Jan
08
The Incredibly Complex World of Fear

By Nicholas Carleton, PH.D., Via Men's Health


temp-post-image


There are two important concepts to take away from this paper. The first: Scientists are huge dorks. The second: One of the biggest causes of fear and anxiety is uncertainty. Our brains, little monkey prediction engines, hate it. They behave strangely around it, like math when it nears infinity.

And if you imagine an infinity of uncertainty, you couldn’t get much closer than 2020. A pandemic, a racial reckoning, a failure of institutions, storms and fires no one could predict. “America is clearly becoming a more frightened nation,” says L. Edward Day, Ph.D., a researcher at Chapman University, which does an annual fear survey. “Only one fear in 2015’s top ten scared more than 50 percent of the population. Now all ten are higher than 50 percent.”

Intolerance of uncertainty is one of three major risk factors that can lead to problems with anxiety and depression, according to Nicholas Allan, Ph.D., who runs the FEAR lab at Ohio University. The other two are fear of feeling fearful and social isolation. All three are up from normal levels. Since early in the pandemic, Allan’s lab has been working on new ways to help people handle these unprecedented times. His intervention: a group session and an app that helps people “mythbust” their maladaptive thoughts, then encourages them to do behavioral experiments, such as leaving home without double-checking that the door is locked. By the time they get home, they’ve proved to themselves that they can handle the uncertainty, and most likely their home is fine.

“The takeaway is the thing you were afraid of happening isn’t probably going to happen, and a lot of times, if it does, it’s not so bad,” he says. The fear is usually a miscalculation, our cautious brains believing it’s better to see a monster than what’s actually there: a boundless statistical gray area.

Why do we even feel fear? Because people who didn’t would get “Darwined” out of existence pretty quickly, Allan says. But that’s the problem with trying to beat fear, especially in a time in which some of our worst imaginings have manifested themselves in objective, observable reality: Every so often, our stupid brains are right.

The key is to manage fear in a way that helps you live your most productive life. “Usually, [fear] is seen as a negative emotion,” says Mathias Clasen, Ph.D., the director of Aarhus University’s Fear Lab in Denmark. “But it’s also the engine of a range of recreational activities and really at the source of meaningful, pleasurable experiences for a lot of people.” If you’re looking to harness your fear for the power of good, the tips from experts and stories from writers over the next few pages will help. —JACQUELINE DETWILER-GEORGE



temp-post-image



DEFANG YOUR FEAR MEMORIES

The new science of fear extinction could kill off many phobias.

People with a phobia have an emotional memory that involves an association between whatever scares them (say, for arachnophobes, a spider) and a dreaded outcome (being attacked). Dutch researchers recently proved that you can override these fears by exposing a person to the source of the phobia—a tarantula, in the study—and administering a beta-blocker.

What’s happening, explains Maartje Kroese, a psychologist at Kindt Clinics, which offers the treatment, is that when an arachnophobe is exposed to a spider in a certain way, it reactivates a fear memory. After exposure, the arachnophobe receives a single dose of propranolol, a widely used beta-blocker. The beta-blocker disrupts the way the memory is stored, eliminating the fear. Kroese says the approach is 80 to 90 percent successful in one session for fears to which the patient can be exposed, such as spiders, dogs, mice, needles, and confined spaces.

The treatment is not available in the U. S. yet, where the conventional approach is exposure therapy. Basically, the therapist creates a fear hierarchy for the patient, starting with the least threatening exposure (for dogs, a stuffed toy) and working their way up (to a real dog), explains Reilly Kayser, M.D., a psychiatrist at Columbia University. He’s also studying ways to make this kind of fear-extinction psychotherapy more effective by combining it with a drug called Nabilone (a synthetic form of tetrahydrocannabinol) that enhances memory formation. According to Dr. Kayser, people with fears, such as flying, PTSD, or obsessive-compulsive disorder, may have problems with fear-extinction learning. Early research shows that this approach can boost that form of learning and help alleviate those fears. —BEN COURT


temp-post-image

OVERCOME THE FEAR OF REINJURY
A huge wave crushed Maya Gabeira’s body and spirit, but the surfer is riding giants again.

