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You're listening to Shortwave from NPR.
Hey, short wavers, Regina Barber here, and I'm going to tell you a secret.
I'm scared of pretty much everything.
Heights, the dark, whales, small spaces, plane rides, and I'm definitely not a fan of scary movies.
Some people love to be scared, though.
Like Dr. Arash Javambah, a psychiatrist from Wayne State University in Michigan.
I do love scary movies.
Do you really?
Yeah.
What's your favorite scary movie?
There's two of them.
Exorcist that I watched when I was a teenager and Hereditary scared me a lot.
He loves talking about fear and anxiety so much.
Not only did he make it part of his job, he wrote a whole book called Afraid.
Throughout the book he gets into many of the reasons people are afraid, including the reason he loves those horror movies so much.
I feel more alive when I am in situations like this, because you logically know this is something happening on the TV and these are all actors and actresses.
There's no reality to it, but a big chunk of you, a big part of your psychic being, believes it, understands it.
Because that involves their thrill brain and excitement brain and gives them a sense of control.
I don't know about you, but sometimes it feels like my brain takes this need to control a little too far into the chronic anxiety realm.
But Arash says it's not just me.
Anxiety and fear-related disorders and trauma-related disorders are very common.
The fact is that they are not visible, right?
So we don't see it in each other and I may think I'm the only one.
To break the stigma, I wanted to bring this up.
About 20-30% of the general population pass the clinical threshold for an anxiety disorder.
Anna Rash gets into this important distinction that's very tricky for my brain to make.
The difference between fear and anxiety.
Fear is more directed towards a clear threat.
But anxiety is when I am expecting something bad to happen, but I don't have a clear idea about it.
Both of these feelings can be helpful, though.
Fear is a universal response and system put in all biological beings with one purpose.
To keep us alive forever.
It's one of the most important functions in any biology, which job is to keep us safe and protect our existence.
In human history, fear has kept us safe when running from predators and anxiety keeps us from going back to that line-infested area.
But what happens when these feelings get out of hand in humans today?
Today on the show, fear.
What is it good for?
Why do some people love horror movies?
And what can we do about our phobias?
You're listening to Shortwave, the science podcast from NPR.
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Okay, so Arash, we're going to go back to our human prehistoric relatives.
What is the purpose of fear?
I always say to understand fear, we have to understand fear in the context it evolved.
So you're talking about a system which is very old.
100000 years ago, the threats that our species was facing were very different than the threats we are facing in the modern life.
So if I am talking to a group of people...
My heart is pounding, my body is sweaty, my pupils are dilated, I'm breathing rapidly.
All those experiences, which don't make sense because they are not helping me.
They are basically blocking my ability to function.
But back in time, when we were these tribal animals or more primitive humans, the real dangers and threats in the environment were all physical.
If I was among a group of my tribe mates and things went wrong, chances were high in a matter of minutes I would have to engage in a fight or run away from them.
So sympathetic nervous system this fight and flight system activates to pump the blood to the muscles and put me in a heightened state of arousal and alertness for the maximum optimal physical activity.
And that's why body gets engaged in the way it does, which doesn't most of the times make sense in the modern life anxieties and worries.
Yeah, like I know what you're talking about, this like false alarm, because I'm just thinking about how important of a survival skill you're saying fear is.
But why do some people like really enjoy watching horror movies?
Is it that false alarm?
Absolutely.
We are basically taking advantage of that false alarm.
I mean the biology of thrill and biology of fear are overlapping, because you need the same sympathetic nervous system.
That's what makes you feel alive and excited.
And that's why let's say even like, when you're in love, when you are experiencing joyful experiences, a big part of that system is involved.
Your heart is pounding.
So a lot of overlaps here. contribute to the excitement that we enjoy.
But the other part is that part of this brain or psyche knows what is going on.
So it's like sometimes you people may put a video of a dog aggressively barking on the TV and get their own dog riled up.
And while the dog is barking, you're laughing and enjoying.
So this is the same thing we are doing when I'm watching a horror movie.
So The animal gets riled up.
Yeah.
But the cognitive brain knows what's going on.
But for this, we need a certain level of balance between these two parts.
Right.
Well, and some research has looked into like how horror movies might actually like ease anxiety in some people.
And it could actually like be therapeutic for some people to watch horror movies.
In several ways.
One way is that we know mindfulness helps a lot.
When you're watching a good horror movie or any good movie, you are totally dissociated from all the challenges you have in your life.
Now you are totally there and you're detached from what's going on in the world.
So there is a moment of mindfulness there.
But you also have sense of control here, which means there are a lot of anxieties out there.
I don't have control over them, right?
But here, there's a situation which is controlled.
