Motivation and emotion/Book/2013/Fear

Fear

Considering its composition, effects, management, and pathology

Multimedia presentation (5 min)

Overview

Fear is an emotional state that is commonly elicited by environmental threats (Gross, & Canteras, 2012). The experience of fear is a systematic connection of stimuli, physiological and psychological experiences, and behaviours (Plutchik, 2001). Fear generally serves an adaptive purpose, helping to protect us and prolong survival, such as the impulse to run if we’re confronted by a dangerous animal (Schiller et al., 2009). However, fear can also inhibit us from attaining objects of our desire or prevent us from achieving our goals, such as the fright of giving a presentation which could advance your career (Jeffers, 2012). Therefore it is important to consider what exactly fear is (physiologically and psychologically), the effects it has (on our behaviour and decisions), how we can manage it, and when it becomes maladaptive (Feinstein, Adolphs, Damasio, & Tranel, 2011; Lindquist & Barrett, 2008; Kligyte, Connelly, Thiel, & Devenport, 2013; Jeffers, 2012; Shiri, Akhaven, & Geramian, 2012).

Focus Questions:

Is fear a physiological, psychological, or combined experience?

What are the advantages of fear?

What are the disadvantages of fear?

What can be done to reduce fear?

What makes fear different from anxiety?

What is fear?

Physiological experience

The physiological components of fear have been identified extensively by research (Feinstein et al., 2011). The amygdala is widely accepted as playing a central role in the experience of fear (Feinstein et al., 2011). Located within the limbic system, the amygdala is an ancient component of the brain that helps to regulate and enact the experience of an array of emotions, including fear (Plutchik, 2001). Regulation of emotions via the amygdala is done so by releasing neurotransmitters (e.g. norepinephrine, dopamine etc.) which influence various processes (LeDoux, 2003). The amygdala is also connected to other brain areas such as the hypothalamus, the brain stem, and the periaqueductal gray (Gross & Canteras, 2012). Here a path arises in which fear is processed sequentially via these regions (Gross & Canteras, 2012). Clearly the amygdala is significantly associated with fear (Feinstein et al., 2011).

Case example:

The amygdala’s association with fear is confirmed by the case example of a 44 year old woman known as “SM” (Feinstein et al., 2011). SM's amygdala contained bilateral damage resulting in a lack of fear (Feinstein et al., 2011). Interestingly SM could still experience all other emotions,but could not experience fear (Feinstein et al., 2011). As a consequence SM tended to engage with typical fear inducing stimuli, somewhat displaying a lack of harm perception (Feinstein et al., 2011).

It is also important to consider the physiological relationship between the mind and body (Oosterwijk, Topper, Rotteveel, & Fischer, 2010) (see example 1). The embodiment hypothesis states that the experience of fear generates physical reactions such as blood flow to extremities, rapid heart rate, goose-bumps, changed posture etc. (Oosterwijk et al., 2010). This “embodiment” largely interplays with the sympathetic nervous system which allows for faster reactions, and enhances sensory input (Oosterwijk et al., 2010). The study conducted by Oosterwijk et al. (2010) found evidence for this hypothesis as induced fear delivered a range of directly observable reactions, most of which were unconscious to the participant. Therefore the physiological experience and processing of fear is imperative to its understanding (LeDoux, 2003; Gross & Canteras, 2012).

Example 1: You're hiking and a snake slithers out in front of you. You notice your heart starts racing, eyes widen and remain fixed on the snake, you feel jumpy and alert (Oosterwijk et al., 2010). These bodily reactions have prepared you to deal with the situation (Oosterwijk et al., 2010).

Psychological experience

The psychological experience of fear is also vital to its comprehension (Lindquist & Barrett, 2008). Lindquist and Barrett (2008) emphasise the Conceptual-Act Model, in that emotions are continuously changing, and dependent on prior individual knowledge and conceptualisations. This model posits that sensory info is rapidly converted into feeling states, meaning the perception of the world as frightening does not cause fear, it is fear (Lindquist & Barrett, 2008). Lindquist and Barrett found evidence for this notion, in that subjects who were primed with fear knowledge and presented with an emotion inducing stimulus experienced fear, suggesting the psychological construction of the emotion. Though, this concept can be criticised in that states of high arousal could be experienced as various emotions, meaning definitions become overlapped pertaining to a lack of distinction (Lindquist & Barrett, 2008).This is important to note as a weakness, as fear can be conceptualised in extreme forms such as terror, or weaker forms such as apprehension (Plutchik, 2001). Therefore fear should be noted as a highly aroused state with low desirability that varies in psychological intensity (Plutchik, 2001).

How fear differs from other emotions

Though psychological and physiological terms explain the experience of fear, it is important to note why we experience fear and how it differs from other emotions (Ropeik, 2004). One of the most important functions of fear is the “fight or flight” response (LeDoux, 2003). This response is our body’s preparation to either stand and attack that which is threatening, or escape as fast as possible in order to protect ourselves (Plutchik, 2001). From an evolutionary perspective, fear was a defence mechanism of our ancestors, so if they were confronted by danger, a fear state would take priority maximising the chance of survival (Reinecke, 2010). In contemporary society, the threats we must attend to are significantly different to that of our ancestors (e.g. economy, pollution, health) but still command concern (Ropeik, 2004). Fears are generally shared not only cross culturally, but cross specially, meaning they are both rational and affective (Ropeik, 2004). Here fear can be seen as an evolutionary adaptation that differentiates from other emotions in both experience and purpose (Reinecke, 2010; Ropeik, 2004).

What effects does fear have?

What fear allows us to do

Based on fears composition, it is therefore necessary to understand what it allows us to do (Ropeik, 2004). Clearly the most important function of fear is to ensure survival and protection (Plutchik, 2001). Though, research indicates that fear may also allow for increased ethical decision making (Kligyte et al., 2013). Kligyte et al. (2013) found that as fear is associated with prevention-oriented goals, the individual may try to sustain equilibrium. Kligyte et al. (2013) indicated that this finding shows fear allows for greater comprehension of situational consequences, which interact with the desire to remove uncertainty. Though this position can be criticised as those with elevated fear levels rarely possess the ability to adequately assess situations, as focus is primarily centred on either escape or attack (LeDoux, 2003). Despite this, the associated benefits of fear for both survival and improved decision making can be sustained (Kligyte et al., 2013; LeDoux, 2003).

Further it is important to note that fear can be used a method of communication (Ropeik, 2004; Zamuner, 2011). Zamuner (2011) conveys a “theory of affect perception” in which fear evaluation depends on affect influenced facial expressions, and their sensory perception. Zamuner’s theory posits that behaviour aims to convey the emotions we are experiencing, and in the circumstance of fear helps to indicate danger. Contrarily, Marsh, Ambady and Kleck (2005) found that fearful facial expressions actually influenced greater approach-behaviours in participants, perhaps showing fear reinforces social relationships. Marsh and colleagues results indicate support for Zamuner’s theory, as clearly the emotion induced facial behaviour of fear indicated the response the participants should adopt. Here fear can be seen as a useful social communicator (Zamuner, 2011; Marsh et al., 2005).

What fear prevents us from doing

Research has also indicated the pitfalls of fear (Ropeik, 2004). Fear has shown to be particularly harmful in instances if misinterpretation, as beneficially short term processes such as increased stress and heart rate are damaging in the long-term (Ropeik, 2004). Evidence has shown the immune system can be weakened, there can be cardiovascular damage, gastrointestinal problems, fertility issues, memory deficits, and possible brain damage to the hippocampus (Ropeik, 2004). Further issues can arise in fatigue exacerbation, impaired mental health, and the ageing process can be accelerated (Ropeik, 2004). In regards to decision making, empirical evidence suggests if the flight response is blocked, fear can progress to levels considered as anxiety, and cognitive overload may occur which impedes decision making (Kligyte et al., 2013). Therefore it is vital to note that the experience of fear is real, and that these experiences may carry consequences (Ropeik, 2004).

