Читать книгу Phobias: Fighting the Fear - Helen Saul - Страница 20

A mixed bunch of academic publishers, scientific editors and advertising sales staff ate dinner together at the end of a conference. One editor was regaling the table with tales of her previous career as an Avon lady. She lost one of her clients, she said, when she took a swipe at the woman’s budgie with her cosmetics bag. Everyone looked up, amazed. ‘It was coming straight at me,’ she said, by way of explanation. This confident, bright young woman had ornithophobia and was not going to stay in the same room as a free bird.

One of the sales staff was listening with particular interest. ‘I know exactly how you feel,’ he said with feeling. He was afraid of butterflies and moths, and they started discussing the intricacies of the unpleasantness of wing flapping. Suddenly other diners were vying to compare the strength of their fears. His boss chipped in with a fear of heights and a publisher managed both a fear of spiders and of flying.

The conversation unearthed five phobias in four people among the twelve at the table. Doubtless a psychologist could have found more by interviewing us individually – those mentioned were specific and without much stigma attached – but even this tiny straw poll was telling. The phobias discussed so freely in the restaurant were all directed at threats in the natural world.

No scientist would be impressed by the dubious methods of this survey, but the results are surprisingly reproducible. Whenever a group starts talking about phobias, notice the fears people describe. Occasionally someone has a weird phobia of buttons, cotton wool or wallpaper, and if they do this may dominate the conversation. But most people fear a limited range of creatures or situations. They fear spiders, snakes, the dark, open or closed spaces; creatures and situations that pose few real problems in the West today but which could be dangerous if we lived less cosseted lives.

Evolutionists believe that this observation is important in our understanding of phobias. They say the things we fear today could have been fatal to our prehistoric ancestors. A bite from a spider or snake could have killed; it would have been dangerous to be out after dark; being cornered in a cave by an animal was definitely best avoided. By contrast, the things that really do kill us today – cars, guns or cigarettes – rarely inspire the same level of fear.

They believe that we are, at heart, barely adapted Stone-Agers, now working in offices and driving cars. We are strangely mismatched with our circumstances. We have modern and sophisticated lives but the deep recesses of our mind have developed to react to long-gone situations. The primeval drive of fear is more easily provoked by ancient threats, evolutionists say, because it is still best attuned to days spent roaming the African plains. Then, it would have made sense to have a proper respect for spiders, the dark or enclosed spaces. Stone-Agers lived in dangerous times and required a certain level of caution to survive and have children. Those who did survive passed their safety-consciousness on to their offspring and it became programmed into the human psyche.

The conversation at the dinner table might have ostensibly been about crazy, overblown fears of harmless objects, but an evolutionist would contend that it was in fact about proper caution for dangerous situations – albeit a few tens of thousands of years late.

The theory of evolution has been widely known since Charles Darwin shocked contemporary society with The Origin of Species, in 1859. The book had ramifications throughout science, religion and society, as discussed in the previous chapter. It hinted that humankind evolved from a primitive creature over millions of years and is related to the apes. Darwin was initially ridiculed and pilloried for his ideas, but acceptance of them grew and they are now largely taken for granted. In the past decade or so, scientists from many disciplines have revisited evolution theory and attempted to apply it to such diverse questions as why nations go to war and what features of the face or body determine sexual attractiveness. It has been used to argue for a new approach to pest control in agriculture; computers have been programmed to use a kind of technological natural selection to continually improve performance.

But what of our reactions to danger? Can evolution theory tell us anything about the nature of fear and anxiety? Evolutionists claim that part of the reason we develop phobias may lie in the mismatch between life in the twenty-first century and the Stone Age. As a species we are still primed to react to the threats and opportunities that our ancient ancestors faced. Evolutionarily speaking, we have hardly budged in the past ten thousand years but our lifestyle has changed beyond all recognition.

Primates are believed to have appeared sixty-five million years ago, followed thirty million years later by the first apelike creatures. They began walking on two legs about four million years ago, and using early stone tools two and a half million years ago. After a phase of rapid brain expansion two million years ago, they started to use shaped hand-axes and moved from Africa into Europe and Asia. This was the beginning of the Stone Age and its people developed a stable lifestyle roaming African plains for food until about ten thousand years ago.

Anatomically modern humans developed from their ancestors a hundred thousand years ago and discovered fire. Farming was introduced ten thousand years ago, the wheel about eight thousand years ago, and people started to write about 4000 BC. The pace of change accelerated and it took less than two hundred years to get from the first machines of mass production in the industrial revolution to the technology that put men on the moon.

It is rather like an old man who has lived for seventy years in an isolated spot in an unchanging world. One summer, somebody strikes oil nearby. Big business moves in, a town is developed, new roads are built, the population soars and he finds himself ill-equipped to cope. Humans have spent 99.5 per cent of their existence as hunter-gatherers and are barely out of the Stone Age in evolutionary terms. But life today bears little resemblance to that of our ancestors.

