Last summer, my wife Amy and I took two months to travel in Europe with our five-month old son, Kai. Amy made an ambitious itinerary: the ideal balance of historical sites, lazy beaches, and vineyard romping -- ideal for a couple anyway. By day three, we'd realised that toting a crib in our little rental car to a new hotel every few days was not going to be a vacation. If we were going to enjoy this trip, it was obvious all the work we'd done teaching Kai to fall asleep alone at very specific times (no small feat) was going out the window.
Image remixed from doglikehorse (Shutterstock)
But screw it -- we were in Europe. And fortunately, we loved snuggling with Kai in our bed after a night walk around Lisbon's cobblestone streets or sampling tapas in Madrid's open-air markets. Problem was, when we came home to San Francisco, ready to go back to the old routine, Kai went on strike. Forget sleeping in the crib. He would go into convulsions just looking at it. If we put him inside, like a wrongly-convicted prisoner, he would stand-up (the new 7-month-old party trick) and rattle the bars, shrieking in terror.
Not fans of the "cry-it-out" method, we devised an exposure therapy plan cobbled together from various parenting books. Though my friends will forever tease me about this, I actually slept with Kai in the crib a couple of times -- murder on my back, but it was a game changer for Kai. He immediately started napping happily in the crib alone. But he still wouldn't fall asleep on his own at night, or soothe himself back to sleep when he woke up. So onto stage two: letting him experience just a few minutes of crying at a time in the crib — to show him that his fear of being alone in there was not really that bad -- allowing an extra minute each time before going in to comfort him. It required some sleepless nights, some tears, but within a week, Kai was sleeping through the night on his own.
Why Exposure Therapy?
Most parents experience something similar with their children's fears, but why do we so rarely apply exposure therapy to ourselves? As adults, our fears and aversions become things we're too busy to deal with, little monsters we repress, or abstract objects we over-intellectualise about, as if telling more stories about why we're afraid will magically give us courage. Our long-held fears transform into beliefs and personality quirks — "I'm just not a good leader", "I'll always be overweight" -- that hold us back from our potential.
There are lots of ways to manage our fear, stress and anxiety: exercise, meditation, talk therapy, medication. All helpful. But "exposure is hands down the most successful way to deal with phobias, anxiety disorders, and everyday fears of any sort," Philippe Goldin, a Stanford neuroscientist who specialises in anxiety disorders told me over tea recently. "But the odd thing is that only 30 per cent of PhDs in psychology are trained in exposure. When you get down to the MFT level, the percentage is even lower."
Freud was right that sometimes our fears have bizarre sources that need gradual drawing out by a professional. Other fears -- say, getting kidnapped by terrorists -- are probably not right for the exposure method. Serious anxiety disorders like Post Traumatic Stress Disorder and Obsessive Compulsive Disorder need special treatment too. But a lot of the time our fears are obvious -- low hanging fruit -- and study after study has revealed that, whether it's sky-diving or public speaking, simply repeatedly exposing ourselves to the thing we're afraid of -- ideally in a positive way -- gradually brings down the physiologic fear response until it's gone, or at least manageable.
Your Brain Is An Onion
Goldin and other fear-specialised neuroscientists like Joseph LeDoux and Daniela Schiller explained to me why exposure works. Our brains developed like an onion, with the most primal functions -- breathing, pulse, hunger, sex, fear -- near the core of the onion, and the complex abstract thinking and logic happening mostly in the outer layer, the pre-frontal cortex. The core of the onion was part of our ancestors' brains long before the pre-frontal cortex ballooned to its massive human size. Similarly, the core of the onion develops in babies long before the cortex, causing them to experience raw emotional urges without reason or inhibition. Because of that, babies are perfect models for how the primal brain learns. When baby experiences something pleasant -- mum's breast -- an attraction develops. When baby experiences pain or discomfort -- abandonment in the crib -- a fear or aversion develops.
As the pre-frontal cortex comes increasingly into play through elementary school and high school, we develop avenues to reason with our emotions. But for the same reason you can't tell your heart to beat faster or slower, it's difficult to get meaningful results telling yourself to calm down when you see a mountain lion or when you're tearing out your hair from a stressful deadline. The primal brain is faster than reason. So if you're afraid of public speaking and someone asks you to give a spontaneous toast, by the time you can tell yourself, "this is no big deal," your pulse has already skyrocketed and you're starting to sweat. Reason can help you give the toast despite the jitters. But the only way to make that annoying heart flutter and gut twisting go away is through doing lots more public speaking -- volunteer to give your own spontaneous toasts, for example (you can secretly plan them so you feel confident).
