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Neurophysiology of fear
The Human being is a multilevel person
Our nervous system (NS) consists of mutually supporting elements which were developed at the different stages of the evolution. There are basic levels which unite us with much more ancient forms of life; there are also superstructural elements which are relatively newer from the evolutionary point of view: they are the unique patrimony of a human being.
Fig. 4. Neocortex is a “human brain”; limbic system is our “animal brain”, and our “reptile, or lizard brain” is located in the brain stem. In this figure you can see several elements of the limbic system: thalamus, hypothalamus, amygdala, hippocampus, and a basal gland, all of which take part in the way our body reacts to any incoming message.
“Reptile level” is our brainstem: this is what unites us with dinosaurs, turtles, and crocodiles. “Animal level” is our limbic system, which we share with cats and dogs. Finally, there is the human brain, per se; it is called the neocortex, and it is what makes us unique. All of these elements coexist within our nervous system. Of course, such a division is only relative since dinosaurs also had a cortex. However, the cortex plays a far more important role in the life of a human being. To a large extent evolution can be viewed as “embraination”, or cephalization, as it was noted by a famous philosopher Pierre Teilhard de Chardin (1881 – 1955).
Nevertheless, there is a more primeval nervous system; it is autonomous, and it is also referred to as “autonomic” which is represented throughout the body with ganglia, which look like “beads” along the spinal column (for instance, in the solar plexus) and even in some organs like our heart. One could observe the following principle: the lower we move down our body, the older the structures we encounter there.
There are several elements of our body which we share with annelid worms and even with hydras.
Our tender cortex
The cerebral cortex requires very delicate conditions to do its work. It is a well-known fact that it has little resistance to various injurious effects such as oxygen deficiency or the poisoning influence of ethanol. If the brain remains without oxygen for 5—7 minutes, its cells begin to die. In case of alcohol intoxication, the cortex starts deteriorating. However, the subcortex is much more resistant to harmful influence. The spinal medulla can remain up to 24 minutes without oxygen, while ganglia of the autonomous nervous system continue functioning without nutrition for many hours.
Emergency situations disturb the fine-tuning of the mind and take it to the realm of ancient survival instincts. When our intellect finds itself in a critical situation and it cannot find any optimal way of reacting to it, it “forwards” this task to the older structures of our mind. It is the place where our mind stores survival experience gathered from millions of years of evolution and this is what may lead to the altered state of mind.
Fright and primitive instincts
It also happens in the cases when the control of the situation is lost due to intoxication. A typical example in such case would be alcoholic intoxication: functioning of the cortex is temporarily slowed down, and a person is overwhelmed with primitive emotions, with aggressive, sexual or other desires which he or she can hardly control. There’s a reason why people say “Wine is in, truth is out”. There’s a similar reaction when a person is under anaesthetic. As you can see, if our cortex analyser fails to complete the task, the amygdala (the brain’s alarm dispatcher) redirects the task to the more stress-resistant structures. Our “subcortex” and autonomous nervous system step in. In these cases, the following behaviours are activated:
a) Bursting with energy and fighting for life;
b) Running away;
c) Preserving energy, “going into the sleep mode”, hiding.
There are not many options to choose from. Something happens that we are not ready for. The signal is sent to the higher divisions of the brain. Our intellect cannot find the solution. A person feels confused.
There’s a shift towards the primitive survival strategies; the autonomic nervous system is activated: reactions like “shock affection” or “apparent death” take place.
Fig. 5. Signal routing when an emergency situation takes place.
Like a bee against the window
It is a good moment to remind you about the observation of Ernst Kretschmer (1888—1964), an outstanding German clinical therapist. In his work “Hysteria, Reflex, and Instinct” first published in 1923 Kretschmer describes the way a bird or a bee behaves when it accidentally flies into a room. In its striving towards light it becomes hectic: “The creature is flapping and fluttering, moving chaotically from side to side; these movements repeat as convulsions until it finds its way through the window to freedom. Then normal flying movements are immediately restored” (Kretschmer, 1996, p.15)
Kretschmer saw the analogy between the above-mentioned behaviour and the way people behave in extreme situations. Thus, during an earthquake the crowd typically behaves irrationally and chaotically. But even these chaotic movements can be life-saving.