However, fear does not strictly segregate into positives and negatives (Groth & Peters, 1999). One aspect of ourselves that fear commonly interacts with is our creativity and immagination, as fear may act as an inhibitor (Plutchik, 2001; Groth & Peters, 1999). However, as fear allows for the evaluation of the future, it therefore positively interacts with our imagination (Groth & Peters, 1999). Fear prediction can be based in Pavolovian conditioning principles, with one stimulus causing another to also elicit fear, therefore revealing causal relationships (McNally & Westbrook, 2006). Here fears can be seen not as inhibitors, but methods to allow future predictions, so that danger can be avoided (McNally & Westbrook, 2006). Based on these notions, it is our interpretation and subsequent actions towards fear which causes it to be either a positive or negative experience (Groth & Peters, 1999; (McNally & Westbrook, 2006).

Fear management

Memory manipulation

As fear can be a negative experience, research has been conducted into memory manipulation to posit its reduction (Schiller et al., 2009). The reconsolidation hypothesis states that each time a memory is accessed it is recreated, meaning memories for events are based on their last retrieval, not the original memory (Schiller et al., 2009). Here reduction may be instituted by adding positive components to fear related memories during their reconsolidation (Schiller et al., 2009). Though this method can be criticised in that it addresses specific parts of memories, not their entirety, meaning residual fear associations may remain (Schiller et al., 2009). Furthermore the strength of fear related memories can be dependent on the developmental stage they were acquired and reconsolidated (Quirk et al., 2010). Therefore the alteration of fear memories during reconsolidation depends on their malleability, and solidity (Quirk et al., 2010). Though an avenue for potential benefits, memory manipulation may not be the most effective method for fear management (Quirk et al., 2010).

Psychotherapeutic contributions

Another area of potential management methods arises from psychotherapies (Marks & Dar, 2000). Habituation (sometimes referred to as extinction) is a decreased rate of response as a result of exposure to a feared stimulus (Quirk et al., 2010). To instil change, considerations must be made as to where enablers and inhibitors of fear react with the environment, meaning extinction depends on contexts and knowledge (Rowe & Craske, 1998). Research conducted by Rowe and Craske (1998) found that exposure is particularly effective if the presentation of feared stimuluses is varied and multiple. Rowe and Craske suggest that stimulus variation enables generalisations, meaning fear reduction is strengthened. Here exposure can be seen as an effective method of fear reduction (Rowe & Craske, 1998).

Though, exposure as a reductionist method is dependent on self-impositions (Marks & Dar, 2000). When self-directed, exposure is ineffective if the subject engages in avoidance behaviour, as fear signals fail to activate the relevant brain area’s necessary for an adequate experience of fear (Marks & Dar, 2000) (see example 2). Unlike habituation, avoidance may also lead to sensitization, causing the individual to become increasingly fearful of the target stimulus (Marks & Dar, 2000; Rowe & Craske, 1998). Therefore it is imperative that when exposure is self-directed, avoidance behaviour and cues to do so are significantly reduced (Schiller et al., 2009; Marks & Dar, 2000).

Psychotherapies have suggested not only exposure, but cognitive therapies of intervention (Marks & Dar, 2000). The reduction of fear via cognitive interventions is based on three main postulations being, identification and acknowledgement of negative thoughts relating to fear, an evaluation of the validity of these thoughts, and the implementation of positive thinking styles (Marks & Dar, 2000). For this method to be self-directive, individuals engage in a form of self-examination therapy which involves selecting concerns of fear, generating methods to aid in their reduction (perhaps even exposure), and then enacting their implementation (Rowe & Craske, 1998; (Marks & Dar, 2000). Though typically therapist oriented, psychotherapies may aid in fear reduction if self-directive (Marks & Dar, 2000).

Example 2: A person is trying to overcome their fear of heights, but every time they're confronted with a situation involving heights they close their eyes until it is over (Marks & Dar, 2000). By closing their eyes the person does not allow themselves to fully experience their fear, meaning their fear response is reinforced as closing their eyes relieves the apprehension (Marks & Dar, 2000).

