Erasing Fears & Traumas Based on the Modern Neuroscience of Fear | Huberman Lab Podcast #49

The video explores the neuroscience of fear, trauma, and post-traumatic stress disorders. It discusses the neural circuits involved in the fear response and methods to extinguish fears. The video also highlights a study showing how deliberate exposure to stress can alleviate depressive and fear-related symptoms. The podcast covers the biology of fear and trauma, including the cells, circuits, and chemicals involved. It discusses tools to unlearn fear and replace it with positive events. The video also discusses the role of autonomic arousal, the hypothalamic-pituitary-adrenal axis, and the threat reflex in fear and trauma. It explores cognitive therapies, such as prolonged exposure therapy, for rewiring the nervous system and reducing fears and traumas. The video also mentions the potential of treatments like EMDR, ketamine-assisted psychotherapy, and MDMA-assisted psychotherapy for PTSD. The importance of social connection, nutrition, sleep, and supplements in erasing fears and traumas is emphasized.

Introducing Fear, Trauma & Trauma

The neuroscience of fear, trauma, and post-traumatic stress disorders is explored in this video. It discusses the neural circuits involved in the fear response and methods to extinguish fears. The video also highlights a study showing how deliberate exposure to stress can alleviate depressive and fear-related symptoms. The podcast covers the biology of fear and trauma, including the cells, circuits, and chemicals involved. It also discusses tools to unlearn fear and replace it with positive events.

What is Fear?

Fear is a complex emotion that involves physiological and cognitive responses. It is distinct from stress and anxiety, but can include elements of both. Understanding the mechanisms of fear can help in managing and overcoming it.

Key points:

Fear involves physiological and cognitive responses
Fear is distinct from stress and anxiety
Fear can exist without stress or anxiety
Trauma occurs when fear becomes embedded and reactivated in maladaptive ways
Phobias and panic attacks involve extreme fear without a specific stimulus or fear of something specific
Understanding the different aspects of fear can help focus on biological and cognitive processes
The video discusses the formation, elimination, and replacement of fears to establish a common understanding.

Autonomic Arousal: “Alertness” vs. “Calmness”

Autonomic arousal refers to the activation of the autonomic nervous system, which controls automatic bodily functions. It has two branches: the sympathetic branch, which increases alertness and vigilance, and the parasympathetic branch, which promotes calmness. The balance between the two branches determines our state of arousal, with increased sympathetic activity leading to heightened alertness and increased parasympathetic activity leading to relaxation. Understanding autonomic arousal is crucial as it plays a significant role in our daily functioning.

Hypothalamic-Pituitary-Adrenal Axis (HPA axis)

The Hypothalamic-Pituitary-Adrenal (HPA) axis is a three-part system in the brain that controls the release of hormones and chemicals in response to various stimuli. It plays a role in stress response and waking up in the morning. The HPA axis can quickly activate the body for immediate action and provide sustained alertness. It also responds to fear and trauma, triggering both fast and long-lasting effects. The slow shutdown of the HPA axis can embed fear in the brain and body, but it can also be utilized to undo the fear response.

“The Threat Reflex”: Neural Circuits for Fear

The amygdala, a key component of the threat reflex, triggers physiological responses such as increased heart rate and heightened attention. It shuts down other neural circuits associated with calmness and perception of the environment. The amygdala is part of a larger complex called the amygdaloid complex, responsible for generating threat reflexes. It has multiple outputs, triggering primitive drives and creating a sense of alertness and action. The threat reflex involves the activation of brain centers like the periaqueductal gray and the locus coeruleus, leading to freezing and other physiological responses. It can be activated by prior memories or immediate experiences and has two major outputs: one for the threat response and the other for reward and motivation. The threat center in the brain can communicate with and activate the dopamine system, important for rewiring new memories.

Controlling Fear: Top-Down Processing

Top-down processing, controlled by the prefrontal cortex, allows us to override reflexes and control our responses to fear. This can be seen in examples such as stepping on a tack or getting into cold water. By providing a narrative and consciously deciding to act differently, we can use top-down processing to override internal reflexes, including the threat reflex.

Fear is a response that involves quickening of the heart rate and breathing, often accompanied by the release of adrenaline.
Most people find the sensation of adrenaline uncomfortable and out of control.
Fear involves attaching narrative and meaning to the experience.
The response to fear can involve remaining still, moving forward, or retreating.
Adrenaline and adrenaline aversion will be explored in more detail in a future episode.

Narratives: “Protective or Dangerous”

Fear is a complex response that serves as a protective mechanism to prevent harm or danger. However, fear can also be harmful internally. Memories can be categorized as either protective or dangerous, as they can either prevent us from making bad decisions or evoke a sense of fear. Understanding the mechanisms and narratives associated with fear can eventually lead to its elimination. The video explores how certain memories become attached to the fear system and how narratives can be either protective or dangerous in relation to fear.

