Fear and Anxiety

All of us, young or old, male or female has at times been confronted with situations that evoke sensations of fear and anxiety. Whether the source is a self-inflicted scary movie, a narrowly escaped auto-accident, or the feeling of impending doom that comes from a walk down a dark and lonely street, we all share, as part and parcel of the human condition, the ability to experience fear and anxiety. But is fear and anxiety just different labels of the same emotion, or are they separate and distinct, different from each other as night is from day? According to Reber (1985), fear is "an emotional state in the presence or anticipation of a dangerous or noxious stimulus . and is usually characterized by an internal, subjective experience of extreme agitation, a desire to flee or to attack and by a variety of sympathetic reactions" (p. 271). Anxiety, on the other hand, can be defined as "a fusion of fear with the anticipation of future evil...a continuous fear of low intensity...a feeling of threat, especially of a fearsome threat, without the person being able to say what he (or she) thinks threatens" (English & English, 1958, p. 34-35). Although, the answer to this question is not straightforward, it can be argued that fear is an individual's reaction to a somewhat clear and present danger, whereas anxiety is a reaction to an anticipated or imagined situation or event. During the past several decades, psychologists have discussed and speculated about the origins of fear and anxiety. While some theorists have proposed that people have innate tendencies to be fearful and anxious, others have speculated that both fear and anxiety are the product of learning through one's interaction with the surrounding environment, and still others have shown that fear and anxiety, as well as other emotional states are the results of physiological responses to environmental stimuli. Since fear and anxiety can be expressed in terms of an individual's thoughts, actions, and physiological responses, this paper will be primarily concerned with the cognitive, learning, and biological perspectives on the motivation of fear and anxiety, in both the individual and social contexts. Biological Perspective The basic premise of the biological or physiological explanation for the occurrence of fear and anxiety is that problems with brain functioning lead to anxiety disorders. For example, current research indicates that generalized anxiety disorder is caused by excessive neurological activity in the area of the brain that is responsible for emotional arousal, and this increased level of arousal is experienced as anxiety. This excessive neurological activity is thought to stem from the fact that certain inhibitory neurons whose purpose is to reduce neurological activity are not functioning properly. The neurotransmitter that is released by the inhibitory neurons is known as GABA (gamma-aminobutyric acid). It is believed that low levels of GABA result in the failure to inhibit the activity (neural transmission) of other neurons, which leads to a high level of neurological activity in the areas of the brain that are responsible for arousal, and this high level of activity is experienced as anxiety. One class of drugs that are quite effective at ameliorating the dysphoric symptoms associated with fear and anxiety states are the benzodiazepines. Benzodiazepines such as Librium, Valium, and Xanax reduce anxiety because they directly increase the likelihood that GABA will bind to the receptors of those neurons that are to be inhibited. This, in turn, increases the effectiveness GABA, thereby reducing neural activity, which subsequently decreases one's level of anxiety. Panic disorder, which is an anxiety state, is generally characterized by brief and intense spontaneous anxiety, is now thought to occur in individuals who have overly sensitive respiratory control centers in the brain stem. Current research has shown that in these individuals, even a relatively minor reduction in oxygen intake will result in the feeling that the person is beginning to suffocate, and it is this feeling of suffocation that leads to panic. It has been found that antidepressant drugs such as Prozac, Zoloft, and Paxil, which increase the level of serotonin at the synapses, are effective in controlling panic attacks. This is because serotonin acts as an inhibitory neurotransmitter in the respiratory control centers of the brain, thus reducing neurological activity, which in turn reduces its level of sensitivity. Cognitive Perspective The basic premise for the cognitive explanation of fear and anxiety is that people have erroneous beliefs or cognitions that lead to anxiety. For example, people who suffer from agoraphobia have an irrational fear of situations in which escape would be embarrassing if panic-like symptoms occurred. In addition, individuals who suffer from claustrophobia have an irrational fear of small or enclosed spaces. Furthermore, someone suffering from zoophobia has an irrational fear of animals. All of the above described anxiety states are based on erroneous beliefs, or a belief system that is not consistent with reality. The two major questions that the cognitive explanation attempts to answer are firstly, how are these erroneous beliefs developed, and secondly, how are they maintained in the face of evidence to the contrary? Cognitive theorists currently believe that the erroneous beliefs that result in fear and anxiety states, are produced as a result of an individual's earlier life experiences, which can be the result of one's actual experiences, the observation of other's life experiences, or even just hearing about a fearful event. Cognitive scientists also believe that once established, erroneous beliefs are maintained because the presence of that belief has a direct influence on a person's current and future cognitive functioning. In other words, our erroneous beliefs allow for a distorted interpretation of the events that occur around us, and it is this