Motivation and emotion/Book/2016/Terror

Overview
"There is no terror in a bang, only in the anticipation of it"

- Alfred Hitchcock

There were 658 employees at work in the Cantor Fitzgerald offices on the 101st-105th floors in the One World Trade Centre on September 11, 2001. An unknown number of them looked out of the window of the North Tower and felt fear as they saw an American Airlines 767 flying directly towards them. The airplane approached the tower at 756 km/h and covered the last mile in 7.6 seconds before it crashed into the tower. That is long enough for unbelievable and paralysing terror to grip everyone who saw what was happening. None of the 658 employees survived, but for those not killed in impact, the terror of the crash could have only of gotten stronger when they realised that they were doomed to die. What the surviving Cantor Fitzgerald employees experienced was beyond, and more crippling than, fear. For these employees, there was nothing but death. Some chose to end the terror quickly by jumping out of the shattered windows while clinging to others in the last seconds of their lives. The ones who didn’t jump, one can only hope it was quicker than it seemed to the bystanders watching the tower fall. Terror ... there is no other word to describe what happened (Hollingsworth, 2010).



Fear is a feeling in humans and animals that occurs in response to an event in the present or to an anticipation or expectation of a future threat to life or body (Blanchard, Hynd, Minke, Minemoto, & Blanchard, 2001; Steimer, 2002). Terror is extreme, intense, sharp and overpowering fear (Connolly, 2003). Fear is an emotion we experience often; a small spider on the wall, a family member jumps out at you from behind a door. But when does one truly experience pure and genuine terror? One would hope very little or never at all. However, with the threat of terrorism and the multitude of heinous and terrible people in the world. The nightly news almost always has a story full of terror to tell. Bombings, kidnappings, terror attacks, mass shootings, war. These are but a few examples of the terror covered by the news outlets of the world. Table 1.

Examples of the Difference Between Fear and Terror

It is important to distinguish fear from terror to fully understand and master what you are feeling. Understanding the difference can mean you have a better grasp of the situations going on around you and whether you are only experiencing normal fear, or you are truly in a traumatic event, or your feelings of terror have become maladaptive and disrupt your everyday life. This chapter will focus on what causes terror, the physiological effects of terror, when terror becomes maladaptive, and how to manage terror.

Causes of regular fear
The most common situations that induce fear are the anticipation and threat of physical or psychological harm, vulnerability to danger, and the expectation that one’s coping skills will not be all that effective (Reeve, 2015). According to Mallan, Lipp, and Cochrane (2013), the perceived threats that cause fear come from biological (spiders, snakes) or sociological (angry facial expressions, strangers, racial out-group members) dangers (as cited in Reeve, 2015). Furthermore, a confirmatory analysis done by Valadão-Dias, Maroco, Leal, and Arrindell (2016) states that fear can be ordered into three categories: (1) Social Fears (fears of interpersonal events or situations, including sexual and aggressive scenes); (2) Agoraphobic Fears (situational, fear of crowded places or enclosed public places), and (3) Specific Fears (fears of bodily injury, death, illness, harmless animals).

Fear conditioning
A direct way to learn about potential dangers is conditioning fear responses. This is a behavioural paradigm where an initially neutral stimulus (conditioned stimulus) is paired with an adverse stimulus (unconditioned stimulus) that elicits a fear unconditional response (Lovibond & Shanks, 2002). A famous study on fear conditioning is done by John B. Watson's in 1920. The Little Albert experiment was inspired after observing a child with an irrational fear of dogs. In this study, an 9-month-old boy was conditioned to fear a white rat in the laboratory, by making a very loud and sudden noise every time Albert touched the rat. After this was done several times, Albert was presented with only the rat. Albert became terrified, crying and crawling away. Albert now associated the rat with the loud noise. The rat, which was originally a neutral stimulus, had now become a conditioned stimulus and it elicited an emotional response (conditioned response) similar to the terror (unconditioned response) which was original in response to the noise (unconditioned stimulus). Another example of fear conditioning is if a person was bitten by a dog, then the conditioning of being bitten would result in that the individual would anticipate an injury if confronted with that dog in the future (Rieger, 2014). This fear of the dog can increase and develop to the individual becoming extremely terrified of all dogs.

