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THE M.D.

Our reactions to fear can put us in peril

When threats loom, we sometimes respond in foolish ways that defy logic.

February 09, 2009|Valerie Ulene

If you're anything like me, you spend too much time worrying about scary -- but unlikely -- events. Plane crashes and child abductions top my list of concerns; for others, it's shark attacks, mad cow disease or flesh-eating bacteria. Most people don't allow fears like these to change their lives, but many of us do make alterations in our day-to-day routines to accommodate them.

Ironically, the things we do to try to keep ourselves safe are sometimes more dangerous than the things we fear.

A friend of mine who is frightened by cranes takes a longer route to work to avoid a construction site in Hollywood. By doing so, she's putting herself at greater risk of a car accident by traveling more miles. Another friend who hates to fly always takes a sedative before boarding a plane. In fact, the risk of a serious side effect from the drug probably is greater than the risk of crashing.

These choices don't seem to make a lot of sense -- and that's because, when it comes to what we fear, our brains aren't completely logical.

For one thing, they're designed to respond quickly to risk -- before we've had time to think things through. "We're literally hard-wired to fear first and think second," says David Ropeik, a consultant in risk perception and author of a forthcoming book, "The Risk Response." "We're also hard-wired to fear more and think less. There are a host of circuits and neurochemicals in the brain that give the instinctive response more weight than the intellectual one." This knee-jerk reaction to danger used to be highly important to humans, keeping them safe from sudden and immediate threats (think attacks by wild animals). As society has evolved, however, and the kinds of risks we're exposed to have changed, our reactions have become in some ways outdated.

To assess threats quickly, the brain employs strategies that allow decisions to be made as rapidly as possible. For example, to resolve a specific problem, it may focus on a more general one. To understand the health risks posed by plastic water bottles it might extrapolate from what it already knows about the ill effects of highly toxic chemicals; to evaluate the threat presented by cellphone radiation it may draw comparisons to an atomic bomb or nuclear reactor. These "mental shortcuts" allow snap judgments to be made -- but they certainly aren't foolproof.

Also, for whatever reason, the brain simply finds some things more frightening than others. "We're more afraid of things that are man-made than those that are natural," Ropeik says. For example, we fear nuclear power more than radiation from the sun and worry more about pharmaceutical medications that have undergone extensive safety testing than largely unregulated alternative remedies.

Things that we're powerless over also tend to be scarier than those over which we exert some control. A greater fear of flying than driving is perhaps the most obvious example of this.

The less we know about something, the more frightening it feels. People may shy away from a new vaccine when it's first introduced or opt for a medication with a long track record over one that has just come on the market. "When you don't have all the facts, you choose to be precautionary," Ropeik says.

We rarely have all of the information we need to make sensible decisions about what to be afraid of. Most people recognize that cranes are capable of falling and crushing everything in their path, but not many could tell you how many deaths they cause each year or are aware that construction workers -- not bystanders -- are at greatest risk of being injured.

And though everyone knows that sharks can kill, very few can identify the types of sharks that are most likely to attack humans or the areas where they are found. "With incomplete and imperfect information, we can't possibly make rational decisions," Ropeik says.

Finally, when it comes to fear, facts aren't all we use to guide us -- feelings, values, past experiences and culture also come into play. If, for example, we know someone who had a bad reaction to a vaccine, we're more likely to be wary of immunizations; if our peers are leery of pesticides and eat only organic foods, we're also more likely to do so.

"At the end of the day, it's not at all irrational to have quirky fears," Ropeik says. "We're doing the best we can with our instincts and the limited information that we have."

That's not to say that we should let these fears dictate our behavior, however. Doing so can be dangerous itself. Electing not to immunize children because of a perceived link to autism leaves them susceptible to a variety of potentially life-threatening diseases. Opting not to take a cholesterol-lowering medication because of possible side effects increases the likelihood of a heart attack.

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