How does the HPA axis contribute to long-lasting fear responses?

The Hypothalamic-Pituitary-Adrenal (HPA) axis, involving the hypothalamus, pituitary, and adrenal glands, triggers the release of stress hormones like Adrenaline and Cortisol. These chemicals have both fast and longer-lasting components, with the latter altering gene expression and building new neural circuits that embed fear in the brain and body over time.

What role does the amygdala play in the 'threat reflex'?

The amygdala, an almond-shaped brain structure, is a critical component of the 'threat reflex.' It integrates sensory and memory information to activate generic fear responses, including increased heart rate, hypervigilance, and suppression of calming systems. It's a key hub for activating fight, flight, or freeze mechanisms.

How does the prefrontal cortex help in controlling fear through 'top-down processing'?

The prefrontal cortex uses 'top-down processing' to control or suppress the threat reflex. It allows us to attach new narratives, meaning, and purpose to fearful experiences, overriding reflexive responses. By consciously reframing a threat, the prefrontal cortex can inhibit the fear circuitry.

Why is 'one-trial learning' more prevalent for negative experiences?

Our fear system is wired for 'one-trial learning' for negative experiences because it's designed to keep us safe by quickly embedding memories of dangerous events. Unlike learning positive or neutral information which takes repetition, intense negative experiences cause rapid changes in synaptic strengths, making the threat reflex easily activated in anticipation of future problems.

What is the two-step process to effectively eliminate fear and trauma?

First, the old, traumatic experience must be diminished through a process of 'extinction,' often involving repetitive retelling of the narrative. Second, a new, positive narrative needs to be relearned and explicitly attached to the formerly traumatic event, leveraging the brain's reward systems to overwrite the fear with positive associations.

How do behavioral therapies like Prolonged Exposure, CPT, and CBT work to reduce fear?

These therapies work by having individuals recount traumatic or fearful events in detail over and over. Initially, this causes a strong physiological response, but with each repetition, the amplitude of this response progressively diminishes, effectively uncoupling the threat reflex from the narrative and leading to fear extinction.

What is EMDR and how does it potentially reduce anxiety?

EMDR (Eye Movement Desensitization and Reprocessing) involves moving the eyes side-to-side while recounting a traumatic narrative. Research suggests that these lateral eye movements suppress the activation of the threat reflex circuitry, particularly the amygdala, leading to reduced anxiety and a calmer physiological state.

What is the role of social connection in mitigating fear and trauma?

Social connection, whether through conversation, sharing meals, or physical touch, is crucial for reducing fear and trauma. It actively decreases levels of Tachykinin, a molecule in the brain that exacerbates fear and anxiety and is amplified by social isolation, thereby suppressing the circuits involved in reinforcing traumatic experiences.

Can trauma be passed down through generations?

Yes, scientific studies show that a predisposition to trauma or fear can be inherited transgenerationally, often as a change in specific genes (like FKBP5 polymorphisms) that sensitize the glucocorticoid (cortisol) system. This means offspring may have a lower threshold for developing trauma, though it's a bias, not a guarantee, and not necessarily to the exact same type of trauma.

How do Ketamine-Assisted Psychotherapy and MDMA-Assisted Psychotherapy aid in trauma treatment?

Ketamine-Assisted Psychotherapy induces a dissociative state, allowing patients to recount trauma without the usual emotional intensity, facilitating extinction. MDMA-Assisted Psychotherapy massively increases dopamine, serotonin, and oxytocin, generating intense feelings of connection and euphoria, which may enable rapid extinction and relearning of new, positive associations with traumatic memories.

What is the significance of the insular cortex in fear and trauma?

The insular cortex is a brain area that maps internal bodily sensations (interoception) and calibrates them against external events (exteroception). In trauma or chronic fear, this calibration can be off, leading to exaggerated internal responses to mild external stimuli. Recalibrating this balance, often through deliberate physiological states, can help reduce fear.

How can short, deliberate bouts of stress help resolve depressive and fear-related symptoms?

Recent studies, particularly in mice, show that 5 minutes a day of self-induced, intense stress can reverse chronic stress-induced depressive-like behavior. This counterintuitive approach leverages the brain's top-down control by making the entry into stress deliberate, potentially recalibrating the system and reducing the impact of trauma and fear.

What lifestyle factors are crucial for supporting trauma and fear relief?

Foundational elements include quality sleep and optimal nutrition. Good sleep regulates the autonomic nervous system, enabling clearer thinking and better self-direction. Social connection is also vital, as it chemically suppresses Tachykinin, a molecule that exacerbates fear and trauma.

Key Moments

Erasing Fears & Traumas Based on the Modern Neuroscience of Fear

Andrew Huberman

Science & Technology4 min read134 min video

Dec 6, 2021|2,349,484 views|54,403|2,994

andrew huberman huberman lab podcast huberman podcast dr. andrew huberman neuroscience huberman lab fear trauma ptsd stress how to deal with stress how to deal with trauma

Save to Pod

Key Moments

TL;DR

Understanding fear's neurobiology: amygdala's threat reflex, HPA axis, and top-down control for effective trauma/fear extinction and replacement.

Key Insights

Fear is a complex response involving physiological stress, anxiety, and cognitive components, with trauma occurring when fear becomes maladaptive.

The amygdala plays a central role in the 'threat reflex,' a rapid, generic response that can be activated by direct experience or prior memories.

Top-down processing, largely via the prefrontal cortex, allows narrative and meaning-making to override or reframe the threat reflex.

Fear extinction and trauma relief often involve a two-step process: diminishing the old fear response and then replacing it with a new, positive association.

Therapeutic approaches like prolonged exposure, CPT, CBT, EMDR, Ketamine-assisted, and MDMA-assisted psychotherapy leverage neurobiological mechanisms to achieve fear reduction.

Deliberate, short-term exposure to controlled stress and social connection can also significantly impact fear and trauma processing.

Lifestyle factors like sleep, nutrition, and social support are foundational for a well-regulated nervous system, indirectly aiding fear and trauma recovery.

Certain supplements like saffron, inositol, and kava may offer indirect support for anxiety reduction, but should be used cautiously and strategically.

THE NEUROBIOLOGY OF FEAR AND TRAUMA

Fear is a fundamental emotion deeply rooted in our nervous system, comprising physiological responses like increased heart rate and cognitive elements such as thoughts and memories. Stress and anxiety form the foundational layers of fear, with trauma emerging when fear responses become embedded in the nervous system and are reactivated maladaptively, often without a present threat. The autonomic nervous system, with its sympathetic (alertness) and parasympathetic (calming) branches, is central to these responses, regulated by the Hypothalamic-Pituitary-Adrenal (HPA) axis, which manages the release of stress hormones like cortisol and adrenaline.

THE AMYGDALA AND THE THREAT REFLEX

The amygdala, a key component of the 'threat reflex,' acts as a critical hub for processing fear. This reflex is a rapid, generalized response designed for survival, involving heightened alertness, energy mobilization, and suppression of calming systems. While the amygdala integrates sensory and memory information, the threat reflex itself is not specific; it can become associated with virtually any experience through learning. This generic nature means the system is highly adaptable but also prone to developing fear responses to non-lethal stimuli.

LEARNING AND UNLEARNING FEAR: NEUROPLASTICITY

Fear and trauma become embedded in the brain through neuroplasticity, specifically processes like long-term potentiation (LTP), which strengthens neural connections. A single intense negative experience can lead to 'one-trial learning,' creating a robust association between a stimulus and the threat response. Conversely, unlearning fear or extinguishing trauma involves weakening these connections (long-term depression) and crucially, replacing the fear association with a new, positive experience or narrative. This requires a delicate balance of diminishing the old memory and building a new, strengthened one.

THERAPEUTIC STRATEGIES FOR FEAR AND TRAUMA

Effective treatments for fear and trauma hinge on this principle of extinction and replacement. Behavioral therapies like prolonged exposure, cognitive processing therapy (CPT), and cognitive behavioral therapy (CBT) work by detailed recounting of traumatic events, which diminishes the physiological response over time. More recent approaches include EMDR (Eye Movement Desensitization and Reprocessing), which appears to suppress the threat reflex through lateral eye movements, and pharmacologically-assisted therapies such as Ketamine- and MDMA-assisted psychotherapy. These latter methods may facilitate rapid rewiring by altering brain states to allow for simultaneous extinction and reinforcement of new, positive narratives.

THE ROLE OF NARRATIVE AND SELF-DIRECTED STRESS

The prefrontal cortex plays a vital role in 'top-down processing,' allowing conscious thought and narrative to influence emotional responses. By applying a new story or meaning to a fearful event, individuals can override the primal threat reflex. Recent research highlights the potential of deliberate, short-term exposure to controlled stress (e.g., five minutes daily) to reverse stress-induced depressive-like behaviors, suggesting that actively engaging with and directing one's stress response, rather than avoiding it, can be a powerful tool for recalibrating fear circuitry.