Most people, standing astride a tow-in surfboard at the apex of a 75-foot wave in Nazaré, Portugal, would have exactly one thought: I am going to die. Brazilian big-wave surfer Maya Gabeira understands this in her bones. Literally, in her right fibula, which snapped as the force of a squirrelly 80-ish-foot wave yanked her out of her board’s foot straps in 2013. A colleague on a Jet Ski dragged her to the beach, where she was given CPR and then rushed to a hospital.

Yet seven years later, Gabeira has gone on to successfully ride more of these sea monsters, including the biggest ridden by a man or woman in 2020—a 73.5-foot behemoth at Nazaré. You might think Gabeira is immune to fear. Nope. “I am scared. Every time the season starts. It’s really hard for me to accept that I want to ride big waves again.”

After her wipeout, Gabeira focused on her physical recovery. She ignored any mental repercussions from the accident and, because she wasn’t in shape to surf big waves, never had to confront her insecurities about being able to handle them. “When I reached peak performance, which was four years later, that’s when I had a real big mental breakdown,” she says. “I was hospitalized and I couldn’t get out of it.”

When Gabeira came back to the sport, decisions about which waves to take and what lines to ride were heavier. She takes antianxiety medication to control her panic. She learned to trust her training and believe in herself. “When attempting to come back from an injury, the most important skill is to focus on the moment, the task at hand,” says Liv Massey, a mental-performance coach at SportStrata NYC. “Many athletes recite mantras or adaptive self-talk statements during high-pressure moments. In the NFL, players will say things like ‘Playmaker, all day!,’ ‘Your time!,’ or ‘See the ball!’ ”

Gabeira often chants as she’s being towed by a Jet Ski to the wave. And she leaves herself an out. The purest, most dizzying moment of terror always hits at the very top of a wave, when she angles her board down that sheer face and chooses it. If I want to pull out, I pull out, she tells herself, over and over, until the moment her tow-in partner powers the Jet Ski to safety over the back of the wave, and she lets go of the rope. —J. D. G.

COPE WITH THE FEAR A LOVED ONE WILL GET SICK
Jagdish Khubchandani, Ph.D., a professor of public health at New Mexico State University, shares his strategies.

Learning about statistics has helped me understand the pandemic data better. While sobering, it helps me process my fear of my parents getting sick. I’m talking to them more, and their stories of enduring hardships give me wisdom.

FEAR: THE POWER LIST
Chapman University in Orange County, California, has been surveying Americans since 2014 to find out what we’re really afraid of. We looked at all the data and created a snapshot of our nation’s greatest fears.


1. Across all five years, corruption among government officials ranked at the top, with 77% reporting they were “afraid” or “very afraid” in 2019.


2. From not even making the top-ten list in 2015, concerns about pollution of oceans, rivers, and lakes hit the second spot in 2019 at 68%.


3. Worries about loved ones becoming seriously ill moved into the top ten in 2016 and appeared again in 2018 and 2019, even before the pandemic.


4. Pollution of drinking water first made the list in 2017, not long after the crisis in Flint, Michigan, and hit 65% in 2019.


5. Fear of people I love dying is a consistent fear, ranging from 38% in 2016 to 63% in 2019.


6. The only other fear to make the list every single year, running out of money, has perpetually eked out a mid-to-low list spot, peaking at number three in 2016.


7. Cyberterrorism is down five spots, from number two to number seven, since 2015.


8. Extinction of plants and animals scored 59% in 2019 but wasn’t a top concern in previous years.


9. Fears about global warming and climate change hit 57% in 2019 but by rank were a greater concern in 2017 and 2018.


10. Since 2015, terrorist attacks, biological warfare, identity theft, and government or corporate tracking of personal information have all fallen off the top ten.



HOW TO CRUSH FINANCIAL FEAR
Michael Arceneaux, author of I Don’t Want to Die Poor, shares how he learned to escape the terror inside his own head.

When you struggle financially, words can often ring hollow. I know this because so many times I ignored the advice of others when I had difficulty paying the rent, my student loans, and my credit-card bills and, in my darkest moments, struggled to find food to eat. It’s hard to see the bright side when times are so dire. It is difficult to see the promise of tomorrow when the day-to-day weighs on you heavily.