Two soldiers in the command unit
Kretschmer also gives another very bright example: “Two soldiers are incapable of dealing with the horrors of war. The first would think about his neat handwriting, his technical skills, and connections at home; he would consider the pros and cons, make several clever steps and would finally find himself working in a quiet office. The other is found in the trenches after heavy artillery shelling; his eyes are shifty. He is taken away, he begins to shiver, then he is taken to the psych ward and after that he is sent to work the garrison service where he meets the other soldier in the quiet office busy writing.
There are two ways: one is exclusively typical for human beings only, while the other is an exemplary biological reaction which the whole animal sequence goes through: from unicellular creatures to a human being. (Ibid., 14—15). Then Kretschmer draws the following conclusion:
“A movement storm is a typical reaction of living bodies to life-endangering situations. A movement storm is self-help of relative biological use”
(Ibid.)
It is quite interesting when this reaction is compared to the behaviour of children; he notes that as a reaction to unpleasant situations there’s screaming, pushing and lashing out instead of adults” balanced words and movements (Ibid., p.17). More than that, he also points out the fact that adult people manifest the tendency to approach a new situation with a calculated action, and only in some extreme situations an adult would react with a “movement storm” (Ibid., p.16).
Freezing
Kretschmer reminds us about another widespread response to danger which is typical for many living beings, which is: “apparent death”. Some kinds of fish are capable of “freezing” up to 15 minutes and sometimes even longer while lying on one side. This is a defence mechanism which helps the animal hide from and look unattractive to the predator.
According to Kretschmer, such responses are “something frozen, as a formula, squeezed into the fixed template without any flexibility in each particular case” (Ibid.)
Psychological emergency mechanisms
A driver uses the steering wheel, brake and gas in order to adapt to the motion of his or her car to the situation on the road and get to the destination successfully. This is how our rational mind helps us adapt to new situations and overcomes challenges in the course of our lives. This is an adaptation of repeated use, which is activated in normal conditions.
However, there’s also an airbag installed in the car. It is activated in case of an accident and does not require a driver’s specific actions. This is how our bodily mind or our autonomic nervous system reacts to the situations which our body identifies as “an emergency”. When our latest “instrument” doesn’t respond, the primitive one steps in, and in this case we are talking about a single-use escape plan with a limited number of strategies (attack, escape or hide), as we have already noted earlier.
Once having been put into use, an airbag will require a replacement because it just won’t return back to where it was before. The psychological emergency mechanisms work similarly: once activated, they have a tendency to repeat non-stop. Time doesn’t really heal anything in this case. Such conditions become chronic or, as psychiatrists say, “processual”. Thus one would need to take conscious action in order to turn these mechanisms off and bring the body back to normal functioning.
And now let’s have a look at what a person feels when he or she is going through this. This is very important because the key to cure phobias and other psychotraumas is all about addressing one’s feelings.
Phenomenology of fear
Out of the blue: how one perceives a danger alert
When describing an episode that led to a disorder, many describe it as “something that hit me mildly on the head”, “it’s like hot water was poured on me” or “like something went through my body”. Shocking information is perceived as something appearing “out of the blue”.
However unusual and even sometimes strange these descriptions may be, they all share the same features. Hundreds of people whom I have worked with in the course of my research claim that at the moment when they got scared, they felt like their bodies swallowed something which has been poisoning their lives ever since. There’s a feeling that this substance moved down to their stomach where one starts feeling an unpleasant sensation whenever the terrible situation which caused this is merely mentioned. In some particularly difficult cases this substance is clearly associated with a poison that infects every cell of the body.
There’s an expression “my heart leaps into my boots” where “heart” is actually your vital energy which moves down to your stomach when you feel frightened. As a result, the top of your head and the surface of your body feel cold. A rapid transfer of energy from the periphery to the centre is taking place.
Vacuum unit
Imagine a vacuum tank that suddenly depressurises. Everything that is around is sucked into it. If this machine was close to the gold bearing river full of golden nuggets, it would suck in all that too, including the sand, and the pebbles. Something similar happens to a person at the moment of confusion: interior space of the body drags down information, including everything that seems to be terrifying.
Fig. 6. When we are faced with something unknown, we often feel at a loss. Such reaction can be seen in the self-portrait titled “Frightened” by Zinaida Serebriakova (circa 1917). The Girl’s eyes are open wide, and her mouth is open too. When there are no reasonable solutions to be found, there is a sensation of emptiness inside. When the “emergency” signal is “sucked into” the area of the solar plexus, the process of “sensibilization” takes place.
When frightened, people open their mouths and eyes widely, make signs of dismay and then sharply inhale.