Take a recent study by neuroscientists Daniela Schiller and Elizabeth Phelps that was published in Nature. At NYU, they taught a group of people to fear a blue square on a computer screen by occasionally pairing images of the blue square with a light shock. (By contrast, a yellow square came with no accompanying shock.) Each participant knew intellectually that the blue square was completely benign. It was that damn buzzer that was doing the shocking. But that didn't stop their primal brains from developing a distinct fear response -- increased sweat on the skin -- to the blue squares, even sans shock.
To emphasise how little control the conscious mind has over unconscious fear learning, Schiller ran this test on me after I'd already read her study. Though I wasn't consciously afraid of the blue squares after the first shock, the monitor measuring sweat on my skin showed otherwise. And when Schiller and Phelps' test subjects came back into the lab a full year later, they still broke into a scared sweat when they saw the blue squares. And if that's how deep and long our fears linger in the primal brain with blue squares and shocks, you can imagine what the brain does with real trauma. The way to heal the irrational fear successfully and permanently, Schiller and Phelps found, was by triggering the original fear memory with a reminder square, then following up very soon after (within six hours to be exact) with positive exposure therapy -- repeated blue squares without shocks, essentially remaking the old fear memory. "Avoidance is the natural response to fear," Schiller told me, "but it's not the one that works."
Do One Thing Each Day That Scares You
It may sound like bad news that it's so hard to talk yourself out of old fears, but just like we use our more developed brains to guide our children toward positive exposure to, say, the dark or a new school, once we understand how fear works, we can create healthy exposure experiences for ourselves. That might sound a little, well, babyish. But if we don't, the primal brain will simply draw its own conclusions based on life's random events -- often prioritising the negative, our failures, for survival -- and integrate those experiences into a personality.
I know this all too well. I'm a military brat and had to change schools often. Being shy, the transitions were tough. But I was the type of shy kid who, once I had friends, I opened up and became gregarious and brave. So the routine was this: wander the playground alone, telling myself that I wanted to be alone -- that I was a thinker, an artist. Eventually, one of the more gregarious kids in the school would take pity on me, invite me to a game, and I'd light up. That first nice guy almost always became my best friend. He introduced me to his friends, and like this, I always had a great crew. When it was time to switch schools again, I'd unconsciously use the same low-risk strategy. It worked, so aloofness -- based on fear -- became part of my personality, a skill that I developed to draw people in.
Growing up in a generation where not caring was cool, this aloof attitude even made me popular. But once I was in the real world, the passivity -- a cover-up for social anxiety -- didn't work as well. Taking the jobs and relationships that sought me out, I often felt dissatisfied. By the time my 30s rolled around, I found myself writing about topics that weren't my passions and in a wishy-washy relationship. It wasn't until that relationship ended painfully that I forced myself to take action. I started researching the science of fear and stumbled on studies about exposure therapy. Based on my favourite quote from Mark Twain -- "Courage is not the absence of fear. It is acting in spite of it" -- I created a homework assignment to do one thing each day that scared me: talking to a stranger in an elevator, contacting an old friend I'd had a falling out with, sending a pitch to a publisher that seemed out of range.
These baby steps became so fun -- bearing surprising results like a book deal and funding for a film project I'd given up on -- I started jumping into bigger, physical fears: diving with great white sharks, big-wave surfing, blind dating.
That last one might not sound like a big deal, but friends had tried to get me to go on a blind date for years, and I always made excuses, thinking the dates would be awkward. But after months of doing my exposure homework — approaching women I actually wanted to date -- this time when the blind date offer came around, it seemed like a fun opportunity. There was a flutter in my chest when I showed up to the wine bar and saw a gorgeous woman named Amy waiting. (I'd wrongly assumed hot women don't get set up.) But it only took seconds of talking to her for that flutter to turn from nervousness to infatuated excitement.
Two years later, we were on a trip to Europe, debating sleep-training techniques for our son.
Jaimal Yogis is an award-winning journalist who has written for ESPN The Magazine, The Washington Post, The Daily Beast, and many others. His critically acclaimed first book, Saltwater Buddha, is currently being adapted into a film. The Fear Project is his second book and launches today. More at www.fearproject.net.