And no, good advice is not the same as money in one’s hand or bank account.

Still, I beg: Don’t be like me.

Don’t allow fear to swallow you whole. My pride, stubbornness, and depression—magnified by money woes—all contributed to the cloudiness in my head in the past. I try not to live with regret, but I admit that ignoring previous well-wishes, words of encouragement, and advice were expensive mistakes. All that stubbornness did was make me more depressed. I couldn’t stop being scared. I couldn’t quit feeling like I’d failed as a man.

2020 only magnified the gross inequality that has long existed for far too many of us. Societal ills are not the fault of the individual impacted by them. Unfortunately, I don’t have the funds or silver spoons to share with millions. What I can offer, however, are words that are not cash but I assure you aren’t cheap: Forgive yourself for conditions not of your making.

As far as your money woes go, if you can’t pay all your bills, pay the ones that you can. If you have to move back home or crash with someone as you try to get back on your feet, don’t consider it a humiliation; be grateful that you have somewhere to lay your head. If you have to let go of certain dreams, or at the very least put them on the back burner in order to do something that helps you simply survive, don’t view that as failure.

Life is so much harder for some of us than it should be, but life cannot be won in fear.

If there’s anything that I have learned from moving home twice, crashing on someone’s sofa for longer than I would have preferred, or the numerous hits to my credit score when the bills became too much to bear, it’s that I wish I hadn’t let it sink my soul as deeply as it did. It only delayed the focus I needed to figure out a way to forge ahead.

I may be in a better place now, but I drove myself to the brink too many times trafficking in fear and doubt when really all any of us can do is our best. None of us can get better if we give in to the feelings designed to have us operating at our worst. So again, please, don’t repeat my mistakes.

You can overcome, but only after faith trounces your fears.



temp-post-image


PONDER YOUR MORTALITY
On a reporting trip to Bhutan, Michael Easter, author of The Comfort Crisis, learned to reimagine his fear of dying.

In Bhutan, people think of the Buddhist concept of mitak - pa, or impermanence, every day. The lama Damcho Gyeltshen explained it to me that nothing lasts and, therefore, nothing can be held on to. All things change. All things die. The lama told me to think of mitakpa three times a day, in the morning, afternoon, and evening. Pondering mitakpa can be terrifying at first. But it adds clarity and urgency to every moment. There’s no procrastinating or saying, “I’ll do x when y happens.” The practice has helped me reprioritize my life and made me calmer and more grateful and happy.

DEAL WITH THE FEAR OF SUCKING AS A DAD
What keeps Steven Rinella, author of The MeatEater Guide to Wilderness Skills and Survival, up at night is not something big and furry with sharp claws.

Steven Rinella, 46, has been charged by a grizzly, stung by a bullet ant, and stomped by a moose, but what hurt him the most was the size of a sesame seed: a tick. Over four decades, Rinella has developed a “practice with the outdoors,” a skill set to avoid and cope with danger in all sizes: That tick gave him Lyme disease. “It’s all about knowledge, preparation, and being aware of your surroundings,” he says. What’s scary for him is the stampede of anxiety that comes with trying to be a great dad to his three kids, ages ten, eight, and five. “Those fears are not fun to anticipate, deeply perplexing, and hard to train for,” he says. “The greatest fear is that your kids turn out to be assholes, and you know that you are the primary driver in that outcome.” To avoid that, he shares his passion for the wild through family adventures that nurture a respect for nature. “I think a lot about the values of self-sufficiency and adaptability, and spending time outdoors teaches that, whether it’s learning to pack a bag, catching your own lunch, or tweaking a plan if a storm blows in.” —B. C.


temp-post-image

SCARE YOURSELF STRONGER
Watching horror movies has surprising psychological benefits, according to new research.

In the lead-up to Halloween 2020, while most of us were trying to figure out how to trick-or-treat from six feet away, University of Chicago researcher Coltan Scrivner, a Ph.D. candidate, was at an interactive haunted house in Denmark, studying people in masks choosing whether to deliver a vial of leaked contaminants to the rebels or the government. Scrivner studies morbid curiosity, a personality trait that involves turning toward images of death, illness, and violence rather than what would make psychological sense—running away.

