Physiology of fear


Regions of the brain affected by PTSD and stress.

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Had a conversation regarding fear and anxiety with someone yesterday. In light of that I am resurrecting a post I wrote from 2007 (with a few edits) regarding the physiology of fear. We often view fear as only a spiritual or faith problem. But for those who want to know what is going on in their bodies when they experience fear, consider the following:

(Those interested in other posts on anxiety can search that and related terms in the search box at the upper right hand of this blog)

Am teaching on anxiety, panic, and OCD tonight. Definition of anxiety: Responding to ambiguous stimuli (life situations) by reading them in the worst or most dangerous possible light. The Scriptures teach us that fear and worry are not good things. Time and time again God tells his people not to be afraid. We see that God wants us to see life through a different set of eyes, much as Elisha wanted his servant to see the army of angels instead of their enemies (2 Kings 6). But given the numerous encouragements to not give in to fear, we must admit it is a common struggle for every human being. Some struggle more than others.

What is going on with those whose lives are filled with worry and fear? Are they less spiritual? More sinful? It is easy to say, “buck up” to folks who are anxious–and entirely unhelpful to most. Logical challenges to fear (e.g., really, what is the chance you will die in a plane crash today?) may help some in the moment, but usually don’t get to the root of the matter. Jesus encourages fearful people by pointing them to see life from 40,000 feet. He doesn’t deny risk and suffering but encourages folks to keep their eyes on him. And with Peter, he reaches out to grab him even when he does start looking at the waves.

But what of the physiology of anxiety? What do we know and how does the christian counselor make use of the data?

  1. Fear responses are quickly learned and seemingly etched into the amygdala. One bad experience of food poisoning from a turkey sandwich at Applebees means my stomach tenses a little when I see deli turkey, even without remembering the food poisoning. Imagine what happens if you suffer repeated assaults or worse! The earlier the person is exposed to deep fears, the more likely they suffer from hyperarousal and startle responses.
  2. Neurotransmitters are involved which means you act first and think later. There’s little conscious cognitive processes involved until after anxiety is under way. Fear inducing stimuli lead to immediate neurotransmitter changes that then divert blood from organs to muscles. Tension builds, shallower, less effective breathing begins. Carbon Dioxide levels decrease in the blood stream which in turns creates pain, numbness, and a sense of danger. And so the cycle continues. During and after, we make attributions and so enhance the connections of the feared stimuli and our flight response. The higher the perception of pain, the greater fear/flight response. Despite medical advances, most of our medications either shut down the feed-back loop (beta blockers, anti-anxiety meds like xanax) or attempt to increase the available neurotransmitter serotonin associated with positive outlook.
  3. OCD, in particular, has some probable links to early exposure to viruses such as Strep and Flu. There is a higher incidence of OCD in people born during winter months and who live in colder climates. The link is not clear.
  4. PTSD patients have higher right hemisphere brain activity (than do non-PTSD individuals) when exposed to anxiety provoking stimuli. Further, it appears that trauma patients have greater difficulty coming back to “center” after a trigger. Likely the hypothalamus and other brain structures are overactive in the stress response and do not “cool” down quickly.

That’s just a few things we think we know about the physiology of fear. Now, what do we do with fear from a spiritual standpoint?

  1. Worship. Worship/meditation on other things takes our attention away from the fear stimulus. It forms habits and relationships as we repeat what we want to believe until we actually own it and believe it on its own merits.
  2. Fight. We do challenge our thinking as soon as we can. Yes, the fight/flight chemicals are coursing through our veins but we challenge just the same so we can break some of the connections and the ways we reinforce our fears. One other way we fight may seem a bit odd. We admit there are real things that are scary and overwhelming out there. We do not try to deny the reality of suffering (past or future) but admit it over and over. It is scary to die. I was assaulted in that alley. I am in pain and more may be coming. But, God is with me and it is good to call on him and ask him tough questions about his protection of me.
  3. Stay Present. Being present in the moment is essential to avoiding living in the fear of the past or the future. Some fear is indeed in the present but most are not. When I am able to focus or describe the now, I am less likely to be imagining a future feared event. “Right now I am sitting at my desk and looking at a picture of my children and enjoying the smiles on their faces. Right now I am getting ready for bed and working on a sudoku puzzle and noticing that I am getting tired.”
  4. Work. Building habits where I do not allow myself to run from the feared situations (where appropriate!). Moving myself closer to some of the feared scenarios in a slow and consistent manner. No, this is not flooding (where you are dumped in the pit of snakes because you have a phobia of snakes…). Allow the work to take the time to reorient the deep recesses of the brain. Don’t expect or look for immediate change!
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16 Comments

Filed under Anxiety, biblical counseling, christian counseling, christian psychology, counseling science, counseling skills, Mindfulness