distorted view of things that maintains our erroneous belief system. As an example, an individual suffering from generalized anxiety disorder might see the world as a really scary and dangerous place, where trouble can occur at any moment. Whereas a person who suffers from panic disorder might be walking down the street at a fast pace (e.g., to be on time for an appointment) and start to think that the shortness of breath he or she is experiencing is a prelude to a massive heart attack which will lead to certain death. People who suffer from fear and anxiety could be said, according to the cognitive perspective, to have a problem with selective attention, in that they focus excessive amounts of attention on perceived threats in the environment, and thus are more aware of these threats than are normal individuals. In addition, these individuals could also have a problem with selective recall, in that they are more likely to recall threatening and scary experiences than are individuals who are not anxious, and that recalling these experiences will lead to the maintenance of fear and anxiety states. Furthermore, the cognitive explanation suggests that fearful and anxious individuals might have a problem with misinterpretation in that they are more likely to misinterpret neutral or ambiguous situations as threatening, thus contributing to the maintenance of fear and anxiety. Thus, problems with selective attention, selective recall, and misinterpretation could, according to the cognitive perspective, lead to the erroneous beliefs or cognitions that can be the cause of an individual's fear and anxiety states. Learning Perspective Learning theorists believe that fear and anxiety are classically conditioned responses, and thus are learned behaviors. In other words, fear and anxiety develop when a fear response has been paired with a previously neutral stimulus and as a result of that pairing (conditioning), the previously neutral stimulus now elicits a fear response. Furthermore, not only does the original neutral stimulus elicit fear, but because of the process of generalization, other stimuli that are similar to the neutral stimulus also begin to elicit fear and anxiety. As an example, a person who was bitten by a dog might become fearful of other dogs, or even other animals of different species. It is of interest to note that people do not have to have a direct experience for conditioning to occur, but can also be conditioned vicariously, in that a person only has to hear about another person's unfortunate experience in order to form a pairing of the fearful event with the neutral stimulus. In addition, learning theorists also believe that some of the symptoms that are associated with fear and anxiety states are learned through the process of operant conditioning. More specifically, behaviors that an individual engages in that reduce his or her fear and anxiety are rewarding, and therefore those behaviors are more likely to be used again in future, similar situations. Because learning theorists believe that fear and anxiety result from the inappropriate conditioning of the fear response, the learning approach to therapy involves the correction of the inappropriate conditioning. This can be accomplished through the process of extinction, as well as through the process of inhibition. Extinction occurs when the feared stimulus is repeatedly presented to the individual without the reason for being afraid. For example, in an individual who has a fear of dogs, the repeated and gradual exposure to friendly dogs that do not bite will result in the eventual reduction and elimination of his or her fear of dogs. This technique is often referred to as flooding because the initial exposure to the feared stimulus may result in the individuals being flooded with fear and anxiety. In addition, there are two basic types of exposure: in vivo exposure, which is actual exposure to the feared stimulus; and in vitro exposure, which is imagined exposure to the feared stimulus. Inhibition occurs when an incompatible response (a relaxation response) is paired with the feared stimulus, and this pairing will result in the eventual elimination of the feared stimulus. This therapeutic approach is often referred to as systematic desensitization, but is also known as counterconditioning. In this procedure, the individual is first taught to relax through a process known as progressive muscle relaxation. Second, a list of feared stimuli are compiled in a hierarchical order, from least feared too most feared. Thirdly, the individual then is instructed (by the therapist) to imagine the least feared stimulus and if he or she is able to remain relaxed while thinking about it, is then instructed to imagine the next least feared stimulus. This process continues until all of the feared stimuli are imagined and thus the relaxation response takes the place of the fear and anxiety associated with the feared stimulus. If, on the other hand the person becomes anxious at some point in the anxiety provoking hierarchy, he or she is then instructed to return to the previous imagined stimulus that did not provoke fear or anxiety, and thus the process continues to fruition. Conclusion Although the primary focus of this paper has been on the dysphoric affects that both fear and anxiety produce in the individual, it should be noted that fear and anxiety states can be adaptive responses when one is confronted with an event that threatens one's survival. In addition, past research has consistently demonstrated that levels of moderate anxiety (versus low or high anxiety) are the most optimal for tasks such as test- taking, and recovery from serious illness. Though there are other perspectives that address the cause and maintenance of fear and anxiety states, this paper has focused on the biological, cognitive, and learning explanations. No one theory or perspective can fully account for or predict an individual's level of fear or anxiety. 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