Fear -Q and A session with Dr.Mahesh Rajasuriya

  1. To what degree is fear learnt, and to what degree is fear a result of bio chemistry/ biology?

Small babies are scared of loud noises, from the very first time they hear it. Certain animals are shown to be afraid of some specific animals/ objects without being exposed to the relevant stimulus beforehand.

However if we look at what we fear as adults, yes, we are still afraid of loud noises, some more some less, but we are afraid of so many other things: Hot kettles, moving cars, people with tattoos, snakes, cockroaches, smiling travelling salesman and so on. The list is different from one individual to another; from one stage of life to another; from one time to another. Hence we have to conclude most of our fears are acquired later in life, in other words, learnt.

  1. Can you explain to me the process where one experiences fear? What part do the neuronal connections play in all of this? What part do our pheromones play in all of this?

When a certain part of the brain, amygdala, is destroyed, people show no fear and they become hypersexual. Amygdala is part of the deep gray matter inside our brain called ‘limbic system’. Limbic system is closely associated with our emotions, including fear.

There is another set of loosely arranged neurons in our brain stem called the ‘reticular formation’, which is associated with the arousal level of the body. ‘Arousal of the body’ or ‘physiological arousal’ means how active our body and mind are. When we are ‘aroused’ our heart rate, breathing rate, blood pressure and so many other parameters rise, and when arousal reduces these parameters fall.

All these brain structures and many other parts of brain as well communicate with our hormone system, mainly through the ‘hormone headquarters’, located inside the brain itself, called the ‘hypothalamus’. Hypothalamus communicates via hormones it secretes with all other organise that produce hormones in our body, such as thyroid gland in the neck, adrenals on top of kidneys and sexual organs. There are two major hormones, adrenaline and noradrenaline, which can arouse the whole body when the reticular formation/ hypothalamus/ brain in general are aroused. These hormones can reach heart and increase heart rate, can reach our breathing centre and increase the rate of breathing, can reach our blood vessels and increase blood pressure, and can reach brain itself and produce a feeling of ‘anxiety’ and ‘fear’.

  1. There are a number of phobias in this world. Are these the result of social conditioning?

Now we know fear can be ‘produced’ as a by-product when our brain/body are aroused through mechanisms described previously. Vice versa when we fear something our brain and body are aroused because of the fear, and this arousal further increases fear, as just described.

We have already learnt that some fears can be inborn, such as fear of loud noises or heights, but many fears are learnt, such as fear of spiders or blood. Let us see how this learning happens.

It may be learning based on actual experience, where a child is bitten by a small creature and now she fears all such small creatures. On the other hand, it may not be based on actual experience, for an example an adult constantly telling a child that small creatures are dangerous and they will “bite you and will kill you.” Sometimes children may witness such fear responses in others and learn the fear themselves, as in the case where a child observes his mother’s shrieking every time there is cockroach around and may develop a phobia towards cockroaches.

The latter two types given above are examples of social learning.  However most fears are complex in origin; frequently with actual experiences as well as social learning being the causative agents. There are so many other fears that we have learnt socially, but may not qualify for a phobia in the books of psychiatry.  Examples are abundant: Fear of people of a particular ethnicity, fear of elevators, fear of being inside a vehicle with all windows/ doors shut, fear of opposite sex, fear of superiors, fear of rules/ law, fear of uniforms/ police/ military and so on.

Sometimes the origin of a particular fear is obsecure. For an example a man who is tortured by robbers who entered his house, may develop a phobia of leather gloves. When carefully assessed, one may find out that the robbers had worn such gloves during the ordeal of robbery and he saw them in these gloves.

  1. Can fears be controlled or permanently removed from the mind through logic and rationale? One famous fear is the fear of spiders? But most spiders are harmless? Is there any way rationalize and rid oneself of this fear?

We can relearn to be unafraid of a particular item we are afraid of. We already know that the limbic system, reticular formation, hypothalamus and many other parts of brain and other organs are involved in the fear response. Medications that modify function of these systems can artificially reduce the signs of fear, such as increased heart rate and breathing rate. Once these signs no longer appear as they used to be, in other words as the body is not aroused as it used to be, the feedback on the brain to feel more anxious and fearful is no longer operating. Hence with medications one might feel less fear and less anxiety. However this is the least preferred way of tacking ling your fears.

Changing thoughts related to the fear is one of the preferred ways of tackling fears. For an example, the woman who is afraid of spiders, may have many erroneous beliefs that all spiders are venomous, they kill you instantly, they particularly prey on humans and so on. Cognitive therapy is a form of psychological treatments that directly addresses such thoughts with a view to modify them in a scientific manner. As the thoughts change, the fear response diminishes. Once completed, usually the person does not develop the fear again, in contrast to frequent relapses seen when medications are stopped.