16 responses to “Physiology of fear

  1. Scott Knapp

    Having not been without vocational employment in quite awhile, I’m quite vulnerable to gut-wrenching, paralyzing panic and fear! I thought about how I’ve applied those four principles to my present situation of being unemployed, and avoided being a captive of panic/fear:
    1) Worship: choosing to believe God uses all things, including periods of no vocational income, to bring glory to Himself and impact my world for good; I worship by my attitude toward Him and others while I’m grieving my present situation.
    2) Fight: I continue to plan for future employment by marketing myself, keeping up on my reading in the field, and trying to go back to school; “fight” can sometimes look like “frightened scrambling” so I monitor how discouraged I get if a “fight plan” doesn’t pan out immediately. I haven’t collapsed into a fetal ball over this (at least, not often!)
    3) Staying present: especially making sure what I’m doing in the present is productive for me and those who need me, and not merely a distraction until I get re-employed; I still have my life apart from my vocation that needs my attention and effort (husbanding, fathering, etc.) which didn’t end with a job resignation.
    4) Work: I liked being employed, I was terrified of having to go back into the job market to sell myself! Each day I’ve got to do the “marketing” things that will help me either get re-employed or into school again: networking, reading, possibly looking for volunteer work in the mean time, etc. Some days it would be easier to lose the discipline, and just sit and watch HGTV with a bowl of chips!
    Thanks for the post!

  2. Amy

    This is going in my Friday Faves this week!

  3. Pingback: Friday Faves: The Apocalyse Edition « Backseat Writer

  4. Bet

    A few years ago I learned another physiological cause of anxiety: pre-menopause. When our oldest daughter was learning to drive (when I was much younger) I was not particularly fearful of getting in the car with her. But when the next one (6 years younger) was learning… I simply could NOT handle it. I had to hand all driving instruction over to my husband with the subsequent children. I was afraid I was going crazy until I read that increased anxiety is a sign of pre-menopause. Frankly, that was the only explanation that made sense to me. My fear was also manifested in some of the other areas you mentioned, and I began to learn to pray, worship, listen and trust God more and my anxiety level has subsided in these other areas. But I still can’t get in the car and teach a kid to drive!

  5. Pingback: Fear and the brain | HeadHeartHand Blog

  6. Rebekah

    My story is too long and complicated to go into here, but I still wanted to tell you that this post helped me this morning, as I’m in an extra-fierce battle with anxiety. Your wisdom and practical advice are so helpful and much-needed. God bless!

  7. very nice presentation and I am not used to the Christian slant but it is interesting. I will have to sit down and assimilate how it works together.

    My relationship with fear and pain have changed drastically on my healing journey. I have chronic pain now from a triple rollover car collision and complex PTSD from childhood. fear is an interesting emotion.

    Studying fear revealed that it never did any damage to me. If I became fearful of a situation and it did not happen, then was I harmed by the fear alone, no.

    I think you use prayer, I used meditation or mindfulness. Staying present is critical as PTSD fuels when we dissociate, gains precious time in our consciousness and grows.

    The part about fighting, I totally disagree. What you resist persists.

    You will not heal by conscious effort because the amygdala operates five seconds earlier than our cognitive skills and is tasked with our self protection. I have a u-tube video of Navy Seals with a huge helmet over their head to block all senses. It is a trainning exercise for handling fear. They pull the cover off the seal and his amygdala alerts and starts the adrenal stress process a full five seconds before our cognitive frontal lobes kick in.

    So thought or fighting this is handling the trauma. The way to handle thoughts, fear, or triggers is first accept them as our own without engaging them.

    Then surrender to them. If you can develop your focus on the breath enough you can go towards your triggers and observe them. Follow the body sensations instead of the story. If you fight and engaged your cognitive side you lose. You heal by staying present and not reacting to thoughts, or triggers or fear one low self worth.

    We heal by giving up judgment and accept things in this moment without judgment. if you judge you own and take it with you.

    trauma fades in the crystal clear moment of now if you can be here, without thought or distraction.

    Our ego judges everything even a donut to file it with all the donuts in our life.

    We construct this ego and it is for identity not taken as the real us. We are perfect without the possibility of failure or shame. Interested in feedback and thank you for a great blog.

    marty

  8. I would also like to ask you, if I may about our body mechanisms like fight or flight, fear etc?

    Our amygdala has the task of protecting us, so without it we wood walk in the middle of traffic or run red lights or injure us. Why do we have to fear or react so violently, if we recognize all these things are just us, cortisol and adrenaline are just drugs secreted by us.

    Fear is my friend, it pumps my blood to my extremities, raises my blodd pressure, heart rate and respiration while narrowing my vision along with my now loss of fine motor skills. My body has prepared me to either defend myself or flee.

    Why not acknowledge the emotion of fear with the knowledge ours is disordered and it is not real fear or real danger. Fear is my friend now. Something that has protected me and helped keep me safe.