At the beginning of the pandemic, Scrivner noticed that many people were doing exactly this: The pandemic movie Contagion had shot from 270 to number 2 on the list of most-watched Warner Bros. films. He distributed online surveys to figure out why and found that the scary-movie watchers were faring better during quarantine than non-scary-movie watchers. Morbid curiosity, as a trait, seems to make people more resilient to psychological distress.

Scrivner’s latest preliminary research suggests that people who have experienced trauma are more likely to engage in morbid curiosity, perhaps using it as a way to process negative thoughts or to feel prepared for other bad things that may happen in the future. “Just anecdotally, if you look on Reddit or online horror forums or talk to horror fans, a lot of them will say that they use horror to cope with traumas in their life or cope with anxiety or depression,” Scrivner says. You can try this yourself: The next time you’re feeling bad, put on a scary movie. It may help even out a depressed mood or focus your anxiety on an external source, rather than on the problems you’re ruminating about. —J. D. G.

IDENTIFY YOUR HIDDEN FEARS
Some fears are so ingrained that you may not realize they’re impacting your behavior, says Phillip Atiba Goff, Ph.D. Correcting that requires societal and personal change.

Phillip Atiba Goff, Ph.D., cofounder of the Center for Policing Equity at Yale University, surveyed more than 700 police officers in 2018 to better understand how bias impacts public safety. One finding seemed ironic: Police who were afraid of being seen as racist were more likely to resort to coercive tactics when dealing with community members.

This, Goff explains, is a stereotype threat, a concern with being evaluated in terms of a negative stereotype about one’s group. It often leads to underperformance, and while not tied to fear, may be exacerbated by it. “When we’re in a fear state, we’re also often in a scarcity mindset,” he says. “You start hoarding resources, like information. Stereotypes are shortcuts that help us make better sense of the world.”

Those shortcuts backfire for a number of reasons, but often when we perceive others stereotyping us. In the instance of those police surveyed, they resorted to coercion when their sense of legal authority failed, says Goff, in the end affirming the stereotype they tried to avoid. The effect has serious implications; in the U. S., Black men are two and a half times as likely as white men to be killed by police.

Overcoming bias is a complex personal and societal problem. Diversity in the workplace is one promising way to change stereotypes. You can take a digital implicit-association quiz at Project Implicit. (There are tests that examine you for biases related to weight, gender, age, disability, and race.) Another tactic is to remind yourself to evaluate people based on their personal characteristics rather than those affiliated with a group.

Still, Goff argues, systemic change is necessary—and buzzy anti-racism training isn’t enough. “There’s this translation of anti-racism as if it’s a self-help concept,” he says. “But if we reduce resisting racism to just a thing that makes you a better person, we missed the damn point.” —JOSH OCAMPO


temp-post-image



OUTSMART A FEAR OF NEEDLES

Ben Court, Men’s Health executive editor, on how he dealt with injections.

Ever since I had a botched blood draw while delirious with malaria as a kid, I fainted when getting injections. Yup, embarrassing. Recently a doctor told me to tense and relax the muscles in alternating limbs—not the biceps area—and breathe deeply through my nose. It stabilizes your blood pressure, and I haven’t fainted ever again.

I AM STALKED, ASLEEP AND AWAKE
When fear and hallucinations and PTSD collide, I claw my way back by anchoring myself in reality.

The visions of violence come without prompts I can anticipate or perceive, typically in moments of tranquility and rest. I’ll be dozing off near a woodstove on a chilly night, perhaps with my dog at my feet. Or I’ll be reclined in bed with a book under a summer moon, in the last moments before sleep, put to ease by the whir of a window fan.

Then it will happen—any of a trio of recurring visual phenomena that clinicians call hypnagogic hallucinations. In one, a hand holding a brick or a grapefruit-sized stone slams down on my face. I almost feel the crunch. In another, a sharp ax strikes the back of my neck. It passes clean through. In the third, I am pelted by a stone that strikes the side of my head. I sense an angry mob closing in.

