Halloween Can Bring Out Our Phobias

Phobia - Halloween.jpg

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It’s Halloween, which means many of us will be using haunted houses and horror-movie marathons to intentionally tap into our deepest fears. We all experience fear, but what happens when those fears become unbearable and turn into phobias? It’s important to remember that fear and phobias are different things – according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, fear “is the emotional response to real or perceived imminent threat” whereas phobias are actually a form of anxiety disorder defined by “a persistent and excessive fear of an object or situation.”

Where do phobias come from, and why do only some people experience them? There are three different types: social phobia, also known as social anxiety; agoraphobia, the fear of being in places where you will be trapped and unable to escape; and specific phobias, characterized as phobias to either animals, natural environments, blood-injection-injury, situational, or other. Specific phobias are the most common form, affecting approximately 8.7 percent of the United States population, according to the Anxiety and Depression Association of America. Continue reading

The Anxious Brain

“Since the 1960s, billions of dollars and probably millions of animals have gone into the search for new and better anti-anxiety medications,” said researcher Joseph LeDoux at an event this week on anxiety at the American Association for the Advancement of Science. But drug makers, who have spent years targeting points along a brain pathway described as the “fear circuit” in animals, haven’t had the success they sought; they have stopped funding many studies. Why?

LeDoux, a Dana Alliance member at New York University who has studied this circuit for the past three decades, argues that the term we use may have blinded us to what the circuit actually does. Instead of labeling it with a human feeling, it would better to call it an unconscious “defensive survival circuit.” Other inputs lead to the conscious feelings of fear and anxiety. For example, while hiking, we have already recoiled from the snake on the trail before our conscious minds have hit the danger signal. The two things happen so fast, though, it’s easy to think the feeling led to the action—but we’re committing the first sin of science: confusing correlation and causation, LeDoux said.

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From left: moderator Mark Frankel, Joseph LeDoux, and Daniel Pine field questions from the audience.

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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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