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Francine Shapiro, Ph.D. Headshot

The Many Faces of Fear and How to Deal With Them

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We've all heard the phrase "life is suffering." Unfortunately, some people misinterpret this to mean there is nothing they can do about their unhappiness. Everyday fears can range from minor anxieties to an intense fear of things that can often be avoided, like snakes or spiders. But generally people enter therapy when life has become unmanageable -- when they can't ignore the level of emotional pain they are experiencing. That often happens when they can't avoid the situation that disturbs them. For some, turning to therapy makes them feel like they have "failed" on their own and that their fears are a sign of "weakness." It helps to know that fear is not a "mental" problem. It's a physiological response arising from physiologically stored memories in your brain. However, just because a fear is "irrational," doesn't mean there is no reason for it. It just means it is unnecessary and that there are things you can do to change it.

Emotions like anxiety and fear are physiological warning signals that something may be dangerous and prepare us to respond to it. Like sorrow and anger, they may be appropriate responses to a situation. But knowing that can sometimes be a trap, because feeling anxiety or fear can cause us to buy into the feelings when they are not appropriate. Because there is really no separation between mind and body, when we feel the negative sensations they are often accompanied by fearful thoughts. We can become preoccupied with these thoughts and worry about what might be happening to us now, or what might happen to us in the future. This becomes a vicious circle, with the negative thoughts and negative sensations feeding off of each other.

Noticing that this is happening gives us an opportunity to step back and use a variety of self-control techniques to deal with mind and body responses. These procedures can involve deliberately changing our breathing patterns, thoughts, or using imagery in certain ways. But first we have to recognize that we don't need to be run by our automatic responses. Yes, these emotions and body sensations have evolved over millions of years for our survival. But just because we're afraid doesn't mean there is a lion in the room.

The reasons for "irrational" fears are often the unprocessed memories encoded in our brains. Some experiences are so disturbing that they cause the information processing system of the brain to malfunction. When that occurs, the experience is stored along with the emotions, sensations and beliefs that occurred at the time. Then when something happens in the present that is similar in some way to the original event, the perceptions link into the memory network to be made sense of, the stored memory is triggered and those emotions, physical sensations and thoughts can arise. But the body/mind can't distinguish between the source of the past and present responses. We experience it in the here and now, and react to the world accordingly. These fearful responses can be focused on a specific object, like a dog because one previously bit me. Or they can be something we call "vicarious traumatization" caused by events we might have heard or seen second hand. Think about how many people had trouble going swimming in the ocean after seeing the movie Jaws.

Other times, fears involve situations rather than objects. For instance, fear of public speaking is a common one and often stems from childhood failures or humiliations. The memories of these early experiences remain stored in the brain and become triggered at even the thought of public speaking. So, many people simply avoid doing it and don't actually feel a need to overcome this fear unless forced into it by a job assignment that demands it, or perhaps a desire to promote a particular cause. In such instances, the anxiety can often be overcome by concentrating on the good that will be accomplished. By focusing on the contribution you are making, and reminding yourself that "it's not about me," certain levels of fear can be overcome. Other times, different kinds of self-control techniques will manage it. But some times the early memories will need to be processed to overcome the problem.

It's also useful to remember that even if we live with pervasive feelings of anxiety and fear, the problems also stem from our unprocessed memories. Here's an example from my book Getting Past Your Past:

Meg came into therapy because of extreme self-consciousness, shyness and lack of self-confidence. She always felt as if people were watching and judging her, even while she was simply standing in line at the grocery store.

Often, we have no conscious recollection of the sources of our problem. However, specific EMDR therapy techniques can be used to identify them. In Meg's case it turned out to be something that happened to her when she was a teenager. Her parents had divorced and she hadn't seen her father in many years. When he called to invite her to stay with him in Florida for a couple of days she was elated. He took her to the beach, but unfortunately she'd never been to one before, didn't know about sunscreen and got severely burned.

The next day, while at his house, she was supposed to help clean but couldn't because she was in so much pain as a result of the sunburn. Her father looked at her with contempt and said, "I can't believe you were so stupid as to not put sunscreen on." That visit was the last time she saw or heard from him. In retrieving the memory for processing, even though it was years later, it felt to Meg "like a kick in the gut." The shame that was part of that memory arose whenever anyone looked at her, causing her to feel insecure and self-conscious. Basically, it had poisoned her sense of who she was over the past 20 years.

Many events can happen in childhood that get locked into our brain as unprocessed memories. They don't always involve parents or major rejections, but they can nevertheless harm us for decades. Here's another example from my book:

Janice came in for therapy with a very long history of taking too many antacids. At this point it was life threatening because she was taking them so often that they were practically ripping up her stomach. She also had no memory of why it had started; she only knew that she was horrified of getting sick to her stomach. The clinician used the EMDR procedures ... to find the source of these feelings. What Janice then remembered was being in grade school when the girl next to her in class vomited. Trying to stop herself, the girl put her hand over her mouth and the vomit went sideways into Janice's hair. Janice went running out of the room feeling panicky, humiliated and unclean. This was the memory at the bottom of the antacid abuse. After processing the memory, she no longer felt the need for them.

Intense fear of vomiting is called emetophobia. A report of a similar case recently appeared in a scientific journal. The 46-year-old patient was so shackled by fear that she couldn't be with her own children when they were ill for fear that they would throw up. She avoided visits to hospitals, medical programs on TV and films for "fear of seeing people that might feel unwell, and who therefore might vomit." Like Meg, her fear stemmed from a childhood incident. In this case, merely seeing another girl vomit in class had given her the feeling of "pure powerlessness" that had become encoded in her brain. After processing the memory she said:

I can already tell you now that my first memory of kindergarten already feels very neutral. That I even thought back with pleasure on it today. The image of filling the paste jars came up again, which I always enjoyed so much, and also the sweet face of the teacher.

After the processing, her symptoms disappeared. The memory became "digested" and was now stored appropriately in her memory networks. The event just became one incident in an otherwise happy time in her life. Now, this case report was published in the journal Mental Illness. But the take-home message is that whether the debilitation is large or small, this kind of description does not need to define you. Rather than buying into the fear, you can use self-help techniques to deal with them. And if they aren't enough, remember that it's OK to ask for a therapist's assistance to process the memories. It's not "all in your head." The problem is generally stemming from unprocessed memories stored in the brain. The bottom line here is that whatever anxiety or fear may be running you, if you approach it as "inappropriate physical storage emitting unhelpful responses," you can take the steps necessary to change.

References:

de Jongh, A. (2012). Treatment of a woman with emetophobia: A trauma focused approach. Mental Illness, 4:e3, 10-14.

Shapiro, F. (2012). Getting past your past: Take control of your life with self-help techniques from EMDR therapy. New York: Rodale

For more information on the EMDR Institute, visit http://www.emdr.com.

For more about the EMDR Humanitarian Assistance Programs, visit http://www.emdrhap.org.

For more by Francine Shapiro, Ph.D., click here.

For more on PTSD, click here.

Read more: "Why Our Unconscious Rules Us and What to Do About It" and "Being a Veteran Can Be Hazardous to Your Health."

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