Saturday, July 11, 2009

Fight or flight

Fear is intimately tied to the sympathetic nervous system. Adrenaline pumps through your veins, getting you ready to fight or flee. Your heart quickens, your muscles tense, and your body gears up in perfect attention. You shake. You quiver. You wait for the next step.

But sometimes there is no next step - we're irrationally afraid. Those are phobias.

Phobias have to be treated by disassociating the fearful stimulus from the fear response, and this can only be done by teaching the body that there's nothing to be afraid of. One classical treatment is through stepwise exposure. Afraid of heights? Picture yourself standing on the second floor of a building and keep that image until your fear is reduced by half. How about the seventh floor? The fiftieth? Now how about actually going up to the seventh floor?

Of course, some people, short on time and money, go for the quick fix. Flooding is the psychological equivalent of ripping off the Band-Aid. In principal, it involves forcing you to directly face the fearful stimulus (à la Fear Factor). Sure you'll be scared out of your mind, but your body can't keep up the fear response forever. So eventually, it will be forced to gear down. Bingo. Hopefully you didn't have a heart attack along the way. My wonderful first year psychology prof described it like this:

Let's describe flooding in a perfect world where there were no ethical constraints. What are you afraid of? Snakes? Great. Then I'll put you in a room with a snake. Close the door. Lock it. And then I'll stand in the control room watching you on the camera. You're not coming out of there until you overcome your fear.

What's the first thing you will do? You'll run around the room trying to get away from the snake. Maybe you'll hop onto the bed to because the snake is on the ground.

"Nice one. Now I am going to retract the bed into the wall..."

So what do you do now? You run around some more. Maybe you have a hammer with you, so you pull out the hammer and you beat the snake to death. Phew, no more snake.

"That's not very nice... Now I'm going to introduce a bigger snake."

So I open the door and I put in a bigger snake, and I take away your hammer... No, the snake eats your hammer. Now what do you do? You freak out. Your run around and around and around trying to get away from the snake! But you can't keep that up forever. Eventually you get tired and worn out, and you have to give up. You lie down and you want to sleep.

So what do you have to do? You make friends with the snake!

That's how flooding works, friends... in principle... in an ethically flexible world.

Overcoming our fears is very much a top-down process. That is, the higher centres suppress what we have naturally learned to do. Allow me to share this anecdote from my psychiatry prof this year:

So my wife and I were on vacation in [insert sketchy little country here]. While we were stopped at traffic light, a robber came up to our car, opened the door and robbed us. Then he ran off.

Now I don't know what I was thinking, but I got out of our car and I ran after him, leaving my wife in the car cowering in fear at this traumatic experience. Boy did I run after that guy. I ran faster and farther than I had ever gone in my entire life... until we hit some dark alleyway where the culprit ducked into a building. It wasn't until then that I stopped and started to think: I don't know where I am. There could be a bunch of guys waiting to ambush me in that building. What am I doing? I should probably go back to my wife alone in the car.

I went back, and we went back to the hotel. It was a scary experience, but by the time we got back I was starving and exhausted. I ate a meal and I slept like a baby. Meanwhile, my wife wasn't hungry and couldn't eat a thing. She was shaking, and she couldn't sleep a wink all night.

My point is, no matter how stupid it was for me to run after that guy, I did what my body wanted to do in that situation. It geared up and prepared to fight or run. That's exactly what I did. I ran like I'd never run before. Meanwhile, my wife, who was a bit more rational stayed in the car, didn't do anything stupid... but all that gearing up her body did had no outlet. So while I slept like a baby, she shook through the night.

I'd also like to note that this professor said the Fear Factor approach (sticking someone afraid of spiders in a tub of spiders) is very bad. But I have to admit, I loved the illustration of my previous prof.

So, the last two weeks have been probably among the most arduous in my entire life, and my adrenaline has been pumping out non-stop. That's unlikely to change anytime soon. It's been challenging to sit quietly and smile, whilst writing entertaining blog entries so my dear readers don't all pick up and run away. Meanwhile I feel like someone has my heart clutched in their hand and is squeezing. That's right, heart ache is not just a metaphorical feeling. I feel like it's the day before an exam that I'm screwed for... except every day.

Putting theory to practice, I therefore decided to start the day off with some warm-up Wii Fit exercises and then cut loose on the punching bag that's been hanging in my basement for the last few years. Did it help? Yes. Do I feel good now? Not really.

Although while I was actually performing the exercises, I did feel pretty good... mostly because I couldn't tell anymore whether my heightened pulse was physiological normalcy or from unhealthy anxiety.


Mello said...

In your own words..."Life sucks sometimes...but that's okay"

this feeling will pass, add oil! I have complete faith in you. And sorry for making your comments even =P

Joyce said...

Let the endorphins take over!
/pat >: