NO FEAR…With a Pill?

Science has Created a pill for Managing how your Brain “Files” Fearful Experiences.

But up to 29 percent of Americans will suffer from debilitating phobias, panic attacks, and disorders like post-traumatic stress at some point in their lives. There may be a cure on the horizon for those whose fears limit their ability to live productive lives.

At the core of much anxiety and fear is your emotional memory. Emotional memory is comprised of the associations you have between various stimuli and experiences and your emotional responses to them. The fields of neuroscience and psychiatry have long considered these emotional memories to become permanent once embedded.

From the late 1950s through 2008, the common treatment protocol for phobias was exposure therapy. This involved repeatedly exposing an individual to the feared object or frightening memory in a safe setting, so that the patient acquired a new safe memory that would reside in the brain alongside the bad memory. The goal was to be able to tolerate the fearsome object/experience. Because the bad memory remained, it was not considered a cure and therefore subjects were at risk of relapse if they encountered the fear inducing object/experience in a less controlled environment.

Relapse is only one of the limitations of exposure therapy. Studies indicate that the therapy only works about 50 percent of the time in patients with PTSD. Many patients also find it upsetting and often intolerable to relive memories of war, rape, or other violent attacks. (The original treatment for these disorders was electroconvulsive shock therapy.)

New research suggests it may be possible to do much more that create a new safe memory, but actually get rid of the emotions attached to the bad one. Yes, there just may be a pill that has the power to erase your bad memories.

We’ve learned that memories are uniquely vulnerable to alteration at two points: when we first lay them down, and later, when we retrieve them.

Merel Kindt, a professor of psychology at the University of Amsterdam, published a study last month in the journal Biological Psychiatry where she and her research team have seemingly erased the emotional fear response in healthy people with arachnophobia. In the study, she compared three groups made up of 45 total subjects. One group was exposed to a tarantula in a glass jar for two minutes, and then given a beta-blocker called propranolol that is commonly prescribed to patients for performance anxiety; one was exposed to the tarantula and given a placebo; and one was just given propranolol without being shown the spider, to rule out the possibility that propranolol by itself could decrease spider fear.

Dr. Kindt analyzed the study participants’ anxiety when they were shown the spider the first time, then again three months later, and finally after a year. Her findings have big implications. Those who got the propranolol alone and those who got the placebo saw no improvement in their anxiety. But the arachnophobes who were exposed to the spider and given the drug were able to touch the tarantula within four days and, by three months, many participants felt comfortable holding the spider in their bare hands. At the one-year mark, their fear had not returned.

To achieve this end, Dr. Kindt used the drug propranolol, which inhibits the effects of norepinephrine in our brains. Norepinephrine is a chemical (similar to adrenaline) which enhances learning, so blocking it disrupts the way a memory is filed in our brains after it is retrieved—a process called reconsolidation.

It is interesting to note, that many people who suffer from phobias access an emotional memory that has not actually happened. For example, most arachnophobes have never been bitten by a spider. However, when the study subjects are exposed to the spider, their “fear memory” reactivates and makes the memory susceptible to the influence of propranolol.

This new research is not without criticism (in the realm of big pharma + mental health issues, there is no shortage of strong opinions). Some argue that it is a mistake to alter our fear responses because they are natural—that humans are hard-wired this way for a reason. Like most creatures, we have a natural fight or flight response that is inspired by a fear-induced warning system.

In my research for this piece, I read several articles. But most impactful were the other readers’ comments—mostly from those people who suffer from phobias and PTSD. As a student of Krav Maga, I recognize the importance of a natural reaction to fear. But what struck me was the debilitating fear many people face in situations that are not actually ‘typically’ dangerous. Nobody is suggesting we rid mice of their natural fear of cats, but if your social anxiety prevents you from being able to work, that is an entirely different situation (and there is no biological benefit from this level of fear). I found this research hopeful. This new approach may well be effective in treating other anxiety disorders like PTSD. The majority of us will not have endured the horrors of war, child abuse, violent assault, or unusual, paralyzing fears, but I have no qualms with releasing those among us who continue to suffer, from their debilitating fears.

The ramifications for self defense training (or any training that mirrors fear-inducing events) in trainees who find it difficult to learn in this environment (due to prior trauma) may also be a natural channel for this drug. War fighting and policing may also be greatly enhanced with the careful and proper utilization of this drug therapy – eradicating improper responses by personnel in the context of a necessary objective may be one of the most promising uses of this new therapy. Bad guys beware when your potential victims are no longer afraid of you or your weapon.