At the level of our sensations, this is exactly the moment when information is “sucked into” the head, chest and the solar plexus, which could later cause a phobia.
Rely on sensations
I treat these descriptions of the sensations as useful clues which could prove very helpful in the course of healing. They should be taken into consideration within the constraints of their own logic, that is: as they exist. You can hear the following description: “It hit me like a ton of bricks, and the dust from them got under my skin,” because this is actual feedback on the processes that are taking place in the body.
Evidence from spatial perception lays the foundation for further work.
Your bodily energy and wisdom is where your attention goes!
In order to restore the process, you need to establish a back-and-forth connection with it. As soon as this connection is established, you get the access to control the processes which earlier seemed uncontrollable. This includes the processes at the level of the autonomic nervous system.
An important discovery of Psychocatalysis is that when attention is paid to the sensations in the interior space of the body, one is able to establish the necessary connection with the processes that take place at the autonomic energetic level, and thus one gets to control them successfully. More than that, this is pretty much the only actual way to access these processes.
One of the principles of our method says: “Energy and reactivation of regulation is where your attention goes.” As soon as a person starts noticing something in his or her interior space, an influx of energy is directed to it, and the process reactivates. However, there is a second factor that also plays an important role, and it is comparing the actual state with the ideal condition. It is our attention that contains information about our ideal state and to what extent our current state differs from it. Any process in the body, once it finds its reflection in the mirror of our attention, begins to turn itself around. That is why we would like to add the second principle to the first one about attention and energy: “Your attention guides you to the wisdom of the body.”
The two components
In the descriptions given by the people who suffer from phobias two components can be singled out:
• Head (or “cognitive’) component: images, thoughts, fantasies about the traumatic incident;
• Bodily (or “sensory’) component: sensations in the body connected with the danger signal and the reaction to it.
Healing from phobias through Psychocatalysis presupposes careful attention to both levels of our consciousness. Psychocatalysis as a cognitive-sensory therapy differs from other psychotherapeutic schools in the way that it appeals to the processes at the level of the atomistic nervous system and to the sensations and energy as it actively works at the levels of both the central nervous system and the intellect.
What one should strive for and what one should avoid
In our body, the solar plexus has a priority for storing information. As a rule, this is where the information about what to strive for and what to avoid is kept.
Useful information usually makes its way to the solar plexus gradually: it is absorbed from the exterior, concentrates in the forehead, then it moves from the head to the chest, and then finally goes down to the stomach. This is how a person enriches him or herself and becomes more competent. At the moment when a person feels lost and confused, unchecked information makes a meteoric decent within the space of our mind. Such unbalanced “competence” turns into a curse for a person.
Imagine there is a man who is going on holiday in a week’s time. He watches the news about a plane crash on TV. This is a tragic event; however, it has a very remote connection to his trip. Anyone would feel sorry for those who lost their lives in this plane crash and for those who would bear the burden of the guilt for this happening; this is a moment to pray and to sympathize with the relatives of the victims. Nevertheless, life goes on, and one needs to move on, too. Every trip has its risk but an adult person usually feels ready to take it.
What happens to a person if he or she is made unstable by such of information? This person will feel confused and with that “vacuum” feeling inside. Fragments of the burning plane will get “sucked into” the solar plexus. The state of shock passes, but the person seems completely different: a “black substance” remains in the mind. The topic of air travelling becomes a sore spot, and reason, having lost its ground, cannot restore its power. Arguments like “planes are the safest kind of transportation, and millions of passengers land safely in their destination points” are no longer convincing. Moreover, it’s doubtful if this person with the plane “debris” stuck inside can really enjoy his or her holidays when there’s a plane home to keep thinking about.
This is how information about danger, whether it is real or imagined, begins to play the main part in the life resources management centre at the moment of instability, and that completely changes the life of a person.
I would like to show an example of a practice which demonstrates how this can be cured.
Highwaymen
Boris was on his way to the countryside when he was falsely accused. As he was changing lanes to the right, he heard a strange noise. It was unclear what exactly happened. A black car, which had been moving behind him, started signalling with its headlights. Boris stopped.
Two people got out of the car saying that Boris had scratched their vehicle and broken a mirror. Boris got out of his car. He saw a small scratch on their mirror, but it also looked rusty and old. While Boris was talking to one of the men, the other made a couple of steps along the car and made a mark with sandpaper on the side that Boris had allegedly scratched. Boris thought that they must have thrown a plastic bottle at his car earlier, and now they were falsifying the rest of the evidence.