FOUNDATIONAL SUPPORT AND EMERGING TOOLS

Beyond specific therapeutic interventions, foundational lifestyle factors like quality sleep, nutrition, and social connection are critical. Social connection, in particular, appears to biochemically counteract the effects of isolation that can exacerbate trauma. Emerging research also points to supplements like saffron, inositol, and kava as potentially aiding anxiety reduction, though their use should be strategic and ideally complementary to other treatments. Understanding the intricate interplay between internal states, external stimuli, and cognitive narratives is key to effectively managing and overcoming fear and trauma.

Mentioned in This Episode

●Supplements

●Products

●Software & Apps

●Companies

●Organizations

●Books

●Drugs & Medications

●Concepts

●People Referenced

Protocol for Managing Fear & Trauma

Practical takeaways from this episode

Do This

Engage in detailed retelling of traumatic/fearful events with appropriate support from a clinician or trusted social connections to extinguish the fear response.

Actively replace fearful/traumatic memories or responses with new, positive associations, linking them back to the original event through narrative.

Prioritize regular, quality sleep and optimal nutrition to support overall mental and physical health, as they indirectly aid trauma relief.

Maintain regular, trusting social connections to reduce Tachykinin levels and suppress fear circuits.

Consider short (e.g., 5 minutes a day for two weeks) bouts of deliberate, self-directed stress (e.g., cold shower, cyclic hyperventilation) to recalibrate the fear system, if appropriate and with caution.

Explore supplements like Saffron (30mg daily), Inositol (12-18g daily for a month), or Kava (100mg extract) for generalized anxiety reduction, but outside of active trauma reprocessing sessions and only after consulting a doctor.

Avoid This

Do not solely focus on extinguishing a fear without actively re-learning and attaching new positive experiences to the previously traumatic event.

Avoid reactivating traumas without considering the necessary social support or clinical guidance, as initial retelling can be intensely anxiety-inducing.

Do not take anxiolytic supplements or drugs during sessions aimed at amplifying intense experiences for extinction, as they can short-circuit the therapeutic effect.

Beware of self-medicating with alcohol or other substances, as they can drive fear, anxiety, and PTSD deeper and prevent effective relief.

Avoid longer durations of deliberate stress (e.g., 15+ minutes daily), as this can exacerbate trauma and fear.

Do not engage in cyclic hyperventilation if you have a predisposition to panic or anxiety attacks without professional guidance.

Common Questions

Fear involves physiological and cognitive responses like increased heart rate and hypervigilance. Trauma is when a fear response becomes maladaptive and reactivates inappropriately, such as experiencing a panic attack without an apparent external trigger, after a fearful event.

Topics

Neuroscience & the Brain Mental Health & Psychology Mindset & Self-Improvement Breathwork Stress Response Trauma Recovery Behavioral Therapy Psychedelic-Assisted Therapy PTSD Treatment Fear Processing

Mentioned in this video

Concepts

Cortisol

A stress hormone released by the adrenal glands, involved in the HPA axis and the longer-lasting component of the fear response, which can influence gene expression and embed fear in the brain and body.

Neuroplasticity

The nervous system's ability to change in response to experience, occurring at a cellular level through mechanisms like long-term potentiation and long-term depression.

Adrenaline

A stress hormone released by the adrenal glands, involved in the 'fight or flight' response, increasing alertness and preparing the body for action, and a key component of the threat reflex.

Dopamine

A neuromodulator primarily associated with pursuit, motivation, craving, and reward, which the amygdala complex can communicate with and activate, offering a pathway to wire in new, positive memories to replace fearful ones.

Long-term potentiation

A cellular mechanism of neuroplasticity involving the strengthening of connections between neurons (synapses), making communication faster and more robust, particularly relevant for wiring in fearful or traumatic memories.

Amygdala

An almond-shaped structure in the brain, critical component of the threat reflex responsible for activating fight, flight, or freeze responses. It integrates memories and sensory information to generate generic fear sensations.

Nucleus Accumbens

Part of the dopamine system and mesolimbic reward pathway, associated with reward and addiction, which the amygdala complex projects to.

Long-Term Depression

A weakening of connections between neurons, which is what happens when a fear is extinguished or unlearned, essentially reversing the effects of long-term potentiation.

FKBP5 polymorphisms

Genetic variations mentioned in Dr. Kerry Ressler's paper, 'Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults,' linked to a predisposition to trauma or fear through the glucocorticoid/cortisol system.

MDMA assisted psychotherapy

A therapy currently in clinical trials in the US, using MDMA (Ecstasy/Molly), a synthetic drug that simultaneously increases dopamine, serotonin, and oxytocin, to create profound feelings of connection and euphoria, potentially allowing for rapid extinction and relearning of traumatic experiences.

