CHAPTER 1
The Biology of Fear
There is No Such Thing as Stress
According to recent surveys, stress is a challenge for most of us. An American Psychological study in 2007 found that close to one-third of all survey respondents described their stress as “extreme” and nearly half felt that their stress was getting worse. Stress is considered a primary underlying factor in many health problems, relationship tensions, and lost productivity at work. Knowing this, it might seem strange to you—even outlandish—for me to tell you that: There is no such thing as stress. Stress, as we know it, does not exist!
In fact, what we are currently calling stress may be something else entirely and I hope to convince you that stress would be best addressed by a different name. To begin our journey, consider the findings of one recent study on stress. A group of researchers followed 30,000 subjects for eight years examining the relationship among reported levels of stress, perceptions of stress, and mortality outcomes.1 At the beginning of the study, investigators asked people to rate their levels of stress. Then, eight years later, they examined public records to see whether or not the reported levels of stress could predict who would still be alive. At first glance, the results seemed exactly what we might predict. Those subjects who had indicated that their stress levels were high at the beginning of the study were 43 percent more likely to have died during the eight subsequent years. However, the findings turned out to be more complicated than that. At the onset of the study, researchers had asked not only how extreme the person felt their stress level was, but also whether or not the person felt that the stress was harmful to their health. It turned out that only the subjects who feared that the stress was harmful suffered its ill effects. The investigators scrupulously ruled out other possible causes for this dramatic finding, leaving us asking: “What’s happening here?”
With that question in mind, let’s begin by exploring a bit of “stress” history. Do you know how old the concept of stress is? It’s a little known fact that “stress” sat around in the science of metallurgy (the contortion of metals) for 500 years bothering no one until the early 20th century when it became a medical disorder that no one has been able to cure. Since its discovery, humankind has cured polio and tuberculosis and has made strides with virtually every form of cancer. Physicians, psychologists, spiritual advisors, and others have been working diligently to identify, describe, and attempt to cure this modern “disease.” But, despite the extensive research, thousands of experts, and multitude of books and articles on the topic, very little progress has been made.
The Biology of Fear
The lion, the gazelle, the monkey, and me; we all have something in common that profoundly affects the success we achieve—or don’t—in life.
So why haven’t we been able to cure stress? The answer lies in the design of the brain. The human brain has been given two essential tasks: regulating the body and surviving in the world. Every other activity is a luxury. The bottom layer is our brainstem, often called the “reptilian brain.” This portion looks like the full brain of an alligator and it’s responsible for most of our basic bodily functions, such as reminding our hearts to beat and our lungs to take in air. This is what keeps us alive when the two other layers are damaged, as when someone is in a coma. The top, or outer layer, is the cortex. This is our luxury—the part that makes us most human. Wrapped around the midbrain, the cortex is where consciousness, problem-solving, and creativity live. Sitting unobtrusively between these two layers lies the powerful midbrain, home to our emotions and key to our survival. The mid-brain is often called “the mammalian brain,” because we share the design with all other mammals, most similarly the chimpanzee.
The task of survival is assigned to the amygdala, an exquisite little almond-shaped structure located in the bottom portion of the midbrain. This structure governs the body’s primitive “fight or flight” response, and is responsible for four Fs in life: food (appetite regulation), fight, flight, and sex (yep, you guessed it—fornication). The fight or flight response is the highly effective alarm system that prepares the body for action. To get a feel for this extraordinary system, just imagine yourself as a lion, lying peacefully in the African savannah enjoying the warm sunshine. You open one lazy eye and spot a delicious gazelle grazing 50 yards away. Your eye sends the message to your amygdala, which rapidly dispatches the information necessary to prepare your body to pursue this new opportunity—lunch has arrived! The gazelle, pausing between bites, sees you lift your head. Its eyes send your threatening image to its amygdala, which immediately prepares it to escape the misfortune about to befall.
Whether running toward opportunity or away from danger, the amygdala triggers the exact same set of bodily responses—both animals become equally primed for action. Pupils dilate to let in more information and the heart races, speeding up circulation of blood to the muscles. The muscles of the upper neck and lower back are tensed, preparing the legs for action. The mouth becomes dry, the stomach slams shut, and appetite is lost. If two gazelle are mating and they sense a lion charging, do you think one of them turns to the other and says, “Wadda you think sweetheart, is it worth it?” Of course not! The blood supply immediately leaves the genitals, preparing the animal for flight. The animals get rid of excess baggage (waste products) so they can run faster and explosive diarrhea and urination ensue. The quintessential example, some might suggest, of being “scared shitless and pissed off!”
