by Dean Burnett
Phobias can be classed as specific (or “simple”) or complex. Both of these labels refer to the source of the phobia. Simple phobias apply to phobias of a certain object (for example, knives), animal (spiders, rats), situation (being in an elevator) or thing (blood, vomiting). As long as the individual avoids these things, they’re able to go about their business. Sometimes it’s impossible to avoid the triggers completely, but they’re usually transient; you might be scared of elevators, but a typical elevator journey lasts seconds, unless you’re Willy Wonka.
There are a variety of reasons for exactly how these phobias originate. At the most fundamental level, we have associative learning, attaching a specific response (such as a fear reaction) to a specific stimulus (such as a spider). Even the most neurologically uncomplicated creatures seem capable of it, such as Aplysia, aka the California sea slug, a very simple 3-foot-long aquatic gastropod that was used in the 1970s in the earliest experiments to monitor neuronal changes occurring in learning.12 They may be simple and have a rudimentary nervous system by human standards, but they can show associative learning and, more importantly, have massive neurons, big enough to stick electrodes in to record what’s going on. Aplysia neurons can have axons (the long “trunk” part of a neuron) up to a millimeter in diameter. This might not sound like much, but it’s comparatively vast. If human neuron axons were the size of a drinking straw, Aplysia axons would be the size of the Channel Tunnel.
Big neurons wouldn’t be of any use if the creatures couldn’t show associative learning, which is the point here. We’ve hinted at this before; in the section on diet and appetite in Chapter 1, it was observed how the brain can make the cake–illness association and you feel sick just thinking about it. The same mechanism can apply to phobias and fears.
If you get warned against something (meeting strangers, electrical wiring, rats, germs), your brain is going to extrapolate all the bad things that could happen if you encounter it. Then you do encounter it, and your brain activates all these “likely” scenarios, and activates the fight-or-flight response. The amygdala, responsible for encoding the fear component of memory, attaches a danger label to memories of the encounter. So, the next time you encounter this thing, you’ll remember danger, and have the same reaction. When we learn to be wary of something we end up fearing it. In some people, this can end up as a phobia.
This process implies that literally anything can become the focus of a phobia, and if you’ve ever seen a list of existing phobias this seems to be the case. Notable examples include turophobia (fear of cheese), xanthophobia (fear of the color yellow, which has obvious overlaps with turophobia), hippopotomonstrosesquipedaliophobia (fear of long words, because psychologists are basically evil) and phobophobia (fear of having a phobia, because the brain regularly turns to the concept of logic and says, “Shut up, you’re not my real dad!”). However, some phobias are considerably more common than others, suggesting that there are other factors at play.
We have evolved to fear certain things. One behavioral study taught chimps to be afraid of snakes. This is a relatively straightforward task, usually involving showing them a snake and following this with an unpleasant sensation, like a mild electric shock or unpleasant food, just something they want to avoid if possible. The interesting part is that when other chimps saw them react fearfully to snakes, they quickly learned to fear snakes too, without having been trained.13 This is often described as “social learning.”*
Social learning and cues are incredibly powerful, and the brain’s “better safe than sorry” approach when it comes to dangers means if we see someone being afraid of something, there’s a good chance we’ll be afraid of it too. This is especially true during childhood, where our understanding of the world is still developing, largely via the input of others who we assume know more than we do. So if our parents have a particularly strong phobia, there’s a good chance we’ll end up with it, like a particularly unsettling hand-me-down. It makes sense: if a child sees a parent, or their primary educator/teacher/provider/role model, start shrieking and flapping because they’ve seen a mouse, this is bound to be a vivid and unsettling experience, one that makes an impression on a young mind.
The brain’s fear response means phobias are hard to get rid of. Most learned associations can be removed eventually via a process established in Pavlov’s famous dogs experiment. A bell was associated with food, prompting a learned response (salivation) whenever it was heard, but if the bell was then rung repeatedly in the continued absence of food, eventually the association faded. This same procedure can be used in many contexts, and is known as extinction (not to be confused with what happened to the dinosaurs).16 The brain learns that the stimulus such as the bell isn’t associated with anything and therefore doesn’t require a specific response.
You’d think that phobias would be subject to a similar process, given how almost every encounter with their cause results in no harm whatsoever. But here’s the tricky part: the fear response triggered by the phobia justifies it. In a masterpiece of circular logic, the brain decides that something is dangerous, and as a result it sets off the fight-or-flight response when it encounters it. This causes all the usual physical reactions, flooding our systems with adrenalin, making us tense and panicked and so on. The fight-or-flight response is biologically demanding and draining and often unpleasant to experience, so the brain remembers this as “The last time I met that thing, the body went haywire, so I was right; it is dangerous!” and thus the phobia is reinforced, not diminished, regardless of how little actual harm the individual came to.