Informational pathway
The informational pathway is the development of a fear through the verbal transmission of danger-related information from others (King, Eleonora, & Ollendick, 1998; Rachman, 1977). A study by Muris, van Zwol, Huijding, and Mayer (2010) stated that parents who provided more threatening narratives about an unknown animal instilled higher levels of fear beliefs in their children than parents who had a more positive narrative about an unknown animal. Also, high trait anxious parents told more negative stories about the unknown animals, which in turn produced higher fear levels in their children. Therefore, the more terrifying the story or warnings of danger, the more terrified of the stimulus the child becomes. For example, if a child learns about terrorism and the consequences of terrorism, the bigger, more negative and scarier the explanation, the more terrified the child becomes of terrorism.

Vicarious acquisition
Vicarious acquisition is fear that is learnt through the process of modelling through an individual observing another person responding with fear to a threatening object or situation (Rachman, 1991; Rieger, 2014). For example, if a child watches another child fall and be trapped in a well and react with extreme fear. Therefore, the child will become terrified of wells even though they themselves have never fallen down and been trapped in a well.

Common thread
What conditioning, informational pathway and vicarious acquisition have in common is that it contributes to the idea of fear, that an individual develops an expectation that given a particular set of circumstances, an adverse and negative outcome is probable (Rieger, 2014). You can feel terror due to an expectation of a negative outcome, but you can also feel terror when presently experiencing a traumatic event.

Physiological symptoms
Terror creates a multitude of physical reactions and interplays with the sympathetic nervous system which allows for faster reactions and enhances sensory input (Oosterwijk, Topper, Rotteveel, & Fischer, 2010).

Table 2.

Physiological Symptoms of Terror

Amygdala
The amygdala is an ancient component of the brain located within the limbic system in the temporal lobes, that helps regulate and enact the experience of emotions, including terror (Plutchik, 2001). There is a large amount of academic research showing that the amygdala is significantly involved in many aspects of fear processing (Davis, 1992; Feinstein, Adolphs, Damasio, & Tranel, 2011; LeDoux, 2007). Extensive nonhuman animal research has been done, which shows that lesions in the amygdala significantly hinders the animals learned fear response (LaBar & LeDoux, 1996). In one rare case study by Feinstein, Adolphs, Damasio, and Tranel (2011) 44-year-old woman, SM had bilateral damage to her amygdala. SM was significantly impaired in fear conditioning, recognising fear in facial expressions and in social behaviour that is thought to be mediated by emotions of fear. Researchers tried to provoke fear in SM by exposing her to live spiders and snakes, taking a tour of a haunted house, and showed SM emotionally evocative films. SM did not experience any fear and never declared feeling more than minimal levels of fear. These results, supported the conclusion that the amygdala is vital in triggering a state of fear and the absence of such a state, prevents the experience of fear happening itself (Feinstein, Adolphs, Damasio, & Tranel, 2011).

Therefore, you would think, if SM can barely feel fear, she would not be able to experience terror.

However, a study by Feinstein et al. (2013), showed differently. Inhaling CO2 stimulates breathing and can provoke air hunger, fear and trigger panic attacks (episode of intense fear-terror). It was hypothesised that bilateral amygdala lesions would reduce CO2 evoked fear in humans, however SM reported the opposite and experienced panic attacks (extreme fear and terror) in response to inhaling 35% CO2. To further explore this, two additional patients, AM and BG, monozygotic twin sisters with focal bilateral amygdala lesions, were tested. AM and BG reported the same results as SM and experienced panic attacks whilst inhaling CO2. However, only 3 out of the 12 neurologically intact participants experienced panic and fear. This indicates that the amygdala is not required for fear and panic, but exhibit an important distinction between fear and panic that is triggered by external and environmental threats versus fear and panic triggered internally by the CO2. Moreover, the high rate of panic attacks in SM, AM and BG suggests that an intact amygdala may normally prevent panic or the amygdala prevents panic acutely (Feinstein et al., 2013).

Fight, flight, freeze response
The fight, flight, freeze response is an alarm response where your body reacts to a stimulus that is perceived as an imminent threat and prepares you to deal with the danger (Rieger, 2014; Seltzer, 2015). The hormone adrenaline (epinephrine) is released into the blood stream to initiate the bodily changes (Rieger, 2014). Fight or flight causes increases in blood pressure as blood flow directs towards the larger muscle groups and breathing increases to provide the brain and muscles with extra oxygen (Mack, Buchanan, & Young, 2015; Reiger, 2014). The pupils dilate as your vision becomes more acute, hearing improves and unnecessary activities, such as digestion and immune responses, are immediately inhibited (Reiger, 2014; Seltzer, 2015).

Fight is when you believe that you potentially have the power to resist and defeat the danger, this is where your sympathetic nervous system, especially adrenaline, prepare and prime you for a fight. Flight is when you view the danger as too powerful to resist and overcome and your impulse becomes to outrun it. Flight ramps up your emergency biochemical supplies so that you can escape the danger (Seltzer, 2015).

Freeze (tonic immobility) refers to when you are in a dangerous situation and you have concluded that you cannot defeat the danger or safely run from it, there is no hope (Bracha, 2004; Seltzer, 2015). In such alarming situations, you feel so terrified that you “freeze up” or “numbing out”. In other words, you dissociate from the here and now, it becomes the only and best thing you can do (Seltzer, 2015). It happens in car accidents, to rape victims and people who are robbed at gunpoint; anybody who is in an extreme situation that elicits extreme fear and terror. Being physically, mentally and emotionally frozen by your terror allows you to not feel the terrifying enormity and the pain of what is happening to you (Seltzer, 2015). Furthermore, when there is continuous reinforcement of the freeze response and the fear and stress levels do nothing but rise, until the person can either break out and fight or flee, or they faint (Bracha, 2004).

Phobias, panic attacks, obsessive-compulsive behaviours, post-traumatic stress disorder and various other anxiety states can be understood as symptoms of a freeze response that never had the chance to “let go” or “thaw out” once the original experience ended (Seltzer, 2015).

Post-traumatic stress disorder
Post-traumatic stress disorder is a close ally of terror. Posttraumatic stress disorder develops from an experience/s of extreme danger and trauma that evokes terror (National Collaborating Centre for Mental Health, 2005; Rieger, 2014). The typical antecedents are living through torture, war, terrorism, rape, assaults, major accidents, or a natural disaster (Reeve, 2015; Rieger, 2014). The traumatic event or object that causes the terror is clear and obvious, however the person feels anxiety and stress because they cannot predict when the terror experience will be re-experienced through vivid flashbacks (Reeve, 2015). Therefore, it is quite difficult to turn off the terror caused by a past trauma because there is no effective coping response (i.e. going back in time and undoing the trauma) (National Collaborating Centre for Mental Health, 2005; Reeve, 2015).

Treatment of Post-traumatic stress disorder is: cognitive behavioural therapy (CBT), psychoeducation, anxiety management techniques, cognitive restructuring, imaginal exposure, in vivo exposure (APA, 2013) (see Table 3).

Phobias
Another close ally of terror is Phobias. Phobias are characterized as extreme fears (terror) of a specific object or situation, which results in the individual avoiding the distressing object or situation (Rieger, 2014). There are four categories of phobias: (1) fear of interpersonal events and situations (i.e. fears of criticism, rejection, interpersonal conflict, especially violent conflict); (2) fear of death, injuries, illness, blood, death and surgical procedures; (3) animals (includes domestic animals, more common are the creepy crawly animals); and (4) agoraphobic fears (getting lost in crowds, entering enclosed spaces, being alone) (Reeve, 2015; Rieger, 2014).

Treatment of phobias is: in vivo exposure, prolonged imaginal exposure, flooding, extinction (APA, 2013) (see Table 3).

Panic attacks
Panic attacks are an episode in which an individual experiences an episode of intense fear or discomfort in which there is a rapid increase of physiological symptoms such as increase of pounding or racing heart, shortness of breath, sweating, trembling, dizziness, faintness, chocking/smothering sensations, hot or cold sensations, fears of dying, going crazy or losing control (APA, 2013). Panic disorder is characterized as having recurrent and unexpected panic attacks (Rieger, 2014).

Treatment of panic attacks is: cognitive behavioural therapy, Interceptive exposure, medications (APA, 2013). Refer to Table 3.

Night terrors
Night terrors, the person, usually a child, will awaken abruptly with feelings of terror or dread (APA, 2013). It usually occurs during the first hours of stage 3-4 non rapid eye movement (NREM) sleep.

Treatment of night terror is: sleep terror is typically outgrown, therefore there are no specific treatment options (APA, 2013) (see Table 3).

Table 3.

Treatments and Managements for Maladaptive Terror

Terrorism
Terrorism is the use of intentional and random acts of violence, which induces terror, in order to achieve a religious, political or ideological aim (Fortna, 2015). Even the symbolism of terrorism can elicit terror and help achieve religious, political or ideological goals (Ruby, 2002). Since the 9/11 attack, elected officials, government officers, emergency managers and citizens have refocused their attention on the threat posed by terrorist attacks (Perry, 2003). Responses to terrorism have been extensive: border and domestic security has tightened, detailed and extensive emergency plans have been updated and created, targeted laws, criminal procedures, deportations and enhanced police powers, preemptive or reactive military action, increased intelligence and surveillance, preemptive humanitarian activities (Hardy, 2015).