Pavlovian conditioning

A Nobel Prize-winning concept explaining how fear systems work by associating a neutral stimulus with an unconditioned stimulus to evoke a response, often leading to 'one-trial learning' for negative experiences.

brain-derived neurotrophic Factor

A protein involved in neuronal growth and survival mentioned in the context of cellular mechanisms underlying long-term potentiation.

prolonged exposure therapy

A behavioral therapy where individuals repeatedly and in detail recount traumatic or fearful narratives, leading to a progressive diminution of the physiological anxiety response over time, essentially extinguishing the fear.

Cognitive Behavioral Therapy

A common type of talk therapy used to treat a wide range of mental health problems, including anxiety and PTSD, by helping individuals identify and change problematic thinking and behavior patterns.

ketamine assisted psychotherapy

A legal and approved therapy in the US (when prescribed by a board-certified physician) that uses ketamine, a dissociative anesthetic, to allow patients to recount trauma from a different emotional perspective, facilitating extinction and relearning.

Periaqueductal Gray

A brain area that contains neurons capable of triggering freezing behavior and releasing endogenous opioids, which numb pain, as part of the threat response.

Locus Coeruleus

A brain structure that generates arousal by releasing Adrenaline, Epinephrine, and Norepinephrine into the brain, contributing to alertness during a threat response.

Prefrontal Cortex

An area in the front of the brain involved in 'top-down processing,' allowing individuals to control or suppress reflexes and provide new narratives or meanings to experiences like threat, acting as an inhibitory brake on the threat reflex.

NMDA receptor

A docking site on a neuron that, when strongly activated by intense events, initiates a cascade of signals within neurons, changing gene expression and increasing communication efficiency, crucial for new associations and fear learning.

Cognitive Processing Therapy

A form of cognitive behavioral therapy specifically adapted for PTSD, focusing on challenging and modifying unhelpful beliefs related to the trauma.

Oxytocin

A neuropeptide associated with pair bonding and general bonding, released in massive amounts by MDMA, contributing to feelings of close resonance and association during MDMA-assisted psychotherapy.

insular cortex

A brain area that contains a map of internal bodily sensations (interoceptive landscape) and is involved in calibrating the intensity of physiological responses (like heart rate and blood pressure) to external environmental changes.

Hamilton Anxiety Rating Scale

A standard inventory used in studies to measure reductions in anxiety, mentioned in relation to the effectiveness of Saffron supplementation.

Serotonin

A neuromodulator typically associated with feelings of happiness and contentment, with MDMA causing large increases in its levels, contributing to feelings of safety and comfort during MDMA-assisted psychotherapy.

Companies

Athletic Greens

An all-in-one vitamin, mineral, and probiotic drink that Andrew Huberman has been taking daily since 2012 to support gut microbiome, immune, nervous, and endocrine systems.

Helix Sleep

A company that makes mattresses and pillows, offering a quiz to match body type and sleep preferences to the ideal mattress.

InsideTracker

A personalized nutrition platform that analyzes blood and DNA data to help individuals understand their body and health goals, providing actionable recommendations for lifestyle, nutrition, and supplementation.

Thorne

A supplement company partnered with Huberman Lab, recognized for high quality stringency and accurate labeling of supplement amounts, also partnered with major sports teams and the Mayo Clinic.

People

David Anderson

A researcher whose group at Caltech has done work on Tachykinin and its role in fear and trauma, noting its increased levels with social isolation.

Andrew Huberman

Host of the Huberman Lab Podcast and a professor of neurobiology and ophthalmology at Stanford School of Medicine.

Kerry Ressler

An MD-PhD, Chief Scientific Officer at McLean Hospital, and Professor of Psychiatry at Harvard Medical School, known for extensive work on fear, including transgenerational passage of trauma.

Karl Deisseroth

A Stanford colleague in psychiatry who, along with Robert Malenka and Liqun Luo, published a paper exploring how systemic Ketamine adjusts brain circuitries, specifically cortical activity rhythms.

Brian Dias

First author on Dr. Kerry Ressler's paper, 'Parental olfactory experience influences behavior and neural structure in subsequent generations,' which explored transgenerational passage of trauma in mice.

Liqun Luo

A Stanford colleague who, along with Karl Deisseroth and Robert Malenka, published a paper exploring how systemic Ketamine adjusts brain circuitries.

Francine Shapiro

The developer of Eye Movement Desensitization and Reprocessing (EMDR) therapy in the 1980s.