The nature of the phobia also plays a part. Thus far we’ve described the simple phobias (phobias triggered by specific things or objects, having an easily identified and avoidable source), but there are also complex ones (phobias triggered by more complicated things such as contexts or situations). Agoraphobia is a type of complex phobia, generally misunderstood as fear of open spaces. More precisely, agoraphobia is a fear of being in a situation where escape would be impossible or help would be absent.17 Technically, this can be anywhere outside the person’s home, hence severe agoraphobia prevents people from leaving the house, leading to the “fear of open spaces” misconception.
Agoraphobia is strongly associated with panic disorder. Panic attacks can happen to anyone—the fear response overwhelms us and we can’t do anything about it and we feel distressed/terrified/can’t breathe/nauseated/head spins/trapped. The symptoms vary from person to person, and an interesting article by Lindsey Homes and Alissa Scheller for the Huffington Post in 2014 entitled “This is what a panic attack feels like” collected some personal descriptions from sufferers, one of which was: “Mine are like I can’t stand up, I can’t speak. All I feel is an intense amount of pain all over, like something is just squeezing me into this little ball. If it is really bad I can’t breathe, I start to hyperventilate and I throw up.”
There are many others that differ considerably but seem just as bad.18 It all boils down to the same thing; sometimes the brain just cuts out the middle man and starts inducing fear reactions in the absence of any feasible cause. Since there’s no visible cause, there’s literally nothing that can be done about the situation, so it quickly becomes “overwhelming.” This is a panic disorder. Sufferers end up being terrified and alarmed in harmless scenarios, which they then associate with fear and panic, so end up being quite phobic towards them.
Exactly why this panic disorder occurs in the first case is currently unknown, but there are several compelling theories. It could be the result of previous trauma suffered by the individual, as the brain hasn’t yet effectively dealt with the lasting issues caused. It might be to do with an excess or deficiency of particular neurotransmitters. A genetic component is possible, as those directly related to a panic disorder sufferer are more likely to experience it themselves.19 There is even a theory that sufferers are prone to catastrophic thinking; taking a minor physical issue or problem and worrying about it far beyond what it is even
vaguely rational.20 It could be a combination of all these things, or something as yet undiscovered. The brain isn’t short of options when it comes to unreasonable fear response.
And finally, we have social anxieties. Or, if they’re so potent they become debilitating, social phobias. Social phobias are based on fear of negative reaction from other people—dreading your audience’s reaction to your karaoke, for instance. We don’t fear only hostility or aggression; simple disapproval is enough to stop us in our tracks. The fact that other people can be a powerful source of phobias is another example of how our brains use other humans to calibrate how we see the world and our position in it. As a result, the approval of others matters, often regardless of who they are. Fame is something millions of people strive for, and what is fame but the approval of strangers? We’ve already covered how egotistical the brain is, so maybe all famous people just crave mass approval? It’s a bit sad really (unless they’re a famous person who has praised this book).
Social anxieties occur when the brain’s tendency to predict and worry about negative outcomes is combined with the brain’s need for social acceptance and approval. Talking on the telephone means interacting without any of the usual cues present in person, so some people (like me) find it very difficult and we panic that we’ll offend or bore the other individual. Paying for groceries with a large line behind you can be nerve-racking as you’re technically delaying a lot of people who stare at you while you try to use your math skills working out the payment. These and countless similar situations allow the brain to work out ways in which you’ll annoy or frustrate others, earning negative opinions and causing embarrassment. It boils down to performance anxiety; the worry about getting things wrong in front of an audience.
Some people have no issues with this, but some have the opposite problem. How this comes about has a variety of explanations, but a study by Roselind Lieb found that parenting styles are associated with likelihood of developing anxiety disorders,21 and you can see the logic here. Overly critical parents can instill in a child a constant fear of upsetting a valuable authority figure for even minor actions, whereas overprotective parents can prevent a child from ever experiencing even minor negative consequences of actions, so when they’re older and away from parental protection and something they do does cause a negative outcome, they’re not used to it, so it affects them disproportionately, meaning they’ll be less able to deal with it and will be way more likely to fear it happening again. Even having the dangers of strangers drummed into you constantly from an early age can enhance your eventual fear of them to beyond-appropriate levels.
People experiencing these phobias often display avoidant behavior, where they actively avoid getting into any scenario where the phobic reaction could come into play.22 This may be good for peace of mind, but it’s bad for doing anything about the phobia in the long run; the more it’s avoided, the longer it stays potent and vivid in the brain. It’s a bit like papering over a mouse hole in your wall; it looks fine to the casual observer, but you’ve still got a rodent problem.
The available evidence suggests social anxieties and phobias are apparently the most common type of phobias.23 This isn’t surprising given the brain’s paranoid tendencies leading us to fear things that aren’t dangerous, and our reliance on approval from others. Put these two together, and we can end up unreasonably fearful of others having a negative opinion of our incompetence. For proof of this, consider the fact that this is the ninth tenth eleventh twelfth twenty-eighth draft I’ve done of this conclusion. And, yes, I’m still sure loads of people won’t like it.
Don’t have nightmares . . . unless you’re into that sort of thing.
