DAILY SLICES OF LIFE

Living with Fear

“My mind is on a constant roller coaster ride. I cannot quiet my thoughts. They are so repulsive to me that I go through intense feelings of anxiety and panic. When they begin, I feel like the world is closing in around me. My body begins to shake, and my nerves become raw. I get instantly dizzy, and feel like I could faint at any moment.”

         These words, spoken in terror, were expressed to me by one of my patients at 4.00 am, shortly after awaking from a tormented, restless sleep. The patient, at that time, was describing the feelings of hopelessness and desperation she experienced as she was overcome by a severe attack of fear. The sentiments were clearly meant to convey the intense pain, urgency, and inadequacy that was being experienced at the time, caused by an acute phobic reaction.

         These events, commonly called Panic Attacks, occur as severe manifestations of overwhelming anxiety that may follow uncontrolled episodes of real or imagined fear. These are the events that led Baz Luhrmann, a very successful Australian film director and author, to equate the long-term damage that this fear can do to people, causing them so much emotional loss that they live only half their lives:

                     “A life lived in fear is only a live half lived.”

         The much-dreaded word “Phobia” is a term used to describe the state of severe, persistent, and irrational fear that causes a person to feel intense, unmanageable anxieties for which there seems to be no solutions. It affects people of all ages, and all intellectual, income and social levels. It has no respect of geographic or racial differences. These episodes are among the most common psychiatric illnesses in women of all ages, and the second most common in adult men. They are often associated with specific triggers, which appear to be consistently present on every occasion. Sometimes the trigger, which may include such situations as heights, enclosed spaces, darkness or specific insects or animals, which can at times be readily identified, but for most of the time, because of an associated intense emotional fear of impending doom, they cannot be easily understood.

         Their outward manifestations may vary widely, ranging from mild symptoms that cause little significant inconvenience, and readily managed, to full-blown panic attacks with severe, debilitating manifestations that may include restlessness, shortness of breath, irregular heartbeats, profuse sweating and uncontrollable shaking. In extreme cases, the symptoms will immobilize the patients to such an extent that they become prisoners in their homes, unable to perform even the simple basic activities of living. This led Michael Crichton, an American physician and very successful author of several best-selling books related to the expressions of fear, including Jurassic Park, to declare:

“At the edge of chaos, unexpected outcomes occur.

              The risk to survival is severe.”

         A variety of theories have been offered by Psychologists to explain the reasons and causes of these fear responses. It is generally accepted that they are the product a complex mixture of a variety of inherited and instinctual psychological and biological factors that are compounded with acquired attitudes and bad experiences. In any single case, a diagnosis can only be made after a review of the patient’s social, environmental, family and life history, which must also include such basic factors as heredity and genetic considerations. All of these, working together, will have significant roles in the development and continuation of the disorder and contribute to the individual’s inability to cope. Sadhguru (Jaggi Vasudev), the highly respected Indian yogi, and author of several well-received books, very effectively described the effects in these very real, easily identifiable terms:

 “The fear is simply because you are not living your life,

 you are living in your mind.”

          The true fact is however is that the emotion of Fear when it is used as it was intended to be used by nature, can be a very important asset to the average individual, mainly because it is has the ability to alter the person’s perception of reality in a variety of ways. In normal settings, it serves to heighten awareness, sharpen perception and activate thinking and reaction in the face of actual or potential danger, and in so doing, improve the person’s ability to cope with the threat; and therefore, enhance the chances of survival. In many ways this fear is the body’s way of protecting itself by initially sounding the alarm, and then, by improving the ability to discern the severity of the threat, as well as in taking the necessary steps to prepare for a defensive response. To do this, it relies on a highly developed vaso-vagal system to stimulate attention, increase alertness, and prepare the body to respond accordingly. All of these changes take place spontaneously, and to a significant extent are, by themselves, instrumental in securing a continued normal life and living under varying threatening situations. Ralph Waldo Emerson, the 19^th century American essayist, philosopher and leader in the transcendental movement, was quite clear in delineating the beneficial role of fear in his life:              

“He who is not every day conquering some fear, has not yet learned the secret of life.”

         When however, for any number of real or imagined reasons, these normal fear reactions go wrong, then, like swimmers trying to swim against the current, we quickly lose perspective, and make things worse by going in the wrong direction. Then instead of being the effective alarm warnings they were meant to be, the fears take hold of our life, and far from being helpful, they now become our worst enemy. They overwhelm and alter every aspect of our physical and mental well-being, and induce severe, mind-changing alterations in thinking and in behavior. The feelings of constant fear they produce can create havoc in the unprepared minds, forcing them to alter their perception, respond wrongly, and overreact to situations, often leading to their own detriment. If allowed to continue, every single aspect of human activity can become involved, causing significant interference and ultimate deterioration. They induce severe changes in the brain, affecting memory, recall and interpretation, leading to loss of the ability to recognize and process information, to regulate emotions, and to a tendency to act out impulsively. All of these effects have the net result of distorting perception, interfering with thinking and leading to wrong conclusions. This fact was instrumental in causing this Unknown Author to correctly declare:

  “Fear is the strongest illusion. It literally has the ability to cripple your mind. So, make sure you don’t let it do so.”

         Indeed, fear does create strong ‘illusions’ in the brain by changing the messages the brain receives, inducing the wrong interpretations, and distorting how they are processed, stored and recalled. In these unfortunate people, the brain becomes inundated by repeated messages of fear and doom, and as a result, forced to adopt stronger defensive attitudes to avoid the potential consequences. But even if these consequences never come to pass, the distorted attitude remains embedded in the psyche as the new standard, replacing the older beneficial responses. So that, in the future, it will be recalled each time a similar threat appears, and on each subsequent time, the response will necessarily be more exaggerated. This is precisely what led the late, great President Franklin D. Roosevelt to declare during his first inauguration speech:

 “There is nothing to fear, but fear itself!”

          Unfortunately, once it becomes embedded, this type of unrelenting fear cannot be easily eradicated, nor will it disappear by wishful thinking or by simply following other people’s advice and admonitions. These, on the surface, may appear as plausible solutions, but they will not reverse the damage done to the normal brain’s altered recall and memory systems. This is the reason why the initial reaction of just trying to encourage them to ‘forget about it’ is unhelpful. But yet, a great deal can still be achieved in alleviating the severity of the symptoms by others actively trying to adopt the correct supporting approaches. These include being present and supportive, encouraging them to understand the causes of their fears and trying to neutralize them, or if this is not possible, finding ways to rationalize their existence. The aim always, is to encourage the victims to avoid having to hide from the unknown, and instead, to embrace and understand it, even if they do not agree with it.

           Isabel Allende, considered to be among Chile’s most successful authors, and, is herself a person who had to live through intense fears in Chile during the Pinochet period, was only able to cope with her incessant fears by devoting herself to constantly trying embrace it and understand its mechanism. She explained this quite clearly in the following quotation:

 “Fear is inevitable. I have to accept that!

But I cannot allow it to paralyze me.”

-Without any doubt whatsoever, so long as we are alive, fear itself is an inevitable component of living. So that, in all things that matter, it is never the actual fear of the object that really matters, but rather, what the mind perceives of its effect on us, that does the greatest damage. This message must never be lost or abandoned however daunting, the horizon appears to be.

 

 

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 [EM1]