Fear motivation - from PTSD to experiential education
Michaela Tralli ‘QC 12 and Jim Stellar
We wrote a previous post on fear associated with panic attacks and what they have to tell us about experiential education – the dark side. That post received such good comment that we decided to come back and talk a bit more about how experiences can leave bad imprints on people’s thinking and psychological being and we all know how that can shape career choice, e.g. the person who wants to be a lawyer but is afraid of speaking in public. A particularly nasty form of learning is post-traumatic stress disorder (PTSD). Let’s start with a definition and tie it back to learning from experience.
According to the DSM-IV-TR, post-traumatic stress disorder (PTSD) begins with a stressor in which a person has experienced, witnessed, or has been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others. The person’s response also involves the intense fear, helplessness, or horror. The traumatic event must also bring about intrusive, recurrent recollection of the event including images, thoughts, or perceptions. Distressing dreams of the event occur as well. A person acts or feels as if the traumatic event is recurring (includes a sense of reliving the experience, illusions, hallucinations and dissociative flashback episodes, including those that occur upon awakening or when intoxicated). During internal or external cues that symbolize or resemble an aspect of the traumatic event, the person experiences intense psychological distress. There is also a persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness.
The individual must experience at least three of the following: efforts to avoid thoughts, feelings or conversations associated with the trauma; efforts to avoid activities, places, or people that arouse recollections of the trauma; inability to recall an important aspect of the trauma; markedly diminished interest or participation in significant activities; feeling of detachment or estrangement from others; restricted range of affect; sense of foreshortened future (does not expect to have a career, marriage, children, or a normal life span). There must also be persistent symptoms of increasing arousal that were not present before the trauma, indicated by at least two of the following: difficulty falling or staying asleep; irritability or outbursts or anger; difficulty concentrating; hyper-vigilance; exaggerated startle response. It is only considered to be PTSD if the duration of the disturbance is more than one month. There is acute PTSD, characterized by the duration of symptoms lasting less than three months; and chronic PTSD, which is when the duration of symptoms is more than three months.
The above discussion relates on the one hand to a recent neuroscientific paper on the management of fear by brain circuits and recent discoveries of how directly to manipulate the function of sub-areas of the amygdala with techniques that combine genetics with optics to produce or reduce anxiety-like behaviors in rats. On the other hand, this discussion relates to a blog post some time ago on a New York Times article where a Harvard Psychologist Jerome Kagan had studied children who had anxiety as a child and grew into college age adults. Some of these adults did not show any signs of their childhood anxiety as adults despite having characteristic activity in their amygdala on a brain scan. The idea expressed in the article was that areas of the frontal cortex put the anxiety-producing tendencies of the amygdala under some kind of control so the patient was not unhappy. Another more recent discussion of this important topic occurred at the last Society for Neuroscience meeting in the fall in a talk by Amy Arnsten of Yale Medical School who gave a talk with the title “Going to Hell in a Handbasket: Molecular Weakening of Prefrontal Cortical Regulation During Stress.” In this talk, she also discussed the top-down frontal cortex connections to the amygdala and mentioned that they were not only weakened in stress but that methods exist for strengthening them and improving the management of PTSD. More good information is found on her laboratory website and this link features many of the slides from her talk.
This kind of neuroplasticity is very important to us in this blog as we see education as being a brain-changer and helping to re-balance emotional circuitry that might underlie normal decision-making whether it is in neuroeconomics (where one invests money in a purchase) or choice of a college major (where one invests time toward a career … and as the old saying goes, “time is money”). The experience of doing an internship in a chosen field (e.g. accounting), working with adult practitioners, coming back to classes in that subject matter, maybe doing a second experience in the field, all can add up to an intense multi-year experience that some have written about as brain circuit changers (e.g. Daniel Coyle in Talent Code, and Malcolm Gladwell in Outliers, to name a few).
If we can change the underlying circuits based on anxiety, maybe that gives hope to people with PTSD. What we are focusing on here, is whether those same circuits can not only be educated in normal college majors by good and by bad internship experiences, but whether for some of us (say folks who are a tad shy) the experience can also overcome natural biases (say not to speak up). Then we are left with a dilemma much like that in the Heisenberg uncertainty principle where by interacting with something, in this case a brain circuit of decision making, we change the way it computes. If that were ever the case, one might think it would be so in a brain circuit that detects risk. That could be bad, but it could also be good if those circuits hold back young student from exploring fields for fear of failure.