague, but our heart will skip a beat at the sight of a rat. For humans, there are other factors involved in fear beyond instinct. Human beings have the sometimes unfortunate gift of anticipation, and we anticipate terrible things that might happen -- things we have heard about, read about or seen on TV. Most of us have never experienced a plane crash, but that doesn't stop us from sitting on a plane with white-knuckle grips on the armrests. Anticipating a fearful stimulus can provoke the same response as actually experiencing it. This also is an evolutionary benefit: Those humans who felt rain, anticipated lightning and remained in the cave until the storm passed had a better chance of not getting struck with thousands of volts of electricity. We'll look at ways in which we are conditioned to fear in the next section.

The circuitry of the fear response may have been honed by evolution, but there is also another side to fear: conditioning. Conditioning is why some people fear dogs as if they were fire-breathing monsters, while others consider them part of the family.

In the 1920s, in what is probably not one of psychology's finest moments, American psychologist John Watson taught an infant to fear white rats. "Little Albert" had no fear of the laboratory's test animals. He showed joy at the sight of the white rats especially and always reached out for them. Watson and his assistant taught Albert to be terrified of white rats. They used Pavlovian (classical) conditioning, pairing a neutral stimulus (the rat) with a negative effect. Whenever Albert reached for one of the rats, they created a terrifyingly loud noise right behind the 11-month-old child. Not only did Albert very quickly learn to fear the white rats, crying and moving away whenever he saw one, but he also started to cry in the presence of other furry animals and a Santa Claus mask with a white beard.

Like Little Albert's fear of white rats, a person's fear of dogs is most likely a conditioned response. Perhaps he was bitten by a dog when he was three years old. Twenty years later, the person's brain (the amygdala in particular) still associates the sight of a dog with the pain of a bite. We'll take a closer look at some common fears in the next section.

A Gallup Poll conducted in 2005 reveals the most common fears of teenagers in the United States. The top 10 list goes like this:

Most of these basic fears are carried into adulthood. Other common fears include public speaking, going to the dentist, pain, cancer and snakes. Many of us fear the same things -- so are there such things as universal fears?

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. This idea of the universal fear is supported by such reputable sources as popular television: NBC's "Fear Factor" offers a weekly $50,000 prize to the contestant who can perform tasks like sticking his head into a box filled with hundreds of spiders and eating a blended rat smoothie.

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.

But 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.

Experiencing fear every now and then is a normal part of life. But living with chronic fear can be both physically and emotionally debilitating. Living with an impaired immune response and high blood pressure causes illness, and refusing to participate in daily activities because you might be confronted with heights or social interaction doesn't make for a very fulfilling life. So what can we do about our fears?

Studies have shown that rats with damaged amygdalas will walk right up to cats [ref]. 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.

Fear extinction

Whereas Little Albert learned to fear white rats in the 1920s, rats learned to fear a simple noise more than 80 years later. 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 amygdalas 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 serve 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.

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 [ref]. 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'd been conditioned to associate a bright light with a foot shock. When the light was presented repeatedly without the shock, the rats who'd 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'd 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. But what about those of us who just get butterflies before delivering a presentation or have trouble getting close enough to the thirtieth-floor balcony to check out the view?

Eight Practical Tips

The Prevention magazine article "What are you afraid of?: 8 secrets that make fear disappear" offers these tips for dealing with everyday fears:

For more information on fear and related topics, check out the links on the next page.