Attaching Fear to Events: Classical Conditioning & Memory

Classical conditioning, also known as Pavlovian conditioning, is a process in which a neutral stimulus becomes associated with a natural response through repeated pairings. This process is how our fear systems work, as they are designed to create memories and anticipate potential threats. Humans can experience one-trial learning, where a single pairing of a conditioned stimulus with an unconditioned stimulus can lead to a response. This learning process involves the amygdala and other brain circuits that are responsible for processing threats and keeping us safe.

Classical conditioning attaches fear to events through one intense experience, leading to immediate and long-lasting fear responses.
Fears can be short-term, long-term, or medium-term, and can be based on acute or prolonged experiences.
The fear system has the ability to batch multiple events in time and create a generalized fear.
Understanding the fear system helps explain reactions to specific incidents that create a general sense of fear or isolated fears about specific circumstances.

How Fear Learning Occurs: Long Term Potentiation, NMDA

Neuroplasticity is the nervous system's ability to change in response to experience, and one mechanism of neuroplasticity is long-term potentiation (LTP). LTP involves strengthening the connections between neurons at the synapses, resulting in improved communication. The NMDA receptor plays a crucial role in fear learning and LTP by triggering signals that enhance communication between cells. This process allows for the creation of new associations and the activation of the threat reflex. However, the NMDA receptor can also weaken connections through long-term depression, leading to the extinction of fear.

Extinguishing (Reducing) Fears

Extinguishing (Reducing) Fears: A Summary

The modern neuroscience of fear offers a process to reduce fears and traumas by weakening the connections between threats and reflexes, and strengthening new positive experiences. Current clinical treatments for fear and trauma, such as SSRIs, benzodiazepines, and beta blockers, only alleviate symptoms and do not address the need for attaching positive experiences to previously fearful events. To develop more effective treatments, it is crucial to target the specific fear circuits in the brain linked to memories and systems involved in pain, relief, and anxiety.

Cognitive (Narrative) Therapies for Fear

Cognitive therapies for fear, such as prolonged exposure therapy, cognitive processing, and cognitive behavioral therapy, use language and narrative to rewire the nervous system and reduce fears and traumas. These therapies involve retelling traumatic experiences in detail, initially causing anxiety but ultimately reducing fear. They require support from a clinician and can be done through therapy sessions, group settings, or journaling. The goal is to transform the traumatic event into a boring story, uncoupling the threat reflex from the narrative and resulting in a lower fear response. Journaling can be effective for those without access to therapy, but social support is important during the reactivation of traumas.

Repetition of Narrative, Overwriting Bad Experiences with Good

The repetition of narrative is a powerful tool for overwriting bad experiences with good ones. Key points include:

Diminishing the physiological response to traumatic events by reducing the amplitude of the fear response and clearing away associations with the threat reflex.
Relearning a new narrative or creating a new association to replace the fear circuitry in the brain with positive associations.
The importance of retelling the narrative to a clinician to extinguish the fear response and reduce physiological symptoms.
The process involves linking positive experiences to previously traumatic events, activating top-down circuitry to inhibit the threat reflex.
The goal is not to forget the negative experience, but to attach a new positive memory to the fear response circuitry.
The three-part process involves retelling and reliving the traumatic experience, replacing it with positive experiences, and utilizing narrative and cognition to rewire the brain.
Narratives are powerful tools for rewiring fear circuitry and relieving fear and trauma.

EMDR: Eye Movement Desensitization Reprocessing

EMDR, or Eye Movement Desensitization Reprocessing, is a therapeutic technique that reduces anxiety and the threat reflex by using lateralized eye movements. It has shown promise in treating fear, trauma, and PTSD, particularly for single event traumas or acute experiences. EMDR focuses on extinguishing the physiological response to the trauma and aims to diminish the negative feelings associated with it. However, there is limited research on the active components of EMDR beyond the extinction of the physiological response. Feedback from individuals who have undergone EMDR is encouraged to improve its effectiveness.

Social Connection & Isolation Are Chemically Powerful

The importance of social connection in relation to fear and trauma is supported by emerging research in neuroscience.

Key points:

Tachykinin is a molecule activated in the central amygdala and nearby structures involved in the threat reflex.
Tachykinin leads to changes in gene expression and reinforcement of fearful or traumatic experiences.
Social isolation increases levels of Tachykinin, which is associated with low to moderate levels of anxiety and aggression.
Social connection with trusted individuals can help alleviate pre-existing traumas or fearful events.

Social connection plays a crucial role in reducing the effectiveness and levels of fear and trauma.

Key points:

Traumatic events and fearful experiences are difficult, and maintaining social connections outside of specific contexts is important.
Trusting social connections, whether with a clinician or therapist, or with others, have a neurochemical basis for relieving fear and trauma.
Regular social interaction can diminish the impact of fear and trauma by suppressing the circuits that amplify these emotions.

Trans-Generational Trauma

Trans-Generational Trauma refers to the passing down of a predisposition for fear and trauma from parents to their children. This genetic predisposition makes individuals more reactive to fearful events, but it does not mean they will constantly be traumatized. Certain gene variations, such as FKBP5, affect the cortisol system and the HPA axis, lowering the threshold for becoming traumatized or afraid. Treatments for trauma are not different for individuals who have inherited trauma. The passage of trauma from one generation to another highlights the role of the threat detection and fear learning system, which lacks specificity and makes individuals susceptible to being traumatized by various stimuli. The children of traumatized individuals inherit a predisposition for being traumatized by a wider range of stimuli. Upcoming behavioral treatments for fear and trauma are mentioned.