Emotion regulation

Research has also shown that emotion regulation may result in fear control (Schweiger Gallo & Gollwitzer, 2007; Plutchik, 2001). This concept states that individuals may consciously control their emotions, when they experience them, and their manifestation (Schweiger Gallo & Gollwitzer, 2007). Commonly a response-focused approach is adopted, in which the person aims to inhibit fear via suppression (Schweiger Gallo & Gollwitzer, 2007). Though this may result in high cognitive load, meaning fear reduction is weakened (Schweiger Gallo & Gollwitzer, 2007). However, Schweiger Gallo and Gollwitzer (2007) found emotion regulation is influential at reduction when an implementation intention is adopted (pre planning in order to counteract negative events). Schweiger Gallo and Gollwitzer found evidence for this as participants displayed significant fear reduction despite also having high cognitive load. Clearly emotion regulation may deliver positive effects of fear reduction, though these effects are substantial if proper regulation methods are adopted (Schweiger Gallo & Gollwitzer, 2007; Plutchik, 2001).

Methods of self help

Further management methods relate to more general self-help options (Jeffers, 2012; Reinecke, 2010). Jeffers (2012) states that by breaking fear down into the three levels of fears that happen, fears in environments, and the perception of self-confidence, one may begin to diminish responses to their fears. Of these three levels, self-confidence is associated with high importance, as the ability to increase one’s perception as an adequate handler may reduce fear (Jeffers, 2012). Jeffers also identifies that the experience of fear can not be completely eradicated, but it is important to address, rather than have fear rule you. Further support for this notion is also given by Reinecke (2010) who conveys that experiencing fear allows one to create options in order to manage it. Research depicts that the management of fear is best operationalized when it is directly addressed (Jeffers, 2012; Reinecke, 2010).

Table 1

Summary of Fear Management Options

Memory Manipulation	Changing negative fear related memories into positive ones through reconsolidation.	E.g. A fearful memory of being attacked by a dog is paired with memories of positive experiences with dogs.
Exposure Therapy	Systematically interacting with the feared stimulus until fear levels drop.	E.g. Reducing the fear of blood by first thinking about blood, then looking at pictures of blood, then visiting a blood bank.
Other Psychotherapies	Cognitive therapies (changing negative thoughts via "self examination therapy").	E.g. Changing the fear of spiders by selecting goals to strive towards and strategically gaining these goals in incremental steps, while simultaneously changing negative thoughts and ideas towards spiders.
Emotion Regulation	Consciously identifying the experience of fear, and using an implementation intention to counteract it.	E.g. You know you will experience fear when giving a presentation, so you try to reduce the experience by consciously tapping your foot in order to distract you.
General Self-Help	Breaking fear down into levels, improving self confidence, understanding the nature of fear.	E.g. You are fearful about asking your boss for a raise, but you recognise that you have a good relationship with them and that you are a competent employee, and hence you use your fear to drive you not inhibit you.

Note. References: Memory manipulation (Schiller et al., 2009), exposure therapy (Rowe & Craske, 1998), other psychotherapies (Marks & Dar, 2000), emotion regulation (Schweiger Gallo & Gollwitzer, 2007), general self help (Jeffers, 2012; Reinecke, 2010).

What happens when fear becomes maladaptive?

Anxiety

Here it is important to consider when normal fear becomes pathological (Rosen & Schulkin, 1998). Anxiety can be seen as an exaggerated form of fear, in that like fear it is a motivator to relieve the state of apprehension, but is excessive in that it may arise in normal situations, is greatly overgeneralised, intense, and interferes with normal function (Shiri et al., 2012). Anxiety can be broken down into several disorders based on characteristic symptoms, these disorders include:

Panic Disorder

Agoraphobia

Specific Phobia

Social Phobia (Social Anxiety Disorder)

Obsessive Compulsive Disorder (OCD)

Post Traumatic Stress Disorder (PTSD)

Acute Stress Disorder, and;

Generalised Anxiety Disorder (GAD)

(Shiri et al., 2012). Rosen and Schulkin (1998) illustrate the difference between fear and anxiety, in that brain activity in response to fear subsides with removal of the threat, where in anxiety this activation continues for a significantly longer period. Though fear may indeed lead to anxiety, it is important to differentiate what constitutes a pathological definition (Shiri et al., 2012).