Evolutionists have attempted to explain many modern health problems in terms of the poor fit between our biological make-up and modern lifestyle. Soaring rates of obesity are a good example. Our ancestors had to move around constantly in search of food, which was often in short supply. The ability to store fat around their bodies so that they could survive times of potential starvation would have been a great advantage. Today in most parts of the Western world, food is plentiful. Supermarkets carry a dazzling and expanding range of foods and food shortages are almost unheard of. Add to that a sedentary lifestyle, in which we are entertained at home by the TV, transported around in cars and have our manual work done by machines. The result, according to the World Health Organisation, is that almost half of Britain’s adults are overweight and the entire population of America will be obese by 2230 if the increase seen since 1980 continues. Obesity is serious, known to contribute to heart disease, diabetes and premature death. Fat storage, the very mechanism which kept our starving ancestors alive, may be killing people off in the modern world.

The Pima Indians in Arizona, US, are a particularly dramatic example. They maintained a traditional way of life, relying on farming, hunting and fishing for food, until the late nineteenth century. Then, diversion of their water supply by American farmers upstream drove them to poverty and malnutrition, even starvation. The Second World War brought both prosperity and contact with Caucasian Americans, which westernised their dietary and lifestyle habits. Since then, the Pima Indians as a group have put on an unhealthy amount of weight. Half of the adults have diabetes and 95 per cent of those are overweight. Scientists from the US Government’s National Institute of Health have studied the Pima Indians for more than thirty years, looking for genetic causes of diabetes and obesity.

Just as the Pima Indians are physically adapted for a traditional lifestyle, our minds may be geared to deal with traditional dangers. We still eat as if food shortages were imminent; perhaps we are also still on the look-out for predators and natural threats. Certainly, evolutionary psychiatrists Randolph Nesse at the University of Michigan, and Isaac Marks, from London University, believe that we are all programmed to react to threats. Anxiety and fear are necessary, they say, and have been essential for our survival throughout evolution.

At the simplest level, mild anxiety boosts performance. It prompts the student to revise for exams, the musician to practise, the sales rep to rehearse a presentation. But evolutionists say it is far more sophisticated than that.

We could improve our understanding of anxiety at a stroke if we stopped thinking of it as a disorder, and considered it a defence that regulates and orchestrates our reactions to every threat and opportunity, say Nesse and Marks. The anxiety system is as important to our survival as is our immune system. It protects against threats to our whole body, and life, in the way that the immune system fights off specific physical threats. Both defence systems have developed within our species as we evolved. The individuals with appropriate reactions to danger or to micro-organisms are most likely to survive, produce offspring and pass on these traits to future generations.

Both have a range of reactions to meet specific threats. The immune system creates a scab to heal a cut finger and produces antibodies to deal with viruses. Similarly, at least some of our reactions to danger are clearly adaptive and matched exactly to the threat, say Marks and Nesse. For example, people who are afraid of heights may ‘freeze’ if they have to walk along a ledge or cross a narrow bridge. They cling to the side, unable to move. They may need a companion’s reassurance and physical assistance to get going again. This sort of reaction is not helpful if it stops you climbing stairs but in natural surroundings someone who became immobile by the side of a sheer drop might avoid a bad fall.

Blushing often seems to make a difficult situation worse. People who lack confidence in social gatherings dread being the centre of attention and burning cheeks do not help anyone blend into the background. But if, as has been argued, blushing signals social submission, a red face could be a plea for continued membership of the group. In ancient times, membership of a group would have been near-essential for survival. Anyone expelled and left alone would become vulnerable to cold, starvation and attack. They would also be unlikely to pass their influence on to the next generation if they could not reproduce.

Blood and injury phobias provide an intriguing physiological example of the possible benefits of an anxiety response. People with these phobias may faint at the scene of an accident or even at the sight of a syringe or needle. These are the only phobias associated with fainting. Someone with agoraphobia may feel extremely dizzy or uncomfortable in a crowded street and believe they are going to pass out, but they almost never do. As the agoraphobic prepares to flee the difficult situation, rising blood pressure effectively prevents a faint. By contrast, the blood and injury phobics’ blood pressure drops at the sight of blood, and they often do pass out. Nesse and Marks argue that this, again, could be adaptive. If a hunter saw blood, it was more likely to be his own than anyone else’s. An injured man loses less blood if his blood pressure drops. Even if he fainted, this could conceivably be useful. Some animals only attack moving creatures and lying still might just discourage further attack by predators.

