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Sunday, December 22, 2013
"Outsmart Your Brain"
Outsmart Your Brain: Use the Science of Fear to
Tackle Your Biggest Challenge
by Carolyn I. Rodriguez, M.D., Ph.D.Dec 21, 2013
"Do one thing every day that scares you." -- Eleanor Roosevelt
I look down into the shallow end of the swimming pool. I take in a big, deep breath. I review my list: I signed up for an adult learn-to-swim class -- check. I'm scared -- check. My heart is beating faster -- and I look for the nearest exit. So, I'm asking myself -- why is this good for me again?
To answer this, I need to understand what it means to be scared.
Fear is an unpleasant emotion we feel when threatened. During a threat, a part of our brain called the amygdala, a tear-drop shape of cells located deep within our brain, can set off a chain reaction that prepares us to respond. The amygdala tells other parts of the brain and the body to secrete chemical messengers that make us more alert and ready to respond. These messengers also increase our heart rate and blood flow to muscles. This helps us get ready for confrontation or running away (this is called the "fight or flight" response). Our brain also can protect us from pain if under attack by releasing messengers called opioids, which numb pain and make us feel like life is just fine. Once a threat has passed, our brain quickly and powerfully records all the details of the event to help us be safe next time by boosting brain cell connections that associate that specific threat and danger.
How can we use this understanding of fear to help us tackle our biggest challenges? Luckily, very effective tools for facing fear have been developed to help treat individuals who suffer from too much fear (like certain types of anxiety disorders). One of the most effective treatments is a form of cognitive behavioral therapy called Exposure and Response Prevention (ERP for short). ERP systematically helps people face and thereby overcome their fears. In this treatment, together with the therapist, a person starts by making a ranked list of feared objects or situations, from least to most distressing. The treatment then involves gradually facing each list item, with the help of a therapist, going from least to most scary, like climbing up the rungs of a ladder. Over time, fear fades.
No matter what kind of fear you or I have, we can use ERP to outsmart our brain. By facing, even embracing, our fear, we can trick our brain into releasing those opioid chemicals that reduce our fear and give us a feeling of comfort. The more we face our fear, the stronger the links become between our biggest challenges and safety -- in other words, we succeed in mastering our fears. Doing this gets easier and easier. It also may give us a sense of accomplishment.
For example: Are you afraid to speak in public? To ask for a raise? To declutter? To swim (like me)?
Here are 6 practical steps to start today to tackle your own challenge:
1. Make a list This is a list of things you are scared to tackle -- from least to most scary. Once you have the list, work your way up the ladder.
2. Get a coach We need someone to help us overcome our brain's survival mechanism to battle or run away. This can be a swim coach, personal trainer, therapist, or other trustworthy confidant.
3. Break it down Once you have your topic, let's say it is swimming, break it down into smaller, manageable steps that can be mastered to leave you less afraid. How did my swim coach help me on the first day? By asking me to just put my feet in the water. Doable right? Then, we slowly worked my way up to my head, the toughest of all.
4. Build a routine We are creatures of habit. By setting a time to practice, we can make becoming fearless a routine.
5. Be kind to yourself Replace thoughts of "I can't do this" with "I'm doing the best I can." Pause regularly and take time to consider how far you have come. Progress may not be immediate or always straightforward, but in time it will be. Keep trying.
6. Show up One day, half way into the swimming class semester, I was surprised to arrive at the pool and find I was the only class member there. I ended up getting additional coaching, which helped me go even further that day. And over time I succeeded. Why? It wasn't because I was the most athletic or coordinated. I just kept showing up. If you too keep at it, you'll be amazed at what you can do.
Carolyn Rodriguez, M.D., Ph.D. Assistant Professor Director, Hoarding Disorders Research Program Columbia Psychiatry
Amanda Levinson, B.A., Research Assistant, Columbia Psychiatry, contributed to this post.