Therfore it is noteworthy to consider how fear may lead to anxiety's development (Rosen & Schulkin, 1998). Rosen and Schulkin (1998) state that anxiety is typically viewed as an overactive fear response. Though, this is not to say that fear will necessarily progress to anxiety, as various situational and genetic factors contribute to its development (Shiri et al., 2012). However, research suggests that pathological development could arise from the circuitry of fear activation (sense – emotion – action – relieve) becoming autonomous and unconscious (Rosen & Schulkin, 1998). As a result, sensitisation may occur, creating greater stimulus perception and attention to (Rosen & Schulkin, 1998). This may indicate the incessant priming of the perceptual-response system which results in anxiety's characteristic hyper-excitability (Rosen & Schulkin, 1998). Though of great difference in intensity and consequence, a link to pathological fear development can be established (Rosen & Schulkin, 1998; Shiri et al., 2012).

Phobias

Example 3: Two people share a fear of public speaking. The first person experiences discomfort, and nervousness, a typical fear response (Muris et al., 1999) The second person experiences light-headedness and an inability to focus on anything other than escape, displaying an anxiety response (Muris et al., 1999).

As phobic behaviour is characteristically similar to fear, their interaction is of important consideration (Muris, Schmidt, & Merckelbach, 1999; Shiri et al., 2012). Fear and phobia are both similar in that they are highly aroused states in response to a perceived threat, though differ in pathological intensity and discernibility (Muris et al., 1999) (see example 3). Like fear, phobias commonly link to a specific target of influence, and categorise into animal type (e.g. arachnophobia), natural environment type (e.g.weather, heights), blood-injection-injury type, and situational type (e.g. claustrophobia) (Shiri et al., 2012). The association of fear and phobia is further highlighted by both occurring only when the stimulus is apparent (Shiri et al., 2012). Here the development of fear to pathological phobia may be illustrated by classical conditioning principles, as typically phobic behaviour is a learned response (McNally & Westbrook, 2006). Vriends, Michael, Schindler and Margaf (2012) found support for this notion, as conditioning lead flying phobic participants to become fearful of previously unconditioned stimuli. Clearly fear and phobia share a potentially strong relationship (Muris et al., 1999).

Treatments

Just as fear can be managed, various treatments exist for pathological anxiety (Smith, 2013). As the fear associated with anxiety is overwhelmingly exacerbated, sufferers generally display a fear of fear itself (Smith, 2013). This can be combated by various treatments such as exposure therapy (as suggested for normalised fear reduction), cognitive behavioural therapy (replacing negative thoughts with positive ones) and lifestyle changes (healthy consumption, exercise regimens, sleep hygiene) (Shiri et al., 2012). Overall research suggests the most important factor to reducing anxiety is not engaging in avoidance, as it also is postulated for fear reduction (Shiri et al., 2012). Just as fears reduction can be achieved, the same is true for anxiety (Shiri et al., 2012; Smith, 2013).

Conclusion

Though fear is a highly aroused state commonly associated with negative affect, its existence is entirely natural (Plutchik, 2001). Evidence for such claims is demonstrated by theoretical research which show strong links to both the physiological and psychological expression of fear (Feinstein et al., 2011; Lindquist & Barrett, 2008). Fear not only enables us to protect ourselves, but, it interacts with our imagination and creativity allowing us to make predictions for the future, and possibly strengthens the accuracy of our decisions (Plutchik, 2001; Kligyte et al., 2013; Groth & Peters, 1999). Conversely, fear can also damage our bodies, and in extreme cases become pathologically paralysing (Ropeik, 2004; Rosen & Schulkin, 1998). However, management options exist which may allow us to take control of our fears, and perhaps wield them as tools for our manipulation and progression (Schweiger Gallo & Gollwitzer, 2007; Jeffers, 2012). Therefore it is the combination of our perceptions, knowledge, and control of fear which ultimately delivers its expression (Lindquist & Barrett, 2008; Plutchik, 2001).

Quiz

References

Feinstein, J. S., Adolphs, R., Damasio, A., & Tranel, D. (2011). The human amygdala and the induction and experience of fear. Current Biology, 21(1), 34-38. doi: 10.1016/j.cub.2010.11.042

Gross, C. T., & Canteras, N. S. (2012). The many paths to fear. Nature Reviews, Neuroscience, 13(9), 651-658.

