Anxious: Using the Brain to Understand and Treat Fear and Anxiety

A new book by Joseph Ledoux

Aug 17, 2015

I really wanted to like Joseph Ledoux's new book, Anxious. It is one of my favorite researchers writing about the nature of emotions and how to treat them.



What I like about Ledoux


Fear vs. Anxiety

In my view, Ledoux succeeds in making his case for a distinction between fear and anxiety based on neurobiology. He points out that different brain regions are activated in experimental situations based on whether a danger is imminent or just possible. For example, if you train a rat that every time you flash a light, he will get a shock, that activates certain circuitry (mainly in the amygdala). However, if you place a rat in an environment that is sometimes dangerous and other times safe, a different brain region is activated as they scan for dangers that might or might not happen (that are more focused in the bed nucleus of the stria terminalis).  These regions are highly connected, but distinct enough to say make the semantic case that fear should be defined as a feeling in response to an imminent threat, while anxiety refers to a feeling in response to a threat that might or might not happen.

From a purely logical perspective, this distinction doesn't make a lot of sense. Any threat is merely possible until it has happened. Whether you actually see a bear in front of you or you're just walking through the woods, your fear response is primarily to a mental construct that hasn't happened and might not. On the other hand, this isn't how our physiology works. We have perceptual systems that scan for situations that require immediate action. I believe that a better differentiation between fear and anxiety would be that fear is a response to a situation that your physiology believes deserves immediate reaction, while anxiety is a warning that danger is likely and seeks to employ conscious cognitive effort in scanning for threats. Anxiety is like an orange alert, while fear is red.

What is a Feeling?

Where I believe the book fails is in Ledoux's attempt to distinguish feelings from non-conscious behavioral states. He argues that a feeling is something that is consciously experienced, and reactions that we might generally called emotional should be defined as behavioral states if they are not consciously experienced.

Imagine you wake up on the one-year anniversary of your divorce. You act grumpy all morning, avoid talking with people, and your face is shaped in a frown that is obvious to everyone but you. Around lunch time, a colleague asks if you're OK and you respond defensively, saying you're fine. By the time a second and third colleague inquire about what's wrong, you realize that it's the anniversary of your divorce and that you're actually pretty sad. According to Ledoux, you weren't having any feelings at all until lunch, because he defines feelings as something consciously experienced. Rather, you were exhibiting non-conscious social defenses that shouldn't be considered emotions.

I believe this is a terrible way of defining feelings and emotions. To the extent that these terms are used (feelings and emotions), they must refer to these states of various affective valence regardless of whether the subject is currently conscious of them.

Feelings/Emotions is a Problematic Construct

I sympathize with Ledoux's attempt to clean up our vague language about affect. As I've written elsewhere, there is not a precise correlate to the notion of emotions in Buddhist psychology. Rather, our experience is the coming together of the 5 Aggregates (Khandhas/Skandhas), namely form (rupa), affective valence (vedana), perception (sanna), mental/volitional formations (sankhara), and consciousness (vinnana). What we call fear (bhaya) can be referred to as a mental factor (cetasika) which is comprised of vedana, sanna, and sankhara. Although fear is not included in the traditional 51 mental factors of the Yogacara school, Thich Nhat Hanh has proposed that it should be.

If we employ systematic introspection, we can experience the component parts of the cetasika called fear. We can experience the bodily sensations, the negative valence, and the threat-oriented thoughts that arise. What we call fear or anxiety would be the sum of those three.

Confusion about Consciousness


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