So I have an exposure to fear.
I am facing some challenges, but I am overcoming those.
So there's a sense of fulfillment.
At the end, I am one of those people who survived at the end of the movie.
OK, totally.
So let's dig more into therapies and treatments because, you know, fear and anxiety can get to levels that can be detrimental.
I mean, like I know that, like at one point I had to take medication just to get on a plane because I was so afraid of turbulence.
So like what can be done when anxiety gets to a point that it's like affecting your life?
One reason I'm in this field is I always say when I train residents and other physicians one reason I'm in the field of anxiety and trauma is that they are so treatable and people don't have to suffer for a long life.
So we have therapies, which is basically different types of talk therapy.
One way is, for example, we talk about the preconceptions that might be in my mind, whether consciously or subconsciously, that lead to me, for example, putting too much weight on how people judge me, leading to my social anxiety and avoiding social situations.
There's also exposure therapy which we will talk about it more later which is basically gradually expose me to more tangible fears.
But then we also have medications.
And when we talk medications, they just reduce the intensity of the anxiety level to the point that I can use my logical brain more comfortably.
And, of course, a lot of times there's a balance between my biology and my psychology in terms of development of these conditions.
So the more the weight of the biological aspect, the more helpful the medications.
And, of course, I would love to talk about exercise, because that's one of the best ways to address anxiety.
I prescribe it for my patients.
What kind of exercises do you prescribe?
So the first thing is what you can do, because whatever you can do is better than nothing.
But what we know from literature is the more cardio the aspect of the exercise, the better it helps with the biological changes.
But there are also a lot of other factors and aspects there also, right?
I go to the gym.
I see some people, I meet some other people.
I go for a walk.
I meet my neighbor.
I may get a dog to walk him.
So all these different aspects of social interactions that...
Join the effect of the exercise.
That can also help with basically community building and other aspects.
Yeah, I love that.
I mean, I've noticed in myself like doing more exercise has helped my anxiety.
And I understand like you're investigating like a specific way to treat fear using augmented reality, like with a HoloLens, this screen strapped to somebody's head.
Yeah, so first I want to say augmented reality is different than VR or virtual reality.
In a way, it's just like an example I always use is Iron Man.
So Iron Man, Tony Stark, what he had was basically augmented reality.
You could see the real and then the unreal was superimposing.
So let's say we talked about exposure therapy.
It's a very effective treatment.
But the problem is, if someone came to my office and said I'm afraid of dogs or spiders or snakes or humans, I don't have a dog or a spider or a snake in my office to do that.
So we use augmented reality glasses to help people create the environments of situations that they're afraid of, that we cannot create easily in the clinic in real world.
Let's say, looking at a spider, a dog or a stranger for people with social anxiety or PTSD.
Helping people face their fears in a matrix like augmented environment.
And we use it for treating these fears and phobias.
And we are very impressed.
We have published the data.
Everybody with terrible fear of spiders was able to touch a real tarantula.
His name is Tony Stark.
Wait, the spider is named Tony Stark?
Yes, yes.
So what's really important for me is to talk about how fear is something that's natural and it's normal.
What do you tell your patients that are ashamed of experiencing fear on these various levels?
So first, a human without fear doesn't have a very good chance of survival.
It's like a human without the ability to experience pain.
We'll end up with a lot of injuries and a lot of burns and a lot of wounds.
So being able to experience fear and anxiety... is normal, and also a lot of times it's a motivator.
You have a whole chapter in the book about how to utilize our own anxiety.
It's not always an enemy.
In the modern life, we see it as an appendix that we have to throw away.
But it's a friend, which is a lot of times misguided.
But when it comes to the pathological levels, when it is basically taking away our ability to enjoy life and function, then it's like being ashamed of having diabetes or high blood pressure or any other medical condition, because we are talking about a brain which is processing things in a different way, which is very common in all humans.
And these days, in this day and age, there's too much anxiety pushed on us by the environment, by the media, by the social media.
So about like one in five or four people around me are experiencing these issues conditions to level what we call it clinically significant.
So how can I be ashamed of something that is affecting one in five people around me?
And a lot of it is not in my hand.
Either it's a biology which was handed over to me, or even a big chunk of my psychology is not of my determination.
At the end of the day, What I find very motivating because now I'm utilizing fear is I remind people you will not be young forever.
Do you want to spend these years of your youth in fear?
Or do you want to fix it and be able to enjoy them?
Because you will never be young again.
Arash, thank you so much.
I have loved this conversation.
Thank you for coming to talk to us about fear.
I appreciate that.
Thank you so much for having me on your show.
Thank you for listening to Shortwave from NPR.
I'm still very afraid of so many things.
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