Groth, J., & Peters, J. (1999). What blocks creativity? a managerial perspective. Creativity and Innovation Management, 8(3), 179-187.

Jeffers, S. (2012). Feel the fear and do it anyway. Random House'.

Kligyte, V., Connelly, S., Thiel, C., & Devenport, L. (2013). The influence of anger, fear, and emotion regulation on ethical decision making. Human Performance, 26(4), 297-326. doi: 10.1080/08959285.2013.814655

LeDoux, J. (2003). The emotional brain, fear, and the amygdala. Cellular and Molecular Neurobiology, 23(4-5), 727-738.

Lindquist, K. A., & Barrett, L. F. (2008). Constructing emotion: The experience of fear as a conceptual act. Psychological Science, 19(9), 898-903.

Marks, I., & Dar, R. (2000). Fear reduction by psychotherapies: Recent findings, future directions. The British Journal of Psychiatry, 176(6), 507-511. doi: 10.1192/bjp.176.6.507

Marsh, A. A., Ambady, N., & Kleck, R. E. (2005). The effects of fear and anger facial expressions on approach-and avoidance-related behaviors. Emotion, 5(1), 119-124. DOI: 10.1037/1528-3542.5.1.119

McNally, G. P., & Westbrook, R. F. (2006). Predicting danger: The nature, consequences, and neural mechanisms of predictive fear learning. Learning and Memory, 13(3), 245-253.

Muris, P., Schmidt, H., & Merckelbach, H. (1999). The structure of specific phobia symptoms among children and adolescents. Behaviour Research and Therapy, 37(9), 863-868.

Oosterwijk, S., Topper, M., Rotteveel, M., & Fischer, A. H. (2010). When the mind forms fear: Embodied fear knowledge potentiates bodily reactions to fearful stimuli. Social Psychological and Personality Science, 1(1), 65-72.

Plutchik, R. (2001). The nature of emotions: Human emotions have deep evolutionary roots, a fact that may explain their complexity and provide tools for clinical practice. American Scientist, 89(4), 344-350.

Quirk, G. J., Paré, D., Richardson, R., Herry, C., Monfils, M. H., Schiller, D., & Vicentic, A. (2010). Erasing fear memories with extinction training. The Journal of Neuroscience, 30(45), 14993-14997. doi:10.1523/JNEUROSCI.4268-10.2010

Reinecke, M. (2010). Little Ways to Keep Calm and Carry On: Twenty Lessons for Managing Worry, Anxiety, and Fear. Oakland, CA: New Harbinger Publications.

Ropeik, D. (2004). The consequences of fear. EMBO reports, 5, 56-60.

Rosen, J. B., & Schulkin, J. (1998). From normal fear to pathological anxiety. Psychological Review, 105(2), 325-350.

Rowe, M. K., & Craske, M. G. (1998). Effects of varied-stimulus exposure training on fear reduction and return of fear. Behaviour Research and Therapy, 36(7-8), 719-734.

Schiller, D., Monfils, M. H., Raio, C. M., Johnson, D. C., LeDoux, J. E., & Phelps, E. A. (2009). Preventing the return of fear in humans using reconsolidation update mechanisms. Nature, 463(7277), 49-53. doi: 10.1038/nature08637

Schweiger Gallo, I., & M Gollwitzer, P. (2007). Implementation intentions: Control of fear despite cognitive load. Psicothema, 19(2), 280-285.

Shiri, M., Akhavan, S., & Geramian, N. (2012). Anxiety Disorder and Its Types. In V. Olisah (Ed), Essential Notes in Psychiatry, (pp. 87-116). Slavka Krautzeka, Rijeka: InTech.

Smith, D. (2013). The phenomenology of fear, anxiety and panic and how this informs treatment. Gestalt Journal of Australia and New Zealand, 9(2), 36-43.

Vriends, N., Michael, T., Schindler, B., & Margraf, J. (2012). Associative learning in flying phobia. Journal of Behavior Therapy and Experimental Psychiatry, 43(2), 838-843.

Zamuner, E. (2011). A theory of affect perception. Mind & Language, 26(4), 436-451.

External links