However the most preferred way is the behavioural treatment for simple phobias. If one is afraid of spiders, one is exposed to spiders as much as possible for as long as possible. It can be done in a gradually increasing manner if needed. As the person spends more and more time with spiders, or with their pictures initially, the thoughts gradually and naturally change. And the fear will disappear. Sometimes the response is so dramatic, fears disappear within a matter of hours.

However complex phobias, such as fear of talking to people and facing social situations, known as social anxiety or social phobia, may need cognitive therapy and behaviour therapy, and sometimes medication for a while, too.

  1. To what extent is religion responsible for our phobias or fears? For example fear of going to hell is something that is learnt. Is this fear induced by our own perceptions or from what religious authoritarians tell us?

All ‘facts’ we learn in religion are ‘learned facts’, and our thoughts change accordingly. Once we learn about hell, we develop thoughts such as what I do now (in a particular situation), though it does not hurt anybody, might be reserving a place for me in hell, since it is against that rule in my religion. Say the person was eating a particular food, and now he may develop a fear of that food. Or more commonly, our parents, religious leaders, frequently telling us doing this and that will send us to hell, we may develop the fear even without ever doing this or that. Hence one may fear a certain food so much, without ever consuming that, due to these learnt beliefs. Either way, all fears related to religions beliefs, are learnt fears.

  1. Fear of the Demonic or Satan is something that some people learn. Now my question Number 3 can be applied to this. Is it possible for an individual to use logic, rationale and reason and rid oneself of this fear?

Yes, can. This is the very method that is used in cognitive therapy: rationally questioning your thoughts/ beliefs related to your fear. However first you need to understand that these are not necessarily actual facts, but mere thoughts. For an example ‘doing act X will send me to hell’ is a thought, and may  or may not be the truth or reality. Then you need to question this belief: Why I think so, what is the evidence for and against etc.

  1. How common is the fear of dying in societies? Some people are afraid of dying because of the perceived end of life. Yet some have no problem with the perceived cessation of life completely? Why is this?

Arguably the fear of death is the worst and most universal fear. This fear worsens as we grow older and more debilitated. It is argued that fear of isolation and fear of losing freedom to do what one wants, are also universal fears.

People who have tackled their beliefs about death successfully, will have no or minimal fear of their own death. They have answered the questions such as what might happen to me after death, will death be painful, how others might cope after my death, if death is sudden, what it means to me, etc.

However it is common to observe that many people who are apparently unafraid of death, especially young people, are actually extremely afraid of death, but they just hide it, from  themselves as from others. People use various mechanisms to do this: Believing in an afterlife (sort of a second chance), denial of death (only others die, I will die after a long time, perhaps never), necessitating your living (I need to see my daughter through until she is married) etc.

  1. Fear of the unknown, unpredictability and uncertainty is even a fear that I sometimes have. What is the basis of this fear?

We generally fear uncertainty. However the only certainty in life is uncertainty. This gives rise to anxiety in us. Anxiety is the physiological term given to the physical and psychological manifestations we discussed previously of the fear response. This is again deemed to be universal. You may have noticed most animals are generally very anxious too. They are always on the look out for predators and dangers in the environment. Some animals hardly relaxe and fall asleep.

Some people worsen this fear by firmly believing that life must go on on a planned trajectory and any tiny deviation is disaster. Again there is lot of social learning in such situations.

  1. Is Fear the beginning of wisdom? Should our children be taught to fear?

Fear is the beginning of end of wisdom. Fear stops us from thinking, asking questions, being rational. Hence people who kill others, rape others, abuse children are people who have lots of fears in them. Especially fears about their own competence and existence as human beings. They are not amenable to rational conversation. Terror, brutal force are their only weapons.

We need to teach our children (as well as ourselves) to question our fears, including the most feared fears. It may be ranging from fear of spiders to fear of death; from fear of talking to an opposite sex person to fear of sexual intercourse; from fear of making decisions to fear of bearing resoponsibility.

  1. What is the difference of Fear from Anxiety? What makes fear become terror leading to paralysis?

This is answered above. When the bodily arousal in fear is so severe, the overload of stimulation in limbic system, reticular formation, hypothalamus and overdose of adrenaline and noradrenaline, the body may suddenly stop. This is called ‘freeze’ response. Lower levels of bodily arousals are called ‘fight or flight’ response, as we prepare our bodies to tackle the object that induced the fear or to run away from that object.