In this post I examine our fear response, and how what once helped us become the dominant species on the planet now can hold us back.
This post will involve some biology, some neuropsychology, some social psychology, and, don’t worry, plenty of bad jokes and GIFs.
Without further ado, onto the post!
All About Fear
No, not the 1996 movie Fear featuring Marky Mark Wahlberg and Reese Witherspoon as well as a soundtrack relying heavily on songs from Bush’s album Sixteen Stone.
Also not Fear Street, the teenage horror fiction series by R. L. Stine. (Although I did read a lot of his watered-down horror series Goosebumps as a kid).
Today we’re talking about the emotion.
Fear is both the unpleasant feeling that something bad is about to happen and a response to any potential threat.
It is a deeply-rooted reaction honed and conserved evolutionarily over eons by organisms (thanks primordial ooze!) to protect against perceived threats to survival.
Except in honey badgers. They don’t fear anything.
A Brief Detour in Neuroanatomy
Our fear centers are found in our amygdalae, the almond-shaped nuclei located in the temporal lobes of our brains. While that’s an oversimplification of what all they do, I’ll run with it here.
Our amygdalae essentially add emotional context to our information processing and activate and drive appropriate responses to stimuli.
The information processing component is important because it also includes memory formation. We are hard-wired to remember that which scares us.
Your Brain's Impetus
Remember the motivational triad mentioned in previous posts?
As a refresher, our brains strive for three things to serve their prime directive of keeping us alive: 1) avoid pain, 2) seek pleasure, and 3) do the former two with the least amount of energy expended.
The overriding motivation, however, is avoiding pain (and, by extension, those things which may cause us pain).
Behavioral psychology shows us that the experience of a loss stings twice as much as the joy reaped from an equivalent gain.
For example, losing 20% of our nest egg when the stock market drops hits us doubly as hard as gaining 20% during a market run-up.
Similarly, one lousy part of our day can ruin an otherwise remarkably successful day. As physicians, we are especially prone to this given our tendency to succumb to perfectionism.
Unfortunately for most of us, nothing shapes our experience of life quite as strongly as fear.
Heck, we even devote a holiday—Halloween—to it.
Fear Is Useful
Now fear is useful when our lives and existence are actually threatened.
The amygdala-mediated “fight or flight” response can be the difference between life and death if confronted, for example, by a bear in the wild.
Pro-tip: always make sure you’re faster than at least one other person you’re with. 
Real pro-tip: you can’t outrun a bear. 
Such quick recognition of danger and activation of the sympathetic nervous system can keep us safe.
Our brains are always scanning for threats. It is background activity for the brain and we’re mostly unaware of it.
It’s one main reason that brain activity accounts for about 20% of our basal metabolic expenditure! Keeping our asses safe is exhausting!
A Life Without Fear
What would our lives look like without this fear response?
There is a medical condition called Urbach-Wiethe disease in which one potential manifestation is eventual destruction of the bilateral amygdalae.
One patient who had this disease (dubbed the “woman with no fear”) was studied longitudinally, and the results were fascinating. She:
- was very outgoing, extremely friendly, and uninhibited
- did not recognize social cues
- could not gauge others’ facial expressions
- lacked a sense of personal space
- displayed no fear in handling snakes or spiders
- could not detect and avoid danger in her environment, and experienced a disproportionate number of traumatic and life-threatening events without psychologic repercussions
- experienced little negative emotion
She unfortunately kept putting herself inadvertently in harm’s way due to her lack of a fully intact fear response and inability to recognize fear in others.
I told you fear is useful!
Fear in Today's World
Unfortunately, fear does not serve us as readily in the stable, safe environment that is modern society.
In fact, when archaic threat detection meets the modern world, fear responses often manifest in maladaptive ways.
Risks of physical harm are generally low (notwithstanding domestic abuse, etc.) but our brains cannot turn off this ingrained threat detection system.
So given the lack of threats to our physical wellbeing, our brain channels the fear response to modern “threats” such as rejection, loneliness, getting hurt (emotionally), and even boredom.
Fear or rejection or getting hurt can keep us from seeking out meaningful relationships.
Discomfort with boredom keeps us buffering away eating, boozing, glued to our mobile devices, or even using illicit substances.
Fear of taking action can trap us in our status quo.
Think of physicians working in toxic environments, burning out, but not moving on because they don’t want to appear weak or fear not being able to find other employment (in some cases this latter concern is valid, but more often than not, it isn’t).
Herd Mentality
A large part of preserving our status quo is to remain part of the herd and not stand out. Following herd behavior is protective as there is “safety” or “strength in numbers,” right?
You don’t want to be one zebra frolicking off away from all the other zebras because you will be singled out by the pack of lionesses on the hunt.
Similarly, if you are the person going against the grain or doing things that others aren’t—advocating for change in medicine, calling out abusive practices in medicine, pursuing entrepreneurial endeavors, busting out your sweet polka moves at a wedding—your brain will be screaming at you to stop and get back to the safety of being ignored.
Same thing happens when your toddler has a meltdown in a public place. Our cheeks flush red as they make a scene due to the anxiety of calling attention to ourselves.
But wait, there’s more!
Here the fear is embarrassment, ridicule, or shame. Often it’s just the potential for these feelings. And these feelings arise when we try new things.
Trying new things makes us stand out from the herd and can result in failure, which further calls attention to ourselves.
What if you fail at something new? What would others think of you?
Sound familiar?
How about “I can’t do…” or “I never have the time to…” or “I’m not good at…?”
All thoughts your brain creates to keep you “safe.”
So to avoid these feelings, we avoid trying new or hard things. Where does that get us?
F alse
E vidence
A ppearing
R eal
Earlier I referenced being confronted by a bear in the wild. That same bear in a zoo would not generate fear because our prefrontal cortex “reassures” the amygdala/emotional response that the bear in a zoo is not a threat
(I still recommend being faster than at least one other person at the zoo, just in case).
The difference? Our thoughts.
We can “out-think” or rationalize our way out of fear!
The first step when you have thoughts like those mentioned above is to recognize them as simply thoughts. They are normal. They are simply evidence of your brain trying to protect you (bless its heart!).
The negative chatter is not some truth that defines you or to which you are beholden.
Also recognize that having those thoughts and the accompanying discomfort means you are taking yourself out of your comfort zone, and that’s a good thing!
You are taking action and steps towards transformation in spite of the fears your brain is throwing up as obstacles!
Brooke Castillo of The Life Coach School often says, “Discomfort is the currency of your dreams.”
She also says, “The more uncomfortable you are willing to be, the closer your life will align to what you want it to be.”
Embrace the discomfort. Embrace the suck. Fear can be the indicator that you’re on the right track!
You’ve got this!
How does fear show up in your life? How do you overcome your fears? Let me know in the comments section below!
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