Brain Oddities: Phobias

Brain oddities

This is the second in a series on unique and zany neuroscience topics. You can read the first entry, on synesthesia, here. Enjoy Brain Oddities!

1990 was a good year for the world: East and West Germany were reunited after the Berlin wall fell at the end of ‘89, Nelson Mandela was released from prison after 27 years, and Seinfeld debuted on NBC. But for memories of my youth, perhaps the most important event of that year was the release of the film Arachnophobia, starring Jeff Daniels and Julian Sands. As neither I nor any of my family members are arachnophobes, or people who have a phobia of spiders, we happily sat down to watch the VHS release. Don’t get me wrong—it was creepy, and to this day some scenes from the film still haunt me, but I would never describe myself as an arachnophobe. While spiders freak me out, what with their venom and their hairiness, I don’t have an extreme or irrational fear of them, which is the defining characteristic of a phobia.Arachnophobia

Speaking like most people with a phobia, I will tell you that my fear—acrophobia, or the fear of heights—is not irrational. Go up on the roof? The wind could blow you away! Ride a roller coaster? The safety bar is like being buckled in by a pencil.

But I have seen how my friends behave in what I would consider extremely high-risk situations, like, say, hanging out on the roof of an apartment building. While they sit and talk and generally enjoy themselves, I am trying to slow my breathing and make the entire world stop spinning while simultaneously on the lookout for danger, like the sudden appearance of a tornado or a tilt in the roof. Mine is a heavy burden.

My fear of heights is “extreme” and “irrational,” which is what characterizes it as a phobia. Fear of things like spiders or heights is known as “specific phobia,” in contrast to “social phobia,” which is thought of by the public as social anxiety. In both cases, when presented with phobic stimuli, phobics will often experience intense distress, dizziness, heavy breathing, and other characteristics of an anxiety attack. Some phobias are obviously more debilitating than others—consider Emily Dickinson, who is thought to have been an agoraphobe. Agoraphobia is the fear of having a panic attack in a place that is difficult to leave, specifically large, open public spaces like shopping malls. As a result, agoraphobes tend to confine themselves to their homes, as Emily Dickinson did for the last 20 years of her life.

Although it was not until those last 20 years that Dickinson refused to leave her home, she exhibited symptoms of agoraphobia for most of her life, though it is unclear why. At present, the cause of many phobias is a mystery. Some phobias can be traced back to traumatic experiences in childhood, but others have no clear etiology. What is known is that phobics appear to have an atypical neurological response to phobic stimuli. Specifically, a region of their prefrontal cortex (the area at the front of the brain implicated in things like planning, personality expression, and behavior moderation) does not have as much activity as normal during down-regulation of emotional responses to phobic stimuli.

Down-regulation of emotional response is a two-part reaction to negative stimuli: effortful and automatic. For example, when you are trying to go to sleep after a scary movie, lying in bed with your eyes wide open, and you hear a noise, the act of telling yourself to relax and just blink, for crying out loud, is called “effortful down-regulation.” Conversely, when you see a cockroach and your heart momentarily stops beating before you begin fervently searching for a weapon/flip-flop is known as “automatic down-regulation,” as you calm yourself without conscious effort.

Why phobics exhibit atypical down-regulation of emotions, and why it only happens in response to very specific stimuli is presently unknown, but there exist a variety of treatments for phobias. For social phobias and some specific phobias, there are a host of pharmacological treatments including antidepressants, sedatives, and beta blockers, which block the effects of adrenaline, a hormone and neurotransmitter that acts as a stimulant, increasing heart rate and blood pressure, among other things.

For other phobias, typically specific phobias, there are behavioral measures that can be taken. One such popular measure is exposure therapy, also commonly used for post-traumatic stress disorder. Say you have an extreme fear of kittens. Your exposure therapy might include first thinking about kittens, and then looking at pictures of kittens. From there you progress to looking at a real kitten, perhaps through a one-way mirror, and then being in the same room as a kitten. After successfully progressing this far, your therapy would conclude with actually touching a kitten.

Though exposure therapy is popular and sometimes effective, neither it nor pharmacological therapy can always be used. (Take, for example, my other phobia: an unusual but extremely specific fear of being wrongly accused of murder. I honestly can’t think of how exposure therapy would work in this case.) If you are suffering from a phobia to the point where it interferes with your daily life, I would suggest browsing the Internet for support groups. There are numerous support groups all over the world for a host of phobias, and if you object to prescription medication or exposure therapy, a support group may be the ideal treatment.

In any case, stay away from cliffs and always have an alibi, for my sake.

–Caitlin Schneider

Sources:

Hermann, A., Schafer, A., Walter, B., Stark, R., Vaitl, D., Schienle, A. (2009). Emotion regulation in spider phobia: role of the medial prefrontal cortex. SCAN (4), 257-267.

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