It is the early hours of the morning. A loud bang outside your bedroom window jolts you out of a snooze. Clunk, clunk, again. You are now bolt upright, uncertain about whether you should wake your wife who is still sound asleep. Then outside the window a shadow passes, cast by the street light. Is it a burglar? Perhaps even a serial killer, the one you heard about on the TV news the night before. Your imagination is running wild. Your heart is beating hard and you are bursting to at least tell someone else that there's someone outside with evil intent.
A small, almond-shaped area of your brain called the "amygdala" is doing what God created it to do. It is receiving signals of a potential danger, and it is letting off a series of alarms throughout your body to prepare you to protect yourself. After all, this may be a threat on your very existence! Clunk, clunk. There it is again. Now you know that you are not imagining it.
It certainly is not a bad dream. But then the amygdala begins to get additional messages. In the bright moonlight you can make out the wavering images of a branch of the tree close to your window and a strong wind blowing. No need to bolt or scream out. Your fear is firmly snuffed out and all the alarm systems are reset. Calm returns, though you may still feel super-alert and vigilant for a while. Now you're glad you didn't wake your wife. You would have paid for it in untold tales told at ladies' gatherings about just how "scaredy-cat" some men are!
Unraveling the fear response
We live in remarkable times. On one hand, since September 11, Americans and others have experienced a dramatic upward shift in our general level of fear arousal. The sudden loss of security, our scared psyches, the uncertainty about what the future holds, grappling with the downturn in the economy with loss of jobs and a general increase in feelings of vulnerability, are taking their toll.
Even though for some non-North- American readers it might feel that the United States is a long way away, the impact of terrorism is being felt throughout the world with a consequent increase in everyone's fear level. I was in Australia on September 11 and experienced firsthand the dramatic effect it had there. On the other hand, we are slowly unraveling the fear response and finding new and effective ways of dealing with it when it gets out of control.
As in the previous two articles, my goal is to help Christian leaders under stand as best they can all that we currently know about important emotional problems people face today. By understanding the "fear circuit" it is hoped that we will develop more effective treatments for fear-related disorders such as phobias where fears are taken to extreme.
In a previous article I made a distinction between fear and anxiety. The two become so entangled that sometimes we cannot tell the one from the other. Clearly, fear will give rise to anxiety when imagination takes over and exaggerates the fear. But anxiety, we now know, uses different brain mechanisms. For instance, and this is an important point for a pastor to keep in mind, we have effective medication to control anxiety when it gets out of control, but no medication can directly help us deal with fear.
Fear involves a "hit and run" process in the brain. Survival is its sole purpose. Anxiety, however, stirs a slower reaction that lasts a while. In fact, anxiety, as we've previously established, can take over and entrench itself in such a way that it appears to be there all the time.
The take-home point I want to communicate to Christian leaders here is that it is extremely important that we help people bring their fear responses under control as soon as possible. Failure to do so will result in an escalation, even entrenchment, of some form of severe anxiety disorder.
Unresolved fear is a powerful stressor that turns even a healthy fear into an ugly fretfulness. It's the form of stress that is designed to be short lived. You can prevent prolonged fear from becoming damaging through informed counseling and by preaching a healthy acceptance of fear. Pastors, especially preaching pastors, can play a very significant role in these frightening days in helping people avoid becoming traumatized by prolonged fear.
Kinds of fear
Psychologists study many kinds of fear. Not all fears are of the dramatic, life-threatening sort. So, while fears persist about terrorist attacks we should not ignore the more common variety of fearful reactions that are very much more commonplace.
There are "lesser" forms of fear that can be just as debilitating as the major forms. Take for instance, someone with an extreme fear of germs. They intellectually know that germs don't inhabit every piece of furniture or doorknob. But intellectual reasoning has nothing to do with obsessive-compulsive disorder, which is what I am describing here. Such people will incessantly wash their hands after touching something like a doorknob, often to the point of causing lesions and bleeding. All this is because they fear that germs are invading their skin. The fear of germs leads them to try and eradicate the imagined, invading microbes.
Another very common group of fears are phobias. Phobias are irrational fears: While the feared object has some reason for creating fear, the sufferer cannot control the fear through reason. A fear of flying, high buildings, snakes, and spiders are all quite natural in that these can harm you. But a normal person can keep the fear in check by understanding the limits of the threat. If a snake is behind a glass wall it cannot bite you. For someone with a phobia, a glass wall makes no difference to the fear.
One particular fear related anxiety dis order, called Generalized Anxiety Disorder (abbreviated GAD), is quite common. While it is referred to as an "anxiety" disorder it is more akin to fear than anxiety. Affecting at least four million people in the U.S. alone, it afflicts twice as many women as men.
People with GAD have an exaggerated and persistent fear sensitivity and it can cause an enormous amount of stress. While there is some strong evidence that a small genetic factor may play a role in its development in that identical twins have a high rate of concordance in developing GAD, the actual mechanism is the tagging of fear with certain memories that do not fade like other memories.