    I have chronic pain with morphine and norco as pain killers in my cabinet but I do not use them. I accept my pain and go out and walk to bring my pain out to secrete my own endorphins and let my body and mind defeat my pain.

    I walk till it hurts and my ego wants to go home and sit on the couch. then I turn my music up and walk another 20 minutes in pain. The pain can not stop me from walking or defeating it. When I am finished my body just has this exhausted achievement against my pain.

    Pain is so personal like air no one else can see it or feel it, but it has power. If you fear or react to your pain at all it grows. I ignore my pain and just accept it and live in this minute. It has compressed it and it is just there like my breath and arm.

    The breath as focus can empty the mind where miracles can happen.

    We use only 3% or 4% of our brains. Are minds are always filled and cluttered.

  9. Marty, thank you for your several comments here. I find your focus one to be very good. I think fighting (the part you took issue with) is still necessary–fighting to stay present in the least. Also, I think we do well to not just listen to ourselves but fighting to step back from our thoughts (and thus to be more present).

    • Phil you give me boilerplate and reiterate your position, not a very strong position.

      Thanks for the judgment of being focused, should I give a judgment of you. Your obvious authoritative position lets you blow me off.

      I did not write a response as looking up to you, I challenged your approach as someone who knows what he is talking about and positive about the specific proven things I have found.

      You do not fight staying present. it is impossible. Your book learning and therapy work is not specific enough and fighting never works.

      let me give you an example.

      We are golfing and on a par three with a large pond to the right.

      I say to you, do not think about the water. it is impossible to stop thinking about that water. Impossible. The only way to succeed is to focusing the green or your landing point. You can not not think of that water.

      Now speak of adrenal stress response, tunnel vision, loss of motor skills, loss of hearing, BP, respirations and heartrate are raised. blood flows to the exterior appendages preparing us for fight or flight. No way under this scary anxious fearful experience will you ever fight to stay present and succeed.

      You may want to switch your approach to a positive one. Start a daily practice of following your breath and then practice accepting the trauma thoughts or staying present. The mind can be influenced by way of Rick Hanson in Buddhas Brain.

      In my opinion I would question how much or how deep you know mindfulness or when and how to apply it.

      I say this without malice but with a plea to open up a dialogue and be taken seriously. if you think my position folly please back up with facts. I can back all of mine up and have developed a model to help mindfulness.

      marty

      • Marty, I’m confused as to what I have done to receive what appears to be sarcasm and judgment. I appreciate your comments, validated some (albeit briefly) and raised my opinion. You do not have to like or agree. I do ask that you refrain from sarcasm and other highly judgmental language–especially positions about who I am or what I think/feel without data. I do not find that such comments encourage dialogue but rather debate. I do find value in thinking parts of responding to PTSD. I also find value in mindfulness. I don’t think one or the other is the whole answer. We will probably disagree, and that is okay too. What I hope is that we have a shared vision in that people with complex trauma find meaning and value to their current and future lives.

      • I asked numerous questions on your musings blogs and all you have to say you are not interested in a dialogue with me.

        Sarcasm, well, Phil, I asked and challenged you to an intellectual discussion and you seem to be authoritative and closed as having the answers.

        Albeit the psychological profession has not done well with trauma is an very kind. Epidemic rates and not even studies to show what works best and far be it from any of you professionals to listen to a lay person with experience like me.

        Where does your profession open up and gain insight and ideas from us. nothing sarcastic about all the soldiers killing themselves as one part of the American Psychological Associations studies taken the “D” disorder out I’d PTSD to limit the stigma, oh yes waste resources.

        I approached you in an open and respectful way, what do you have a blog for, to sit up there and dictate what you think is infallible.

        like I say if I am below your standard of having a one on one discussion rather than you as authority maybe a Christian man could see so good, maybe not.

  10. Semantics, but I cringed when we cognitively engage , Phil.

    Most PTSD suffers react to triggers, thoughts and fears by engaging them. I believe it is like a tug of war, you grab the rope and you lose.

    Why fight what you can accept while focusing on the breath empty of thought, following any body sensations to know our inner world.

    This is how and when integration happened for me. Fighting or cognitively handling triggers or trauma spells a nervous system full of cortisol, for most.

    Do you think you can reach the amygdala consciously by yourself?

    Fighting may just be a word that trips me some because I fought it till I ended up shaking in my dark garage for six months shaking in terror. That where fighting got me.

    I healed accepting without any thought and followed the body sensations.

    I have experience exactly when triggers or trauma integrates partially.

    Staying present is accomplished by a daily practice routine like my breathing track model. The ability to stay present when all the adrenal stress reactions explode and observe, is the precise instant I healed some. repeated application with every trigger integrated them and they faded for me.

  11. theperkster

    Thanks for your thoughtful post. Stumbled here searching the issue of mindfulness. Anxiety (or fear) is not the problem, it is a symptom. http://choosetotrust.com/2012/06/our-response-to-anxiety

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