FEAR.

On a beautiful Saturday evening in May 1998, I was sitting outside enjoying the late afternoon air on my farm in upstate New York when I felt a little "peculiar," nothing significant that I could put my finger on, but none the less, "not right."

Later on that evening, after dinner and attempting to go to sleep, I knew something was "wrong." Being a healthcare provider for more than thirty years, I ignored all the signs during the day, the light headedness, dizziness, weakness, irritability and "fluttering in my chest." I ignored these feelings because of FEAR. Subconscious FEAR! Fear of the unknown. My chest contained my heart and nothing could go wrong with that organ, not in me anyway. FEAR was the biggest part of my putting the signs aside and going on with the "it will pass" attitude.

The drive to the Emergency Department of the local hospital five miles away, was very, very quiet. Seeing anxious faces at the door, and now knowing that I would become the recipient of the healthcare network of which I am a part, only increased my FEAR. The diagnosis of cardiac arrhythmia, IV's in each arm, Coronary Care Unit, temperatures at three in the morning, unknown persons poking and probing and isolation from my outside world increased my FEAR even greater.

What is this FEAR that we all speak and read about? It is usually a normal emotional response during which we recognize an external source of danger giving us alarm, apprehension or disquiet. However, it can be and often is very debilitating for the individual.

FEAR and its close companion anxiety, in many ways represent a hard-wired alarm system in the brain in search of genuine life-threatening dangers. We are equipped to respond to threats instantaneously. We respond to danger signals, BUT we have now come to associate some danger signals with social problems such as the intolerant mate, the boss, the teacher or the bully. The number of phobias today may represent the overreaction of life-preserving mechanisms to normal everyday social stimuli. Social stimuli include the fear of the unknown, fear of a nuclear explosion, or the spread of disease, especially AIDS. Dr. Joseph LeDoux, a prominent neuroscientist at NYU stated, "A rat can't worry about the stock market crashing, BUT we can!"

It is traditional to think about FEAR and anxiety as a battle ultimately waged between the rational and irrational minds, between human reason and animal fear. In all but the most dangerous circumstances, it is a battle that reason and rationality should win every time, and yet 10 to 15 percent of adults in America suffer from some sort of anxiety based disorder that is becoming a widespread feature of the modern condition.

The experience of irrational fear and anxiety represents a battle between conscious memory and unconscious emotional memory. Human experiments in the past few years have confirmed that FEAR travels in two distinct circuits in the brain, one of which threads its way through the higher, cortical thinking precincts of the brain and one which seems to occur with lightening speed just below the radar of our awareness. The brain processes sights and sounds, including threatening ones, in milliseconds, while the simplest thought takes full seconds to develop.

The part of the brain that instantaneously looses the hounds of FEAR when you hear a loud bang, feel an earthquake is called the amygdala or central nucleus. Nerves running out of this little knot of excitation carry the messages that control heart rate, blood pressure, sweating, respiration, freezing, increased jumpiness; all the engines that get revved up in a fearful situation. The wiring mechanism does not stop there. Other nerve fibers thread their way back into the uppermost part of the brain, to regions that control the release of stress hormones which may play a part in the region of irrational fears, to the cortex and to sensory areas. When a threat occurs and when imminent danger needs to be sorted out RIGHT AWAY, alarms go off throughout the brain; the result is a very alert individual. FEAR has a distinct modern responsibility. It instantly primes animals, including us, to notice and pay special attention to the stimuli.

We experience, learn and unconsciously commit to emotional memory many fearful situations, without ever being aware of what hats triggered the racing heart and quick pulse. During a panic attack, the victim cannot understand what has triggered such a powerful reaction. The implication of fear-conditioning is that we have a separate memory of a fearful stimulus, be it a loud noise or shaking ground, we have either heard it or felt it before, but do not consciously remember it. The amount of environmental information coming into the brain at any given moment, not to mention terrifying moments, is probably more than the conscious mind can keep up with so we store it in the subconscious mind. An experiment at Massachusetts General Hospital by Dr. Scott Rauch confirmed that humans can indeed activate their FEAR circuitry without ever being aware of it. The approach suggested was subliminal advertising, known as "masking." A fearful face was flashed before subjects' eyes for 33 milliseconds, followed by a longer masking exposure for 167 milliseconds. The subjects had no memory of seeing fearful faces, yet their brain did. PET scans (positron emission tomography) revealed a lighted area in the central nucleus whenever the same stimulus was activated. The reaction was the FEAR mechanism. Subliminal stimulation is a very fast and preferential way to get information across to the public. Anxiety is about hypervigilance and subliminal stimulation is just that.

The role of imagination in anticipatory anxiety and FEAR introduces a powerful cognitive wild card to disorders of our age. Each one of the anxiety and FEAR disorders represents a glitch somewhere in the FEAR circuitry, either because of inherited (natural) or remembered experiences.

FEAR, in other words, has become soldered into the circuitry in our brain, just waiting for the right circumstances to trigger the effect again. In essence FEAR is forever! It can be CONTROLLED.

Hypnotherapy is a very powerful tool used alone or in conjunction with other therapies. The use of hypnosis in phobias has shown remarkable positive results in those individuals who experience such phobias. The reeducation of the conscious and subconscious minds can be achieved for those seeking relief from FEAR and anxiety. The positive affirmations of"I will or I can" is foremost in hypnotic therapy.

Dr. Albert C. Bottari, Ph.D.., F.B.H.A., 82-01 Rockaway Blvd., Ozone Park, NY 11416. Dr. Bottari is a Certified Clinical Hypnotherapist and lifetime member of IMDHA. Dr. Bottari will be a presenter at the IMDHA Conference October 26-31, 2000.