Many animals are known to play dead while remaining conscious. Charles Darwin himself once caught a robin in a room and said it ‘fainted so completely, that for a time I thought it was dead’. David Barlow, an eminent psychologist in Albany, New York, says there may be a human parallel. Women who have been raped frequently describe being paralysed, rigid and cold during the attack. They are not unconscious because they can later remember details of what happened. In the past, this freezing has been wrongly taken by courts to mean that the women somehow consented to sex. Barlow says their immobility may in fact be an ancient defence mechanism. Remaining still may reduce further violence by a more powerful assailant and could conceivably reduce his sexual arousal.

In this way, the nature of a reaction is matched to the threat. Blushing is not likely to scare off a snake and freezing would not help in a difficult social situation. Normal phases of development also fit the evolutionists’ model. Babies may suddenly become afraid of strangers between six and twelve months old, just when they are starting to crawl and coming into more contact with unknown people. Animal fears peak at about four years old, the age when they may start meeting and playing with animals unattended. Social phobia typically starts in the late teens, just when young people are establishing their identities and facing all sorts of social pitfalls. While it would be unwise to take the argument too far – even Marks and Nesse have admitted that imaginative thinkers could come up with an adaptive use for virtually any human reaction – there are many compelling examples.

The strength of a reaction to a threat is every bit as important as its nature. Both the anxiety and immune systems are tightly regulated and over- or under-reaction causes problems. The human immunodeficiency virus, HIV, does not itself kill, but its destruction of immune defences means normally harmless bacterial and viral infections can become fatal. At the other end of the scale, allergies and hay fever develop when the immune system is overreacting to irrelevant stimuli like dust or pollen.

Anxiety is similar, argue Marks and Nesse. An underactive anxiety system may create real problems, as demonstrated by Max Klein in Fearless. A lack of concern about the future sounds wonderful, but not if this destroys all ability to plan for it. Never worrying about the consequences of your actions may mean you speak out when it would be diplomatic to say nothing. Telling your boss exactly what you think of him or her is a fantasy for many of us, but we never do it. A moment of extreme satisfaction could cost you your job. Similarly, you might feel like objecting loudly when someone pushes past you at a bar, but if they are big, drunk and bad-tempered, you probably keep your feelings to yourself. Those without normal levels of anxiety may lack basic caution and end up losing jobs and getting into fights where others simply sidestep trouble. Without the push of anxiety, it may be difficult to revise for exams or apply yourself to any long-term project. Marks has termed this hypophobia. It is interesting but speculative. It has not been studied much because those who lack anxiety often don’t imagine they have a problem and tend not to come forward for help. However, New Zealand researchers have some evidence to back the idea and at the same time, challenge the widespread assumption that a traumatic experience can trigger a phobia. They looked for height phobias among children who had serious falls between the ages of five and nine. They found that, at eighteen, these children were much less – not much more – likely than others to have height phobias. This study implies that temperament (discussed in chapter 7) may be all-important and suggests that children without fear, those who have never worried about heights may be hypophobic, and most likely to injure themselves in a fall.

The over-reactive end of anxiety is far more familiar. A wealth of anxiety disorders, including phobias, result directly from a tremendously sensitive anxiety system. People with these disorders can become upset by things others would never notice. Hoarders, obsessives and agoraphobics fear things but they all have hair-trigger anxiety systems. The hoarder is so afraid of losing something important that he cannot throw away anything. His house gradually silts up with layers of junk and old newspapers. The obsessive washes and cleans for three hours every morning and is quite unable to go to work unless she, and the house, are immaculate. The agoraphobic may hear about a road accident fifty miles away and be housebound for days afterwards.

Nesse carried out an interesting exercise in which he listed the physical and social dangers that would have threatened early humans. Physical dangers included accidents, disease, starvation, predators, hostile humans; social dangers included rejection, attacks on status or disruption of relationships. Modern anxiety disorders correspond well with these ancient threats. The hunter-gatherer’s proper fear of predators could have become today’s animal phobia; storage of food in times of plenty to ward off starvation could have become hoarding; cleaning rituals and taboos to ward off disease or contamination could have become obsessive-compulsive disorder. The hunter who sensibly stayed at the home base while a hungry lion roamed may have become today’s agoraphobic, highly reluctant to go out.

Responses that may once have been life-saving reactions have become inappropriate. Fear of heights, once a proper respect for the danger of a high cliff, is now a nuisance if it translates into fear of bridges or high-rise apartments. Reluctance to approach spiders may have been wise, and still is in some parts of the world. But fear of spiders in countries like Britain, where none is harmful, is widespread, and serves no useful purpose.

Nesse’s point is that today’s anxiety reactions would often have been essential in the Stone Age. There is nothing essentially wrong with the reactions, they are just too easily triggered for life today. It is a helpful idea. Fear of danger is a natural response and one which in other circumstances, thousands of years ago, might have protected us rather than blighted our lives.