All mammals, including humans, possess this primitive, highly effective alarm system that prepares the body in response to opportunity (the lion) or threat (the gazelle). It is the most life-saving mechanism in the brain. But let’s take a minute now to consider the symptoms: racing heart, dry mouth, shortness of breath, neck, back, and stomach pain, frequent urination, diarrhea, change in appetite, headache, insomnia, and loss of libido. Does the list sound familiar? I expect it does. If you look up the symptoms of stress or anxiety in any medical textbook, you’ll find that the “disease” symptoms listed are identical to any body’s healthy, natural response to fear. When the body’s alarm system—its fight or flight response—is switched on for hours, days, or weeks at a time, it creates a sense of “dis-ease” in the body. The result is what we now call a stress disorder. The term stress is humankind’s attempt to take one of nature’s finest gifts to our bodies and label it a disease!
So what difference does it make if we call this alarm system stress or fear? More than you might imagine. To understand how a simple choice of words can affect our long-term success in all areas of life, let’s begin first by looking at a fundamental problem with our current use of the word stress. The father of stress research, Dr. Hans Seyle first coined the term in 1938, making a clear distinction between a “stress response” and “stress” itself. He identified life challenges—our jobs, the traffic, financial struggles, relationship trials—as stressors and the body’s inability to deal successfully with these challenges as stress.
Stressors are external threats or challenges.
Stress is our body’s reaction to those challenges.
In today’s world, we have confused our stressors with stress, and we now erroneously believe that the source of the problem is the mortgage, the difficult marriage, the unruly children, the demanding boss, the unfinished projects (threats), or even the recent promotion, the new house, or the budding relationship (opportunities). People rarely have control over their stressors, yet most of us persist in attempting to “cure” stress by endeavoring to control them. People unsuccessfully blame external factors—life situations and other people—for their chronic discomfort and high-alert state (stress disorder), rather than seeking to address the body’s unhealthy, often changeable, stress response. Incorrectly identifying the source of the problem leads people to make excuses rather than progress.
The Vocabulary of Fear
Many of us today use words like “stress, anxiety, depression,” or “nerves” to describe a strong, persistent feeling of upset in our bodies. However, throughout my research, I have been especially intrigued by how rarely highly successful people use these words to describe the uncomfortable feelings typically associated with stress. As I watched interview after interview of incredibly successful people talking about their lives, I noticed that they consistently used different words to capture this experience. They all used the word fear or one of its synonyms (afraid, scared, etc.) to describe the physiological responses we all share.
At first, it seemed a simple matter of semantics, possibly not worth further investigation. However, after a while, the frequency of so many successful people using the words “fear” or “scared” was hard to ignore. For example, consider the book Creativity, Inc.2 by Ed Catmull, president of the hugely successful film production company Pixar. The story of the history, evolution, and processes used by this magical studio—creator of epic animated movies such as Toy Story, Finding Nemo, and Monsters, Inc.—is inspiring to read. Most interesting to me, however, was the fact that in the book Catmull used the word “anxiety” once and “stress” once, but used “fear” or “scared” 78 times! “If we aren’t always at least a little scared,” he wrote, “we are not doing our job.”3
Ed Catmull is not the only highly successful person who chooses to use these powerful words regularly. Note how many others who have achieved remarkable results in the world have used the words fear or its synonyms:
When you are running an institution, you are always scared at first. You are afraid you’ll break it. People don’t think about leaders this way but it is true. Everyone who is running something goes home at night and wrestles with the same fear. Am I going to be the one who blows this place up?
—Jack Welch, past-CEO, General Electric
All adventures, especially into new territory, are scary.
—Sally Ride, astronaut
Never let the fear of striking out get in your way.
—Babe Ruth, baseball player
Fear is your ally. The minute you come onto a set and you’re no longer afraid, you are in big trouble.
—Stephen Spielberg, author and producer
I’m coming from a place of acting, so you’re never quite sure if you’re going to get the crew to even be on your side and you always have this great fear that they will discover that you’re an imposter and that you have no business being there.
—George Clooney, actor (Los Angeles Times, January 27, 2012)
You gain strength, courage, and confidence by each experience in which you really stop to look fear in the face. You are able to say to yourself, “I have lived through this horror. I can take the next thing to come along.”
—Eleanor Roosevelt, First Lady
If you can take the time to understand fear, you can use it. I was always a little afraid in each game I played. Afraid of failure, of letting my teammates down, and of being hurt. I used that fear to make me a better player.