Each vision is but a flash, over as soon as it begins. The effects endure. First I jolt to alertness, flushed by the chemistry of fear. My heart rate will soar, my breathing will quicken, and my muscles will tighten and twitch as if ready for a decisive act—a sprint for safety or a lunge into a fight. I will have passed from near sleep to full arousal in a blink.

Then comes the climb-down. In many ways I am lucky. When the hallucinations jump-start my body into high RPM, I disassociate from my surroundings only briefly. Though I feel an instant of pain at the imagined impact of stone or blade, my lurch into overdrive is quickly followed by an awareness that there is no such threat. My mind senses, then assesses, reality. I realize I am in bed or on a chair in a quiet room. I am not bleeding, not wounded, not dead. There is no assailant, no menacing crowd, no pressure to decide whether to fight back or escape. I take over and override whatever has overridden me.

Dreaming again, I’ll mutter, with a choice word or two added, and go meta, coaching myself to process my unwanted surge. I’ll rise to pace rooms in the dark, sometimes stopping to lean against a bathroom sink and look in the mirror, confirming that I have suffered no physical harm beyond that I might be haggard with insomnia. I’ll pour and drink a glass of tap water. I might engage in a breathing exercise. Soon my heart rate settles. With time I reclaim a sense of sanctuary and calm. Then, if mind and body will agree, I try returning to rest.

THERAPY HAS TAUGHT ME that my hallucinations are associated with PTSD, that complex ailment for which I am supposedly primed by a life around organized violence, terrorism, and war, as well as by volatility in personal and professional relationships. Put simply, this is a condition picked up in the provinces of conflict and fear.

I am a former Marine, was present at the attacks on the World Trade Center in 2001. I spent years alongside combatants in multiple wars, and survived near misses in many ambushes, and once, an air strike. For years I mastered the expressionless face and channeled whatever happened into preparing for, and learning how to survive, the next bad event, into which I willingly headed. My work required proximity to extraordinary violence and the abuse of power, along with association with unsavory people and a boss or two who, in hindsight, were not qualified to lead. The history matters to me now, because after being exposed to many years of trauma and dread, with incidents beyond counting, and concurrently suffering disillusionment with authority and betrayal by a senior manager, I have learned to hesitate when pinpointing the sources of my malady.

I am, however, familiar with its manifestations, which are a bundle of reactions to fears I once suppressed: a penchant for readiness and preparation, an urge to avoid crowds and the danger they may pose, a susceptibility to startling, and almost an overpowering activation when my mind perceives danger. The threats can be real or, as with the hallucinations, imagined. Either way, my symptoms are bathed in fear, an irrefutably necessary sensation (fear informs actions and judgments that are essential to our survival) that now runs amok. It feels as if fear reactions, which can be lifesavers, are stored in the brain, ready to be released viscerally and automatically when tripped.

The grab bag of reactions and behaviors in my case are not atypical. In The Evil Hours: A Biography of Post-Traumatic Stress Disorder, the author David J. Morris, a former infantry Marine officer and reporter in occupied Iraq, embraced the confusing elements of life after trauma. “PTSD, as it is understood today,” he wrote, “is a very heterogeneous disease, essentially a junk drawer of disconnected symptoms, which include a numbing of the emotions, hypervigilance, social isolation, and a variety of intrusive manifestations, such as nightmares or hallucinations.”

Molly Boehm, a licensed clinical social worker in Washington, D. C., who formerly worked with wounded service members at Walter Reed National Military Medical Center, tells clients suffering from PTSD that it is as if mind and body, once exposed to a stressful enough trauma, keep returning to a primitive mode. “When I am explaining the concept, I tell them they are almost in a time machine and brought back to that moment of past trauma,” she says. “It’s like you are seeing a saber-toothed tiger in your living room, and perceive a threat to your health, safety, and well-being.” What I describe as a “fear chemistry” that sometimes floods me Boehm interprets as “adrenaline, cortisol, and other reactions we don’t even fully understand yet, such as the inflammatory response.”

