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Be Fear Free



(This post first appeared in April 2011. See you all next year!)

If you have a fear of heights, called acrophobia, you probably consider activities such as standing on a glass ledge 103 stories high to be stressful. But a scientist in Switzerland says that cortisol, the stress hormone, can actually help banish your fear.

A team of researchers led by Dominique de Quervain at the University of Basel recruited 40 patients with serious acrophobia. All the patients received a series of virtual reality sessions, in which they traveled across virtual bridges and stood on virtual platforms, to treat their phobia. 

This is a standard and effective treatment called exposure therapy. It assumes that the patient's phobia is a "conditioned response." Just like good old Pavlov's drooly dogs, a person reacts automatically to a specific stimulus (say, being up high) with a specific response (say, panic). But if you repeatedly expose patients to the stimulus in a safe environment, and help them tone down their fear reaction, they learn a new association. If Pavlov had started giving his dogs empty bowls after ringing his bell, they would have eventually stopped drooling.

The patients in the study responded well to the virtual-reality treatments. Their acrophobia was reduced,  according to both questionnaires and skin-conductance measurements. (Your skin gets sweaty when you're worked up; this is how lie detectors work.) 

But there was another factor in the study: half the patients, before each of their treatment sessions, had been given a dose of cortisol. The other half had taken a placebo. The patients who received cortisol had a greater reduction in their phobia than the placebo patients, both a few days after treatment and a whole month later.

It seems like a counterintuitive result. Why would stress make you less afraid? The answer may have to do with memory. Cortisol can impair your ability to retrieve memories, especially emotionally powerful ones. This could include your memories of previous panic attacks--or a memory of a traumatic event that inspired your fear in the first place. Additionally, cortisol helps you to store new memories. In general, the stress hormone tells your body and brain that what's happening right now is vitally important. In exposure therapy, cortisol may give extra weight to new memories of experiencing a stimulus in a safe setting, while simultaneously damping down fearful memories.

The paper's authors are also studying the use of cortisol in treating social phobia, a condition that causes some people to avoid all social interaction. For the rest of us, the results may not be as life-changing. But they tell us that it's OK to feel stressed when we face our fears. If this inspires you to go up the Sears/Willis Tower, just make sure to bring a camera so you can prove you did it.

de Quervain, D., Bentz, D., Michael, T., Bolt, O., Wiederhold, B., Margraf, J., & Wilhelm, F. (2011). From the Cover: Glucocorticoids enhance extinction-based psychotherapy Proceedings of the National Academy of Sciences, 108 (16), 6621-6625 DOI: 10.1073/pnas.1018214108 

Photo: by me.

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