13. The brain evidence reviewed in this section is based on Dennis Charney's excellent article, "Psychobiologic Mechanisms."
14. Charney, "Psychobiologic Mechanisms," 300.
15. Role of prefrontal cortex in unlearning fear: In Richard Davidson's study, volunteers had their sweat response measured (a barometer of anxiety) while they heard a tone. followed by a loud, obnoxious noise. The loud noise triggered a rise in sweat. After a time, the tone alone was enough to trigger the same rise, showing that the volunteers had learned an aversion to the tone. As they continued to hear the tone without the obnoxious noise, the learned aversion faded away—the tone sounded without any increase in sweat. The more active the volunteers' left prefrontal cortex, the more quickly they lost the learned fear. In another experiment showing the prefrontal lobes' role in getting over a fear, lab rats—as is so often the case in these studies—learned to fear a tone paired with an electric shock. The rats then had what amounts to a lobotomy, a surgical lesion in their brain that cut off the prefrontal lobes from the amygdala. For the next several days the rats heard the tone without getting an electric shock. Slowly, over a period of days, rats who have once learned to fear a tone will gradually lose their fear. But for the rats with the disconnected prefrontal lobes, it took nearly twice as long to unlearn the fear—suggesting a crucial role for the prefrontal lobes in managing fear and, more generally, in mastering emotional lessons. This experiment was done by Maria Morgan, a graduate student of Joseph LeDoux's at the Center for Neural Science, New York University.
16. Recovery from PTSD: I was told about this study by Rachel Yehuda, a neurochemist and director of the Traumatic Stress Studies Program at the Mt. Sinai School of Medicine in Manhattan. I reported on the results in The New York Times (Oct. 6,1992).
17. Childhood trauma: Lenore Terr, Too Scared to Cry (New York: HarperCollins, 1990).
18. Pathway to recovery from trauma: Judith Lewis Herman, Trauma and Recovery (New York: Basic Books, 1992).
19. "Dosing" of trauma: Mardi Horowitz, Stress Response Syndromes (Northvale, NJ: Jason Aronson, 1986).
20. Another level at which relearning goes on, at least for adults, is philosophical. The eternal question of the victim—"Why me?"—needs to be addressed. Being the victim of trauma shatters a person's faith that the world is a place that can be trusted, and that what happens to us in life is just—that is, that we can have control over our destiny by living a righteous life. The answers to the victim's conundrum, of course, need not be philosophical or religious; the task is to rebuild a system of belief or faith that allows living once again as though the world and the people in it can be trusted.
21. That the original fear persists, even if subdued, has been shown in studies where lab rats were conditioned to fear a sound, such as a bell, when it was paired with an electric shock. Afterward, when they heard the bell they reacted with fear, even though no shock accompanied it. Gradually, over the course of a year (a very long time for a rat—about a third of its life), the rats lost their fearfulness of the bell. But the fear was restored in full force when the sound of the bell was once again paired with a shock. The fear came back in a single instant—but took months and months to subside. The parallel in humans, of course, is when a traumatic fear from long ago, dormant for years, floods back in full force with some reminder of the original trauma.
22. Luborsky's therapy research is detailed in Lester Luborsky and Paul Crits-Christoph, Understanding Transference: The CCRT Method (New York: Basic Books, 1990).
Chapter 14. Temperament Is Not Destiny
1. See, for example, Jerome Kagan et al., "Initial Reactions to Unfamiliarity," Current Directions in Psychological Science (Dec. 1992). The fullest description of the biology of temperament is in Kagan, Galen's Prophecy.
2. Tom and Ralph, archetypically timid and bold types, are described in Kagan, Galen's Prophecy, pp. 155-57.
3. Lifelong problems of the shy child: Iris Bell, "Increased Prevalence of Stress-related Symptoms in Middle-aged Women Who Report Childhood Shyness," Annals of Behavior Medicine 16 (1994).
4. The heightened heart rate: Iris R. Bell et al., "Failure of Heart Rate Habituation During Cognitive and Olfactory Laboratory Stressors in Young Adults With Childhood Shyness," Annals of Behavior Medicine 16 (1994).
5. Panic in teenagers: Chris Hayward et al., "Pubertal Stage and Panic Attack History in Sixth-and Seventh-grade Girls," American Journal of Psychiatry vol. 149(9) (Sept. 1992), pp. 1239-43; Jerold Rosenbaum et al., "Behavioral Inhibition in Childhood: A Risk Factor for Anxiety Disorders," Harvard Review of Psychiatry (May 1993).
6. The research on personality and hemispheric differences was done by Dr. Richard Davidson at the University of Wisconsin, and by Dr. Andrew Tomarken, a psychologist at Vanderbilt University: see Andrew Tomarken and Richard Davidson, "Frontal Brain Activation in Repressors and Nonrepressors," Journal of Abnormal Psychology 103 (1994).
7. The observations of how mothers can help timid infants become bolder were done with Doreen Arcus. Details are in Kagan, Galen's Prophecy.
8. Kagan, Galen's Prophecy, pp. 194-95.
9. Growing less shy: Jens Asendorpf, "The Malleability of Behavioral Inhibition: A Study of Individual Developmental Functions," Developmental Psychology 30, 6 (1994).
10. Hubel and Wieseclass="underline" David H. Hubel, Thorsten Wiesel, and S. Levay, "Plasticity of Ocular Columns in Monkey Striate Cortex," Philosophical Transactions of the Royal Society of London 278 (1977).
11. Experience and the rat's brain: The work of Marian Diamond and others is described in Richard Thompson, The Brain (San Francisco: W. H. Freeman, 1985).
12. Brain changes in treating obsessive-compulsive disorder: L. R. Baxter et al., "Caudate Glucose Metabolism Rate Changes With Both Drug and Behavior Therapy for Obsessive-Compulsive Disorder," Archives of General Psychiatry 49 (1992).
13. Increased activity in prefrontal lobes: L. R. Baxter et al., "Local Cerebral Glucose Metabolic Rates in Obsessive-Compulsive Disorder," Archives of General Psychiatry AA (1987).
14. Prefrontal lobes maturity: Bryan Kolb, "Brain Development, Plasticity, and Behavior," American Psychologist AA (1989).
15. Childhood experience and prefrontal pruning: Richard Davidson, "Asymmetric Brain Function, Affective Style and Psychopathology: The Role of Early Experience and Plasticity," Development and Psychopathology vol. 6 (1994), pp. 741-58.
16. Biological attunement and brain growth: Schore, Affect Regulation.
17. M. E. Phelps et al, "PET: A Biochemical Image of the Brain at Work," in N. A. Lassen et al., Brain Work and Mental Activity: Quantitative Studies with Radioactive Tracers (Copenhagen: Munksgaard, 1991).
PART FIVE: EMOTIONAL LITERACY
Chapter 15. The Cost of Emotional Illiteracy