In a packed theater at the Rubin Museum last Wednesday, Joseph LeDoux, Ph.D., and Mark Epstein, M.D., shared the stage to untangle the mysteries behind two emotions that we are all too familiar with: anxiety and fear. Epstein is a psychiatrist in New York City, who blends Buddhist practices with his work in psychotherapy. Ledoux directs the Emotional Brain Institute of New York University, where he is also University Professor.
Both men began exploring the connection between the brain and emotions in the 1970’s, when the field of “mind-body medicine” —and the correlation between the brain and emotions—was just beginning to unfold. “In some way, we started out in parallel places,” Epstein noted as he acknowledged the different angles from which they approached a similar science.
Epstein studied under Herbert Benson, a Harvard physician who did the first studies on the physiological effects of meditation and popularized the concept of the “relaxation response”—a physical state of deep rest that alters the physical and emotional responses to stress. LeDoux, a Dana Alliance for Brain Initiatives (DABI) member, found his niche in neuroscience while working with fellow DABI member Michael Gazzaniga, Ph.D., to study the split-brain. Since then, his work of over thirty years has focused on how the brain detects and responds to threats, and has helped shed light on anxiety disorders in humans.
Epstein opened up the conversation about anxiety by praising LeDoux for including “a very fundamental concept” in his new book, ANXIOUS, which is that “fear and anxiety aren’t necessarily wired into the brain the way we were all taught coming up in the field.” LeDoux acknowledged that when he first began his “fear work” with split-brain patients, the ability to feel fear was believed to be a conscious experience produced by brain systems that detect and respond to threat.
However, after further research, it was learned that while fear is a conscious feeling, it is not produced by those systems; it is separately constructed in the brain to stimulate its response for survival. LeDoux added that fear is more than just a perception of danger itself, it is recognition—gained through self-awareness—that you are in danger. “Every living organism has to be able to detect danger and respond to danger in order to stay alive, whether it’s a bacteria cell living in your lower intestine, or a human being,” he said. “If you have a brain that can be conscious of its own activity, then you experience fear.”
Epstein brought up an interesting question when he asked if we are able to experience a threat as “pure physiological stimulation” without our conscious minds reacting with an explanation—a.k.a. responding with fear. Such is the case for people with panic disorders, LeDoux responded.
Someone with a panic disorder may not be detecting an actual threat; but they feel some kind of sensation—such as chest pain—and interpret that as a threat to their existence, which then leads to their brains constructing a sense of fear or anxiety, he explained.
When asked if he ever has to deal with his own anxieties, LeDoux replied, “Everybody has anxiety; that’s why we’re all here.” While we in the audience laughed, it was true. His own method of treating his occasional anxieties uses the “simple physiology of breathing,” very similar to Epstein’s meditative practice.
The discussion concluded with LeDoux’s colorful analogy of fear and anxiety, or any other emotion, being made in the brain just as you would make a soup. He started by listing the initial ingredients—water, garlic, onion, carrots, etc.—and explained how you can change the character of the soup entirely, based on the next ingredients you add. For example, he said, you can make a roux and add some chicken to make gumbo, or throw in curry paste and spices to make an Asian dish. “The point is that none of those ingredients are soup ingredients; they’re all things that exist in nature that, when combined in a different way, give rise to the character of the soup.”
To intensify the flavors, add salt and pepper. That’s what arousal does to the brain, LeDoux said. The character of the feeling (e.g. fear, love, anger, joy) is determined by the other “ingredients” that are activated unconsciously; they create consequences in the brain and body that then have implications for what you feel.
The five survival systems LeDoux referred to throughout his discussion with Epstein are defensive threat detection, food acquisition, balancing fluids, thermal regulation, and reproduction.
Those [systems] are as old as life itself; they aren’t in nature to make emotions. But when put into a brain that has the capacity to experience what’s going on, emotions are the result. Emotions emerge out of the brain the way the character of a soup emerges out of the ingredients.
– Seimi Rurup