Your brain on terror — a writer faces the science behind her fears

Originally published on May 16, 2020.

Fear is a universal human experience.

It seems to be little more universal at the moment, with a lethal pandemic scouring the planet. But fears are often more personal.

For Canadian writer Eva Holland, she was afraid of losing her mother, and of heights. And after her mother passed away in 2015, she started to examine the role that fear played in her life and decided to see if it was possible to get rid of her fears — for good.

That led her down a deep exploration of the science of fear. And she turned this quest into a new book, in which she explores, among other things, whether it's possible to become truly fearless, and whether that's even something worth striving for.

Eva Holland joined Quirks & Quarks host Bob McDonald to talk about her new book Nerve: A Personal Journey Through the Science of Fear.

This interview has been edited and condensed. 

So what exactly sent you on this journey to understand fear?

The first was my mom's death in the summer of 2015. My mom had been an orphan, and so I had always been really afraid of the idea of losing her. When I came through the worst of my grief about six months after she had died, I sort of realized I had faced my worst fear and survived, and that was empowering in a way.

That made me think maybe I can do something about my relationship with my other fears. Right around the time that I was starting to think about these issues, I had a pretty severe panic attack while on an ice climbing trip with some friends in the mountains in northern British Columbia, and decided that that was just unacceptable and that launched me on this idea that I was going to try to understand what was happening to me, and try to fix it.

In your book you say for you it's almost a paralysis. You say you found yourself on an ice wall, and you just couldn't move — you were frozen.

When you think about "what does it mean to be afraid," for me it's that tightness in your chest, maybe constricted breathing. You know, when you can feel that your pupils are dilated, that your eyes are wide, maybe goose bumps, accelerated heart rate. All those physical symptoms of fear sort of packaged together really define the experience.

What's happening in our brains when we experience fear?

It's something that neuroscientists are still trying to map precisely, but they have a pretty good understanding of the circuit that drives our physical reactions at this point. A neuroscientist named Joseph LeDoux has done a lot of work on the fear circuit.

Our brains have different structures and the key one — although not the only one — involved in our fear response is the amygdala. What it appears to do is receive sensory information from our body and perform a threat assessment — "Is this stimuli threatening?" If yes, then it passes that information along to the hypothalamus, which triggers what we call our fight or flight response — although some people are now calling it a "fight, flight or freeze" response. 

Now in your book you set out not only to understand fear but to conquer fears, and you have a number of amazing stories that you went through to face them. So tell me about some of your experiences with that tactic of trying to conquer your fears.

Yeah, that was the goal when I set out. And I think by the end, I had to some extent set aside the idea of conquest, in favour of maybe more of a renegotiation? 

The first thing I did was I signed up to go skydiving to see if I could sort of break through my fear of heights and specifically, falling from heights. And I would not call it successful.

Well, then you ended up working with researchers at the University of Amsterdam who had a better treatment. Tell me about that experience.

Yeah, that was really amazing. So I had heard about this researcher in Amsterdam who was curing phobias — the tagline went "with a single pill." 

It's a bit more complicated than that, but what she does is use the latest neuroscientific understanding of memory storage and retrieval to try to meddle with our fear memories and with those patterns in our brains. 

We know that protein synthesis is involved in putting our memories into long-term storage when they're first formed. Protein synthesis is also involved when we pull our memories up from long-term storage for lack of a better analogy and then put them away again.

So when you block protein synthesis you can block the formation of memory and you can also disrupt the re-storage of memories, is the basic idea. So what this researcher Merel Kindt in Amsterdam does is she triggers people's phobias pretty close to as strongly as possible. She calls up their fear memories — that pattern of fear and reaction — and then she hits them with a dose of a common beta blocker, propranolol. It's a common medication for high blood pressure, stage fright, that sort of thing. It sort of calms you.

But dosing people with it at the moment that they have pulled up their fear memories and are in the grips of that pattern seems to prevent us from restoring those memories correctly in their original form. 

It's not that they're erased. It's like they're sort of dislocated from our reaction. Kindt has been having really remarkable results of disrupting decades-old phobias with this treatment. It's sort of sci-fi.

So how did it work for you?

It worked amazingly well. She put me in the bucket of a firetruck and sent the bucket up as high as it would go. Well when we got back down, my legs were shaking — I felt like I might fall over. Then they gave me the pill and told me to go home for 24 hours and not think about it and try to get a good night's sleep. And the next day, they put me back in the fire truck bucket and set me up again, and I was completely fine.

So did that cure your fear of heights?

I think so. I tested it on quite a steep dramatic hike last summer. There was a mountain pass I had to go over that I would have previously expected to go over on my hands and knees sobbing. I was nervous, but I did it, and I wasn't panicked. I was cautious.

That's the other thing — relearning how to listen to my fear now that it's no longer so exaggerated. Of course, I should be cautious in a very steep high mountain pass.

In your book, you talk about a person named S.M. who is truly fearless. How was she different?

So her Urbach–Wiethe disease is a really rare condition that, in addition to affecting a person's skin and their vocal cords in some various unpleasant ways, it attacks their brains, and it particularly calcifies the amygdala. 

People might think, 'Oh, that sounds pretty cool.' It's incredibly dangerous. She's very lucky to still be alive in her mid-50s with essentially no sense of survival instincts.  

She has been beaten and assaulted. She has had a gun held to her head. She didn't flinch. She has trouble with money because she has no sense of consequences. She sometimes forgets to eat. She has no notion of risk at all for herself, for her personal safety. 

In comparison a few decades ago, a scientist removed the amygdala from a number of monkeys and released them into the wild, and they were all dead within two weeks.

So what can we learn from someone like S.M.?

I think she teaches us that even though we treat fear as unpleasant or even shameful — we spend a lot of time talking about defeating it, conquering it — fear is really important. It's really necessary to our lives. 

And so I think it really teaches us that even though we treat fear most often as a negative, it's a really hugely important part of our lives, in way more ways than we think about.

Produced by Amanda Buckiewicz. Written by Jim Lebans.