—Lynn Swanson, NFL player on four Super Bowl teams
I was puzzled. Why would so many successful people prefer the word fear over stress? Then one day, while I was following one of our resident physicians through her clinic visits, the answer suddenly became obvious. As an educator on faculty at two medical schools, through the past 25 years it has been my responsibility to help students in family medicine excel in their communication with patients and families. In this role, I spend more than half of my time shadowing new doctors on their rounds, observing their interactions, and providing feedback about their clinical work and bedside manner. As a result, I’ve witnessed thousands of interactions with patients and family members as they’ve faced surgery, pregnancy, diabetes, cancer, rashes, insomnia, heart disease, aging, and more. While listening to patients that day, I began to recognize the very different vocabularies used by adults and children when describing feelings of “upset” or emotional pain in their bodies. When adults talk with a doctor, they almost always used words such as depressed, anxious, stressed, nervous, or tense. But children never use these words. They talk about being scared or afraid.
Tell me, have you ever heard a child say she was “anxious” about the boogey man? Or he was “depressed” because the other kids at school were going to the zoo, but he was going to the hospital for surgery? Of course not! Children state things simply and directly—they are scared, mad, sad. At some point, you have probably witnessed another adult crying who immediately reached for a tissue and apologized, saying something like, “Oh, I’m so sorry. You must think I’m such a weakling!” Children, on the other hand, cry freely, sobbing loudly with snot dripping down their faces, not apologizing for a thing. So why do children simply cut to the chase? It’s because children know they live in a world that they cannot control. They can’t control whether their parents are in a good mood or bad or whether their new teacher will be nice or mean. They can’t control thunder and lightning, the stomach flu, or who will be their best friend at recess tomorrow. As a result, children seem to have a different relationship than adults do with emotional joy and pain.
Give this a try. Sit down with a young child; ask him what he wants for Christmas and you’re in for a 20-minute discussion. Then, ask what he’s afraid of—another 20-minute conversation will definitely ensue. What kind of movies do kids love to stand in line to see? Scary ones! Children accept that they live in a world of fear, so they figure that they might as well have some fun and learn to deal with it in the process. Because they lack control over so many aspects of their world, and because they accept this lack of control, children can easily discuss their fears.
By the time we become adults, however, fear is no longer seen by most of us as a normal, healthy part of life, but instead something we get angry at for showing up. In a culture obsessed with self-reliance and the preservation of self-esteem, the term fear has become a four-letter word. We do not accept our lack of control and so we rarely learn how to deal with it successfully. We consider fear a disease. We call it stress and blame the person or situation that triggered the feeling rather than addressing the fear itself. Let me see if I can convince you of this in two ways:
First, right now, put down your book and call up a friend. Wait for a natural pause in the conversation, then ask, “So, what are you afraid of?” Do you think this will trigger an interesting conversation or will your friend question your sanity and change the topic? Probably the latter. It’s a question that makes most people uncomfortable. As mentioned earlier, most of us have banished fear from our conversations and awareness, focusing instead on the external problems we face while labeling the body’s most powerful and basic emotion a disease.
A second exercise demonstrating our strange, unmindful relationship with fear is one I use with audiences all over the world. I begin by saying, “Please raise your hand if you are afraid to cross the street.” In a room of 100 people, one or two hesitant hands will lift. Okay. I then say, “So, if I were to blindfold you and ask you to cross the street, would you then be afraid?” All hands go up. Good—we’re making progress. “One final question. Imagine you and I are walking down the street, engrossed in conversation. You sense that we’re getting close to a busy crossing, but I appear to be oblivious to the rapidly passing cars. As we reach the intersection, do you keep eye contact with me as we cross the street? Of course not! No matter how rude it might seem, you’ll break eye contact, look left and right, and assure that the cars have stopped before crossing.” I pause for some reflection time, then conclude: “We engage in this elaborate set of behaviors for only one reason—we are afraid that if we don’t, the results will be painful. For this reason, I suggest that we are all afraid to cross the street.”
What these exercises convey to us is that fear is a gift. But most of us have forgotten that, just as we’ve forgotten that we’re afraid to cross the street. When we visit cities like New York, London, or Rome, where the rules between cars and pedestrians may be different than what we’re familiar with, we need to adapt in order to survive. So, at these times, we become more aware of our fear. Where do you think we are most likely to get hit by a car—in a crosswalk or jaywalking? We are four times more likely to get hit in a crosswalk! Because when we’re jaywalking, we know that we’re not where we’re supposed to be, so we think much more about the car danger and potential police officers, and the street has our complete attention. But in a crosswalk, there is an illusion of safety. And there, metaphorically speaking, is where most of us spend our lives.