Such a person, then, has a brain that is tagged and a fear structure is put in place. This is why trauma needs to be dealt with as early as possible. Seeing a friend killed or facing a severe risk to one's own life can, in people who are vulnerable, permanently fire up their fear response.
Helping people deal with the memory of some tragedy or fear as soon after the event has occurred is, therefore, an extremely important aspect of ministry. In particular, victims of trauma must be given an opportunity to talk about their feelings surrounding such trauma.
Externalizing one's feelings is part of how the brain is designed to heal them. I say this because I believe that spiritual resources, especially having a healthy faith, can help to heal these memories by robbing them of their sting.
Understanding the fear response
It is vital that all "people helpers" understand the fear response, if only to avoid perpetuating damaging beliefs that could reinforce unhealthy fears.
Although a reaction to some fearful event is perfectly natural, it can be quite unpleasant. As mentioned earlier, it all starts in the amygdala that is weighing the evidence coming from all the body's sensors and searching for a possible threat. If a threat is sensed, it immediately sends out signals to the adrenal glands, which in turn cause the heart to pump more blood to the brain and muscles. Breathing quickens, pupils widen, saliva dries up, and the hands become cold and clammy—all very necessary for survival and part of how God has created us. One of the consequences of this inbuilt alarm system is that fear weakens the ability to concentrate. You are easily distracted and cannot focus on much besides what is causing your fear.
While this is healthy in an extraordinary fear-provoking situation like the clunks mentioned earlier, when the danger is less acute and prolonged, this response can be debilitating. This is the effect many are now experiencing given the time that has elapsed since September 11 of last year.
People need to be helped to "let go" of fears that are no longer imminent and to embrace a more positive outlook toward the future. Reassurance of so much that has and is being done to make our world safer, needs to be embraced in the context of our faith in a God who does control our world, even though the way He is doing it may not always be obvious.
Bringing fear under control
The first and one of the most important ways for dealing with fear is help the person find out where the fear is coming from. Is this fear a carry-over from some bad childhood event? For many, bad childhood experiences have inculcated a conditioned response in which any similarity between some thing in the present (that might be quite harmless) with something in the past (that was terrifying) triggers a fear response that really doesn't belong in the present.
This is illustrated in the experience of a couple I once counseled, who were having marital difficulties. The husband happened to be a pastor who was a little impatient and reactive. Whenever he raised his voice at his wife she would go into a catatonic state and start to tremble from fear. He couldn't understand this extreme reaction and so he became angry with her when she reacted in this way. Of course, this only made matters worse.
As we explored her reaction (and his temper) it emerged that her father, also a pastor, would lose his temper and physically slap her. So, even though her husband would never do this, just a slight anger reaction in him would bring out all the fear that was connect ed to her father.
We worked at helping her "disconnect" her fear for her father from her husband's reactivity, and, obviously, helped the husband to stop his behavior, which now he knew was traumatizing to his wife.
Second, the person should also be helped to explore whether the fear is imagined or not. Not all fears are based in reality. Sometimes we create fears in our imagination or by reading or hearing about something that happened to someone else. Such improbable fears need to be challenged, not left to do their damage. God designed us to deal with real fears only.
Third, the imminence of the fear should be examined. For instance, we all fear death. But most of us don't expect to die in the foreseeable future. If we have just received traumatic news of some terminal illness then it is appropriate to be fearful and then to take steps to deal with the certainty of that fear. For those who fear death a long way off, inevitable as it is for all, they need to be enabled to put that fear aside and get on with the business of living.
Lastly, because it is not possible to eliminate all threats and therefore all fear (we'd be creating a monster if we did), we need to facilitate ways in which a person can better tolerate reasonable fear. Here are some suggestions for pastors to consider in helping them selves and others:
- Reassure people that they are not crazy to continuously feel bothered by current events and threats. It is normal to be afraid, even for months after wards. As concentration-camp survivor Viktor Frankel remarked: "An abnormal reaction to an abnormal situation is normal behavior."
- Reactions to fear that may be expected include preoccupation with recent events, some sleep disturbances, resurgence of previously frightening memories, limited ability to attend to normal routines, and increased emotionality such as depression and crying.
- To prevent these reactions from becoming excessive, limit attention to media coverage (turn off the news if it bothers you), focus on distracting tasks or hobbies, and carry on your life as you normally would. Do what you would normally enjoy.
- Look for a positive perspective on negative events. Find ways to help others and engage in constructive discussion only with those who have a positive outlook.
- Take extra time to rest; exercise and eat healthfully, and avoid taking on too many outside activities.
- Spend time with God—in praise, meditation, and prayer. After all, Scripture still has the most powerful antidote for fear: "Do not be anxious about anything, but in everything, by prayer and petition, with thanksgiving, present your requests to God. And the peace of God, which transcends all understanding, will guard your hearts and your minds in Christ Jesus" (Phil. 4: 6, 7, NIV).