Learning to Live With Fear

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Fear is often a lonely experience. Its intensity can isolate us and make us question ourselves—make us feel flawed, weak and foolish. But because of the pandemic, millions of people around the world are sharing the same fears. That’s a rare thing, and it offers us a reminder that fear isn’t always something to be hidden or quelled, but something to be acknowledged and addressed. In times like these, fear can be an asset. It’s what motivates us to identify a threat and take measures to counter it.

What we need to do—always, but especially now—is understand how our fears function to help us survive. Not everyone experiences fear the same way, and scientists studying our most dramatic responses—like mine, when exposed to open heights—increasingly are helping us understand how our fear system works. It turns out that those of us who tend to overreact can teach the world something about how to react better.

Scientists have spent centuries misunderstanding fear. The ancient Greek doctor Hippocrates tried to purge what he believed was an excess of black bile in patients whose symptoms we would recognize today as phobias: people who refused to leave their homes in daylight, who were unduly terrified of cliff edges or bridges. In Europe’s Middle Ages, phobics were often assumed to be possessed. In the mid-1600s, Descartes theorized that powerful fears might arise from disturbing childhood experiences. A couple of centuries later, Freud put his own twist on that idea. And in the 20th century, people suffering from phobias and anxiety disorders have been among those who were lobotomized, treated with electroshock therapy or given a drug to induce violent seizures.

A milestone in the science of fear came in 1920, when the psychologists John Watson and Rosalie Rayner published their study of “Little Albert.” The pair used Pavlovian conditioning techniques to teach an 11-month-old to fear furry white creatures, pairing a loud crashing sound with the appearance of a white rat until he wept and tried to flee at the sight of the rat alone. (His mother eventually took him away from the researchers.) More humanely, researcher Mary Cover Jones accomplished the inverse with her own study of “Little Peter,” who already couldn’t bear to be near rabbits or other furry things. She was able to de-condition him by gradually bringing a rabbit closer, accompanied by snacks, until he could pet it.

This was the clinical expression of the truism that in order to manage our fears, we have to face them. By the 1990s, Edna Foa, now the director of the University of Pennsylvania’s Center for the Treatment and Study of Anxiety, had developed a program that she called prolonged exposure therapy. To address debilitating fears, she argued, patients had to build a new brain structure—one that, as she put it to me, did not create “the perception that the world is entirely dangerous and that oneself is entirely incompetent.” She famously and successfully adapted the treatment for use with post-traumatic stress disorder.

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Fearlessness isn’t all that it’s cracked up to be. Think of the now-infamous footage of the spring-break partiers in Florida, declaring: “If I get corona, I get corona.” Rejecting fear can be admirable under some circumstances, but it’s dangerous in the context of a pandemic. The fear itself is not what’s important; it’s the ability to recognize the nature of the threat.

Somewhere in the Midwest, there is a woman known to neuroscientists as Patient S.M. Her story offers a lesson about how much we need our fears. S.M. was born with an extremely rare genetic condition, Urbach-Wiethe disease, which causes calcification in the brain. S.M.’s disease desensitized her amygdala, the structure that is critical to triggering our fear response. Over the years, to try to help S.M. feel fear, scientists have exposed her to snakes and tarantulas, scary movies, a haunted house—all with no result. Without the ability to fear consequences, she had been beaten, assaulted, strangled and taken advantage of. Sometimes she forgot to eat.

In 2013, researcher Justin Feinstein finally found a way to scare S.M., by using (to his surprise) a standard experimental technique. Subjects breathe air tainted with 35% carbon dioxide—safe in small quantities but still enough to trigger our systems to react with some alarm at the threat to our oxygen supply. Dr. Feinstein predicted that S.M. would once again be totally impervious to fear. Instead, she and two other subjects with a damaged amygdala experienced full-blown panic attacks, a stronger fear reaction than in a control group. It was S.M.’s first experience of fear of any kind, and it indicated that our bodies can find an alternate way to route the sensation of fear in response to an internal physical threat to survival.

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At Stony Brook University, the neuroscientist Lilianne Mujica-Parodi studies a specific question about fear and survival: What kind of person would make the best Navy SEAL? In a 2014 paper published in the journal Neuroimage, she reported on a study of first-time sky divers who had volunteered on their own for the jumps. Dr. Mujica-Parodi wanted to know if it was possible to distinguish physiologically between the volunteers who had a full understanding of the possible danger and those who didn’t—in other words, between those who were “brave” and those more likely to be “reckless.” The brain activity of the “reckless” group turned out to mirror that of people who were anxious or phobic, with both diverging from the more optimally balanced people: Too much fear or too little, the pattern was the same.

She realized, she told me, that she had been thinking about the difference between bravery and fear “in the wrong way.” She had imagined a spectrum of resilience to fear, from most resilient—the desirable end—to least. Instead, her research suggests that what matters is the quality of a person’s threat detection. What warrants a fear response? A popular platform with a view of Florence? Surely not. A dark street at night? It depends. A global pandemic? Yes.

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Read the whole story (subscription may be required): The Wall Street Journal