Now, it’s not likely that forgetting you are afraid to cross the street will get you into any real trouble—your parents did too good of a job training you. The important point to consider is that if you have forgotten that fear, are there any other fears you have buried along the way?
If I’d asked you before reading this chapter if you’d like to live your life fearlessly, many of you would have leapt at the offer. Everyone has a long list of times when we believe that fear has gotten in our way. I hope that by now, however, you will consider the possibility that fear is a gift. Without it, you might not live another week! Consider the many simple behaviors we engage in out of fear every day:
• Do you wear your seatbelt when you get into the car? If so, is it due to the sheer pleasure of having that strip of cloth across your chest? Of course not! You’re either afraid of going through the windshield or of getting a ticket.
• Do you take better care of your teeth the week before you go to the dentist? Is this because your teeth and gums are in greater need than they are the other 51 weeks of the year?
• Do you make some food choices based on what is best for your body rather than what might taste best, or exercise with the thought that your body might not otherwise sustain you as you age?
I hope that by now we all agree that everyone experiences fear at some level on a daily basis. So, you might ask, what does this have to do with achieving success? To answer this question, let me share the first law of success—the first half of the one essential skill for creating and maintaining excellence in health, career, and relationships. It is to do what successful people do—develop an awareness and acceptance of fear. Successful people are consistently aware and accepting of their fears. They assume that whenever they are doing something important, fear will show. The bigger the streets they want to cross, metaphorically speaking (for example, creating a loving relationship, dealing with a promotion, starting a new business, or committing to a healthy lifestyle), the more fear will be present.
If you want to improve your skills in becoming more aware and accepting of fear, I recommend that you consider reading Susan Jeffers’ book, Feel the Fear and Do It Anyway4 to glean her insightful perspectives on the subject. You may also want to try out the following two exercises:
First, sit across the table from another adult and begin a conversation. Start by having one person ask, “What are you afraid of?” and the other partner respond each time with, “I’m afraid …” or “I’m scared.…” Fill in the blank with any fear large or small that you can remember, anticipate, or imagine. You might begin by saying, “I am afraid to do this exercise.” Go back and forth with your partner for five minutes, taking turns asking and answering the question. As you proceed with this exercise, remember that you don’t need to be profound. Most fears are genuinely simple and very childlike.
At least once each day, when you or someone else is upset, assume that there is an underlying fear and try to discover what it might be.
Do all upsets come from fear? We don’t know for sure. However, based on the research, I suggest that this is a most useful way of looking at them. The spiritual literature suggests that there are just two basic human fears: a fear of not being worthwhile, which tends to be associated with self-esteem (for example: Why didn’t I get that promotion? Why don’t my friends call me back? Why can’t I find love? What if my new venture doesn’t succeed?) and a fear of losing control, which we tend to associate with health or financial concerns. Let me demonstrate how broadly you can apply fear to any upset. Do you or does anyone you know get frustrated in traffic? If I were to suggest to you that the only reason we get upset in traffic is because we’re afraid, would that sound ridiculous? Consider this scenario:
You woke up this morning because the alarm clock triggered your amygdala. If you are highly spiritually evolved, your first thought was: “Thank God I get to live another day!” For those of us not so spiritually advanced, however, those first thoughts may have a slightly different ring. They may sound something more like this: “You should have gone to bed earlier! You shouldn’t have had that cake last night! You should have gotten up an hour ago to exercise! You have way too much to do today—get out of bed!”
Does this harsh voice, or some version of it, sound somewhat familiar? For many of us, these are the words that greet us with the miracle of life each morning. A host of underlying fears, all of them rushing in to help us start our day.
Now imagine that I greeted you by saying, “How was your shower this morning?” You would think I was crazy! And yet, the shower is one of the most sensual parts of our day. The miracle of that warm, clean water pouring over our pain-free bodies—some days, that’s as good as life gets! But what are most of us typically doing in the shower? Oblivious to the pleasure of the moment and the boost to our physical health, we are busy building our list of what we need to accomplish (or what we can’t accomplish) that day. We rehearse our schedule and plans and potential failures until we’re out the door and, by the time we reach the roadway, all those cars are standing between us and our list! When we get to work, we’re feeling rushed and behind-schedule. Excited about last night’s big game, a friend stops to ask if we saw it. We make the mistake of saying “no” and he takes this as an invitation to tell us all about it, play by play. By the end of his story, we’re seething—this fool standing between us and our list! And that list is standing between us and our feelings of self-worth, self-esteem, and accomplishment. Do you see now how fear may underlie even the simplest upsets in life: a late shower, cars on the highway, a talkative colleague, or any other frustration?