Robert Malenka

A Stanford colleague in psychiatry who, along with Karl Deisseroth and Liqun Luo, published a paper exploring how systemic Ketamine adjusts brain circuitries.

David Spiegel

Associate Chair of Psychiatry at Stanford, collaborating with Andrew Huberman's lab on respiration protocols for stress relief and emphasizing the role of self-directed engagement in therapeutic states.

Supplements

Vitamin D3 K2

A year supply of Vitamin D3 K2 is offered as part of an Athletic Greens promotion; D3 supports metabolic, immune, and endocrine factors, while K2 is important for cardiovascular health.

GABA

An inhibitory neurotransmitter in the brain, whose levels are increased by drugs like Benzodiazepines to reduce anxiety, and which is also involved in the prefrontal cortex's inhibition of the threat reflex.

Benzodiazepines

A class of drugs that reduce anxiety (anxiolytics) by increasing levels of inhibitory neurotransmitters like GABA in the brain, sometimes used to manage fear and PTSD symptoms.

beta blockers

Drugs designed to prevent the heart from beating too fast or to reduce blood pressure, thereby reducing some elements of the HPA axis response associated with fear.

Saffron

An orally ingested supplement (30mg dose) shown in 12 human studies to reliably reduce anxiety on standard inventories like the Hamilton Anxiety Rating Scale, with significant anxiolytic effects.

Inositol

A supplement shown to notable decrease anxiety symptoms at high doses (12-18 grams for a full month), with potency comparable to prescription antidepressants, also having some evidence for obsessive-compulsive disorder.

Ashwagandha

A supplement previously discussed on the podcast for its role in managing stress, mentioned as another tool in the context of anxiety and fear reduction.

Kava

A substance shown in eight studies to have a potent anxiolytic effect and general improvement in depressive symptoms, functioning by increasing GABA and dopamine simultaneously. Active kava lactones at 150mg is a common dosage amount.

Products

Dusk mattress

A specific mattress type from Helix Sleep that Andrew Huberman was matched to, described as not too firm and not too soft.

Drugs & Medications

Endogenous Opioids

Chemicals released from neurons in the Periaqueductal Gray (PAG) and elsewhere that provide a natural numbing effect against pain as part of the body's response to threat.

Tachykinin

A molecule in the brain, activated in the central amygdala after traumatic events, that reinforces fearful experiences and is further increased by social isolation, contributing to anxiety and irritability. Its effectiveness is reduced by social connection.

Selective Serotonin Reuptake Inhibitors

A class of antidepressants (e.g., Prozac, Zoloft) that can reduce anxiety, indirectly helping alleviate fear and PTSD symptoms by modulating mood but not directly targeting the neurobiology of fear formation.

Ketamine

A dissociative anesthetic used in psychotherapy to create a state of dissociation, allowing individuals to recount traumas without experiencing the usual intense emotional responses. It's being explored for PTSD and depression.

MDMA

A powerful synthetic drug that, in therapeutic settings, leads to massive increases in dopamine, serotonin, and oxytocin simultaneously, inducing feelings of euphoria, connection, and safety, making it a promising treatment for trauma.

Software & Apps

Eye Movement Desensitization and Reprocessing

A therapy developed by Francine Shapiro in the 1980s that involves moving the eyes side to side while recounting a traumatic narrative. Research suggests it reduces activation of the amygdala and threat reflex circuitry.

Organizations

McLean Hospital

A psychiatric hospital where Dr. Kerry Ressler serves as the Chief Scientific Officer.

Stanford School of Medicine

The institution where Andrew Huberman is a professor and where some of the discussed research and collaborations take place.

Harvard Medical School

The institution where Dr. Kerry Ressler is a Professor of Psychiatry.

Caltech

The institution where David Anderson's research group, mentioned in relation to Tachykinin research, is located.

Mayo Clinic

A renowned medical center partnered with Thorne, indicating a high degree of trust in Thorne's products.

Science (journal)

An apex scientific journal that published the paper 'Fear balance is maintained by bodily feedback to the insular cortex in mice,' exploring the role of the insular cortex in calibrating internal sensations with external events related to fear.

Studies & Research

Hypothalamic-Pituitary-Adrenal (HPA) axis

A neuroendocrine system that controls reactions to stress and regulates many body processes, including digestion, the immune system, mood and emotions, sexuality, and energy storage and expenditure. It comprises the hypothalamus, pituitary gland, and adrenal glands.

Books

Psychoneuroendocrinology

The journal that published the paper 'Plasma oxytocin concentrations following MDMA or intranasal oxytocin in humans,' highlighting the significant increase in oxytocin levels due to MDMA.