One against two; both men were wearing black leather jackets and definitely looked like veterans of the Afghan war.
He tried to phone friends for help but they didn’t pick up. Moreover, Boris was a thirty-minute drive away from the city. He couldn’t even say where he was exactly. Even if anyone could have helped him, that would have taken time.
Intimidated, Boris made a decision to buy them off. After some negotiation, he paid them $300. His troubles were over, and he was able to continue his trip, but what were the consequences?
During the psychotherapeutic session Boris feels that some “darkness” has entered through his spine, at the level of kidneys. Something that looked like a saucepan full of dark beetroot soup. It was then when Boris realized that he stopped enjoying going by car to the country.
In the process of self-regulation Boris let this “dark soup” spill out away from his body. His spine become “whole” again.
He also created a backup plan for possible similar situations. Should he carry a gun? That would be too much. Should he call the police? Sounds much better. Should he call the authorities or should he just deny all the demands of these racketeers? While Boris was considering his options, he went back to his feelings. In his inner vision toads and crocodiles begin to jump out of his back. These were his fears which he had been accumulating about meeting strangers on the road. Then there were numerous pictures of corpses coming from the back of his head. These were the words of eyewitnesses, coming mainly from TV programmes. During the “tough” nineties in Russia one heard endless stories about highwaymen. Their trick was to use falsified evidence as an excuse to intimidate their victims.
Closer to the end of the session Boris made a sensible decision:
“If I ever meet such people again, I will be firm, write down their number plate, call the police and tell them that my insurance will cover it.”
These words are the evidence of the reverse process: that “dark soup” was pouring out of his kidneys, those “toads and crocodiles” were coming out of his spine, and the “pictures of corpses” were “flying out” from the back of his head.
After the session Boris felt like a new man.
1.4. Other ways of working with phobias
Hypnosis and archaic practices
Once a woman who was suffering from a fear of planes came to an appointment with the famous hypnosis specialist Milton H. Erickson. The doctor sensitized her for an imaginary flight and made her believe that if she landed safely, her fear would slide off the seat and be gone. When the patient realized that, she jumped up from the seat screaming “It’s contagious!” and wouldn’t let the doctor’s wife, Mrs. Erickson, sit on this seat, trying to protect her from the danger. This is another way of working with phobias. One more example is the practice of “ebbing the fear” which comes from traditional practitioners. They part from the idea that fear goes into the body. Then the healers create a special condition to remove fear from the body. The healer pronounces the spell and pours melted wax into a bowl filled with water that is held above the patient’s head. Both the healer and the patient expect the fear to move to the wax. When the wax solidifies in the water, the form it takes should reveal the real former fear of the patient. For example, if the patient was afraid of dogs, the wax might take the shape of a dog’s face. This also serves as proof for the patient that the fear is gone. When I went to Bashkiria, I learnt how fear was understood in the local shaman practice. During the seminar, there was one participant who was really interested in the customs and traditions of her people. According to her, the moment the person is frightened, he or she loses a part of their good soul, and a dark spirit settles inside.The task of the shaman is to find the lost part of the soul and send away what wrongfully entered the body. I would say it partly looks like what we witness during the psychotherapy sessions. What is the difference then?
Expecting a miracle
In the above-mentioned examples a patient is looking forward to the fear moving away, be it sliding on the seat, pouring into the wax or going to the centre of the Earth (which is what shamans in Siberia do). Expectation should trigger some sort of work in the body which will eventually lead to the healing. However, neither hypnotist, nor healers nor shamans tell you how exactly this result is achieved. It is impossible to trace what is hidden in the core of the process. There’s only the expectation of the miracle.
Both parties, the healer and the patients, hope that liberation will take place. This is an option of “righteous expectation therapy’: if you hope for something positive, it will definitely happen. Nevertheless, the result is not at all guaranteed because the whole process is delegated to the subconscious, and it just cannot do all the work by itself. The patient cannot just play a passive role in this process.
Trance is not enough
Neither auto-training (autosuggestion), nor meditation of the general character really work in case of phobias and other traumas. “Formulae of auto-training” set the idea of striving for an ideal condition but they do not offer any step-by-step instructions on how turn a halted psychological process around. In serious cases these methods are futile. Trance as such, without any active participation of consciousness, can be healing but it might be considered more like luck rather than an efficient method. The same applies to other methods which are aimed at non-directive activation of nervous and psychological processes (holotropic breathing, etc.)
