Advertisement

Managing Fear In An Unsafe World

(Melanie Wasser/Unsplash)
(Melanie Wasser/Unsplash)

An all-too familiar news alert blinked across the internet last week: a shooter killed a police officer, a doctor and a pharmacy resident at Chicago’s Mercy Hospital, before turning the gun on himself.

I’ve worked in hospitals for nearly 20 years. But now, because of this never-ending stream of violence, I am required to complete active shooter training. We can no longer take safety for granted in hospitals, or in schools, houses of worship, night clubs — or really in any public place.

More people are frightened. Growing extremism, gun violence, anti-Semitism and racism terrify us. The fearmongering rhetoric of the midterms amped up this dread and brought out a new dimension. People are targeting advocates and activists and those associated with them.

Recently, I went to hear Alec Baldwin and Julianne Moore on a panel discussion at Boston’s Museum of Fine Arts about the artist Candice Breitz’s powerful work, "Love Story," in which they share stories in refugees’ own words. As we settled into our seats, the MFA announced that Alec Baldwin would not be attending.

Under what structures could we hide? Do I know how to act dead well enough?

The FBI had apparently warned him not to come because his safety and ours would be put at risk. With the recent pipe bomb mailings, followed by the Pittsburgh synagogue shooting, we assumed he had been targeted for his activism.

After hearing this announcement, I started looking at the doors and the crowd, wondering how I would escape if a shooter came in. Under what structures could we hide? Do I know how to act dead well enough?

Following the panel, others in the audience told me they also felt afraid. Since this experience of feeling threatened is so pervasive, we need to find ways to manage it. Understanding the physiology of fear and its impact is a good start.

Chicago Police work the scene after a gunman opened fire at Mercy Hospital, Monday, Nov. 19, 2018, in Chicago. (David Banks/AP)
Chicago Police work the scene after a gunman opened fire at Mercy Hospital, Monday, Nov. 19, 2018, in Chicago. (David Banks/AP)

The fear center in our mind, the amygdala, is housed deep in the brain. It is one of the most primitive structures and has evolved since the beginning of time to keep us safe, equipping us with survival instincts. Once activated, the amygdala triggers the adrenal glands to release adrenaline, the fight or flight hormone. This signals the lungs to move air and the heart to pump powerfully, allowing us to act quickly.

At its peak, this experience can feel very uncomfortable. And when this becomes a regular experience through real or even perceived threats, the chronic stress and fear can hijack the nervous system — it becomes reactive and the mind races, ruminates and obsesses. Over time, our immune system suffers, and we become exhausted and more prone to illness.

But there are things we can do to counter fear. By activating the parasympathetic nervous system, known as the “rest and digest” system, we can stay resilient. With practice, we can learn how to elicit our own “relaxation response,” the term coined by the pioneer of mind-body medicine, Dr. Herbert Benson, which counteracts the effects of fight or flight, and gives us a renewed sense of focus and calm.

Managing fear is so important in light of the escalation of violence and threats.

Deep breathing, which is simple and intuitive, is a key to the relaxation response. Slow your breath down, deepen it and soften your belly to allow your lungs to fully inflate. Practice bringing your awareness back to your breath throughout the day. With time, you can train your nervous system to stay increasingly calm despite emotional spikes.

In addition, given that one of the roots of resilience is in social connectedness and that research suggests loneliness itself can be a source of stress, I highly recommend finding a partner or group and exploring activities that are known to elicit the relaxation response.

Try taking a nature walk. Listen to soft music. Download a meditation-made-easy app (Calm and Headspace are two good ones). Find a restorative yoga or Tai Chi class. Spend time with family and good friends.

Managing fear is so important in light of the escalation of violence and threats. The senseless tragedy at Mercy Hospital, dreadfully, won’t be the last. We must find ways to recharge so we can maintain our health and strength, stand up to fear-mongering and fight for the safety of our communities.

Related:

Headshot of Marni Chanoff

Marni Chanoff Cognoscenti contributor
Marni Chanoff, MD is a psychiatrist on the faculty at Harvard Medical School and McLean Hospital.

More…

Advertisement

More from WBUR

Listen Live
Close