Emotion regulation
People can adjust their emotions in various ways to suit their needs in a situation (Sheppes, Scheibe, Suri, & Gross, 2011). The concept of emotion regulation is the complex process of initiating, inhibiting or modifying one’s emotions (Gallo & Gollwitzer, 2007; Thompson, 1994). A response-focused approach is used when a person aims to hinder terror via suppression (Gallo & Gollwitzer, 2007). Although, this approach may result in a high cognitive load, meaning the terror reduction is weakened (Gallo & Gollwitzer, 2007). According to Gallo and Gollwitzer (2007), emotion regulation is effective at reduction when an implementation intention is used (pre plan in order to counteract the negative event). According to a study done by Gallo & Gollwitzer (2007), participants displayed significant fear reduction even though they had a high cognitive load. This shows that emotion regulation may reduce feelings of terror. An example of emotion regulation being effectively would be you are stuck in a burning building and you become frozen due to the terror you feel because you are going to be burnt alive. Employing emotion regulation strategies should help reduce the terror you feel, so you can unfreeze and regain enough clarity to escape the burning building.

Terror management theory
Terror management theory (TMT), originally proposed by Greenberg, Solomon, and Pyszczynski (1986), states that humans are aware of our eventual and inevitable death and that this awareness is known as mortality salience. This awareness can cause extreme and incapacitating terror (hence the “terror” in terror management), that hinders psychological well-being due to the conflict of being aware of our death which is at odds with our evolutionary drive to survive (Juhl & Routledge, 2016; Major, Whelton, & Duff, 2016). Therefore, to avoid being constantly terrified about death and remove the death thoughts from focal attention, humans use the cognitive abilities that created the conflict, to resolve it (Abeyta, Juhl, & Routledge, 2014; Major, Whelton, & Duff, 2016). The duel process model of terror management theory proposes that the initial efforts to counter consciousness mortality salience is referred to as proximal defenses, which include strategies such as death thought suppression and denial of vulnerability to mortality (Abeyta, Juhl, & Routledge, 2014). For example, to deny vulnerability to death, a person my employ and rely on health-relevant strategies (Abeyta, Juhl, & Routledge, 2014). These strategies include adaptive (e.g. increased health intensions) and maladaptive (e.g. denial of being vulnerable to health risk) (Abeyta, Juhl, & Routledge, 2014). The impact on physical health is somewhat disregarded as these defenses serves its psychological purpose by removing death thoughts from the centre of attention (Abeyta, Juhl, & Routledge, 2014). Proximal defenses cease when death thoughts have been removed from focal attention and become active outside of central awareness yet remain highly accessible (Abeyta, Juhl, & Routledge, 2014). This is when distal defenses are activated. Distal defenses are focused on promoting a symbolic self that is more meaningful and enduring that the physical self (Abeyta, Juhl, & Routledge, 2014). This is done by creating psychological structures, also known as a buffer, which unconsciously combats the negative impacts of the terror caused by the mortality salience (Juhl & Routledge, 2016; Major, Whelton, & Duff, 2016). This buffering system is made up of three structures; cultural worldviews, self-esteem and meaningful interpersonal relationships (Greenberg, Solomon, & Arndt, 2008; Lewis, 2014). When used simultaneously, these buffers allow an individual to perceive their existence as significant and meaningful, which helps reduces the terror cause by being aware of their inevitable death (Juhl & Routledge, 2016).

Table 4.

Buffering Systems of Terror Management Theory

Quiz questions
{Terror can be learnt through conditioned fear responses. True or False? + True - False
 * type=""}

{Immobility is a physical symptom of terror. True or False? + True - False
 * type=""}

{Which one is NOT a buffer for Terror Management Theory? - Cultural worldview + Proximal defence - Self-esteem
 * type=""}

{You can regulate the emotion terror. True or False? + True - False
 * type=""}

Conclusion
Terror is a negative, unpleasant and unwanted emotion, however, feeling terror in traumatic events in unavoidable. The physical effects of terror can be so overwhelming to the point of freezing and fainting, yet management options are available which allows us to take control of our terror and either reduce it or use it to our advantage. Terror that has become maladaptive can disrupt everyday life and decrease quality of life. Therapies and behavioural techniques need to applied to reduce irrational terror from conditioned objects/situations and in situations that does not warrant feeling terror. However, people do use terror as a weapon and the only way to escape and manage that, is to eliminate terrorism all together.