(Why people like being scared and actively seek it out)
Why do so many people literally jump at the chance to risk smearing themselves over the unforgiving ground in pursuit of fleeting excitement? Think of base jumpers, bungee jumpers, parachutists. Everything we’ve learned so far shows the brain’s drive for self-preservation and how that results in nervousness, avoidance behavior, and so on. Yet authors such as Stephen King and Dean Koontz write books featuring fear-inducing supernatural occurrences and brutal, violent deaths of characters and they are raking it in. They have sold nearly a billion books between them. The Saw franchise, a showcase for the most inventive and gory ways in which humans can be prematurely killed for obscure reasons, currently numbers seven films, all of which were shown in cinemas worldwide rather than sealed in lead containers and launched into the sun. We tell each other scary stories around the campfire, we ride ghost trains, visit haunted houses, dress up as the walking dead at Halloween to extract sweets from neighbors. So how do we explain our enjoyment of these entertainments, some of which are aimed at children no less, that depend on us being scared?
Coincidentally, the thrill of fear and the gratification gained from sweets are both likely to be dependent on the same brain region. This is the mesolimbic pathway, often known as the mesolimbic reward pathway or the mesolimbic dopaminergic pathway, because it is responsible for the brain’s sensation of reward, and it uses dopamine neurons to do it. It is one of several circuits and pathways that mediate reward, but it is largely acknowledged as being the most “central” one. And this is what makes it important for the “people enjoying fear” phenomenon.
This pathway is composed of the ventral tegumental area (VTA) and nucleus accumbens (NAc).24 These are very dense collections of circuits and neural relays deep in the brain, with numerous connections and links to the more sophisticated regions including the hippocampus and the frontal lobes, and the more primitive regions such as the brainstem, so it’s a very influential part of the brain.
The VTA is the component that detects a stimulus and determines whether it was positive or negative, something to be encouraged or avoided. It then signals its decision to the NAc, which causes the appropriate response to be experienced. So if you eat a tasty snack, the VTA registers this as a good thing, tells the NAc, which then causes you to experience pleasure and enjoyment. If you accidentally drink rotten milk, the VTA registers this as a bad thing and tells the NAc, which causes you to experience revulsion, disgust, nausea, practically anything the brain can do to ensure you get the message, “Do not do that again!” This system, when taken together, is the mesolimbic reward pathway.
“Reward” in this context means the positive, pleasurable feelings experienced when we do something our brain approves of. Typically, these are biological functions, like eating food if hungry, or when said foods are nutrient or resource rich (carbohydrates are a valuable energy source as far as the brain is concerned, hence they can be so difficult to resist for dieters). Other things cause much stronger activation of the reward system: things like sex; hence people spend a lot of time and effort to obtain it, despite the fact that we can live without it. Yes, we can.
It doesn’t even have to be anything so essential or vivid. Scratching a particularly persistent itch gives pleasurable satisfaction, which is mediated by the reward system. It’s the brain telling you that what just happened was good, you should do it again.
In the psychological sense, a reward is a (subjectively) positive response to an occurrence, one that potentially leads to a change in behavior, so what constitutes a reward can vary considerably. If a rat presses a lever and gets a bit of fruit, it’ll press the lever more, so the fruit is a valid reward.25 But if instead of fruit it gets the latest Playstation game, it is unlikely to press the lever more frequently. Your average teenager might disagree, but to a rat a Playstation game is of no use or motivational value, so it’s not a reward. The point of this is to emphasize that different people (or creatures) find different things rewarding—some people like being scared or unnerved, while others don’t and can’t see the appeal.
There are several methods via which fear and danger can become “desirable.” To begin with, we are inherently curious. Even animals such as rats have a tendency to explore something novel when presented with the opportunity.
Humans even more so.26 Consider how often we do something just to see what happens? Anyone who has children will certainly be familiar with this often-destructive tendency. We are drawn to novelty value. We are faced with a huge variety of new sensations and experiences, so why go for the ones that involve fear and danger, two bad things, rather than the many benign-but-equally-unfamiliar ones?
The mesolimbic reward pathway provides pleasure when you do something good. But “something good” covers a very wide range of possibilities, and this includes when something bad stops happening. Due to adrenalin and the fight-or-flight response, periods of fear and terror are incredibly vivid, where all your senses and systems are alert and poised for danger. But, usually, the source of the danger or fear will go away (especially given our overly paranoid brains). The brain recognizes that there was a threat, but now it’s gone.
You were in a haunted house, and now you’re outside. You were hurtling through the air on the way to certain death, but now you’re on the ground and alive. You were hearing a terrifying story, but now it’s finished and the bloodthirsty serial killer never appeared. In each case, the reward pathway is recognizing danger that suddenly ceases, so whatever you did to stop the danger, it’s vitally important that you do that next time. As such, it triggers a very powerful reward response. In most cases, like eating or sex, you just did something to improve your existence in the short term, but here you avoided death! This is far more important. On top of this, with the adrenalin of a fight-or-flight response coursing through our systems everything feels enhanced and heightened. The rush and relief that follows a scare can be intensely stimulating—more so than most other things.