PUBLIC PERCEPTION often associates PTSD with veterans of war. On one level, attention on the relationship of combat and PTSD has value, as young combatants, like young athletes, can be prone to a sense of invincibility, and the male-dominated ethos of martial culture can discourage veterans from admitting to pain and seeking help. Public attention can reduce stigma. But on another level, the association of PTSD with veterans can be a disservice, as it risks occluding trauma’s effects on an immeasurably larger cross-section of people, including refugees, victims of sexual violence and abusive relationships, survivors of workplace or vehicular accidents or any number of other frightening experiences, like natural disasters, fires, bullying, or stalking. Almost anyone around us can quietly be suffering from PTSD, and their triggers for a full-blown reaction might seem harmless or small: a slightly raised voice, an accidentally slammed door, a car horn, the onset of night.

One time, the image that sent me into high RPM was the bottom of a broken bottle discarded in a salt pond. I was walking on exposed muck at low tide, harvesting clams on a winter afternoon, scratching mud with a stainless-steel rake. When I glimpsed the circular object on the bottom in my peripheral vision, my mind mistook it for a PMN land mine, a common weapon in Afghanistan that had claimed the legs of a friend, something I had spent years scanning for as I walked.

My mind leaped into its heightened state. I was awash in emotions with my fear neurocircuitry fully activated. Heart pounding, lungs swelling, my quadriceps and back muscles rippling for action, I froze. Then I reassessed. There’s no land mine here, I told myself, staring at the little disk until it assumed its harmless shape. To anyone watching from shore, I must have been an odd sight—harvesting one moment, statue-still the next. I was aware of this as I reset myself, and did not care. I was trying to return to the moment, and get on with my life as I know it can be.

ASK THE SCARY QUESTIONS
Kiese Laymon, author of How to Slowly Kill Yourself and Others in America, riffs on facing his greatest fear: being more compassionate.

I’m really terrified of asking people whom I love how I can be better to them. That’s a hard thing to say. “I love you, but lemme ask: How do you think I could love you differently? Let me talk to you about what I think my capabilities are.” I’m terrified of asking myself that—like a PSA. Honestly, what can you do today to love yourself better? Or to accept love better from other people? Unless we will ourselves to ask ourselves these questions: “Can we be better at love?” And, “Do we want to be?” To me, those are two of the craziest, scariest questions in the world. I just think we have to be better. Because what we’re seeing in this country, among other things, is people aren’t really good at loving the people they say they love. We’re not really good at loving ourselves. We’re not really good at loving our partners. We’re not really good at loving the country. Not really. Not really.

BANISH YOUR FEAR OF FAILURE
Escape a negative feedback loop with these tips from clinical psychologist Ellen Hendriksen, Ph.D., author of How to Be Yourself: Quiet Your Inner Critic and Rise Above Social Anxiety.

IDENTIFY THE SPECIFIC FEAR
Anxiety is often vague: “What if I fail?” or “What if something bad happens?” Narrowing down the fears makes them more specific and manageable.


ANSWER WHAT-IFS?
When you start answering the worst-case-scenario questions, you start to plan how you would cope, deweaponize anxiety, and reduce stress.

TRY MENTAL CONTRASTING
When visualizing a plan to overcome failure, don’t just imagine success. Visualize the grind as well. This prepares you to better anticipate roadblocks.

FAILURE IS NOT FOREVER
Failure is an event, not an identity. Remember that failure is a temporary experience, not a destination. It doesn’t feel good, but learn something and move on.

REWIRE YOUR FIGHT-OR-FLIGHT CIRCUITRY
Overcome any fear using this simple strategy, says the Iceman, Wim Hof, author of The Wim Hof Method.

After Wim Hof’s wife committed suicide in 1995, the father of four was paralyzed with fear, and to regain control, he experimented by seeing how much exposure to freezing cold he could endure. By breathing deeply and focusing his mind, he was able to warm his core and skin temperature. He effectively trained his mind not to freak out when his body was sending fear signals.

TWO-MINUTE WONDER
You can do the same by taking a daily cold (under-60-degree) shower for two minutes. You can start with a warm shower, and then spray only your feet and legs, then gradually go to full immersion for as long as you can handle—30 seconds is a reasonable initial goal, with two minutes the target. After doing this five days a week for four weeks, your mind will start to override the fight-or-flight response, and you will feel empowered in other situations when facing fear. —B. C.



ANA CATARINA. GETTY IMAGES. SHUTTERSTOCK