Phobias: Fighting the Fear. Helen Saul

unfashionable in the age of computers and hard data.

      Practical progress has been most marked where sciences have interacted. The theory of cognitivism may have overtaken behaviourism, but most phobia clinics now offer cognitive-behavioural therapy. The theories may be irreconcilable, but the two approaches taken together are more effective than either alone.

      This could also be true of the neurosciences, psychology and psychoanalysis, which continue to pay scant regard to each other’s findings. They have developed more or less independently, with little reference to each other. Neuroscience is a thriving field at the beginning of this new century and it is tempting to feel we can safely reject everything that has gone before. Undue attention to underlying problems, spearheaded by Freud, held back treatment of phobias for years and the demise of psychodynamics has been liberating and productive for scientists, clinicians and those with phobias. It is thrilling to be able to discard confusing psychoanalytical theory in favour of neuroscience and its promises of definite answers to clearly defined problems. But the dawn of the neurosciences could yet produce a need for a deeper understanding of the meanings of fear. Because, in the end, fear is more than a chemical reaction. No one with a phobia really cares about their hormone levels or brain activity. What they want is an end to their phobia and the sensation of fear.

       CHAPTER 2 Evolution

      Living Without Fear

      The man stood, arms outstretched, looking at the traffic below. He grinned, threw back his head and laughed. The wind ruffled his hair and tugged at his coat and he seemed euphoric. He started to turn clumsily round and round on the spot, like a small child having fun. A few yards away, his wife stared at him in disbelief. He was dancing on the corner of a parapet on the roof of a San Francisco skyscraper, one step from certain death.

      The fictional character Max Klein, played by Jeff Bridges in the film Fearless, had survived a plane crash and became convinced he was invulnerable. His high-rise jig came some time after he walked across a city highway without looking, cars and vans screeching to a halt all around. He ate a bowl of strawberries, knowing that his allergy to them could cause a fatal reaction. Finally, he drove at top speed into a brick wall.

      Klein survived a few months of this behaviour, but his life was disintegrating. His close encounter with death during the crash had eliminated his day-to-day anxieties and he felt he did not have to answer to anyone. He became so self-sufficient, not to say arrogant, that he felt little need for the closeness of those around him. He was remote and distant from his wife; he alienated friends with his lack of sensitivity. He spent more time with a young boy he had rescued from the crash than with his own son. He was not working, but spent his days looking at buildings. When introduced to a fellow survivor of the crash, he told his wife he had a feeling of overwhelming love for this woman. He had never felt anything like it before, he said. A few months of this and his wife was ready to leave him.

      His psychiatrist was struggling with an extreme case of post-traumatic stress disorder; Klein himself claimed the crash was the best thing that had ever happened to him. It had been extraordinary, and had shown him ‘the taste and touch and beauty of life’. He would not give up this state of mind.

      Subjectively, Klein felt more alive than ever; objectively, he stood to lose his wife, son and home, his friends and his livelihood. It is an interesting take on fear. We are so used to portrayals of neurotics crippled by a million anxieties that we seldom stop to think what would happen if we had none at all. Anxiety and stress have a bad image. They are the scourge of the modern age, blamed for everything from undermining happy marriages to destroying sleep and causing headaches. Anxiety exaggerates bodily pains, it ruins good performances at work or school and quenches joy and laughter. It leads to alcoholism, eating disorders, domestic violence. The lifestyle pages of newspapers and magazines are filled with articles about dealing with stress and, we are told, life without anxiety would be wonderful.

      Yet in this film, fear is portrayed as the glue that holds lives together, keeps marriages, friendships and careers intact and protects us from avoidable accidents. Klein eventually realises he needs help, regains normal sensitivities – along with his allergy to strawberries – and the story is resolved. Anyone behaving like this in real life would be lucky to escape so lightly.

      The anxiety system can go wrong, of course, and we would all like to banish the misery of panic attacks, obsessional behaviour or phobias. Successful treatment for these problems can revolutionise lives and nobody wants to get in the way of this. But evolutionists insist we would benefit from taking a step back and looking at why there is so much anxiety in society. They challenge the prevailing view of anxiety as a wholly negative experience. On the contrary, they say anxiety is a prime motivator, a positive drive, a force for good. It prompts us to achieve at work, to guard our reputation and to keep our families together.

      We do not doubt that other animals need the ability to recognise and respond to threats. All living things face danger and must react appropriately if they are to survive. Creatures have a fascinating array of defence mechanisms, each specific to the threats they most commonly encounter. The chameleon changes colour to blend in with its surroundings and hide from potential attackers. A threatened squid squirts ink at its aggressors. Antelope simply run away from lions. Moths are preyed on by bats and have become experts in bat-frequency signals. They monitor the signals continuously and map the direction of their predators’ flight. Only if the bat is heading directly for it does the moth snap its wings shut and fall, as if dead, to the ground. Familiar reactions like these have been sufficient, not for every animal to survive, but to keep the species going.

      The intensity of the reaction also has to be appropriate since animals use up precious resources when trying to defend themselves. An antelope that is too ready to give up grazing and run will soon become undernourished; squid do not have unlimited ink. Even the simplest creatures have remarkably sophisticated responses, as demonstrated by American biologist Herbert Jennings, working in Europe at the turn of the century.

      Jennings was interested in the ordered and elegant lifestyle of a tiny pond animal called a stentor. A stentor is only one cell big, a trumpet-shaped creature, attached by a ‘foot’ to a rock on the water bed. It has a tube at its base which can provide shelter, and the trumpet is an open pouch at its free end for feeding. Hairs around the edge of the pouch waft in food particles.

      Jennings used carmine, a natural red dye extracted from the cochineal beetle. It can be an irritant even for humans and is certainly toxic to tiny animals like stentor. He added carmine to the water tank in which the stentor was living, and simply watched to see what happened.

      The stentor did not at first react to the carmine in the water, but then decisively bent away from the oncoming red specks. The gesture is normally enough to keep it out of trouble in the peaceful conditions at the bottom of a pond. It costs the animal little to try, and it can continue feeding even as it defends itself. In Jennings’s experiment, the stentor bent this way three or four times, and when the strategy did not work, demonstrated a second line of defence. It suddenly pushed its pouch out in the opposite direction in an attempt to dislodge any poisonous particles around the mouth. Again this failed, as Jennings continued to drop carmine into the water. Red particles settled on the pouch and a few more similar moves by the stentor proved futile.

      Drastic measures were called for, so the stentor retreated. It contracted and moved down into the tube at its base. It waited there for a time but could not wait for ever because a single cell does not store much energy and it cannot feed in its bolthole. It moved tentatively upwards out of the tube, but found the water still full of carmine and had to force itself back down again. It advanced to test the water a couple more times but when conditions had not improved, the tiny creature risked its remaining precious energy, contracted violently, dragged its foot away from the rock and floated away in search of an uncontaminated spot.

      Experiments like this have been given new significance by the latest thinking on the adaptive and positive role of fear. A one-celled creature like the stentor has a graded response to a threat, from simply swaying