To understand is not enough
There are completely opposite approaches which presuppose addressing the intelligence of the patient: “Don’t you see that your fears are ridiculous, and that you can easily overcome them?“Of course, such kind of understanding is important but it is not enough for healing oneself from fear. Increasing one’s level of competence doesn’t have that much influence at the autonomic level. The head can understand that there is nothing to be afraid of, but once the object of fear is mentioned, a sinking feeling will appear in the stomach.
There’s a curious story about a patient in therapy who imagined that he was a seed and was afraid of being pecked by a rooster. After various therapeutic sessions his doctor asked him: “Well, do you understand that you are not a seed?” – “Of course, I do! I am a person!” – “Will you go home without worries?” – “No, doctor.” – “Why?” – “Because I know I’m not a seed, but does the rooster know?”
Understanding creates some background which can make further work with the autonomic nervous system more efficient but unfortunately it cannot automatically unblock the initial reactions of the body.
Synthetic practices
One should pay special attention to the following synthetic practices based on Pavlov’s neurophysiological research.
Ivan Petrovich Pavlov (1849—1936) and his supporters while studying the physiology of nervous processes came to the conclusion that in cases of impulsive obsessions, nervous processes lose their typical agility, there is certain inertia of nervous processes, and it manifests in congestive centres. (Pavlov, 1950).
Joseph Wolpe (1915 – 1997) was a South African psychiatrist who parted from Pavlov’s research of conditioned reflexes and developed a concept of neurotic fears from the point of view of learning theory. At a certain moment “a body learnt” to treat some factor with fear. Now it has to learn how to stop doing this. “If your fears are automatic emotional habits, then you will have to use different emotions to destroy these habits. If some of your fears appeared due to disinformation then we will provide correct information (Wolpe, 1982, p.87). He introduced “systematic desensitization’: a patient is brought to a very relaxed state and then he or she is subjected to a light stimulus that causes fear. Once the patient has acquired tolerance to such a level of anxiety, the dose of the stimulus is gradually increased until the patient gets accustomed to the bigger dosage and considers it low, which would then lead to a decrease of anxiety. (Wolpe, 1958, 1961). This approach was named, behavioural therapy.
It is essential that the process of adaptation is gradual, and it is based on the fact that the patient is relaxed and well informed. However, there is one issue that is left out when this approach is taken. The signal that has gone deep into the body and that has activated the autonomic system is ignored. Thus the new reaction is imposed “over” the old one. This slows down the treatment and doesn’t actually set the patient completely free from his or her internal fear fighting.
There is another method based on Pavlov’s neurophysiological approach. This is a method of working through traumas which relies on eye movement activation (Shapiro, Francine, 1996). The foundation of the method is a highly interesting observation. When a person stops looking for solutions, the frustration settles in, and his or her eyes seem to stop, and it looks as if this person is gazing into space. In contrast, when a person is trying to find a solution, his or her eyes are moving actively. In order to help a person overcome the inertia of nervous processes, he or she is motivated to move his or her eyes. The therapist moves his or her hands in front of the patient’s face and thus sets the direction of the patient’s vision. The directions can be the following: left-right, diagonally, in a circle or figure eight. The movements must be quite quick. Just as the eyes begin to move, “impulse movement” is triggered in the brain. When the stagnant focus begins to “blur”, the chance comes to work through the traumatic experience.
This approach can provide quite useful results in some cases, though it is still artificial. I have never applied it in my practice. If I reconnect the attention of the patient with the aspects that are holding his or her mind and nervous processes, then the release happens automatically, with great precision, a full-scale feedback, with the total participation of the patient and understanding of the significance of the process. Further on I will try to demonstrate it with examples.
Having paid my respects to my colleagues, who have been working on the idea of counteracting fears and other conscious fixations, I would like now to describe my own approach.
Conscious self-regulation: Psychocatalysis
Self-regulation based on the primary sensations is a mild directed alternative to other kinds of therapy which appeals to the subconscious (meditative techniques); it may also serve as a supplement to the kinds of therapy that work with the conscious mind (analytical techniques).
A patient can observe the processes that take place in his or her mind, and the result depends on the patient, on his or her decisions and not on favourable circumstances or the authority of the healer. This is a method of internal work: it’s reliable, simple, natural, and fast.
Let’s have a closer look at the details.
