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Regulating Fear

Updated: Apr 25, 2023

The subtle ways that our nervous system

"I'm afraid of being afraid" told me one of my clients. "Maybe you are afraid of not being afraid too" I told them. The assented.

Fear is very present in our lives and once is activated regularly can make us afraid of its presence and of its absence. It can become pervasive and the way we relate to everything around. That's not life!

Fear could be described as an all-consuming brain circuitry designed to provide protection from danger that could also cause great harm to the system and the life of those that live scared.

There is a well-received theory (Barrett, 2019) stating that the human brain constructs instances of fear as a consequence of predicting and inferring the cause of incoming sensory inputs from the body (interoceptive and somatosensory inputs) and the world (exteroceptive inputs). Other views see defensive behaviors as the manifestation of hard-wired fear (or survival) circuits that are controlled and modified by flexible circuits (cognitive). Since there is still a debate of what fear is, there is no clarity in how to control it either. Behavioral approaches of mental health assume that we have some sort of volition over our behaviors and proposes that we either cope, control, or suppress or emotional experiences. It's not as simple.

To start the investigation on how to remove fear from our lives, I like using the approach that sees fear as the motivational system that promotes defensive behaviors (detection, escape, and avoidance of possible sources of danger) elicited from an immediate specific threat cue. I also like combinaning that perspective with a physiological (or affective) approach that sees fear as movement in our organs. If we combine both, then we see that fear needs to be “regulated” more than controlled.

Emotion regulation has become more broadly explained and understood. Emotion regulation involves the coordinated activity of various brain regions and neural networks, including the prefrontal cortex, amygdala, and insula. These regions play important roles in detecting and appraising emotional stimuli, generating and modulating emotional responses, and regulating emotional expressions and behaviors.

When we see fear as the activation of certain brain circuits, the possibility to 'regulate' that activation is what could allow us to regulate its manifestation. Fear can be excessive or irrational but it can increase or diminish depending on the emotion regulation strategy we apply when identify we are afraid. When we experience fear we are feeling the activation of a brain structure called the amygdala, which sends signals to the hypothalamus and brainstem, leading to a range of physiological responses such as increased heart rate, breathing rate, and sweating.

Emotion expression involves the conscious or unconscious display of emotional states influenced by the insula, which is involved in the representation of bodily sensations and emotions, as well as the anterior cingulate cortex, which is involved in the regulation of attention and conflict monitoring. Emotion regulation then becomes handy providing us with a set of actions that are designed to influence our emotional states and our body's changes in physiology. Emotion regulation includes actions that aim to alter the form, frequency, duration, or situational occurrence of events that may precede an emotional response as well as the events that may follow an emotional response, all sharing the similar theme of altering the experience of fear before the occurrence of fear take over.

One components of emotion regulation is cognitive reappraisal, which involves changing the interpretation or meaning of a situation to alter the emotional response. This process is thought to involve the prefrontal cortex, which can inhibit or modulate activity in the amygdala and other subcortical regions that generate emotional responses. The prefrontal cortex, which is responsible for higher-order cognitive functions such as decision-making and emotional regulation, can modulate the activity of the amygdala and other fear-related brain regions. This process is known as top-down regulation of emotion, and it involves the prefrontal cortex inhibiting or modulating the activity of the amygdala to reduce the fear response. Emotion regulatory behavior can manifest in many obvious and subtle ways and include: re-appraisal, distraction, avoidance, escape, suppression, focus, problem solving, and even the use of substances to enhance or blunt emotional experiences (Gross, 2002).

If what we want is to have a healthy and voluntary regulation of fear, we can leverage of what cognitive-affective neuroscience has consistently demonstrated: that higher-order cortical structures, particularly the prefrontal cortex (PFC) and its subunits mediate attempts to regulate emotions. Therefore, activating the PFC is a natural way to regulate fear. You can activate the PFC in several ways, like by assessing the real level of danger, or by noticing your mental and psychical state, by deciding to be in the present, by activating your senses, by managing your thoughts, or by simply regulating your breathing consciously. Attentional deployment, for instance, involves shifting one's attention away from negative or threatening stimuli, process that involves the frontal and parietal regions of the brain.

We can also make use of the characteristics of the parasympathetic nervous system, which is responsible for the "rest and digest" response; it can counteract the sympathetic nervous system's activation during the fear response. We can do this by deep breathing or meditation, which can activate the parasympathetic nervous system and reduce physiological arousal, which in turn, will regulate the activation of the circuits that make us feel scared.

Overall, the regulation of fear involves a complex interplay between different brain regions and the nervous system, with the prefrontal cortex and the parasympathetic nervous system playing key roles in modulating the fear response.

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