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Erasing Fears & Traumas Based on the Modern Neuroscience of Fear

Episode 49 Dec 6, 2021 2h 10m 21 insights
In this episode, I discuss fear and trauma, including the neural circuits involved in the "threat reflex" and how specific experiences and memories come to activate that system. I also discuss how our body is involved in trauma and fear. First, I describe the logic of fear mechanisms and how "top-down" processing-- meaning connections from the parts of the brain that assign meaning to our feelings, are involved in fear and erasing fears and traumas. Then I discuss what successful fear and trauma treatment must include and consider various treatments for whether they meet that standard, such as EMDR, Cognitive Behavioral Therapy, Ketamine, other drug-assisted therapies, and more. I also review new data on how 5 minutes per day of deliberate, self-imposed stress can erase fear and depression. And I review the role that social connection plays in erasing or maintaining fears by activating specific molecular pathways in the brain and body. Finally, I review supplementation with over-the-counter compounds for their effects on anxiety and fear and when to take them, if at all.  Read the full show notes for this episode at hubermanlab.com.
Actionable Insights

1. Replace Fear with Positive Events

Understand that fears cannot simply be eliminated; they must be replaced with new positive events or associations. This is a fundamental principle for unlearning fear and trauma.

2. Three-Part Fear/Trauma Relief

Engage in a three-part process for fear and trauma relief: First, diminish the old experience by repeatedly recounting the traumatic narrative in detail to reduce its physiological amplitude. Second, relearn a new narrative that includes a sense of reward. Third, actively link these new positive associations back to the formerly traumatic event.

3. Use Narrative to Rewire

Utilize the power of narrative and top-down processing from the prefrontal cortex to override internal reflexes, including the threat reflex. Deliberately tell yourself a new story or attach new meaning and purpose to experiences to rewire your fear circuitry.

4. Repeated Detailed Retelling of Trauma

If working with a clinician, engage in detailed recounting of traumatic or fearful events multiple times. The initial retelling will likely elicit a strong anxiety response, but subsequent retellings will progressively diminish the physiological response, turning a terrible story into a ’terrible, boring story’ (fear extinction).

5. Journaling for Trauma Relief

If access to therapy is limited, journaling in detail about traumatic or fearful experiences has been shown to be effective in diminishing the physiological response, similar to therapeutic retelling. However, proceed with caution and consider social support during this process.

6. Engage in Trusting Social Connection

Actively seek and maintain regular, trusting social connections. Social connection reduces levels of tachykinin, a molecule in the brain that amplifies fear and trauma responses, thereby providing neurochemical relief from fear and trauma and supporting the healing process.

7. Self-Directed Short Bouts of Stress

Consider deliberately inducing short (e.g., five-minute) bouts of intense, self-directed stress daily, as this has been shown in animal models to reverse chronic stress effects. This could involve cold showers, ice baths, or specific breathing protocols that increase adrenaline, but caution is advised, especially for those with panic or anxiety disorders.

8. Physiological Sigh for Calming

Practice cyclic physiological sighs for five minutes daily to induce calmness. This involves a double inhale through the nose (even if the second inhale is small) followed by a long, complete exhale through the mouth, which helps offload carbon dioxide and calm the nervous system.

9. Cyclic Hyperventilation for Arousal

For those without panic or anxiety disorders, practice cyclic hyperventilation for five minutes daily to deliberately increase autonomic arousal. This involves deep inhales through the nose and exhales through the mouth, with a breath hold (lungs empty) every 25-30 breaths for 25-60 seconds. This is a stimulating practice and should be approached with extreme caution.

10. Prioritize Foundational Lifestyle Elements

Ensure consistent quality nutrition, ample sleep, and regular social connection. These foundational elements indirectly support trauma relief and fear management by regulating the autonomic nervous system, improving cognitive function, and chemically suppressing fear-amplifying molecules.

11. Assess Interoceptive-Exteroceptive Balance

Evaluate your interoceptive-exteroceptive balance to understand your fear response. This involves assessing if your internal bodily sensations (interoception) are proportionate to external circumstances (exteroception); an imbalance can indicate a low threshold for fear/anxiety.

12. Consider EMDR for Single Traumas

If experiencing single-event or constrained traumas, Eye Movement Desensitization Reprocessing (EMDR) therapy, performed with a clinician, may be beneficial. Moving eyes side-to-side while recounting the trauma can suppress the threat reflex and reduce anxiety, though it primarily addresses extinction, not the full replacement of memories.

13. Strategic Supplement Timing

If using anxiety-reducing supplements, consider taking them outside of sessions or periods where you are actively trying to amplify and recount traumatic experiences for extinction. Taking them during such times might short-circuit the necessary intensity for the extinction process, instead use them to return to baseline afterwards.

14. Explore Saffron for Anxiety

After consulting a doctor, consider orally ingesting 30 milligrams of saffron daily, as studies suggest it can reliably reduce anxiety symptoms. This is an over-the-counter option, but individual suitability and potential interactions should be discussed with a healthcare professional.

15. Explore Inositol for Anxiety

After consulting a doctor, consider taking 12-18 grams of inositol daily for at least a month, as studies indicate it can significantly decrease anxiety symptoms, with effects comparable to some prescription antidepressants. This is an over-the-counter option, but high dosages and individual suitability should be discussed with a healthcare professional.

16. Explore Kava for Anxiety

After consulting a doctor, consider taking kava (e.g., 100mg extract, or 150mg active kava lactones) for about three weeks, as studies suggest it can potently reduce anxiety and improve depressive symptoms. Kava increases both GABA and dopamine, but individual suitability and potential interactions should be discussed with a healthcare professional.

17. Adopt Operational Definitions

Adopt operational definitions for concepts in discussions to reduce misunderstandings and arguments, facilitating clearer communication and progress.

18. Insight 18

Use Athletic Greens daily (once or twice) to cover basic nutritional needs, address potential deficiencies, and support microbiome health with probiotics.

19. Insight 19

Supplement with Vitamin D3K2, as D3 is essential for brain and body health (many are deficient even with sun exposure) and K2 supports cardiovascular function and calcium regulation.

20. Insight 20

Ensure proper hydration and electrolyte balance by dissolving one packet of Element (sodium, magnesium, potassium, no sugar) in 16-32 ounces of water first thing in the morning and during physical exercise.

21. Insight 21

Utilize the Waking Up app for meditation, mindfulness training, yoga nidra, or NSDR sessions, which can restore cognitive and physical energy in as little as 10 minutes, adapting to available time and desired mental states.