You may want to consider keeping a journal of these sorts of observations for a time, to help establish the habit of looking for and becoming more aware of underlying fears. As you explore this idea, remember that we suggest that most fears can be reduced to either a fear of losing control (usually referring to health or finance) or a fear of not being worthwhile. To help you get started, here are a few examples of “upsets”—anger, frustration, irritation—that may develop from an underlying fear:
• “I’m upset with my friend for not returning my call.” I may not be valuable enough to that friend, proof that I am not worthwhile or important.
• “I’m upset with my spouse for not doing more around the house.” If he or she loved me more, they would treat my needs more seriously; or, if I had more help, I would feel less out of control.
• “I’m upset with a colleague at work who is taking all the credit for a collaborative project.” I’m afraid if they start laying people off, I may be seen as less valuable and could lose my job; or, I’m afraid my colleague sees me as weak and thinks I can be trampled on in this way.
• “I’m upset with all the people who take advantage of me!” I am afraid to say no and risk other people’s rejection. Doing for others gives me a sense of importance. I’m afraid if I stop doing for others, I’ll feel worthless.
It’s important that we don’t confuse our desire to recognize and address our fears with a wish to eliminate them entirely. For most of our existence as a species on this planet, we’ve lived as hunters and gatherers. We did not see as well, run as fast, or have the strength of the animals who preyed upon us. When we came out of our caves, it was useful—essential really—that we approach the world with caution (another grown-up word for fear). What I am suggesting to you, then, is that fear can be a guide and a friend and it remains as essential for our survival and success in today’s world as it was in the wild.
Recognizing our underlying fears, however, helps us to quiet the amygdala and allows us to more easily identify specific ways in which we might address a challenge. In later chapters we will address the fact that denying fear’s existence or getting angry when you encounter fear can lead to anxiety or depression. This can defeat the value of fear in guiding us to confront and resolve the challenges of life. When these same fears are recognized and addressed in constructive ways, people’s lives tend to flourish.
A study in the American Journal of Psychiatry dramatically illustrates the danger of not having a typical fear response in today’s world. A group of 400 children was assessed at age three to identify environmental risk factors such as lack of parental education, poverty, and being born to teenage parents. Additionally, each was assessed to determine their fear response. Twenty years later, these same children (now young adults) were evaluated to determine which of them had been convicted of serious crimes.5 The best predictor for the likelihood of criminal convictions in adulthood was the person’s lack of fear response at age three. The authors of the study hypothesized that a poorly functioning amygdala led to a weak fear response. This finding aligns with similar studies, which have found that psychopaths have a poorly functioning amygdala as well. So you see, as uncomfortable as it may feel at times, fear is good for human beings and it is essential to our well-being!
I suspect that, by now, you’re beginning to wonder what all this information about fear has to do with success? Successful people find fear as uncomfortable as anyone else does, however instead of rejecting or avoiding it, they see it as a signal that something important is happening that requires their attention. As children do, they assume that fear is a natural part of life, and they know that whenever they’re doing something important, fear will show up. Fear is something to be recognized, embraced, and boldly addressed; and developing an acceptance and awareness of fear is crucial in maintaining success in work, health, and relationships.
In today’s world, what we currently call stress often hampers our happiness and stalls our success in many areas of life. And yet, with all of our collective efforts, we have not yet been able to cure it. Why is this? As we mentioned earlier, the primary reason is because there is no such thing as stress. Stress is actually fear trapped in a culture with an unhealthy relationship to that emotion. The “stress symptoms” listed at the beginning of this chapter are not signs of disease. They are our body’s gift to us to let us know something important is happening that requires our immediate attention. Without these symptoms we would have perished as a species long ago.
We do not want to be afraid of fear. Recall the study mentioned earlier in this chapter where, of 30,000 adults who reported high levels of stress, only those who believed that stress was harmful met an early death. “Stress” was not the villain—it was the fear that stress was harmful that was the danger.
Fear is designed to help and protect us and it gives us the tools to solve life’s challenges if we use it well. As Kelly McGonigal writes in The Upside of Stress: “The energy you get from stress doesn’t just help your body act; it also fires up your brain. Adrenaline wakes up your senses. Your pupils dilate to let in more light and your hearing sharpens. The brain processes what you perceive more quickly. Mind wandering stops and less important priorities drop away. Stress can create a state of concentrated attention, one that gives you access to more information about your physical environment.”6 Remember the responses of the lion and gazelle? What McGonigal is describing here is the upside of fear.
So, if we wish to alleviate stress and improve our chances of success in all areas of life, then the question becomes: “Just what is a human being’s healthy response to fear?” Let’s travel forward into the next chapter to unearth the answers.