PTSD Treatments: Ketamine, MDMA, oxytocin

Ketamine-Assisted Psychotherapy and MDMA-Assisted Psychotherapy are emerging as potential treatments for PTSD. Both drugs alter brain activity and induce dissociation, allowing patients to recount their trauma and form new emotional experiences. MDMA increases oxytocin levels, creating feelings of connection and bonding. Clinical trials have shown promising results, with quicker trauma reduction and the rewriting of traumatic narratives. While these drugs are still illegal outside of trials, the future of MDMA-assisted psychotherapy for trauma looks promising.

How Do You Know If You Are Traumatized?

Assessing the balance between interoception and exteroception is important in determining if you are traumatized or have chronic fear.
Fear and trauma involve funneling external experiences into the fear circuitry in the brain.
The insular cortex plays a role in determining whether our internal bodily sensations are reasonable given the external circumstances.
Inhibiting or reducing the activity of the insular cortex can lead to a mismatch between the intensity of an outside world experience and the internal effects it produces.
Recalibrating physiological responses through a simple protocol can potentially reduce fear and trauma experienced in response to memories or real events.

Deliberate Brief Stress Can Erase Fears & Trauma

Deliberate brief stress can erase fears & trauma

Repeated exposure to short-term behavioral stress can resolve pre-existing stress-induced depressive-like behavior in mice.
Mice subjected to long-lasting restraint protocol exhibited depressive symptoms similar to humans under chronic stress.
Instead of traditional methods, researchers used a counterintuitive approach to provide stress relief.
Brief, intense stress lasting only five minutes a day can reverse the effects of chronic stress.
Short bouts of stress have shown significant effects on stress reduction.
This includes both calming respiration protocols and protocols that induce a heightened state of stress.
The findings have potential implications for the treatment of fear, trauma, and PTSD in humans.

Erasing Fears & Traumas In 5 Minutes Per Day

The video discusses the role of the brain structure called the insular in calibrating our internal feelings with external events.
Trauma, PTSD, and chronic stress can cause the threat response system to become overactive, leading to symptoms.
Breathing protocols can be used to recalibrate the system and reduce stress response.
The calming protocol involves physiological sighs, which are patterns of breathing that occur during sleep when carbon dioxide levels in the bloodstream are high.
A breathing technique involving a double inhale through the nose followed by a long exhale through the mouth can help erase fears and traumas.
Cyclic hyperventilation, a more stressful technique, can also be used for stress relief and relaxation.
Individuals with a predisposition to panic or anxiety attacks should not attempt cyclic hyperventilation.
Deliberately inducing a physiological state of increased autonomic arousal can help address fears and traumas.
Brief interventions of five minutes a day for two weeks, with the support of a clinician, can be effective.
Self-directed stress responses can alleviate fear and trauma, but caution is needed to avoid exacerbating them.
Ongoing research aims to understand the sensory and interoceptive components of fear and trauma.
Deliberate self-directed exposure to short bouts of stress can be a promising approach to overcoming fears and traumas, but individuals with anxiety or panic disorders should seek support from a clinician.

Nutrition, Sleep, & Other General Support Erasing Fear & Trauma

The most profound aspect of the text is the importance of nutrition, sleep, and general support in erasing fears and traumas.

Key points:

Quality nutrition and regular, sufficient sleep are foundational for mental and physical health.
Good sleep regulates the autonomic nervous system, improving the functioning of fear circuitry and cognitive circuits.
Social connection is essential for trauma relief and overcoming fear.
Sleep deprivation and improper nutrition hinder the ability to work through fears and traumas.
Chemical support, specifically suppressing Tachykinin, is mentioned as a key factor in overcoming fears and traumas.
These foundational elements have an indirect impact on erasing fears and traumas.

Supplements for Anxiety, Fear: Saffron, Inositol, Kava

Saffron, Inositol, and Kava are three supplements that have shown significant effects in reducing anxiety and fear. Saffron, when orally ingested at 30 milligrams, reliably reduces anxiety in both males and females. Inositol, comparable to prescription antidepressants, creates a notable decrease in anxiety symptoms. Kava, which increases GABA and Dopamine in the brain, has a potent anxiolytic effect. However, it is important to consult with a doctor before taking these supplements, as they may not be suitable for everyone.

Synthesis

The synthesis of fear and trauma is explored in this video, focusing on the circuits underlying the fear response and their connection to chronic fear, trauma, and PTSD. The speaker discusses various approaches to addressing fear and trauma in clinical settings, highlighting the potential benefits of deliberate self-directed stress, such as through respiration. Understanding the logical structure of these circuits can aid in selecting appropriate treatments. The speaker advocates for re-exposure to traumatic events in a supportive environment to extinguish fear and suggests self-directed practices for individuals with milder fears or traumas.