Anxious book coverCollectively, anxiety disorders are our most prevalent psychiatric problem, affecting about forty million adults in the United States. In Anxious, Joseph LeDoux, whose NYU lab has been at the forefront of research efforts to understand and treat fear and anxiety, explains the range of these disorders, their origins, and discoveries that can restore sufferers to normalcy.

LeDoux’s premise is that we’ve been thinking about fear and anxiety in the wrong way. These are not innate states waiting to be unleashed from the brain, but experiences that we assemble cognitively. Treatment of these problems must address both their conscious manifestations and underlying non-conscious processes. While knowledge about how the brain works will help us discover new drugs, LeDoux argues that the greatest breakthroughs may come from using brain research to help reshape psychotherapy.

Arguably the biggest revelation is the fact that fear manifests itself in the brain both “non-consciously” (when the “survival circuits” pick up a change in atmosphere or a threat on the horizon) and “consciously” (when we notice these symptoms of fear – tight gut, tense muscles – and try to explain, through language, why we are feeling like this). Real distress occurs when the stories that we tell about these body sensations get out of hand. People suffering panic disorders start to fear a potential event in the future and go to great lengths to avoid new situations that elicit anxiety. A natural desire to stay alive became a form of obsessive risk avoidance.

joepsh ledouxLeDoux, who directs the Emotional Brain Institute at NYU and at the Nathan Kline Institute, explains that technical advances have given neuroscientists precise tools to investigate these structures, and psychologists have been active in the process as well. The result is a torrent of findings from neuroscientific laboratories that often conflict with psychological theories. LeDoux recounts them in detail and tries to reconcile them. He offers new ways to cope. He mentions experimental drugs and describes how various brain structures respond to psychotherapy, and seems particularly intrigued by the benefits of meditation.

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