Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=101455
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Alison Flowers/MEDILL

Three people in downtown Chicago reveal their fears.


Fearing fear perpetuates fear, psychologist says

by Alison Flowers
Oct 22, 2008


Snakes, heights or a trip to the dentist: Fear can control a person’s behavior. In fact it is precisely the lack of control that contributes to fear, according to one author.

“Control is a huge factor for how scary things feel or not,” said David Ropeik, an instructor at Harvard University and co-author of “RISK! A Practical Guide for Deciding What’s Really Safe and What’s Really Dangerous in the World Around You.” He argues that humans are hard-wired to fear first and think second.

Scientists agree that fear originates in a part of the brain called the amygdala. Here the classic “fight or flight” response is launched, surging adrenaline through the human body during a fearful experience.

But for those who struggle with phobias, why they fear what they fear is an especially pertinent question, as well as how to manage the accompanying anxiety. Fortunately, one clinical psychologist has answers for both.

“Our bodies come biologically prepared to go into a fear reaction,” said Dr. Christopher Leonhard of the Chicago School of Professional Psychology. He specializes in phobias and anxiety.

According to Leonhard, the question is not whether a fear is learned or instinctive, but rather what it is that causes a person to fearfully react.

“What is learned very early on and very quickly is the type of circumstance in your environment that causes you to go into that fear response,” Leonhard said.

While the feeling of fear is instinctive and necessary for survival, people can be taught what to fear.

Behaviorist John B. Watson, author of “Psychological Care of Infant and Child,” is most infamous for his 1920 study in fear conditioning at Johns Hopkins University. By striking a hammer against a steel bar, Watson taught 11-month-old baby “Albert” to fear otherwise benign items, such as a Santa Claus mask.

“This would definitely not get approved today,” Leonhard said of the study.

Watson would produce the sharp, clanging sound when the Santa mask was in Albert’s view. “Little Albert” naturally became anxious from the noise. Later Watson would wear the cotton-balled, bearded mask without making the sound, which also caused Albert distress.

Researchers in a study published in the October issue of “Neuron” applied a method similar to Watson’s — but they used mice, not babies. Through a shock test paired with auditory tones, they were able to demonstrate that safety, as well as fear, can be conditioned without the use of anti-depressant medication.

While some medications can effectively treat fears and anxieties, depending on the type, they do have their drawbacks, according to Leonhard.

Short-term medications, such as Xanax, may be well-suited for a person who needs help handling a particular fear. Someone who is afraid of flying and seldom travels would be a good candidate, Leonhard said.

Long-term medications may help to manage fearful circumstances that one frequently encounters, but they can be habit-forming. More importantly, relapse is guaranteed if they are discontinued, according to Leonhard.

Another way to treat fear is not as easy as popping a pill, but it is proven to be more effective: extinction.

Extinction involves a step-by-step approach where patients are exposed to the very thing they fear, making them uncomfortable. The goal is not to eliminate a fearful circumstance, but rather the contrary. A person should fully experience fear without using self-protective behavior, like praying feverishly or sipping water. The subjective experience of letting the body naturally process fear is what really teaches someone how to handle it.

“If you try to run away from it, if you try to hide from it, if you take a Xanax, if you don’t stick it out until it naturally subsides, then that’s actually how you perpetuate fear,” Leonhard said.

The good news about this approach is that after a session or two of graded exposure, people can move forward with their lives.

Leonhard is quick to point out that while the benefits of extinction therapy are long-lasting, it doesn’t mean a person won’t have another fearful response.

“But now you’ll know what to do. …that fear doesn’t hurt you,” he said. “It’s not that comfortable, but it’s also not dangerous, and you can just let it run its course.”

Ropeik also validates the extinction method: “It doesn’t make fear go away. It teaches you something else that supersedes the fear.”