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An Rx to inoculate yourself against scare tactics

Why is an epidemic of fear sweeping America? The answer, according to nationally renowned health commentator Dr. Marc Siegel, is that we live in an artificially created culture of fear. From the anthrax panic to the SARS "epidemic," from "official" rumors of bioterror to Orange alerts to West Nile virus — the media continually bombard us with breaking news of yet another super-bug, terrorist plot, or natural disaster that's about to wreak havoc. Siegel was invited on the "Today" show to talk about the book. Here's an excerpt:

Fear invades our homes like never before, affecting more and more people. Newspaper headlines are apocalyptic warnings. Media obsessions fuel our cycles of worry, which burn out only to be replaced by more alarming cycles. The passions and routines of everyday life are our primary defenses against this contagious fear. These defenses, however, are being eroded, bombarded by the ongoing doom-and-gloom of the daily news. Twenty-four hours of cable news infiltrates our sleep and may be as damaging to our health as cigarette smoke is to our defenses against cancer.

How did it get to be this way? My investigation of fear started with the discovery that animals respond by instinct and conditioning, while we, with the same essential fear apparatus as they have, feed our fears through verbal communication. A zebra is wise to be afraid of a roaring lion, yet we are not so wise to fear a metaphorical lion that is a thousand miles away from us. As soon as we hear about a danger, however remote, we tend to see it as a personal threat, especially if the danger is exaggerated to begin with.

When did the crew-cut, thick glasses, thin-tie anchorman become today’s harbinger of doom? For me, realization of the fundamental change in the media occurred at the beginning of May 2004, when I received a phone call from the WNBC-TV doctor, David Marks. He was looking for a sound bite about the new Medicare discount cards, the latest in false comfort. Marks was a well-dressed young internist with news-anchor features and a kindly face. He had a private practice in Connecticut, and he came to New York two days a week to tape health spots for the TV station.

As we were being powdered and prepped for the interview, I mentioned that I was investigating the epidemic spread of fear. “What role do you think the media play?” I asked him. “We’re so guilty of spreading it,” he said. “I don’t like reporting the overhyped stories that unnecessarily scare people. But these are my assignments. I try to put things in perspective, to do my best to tone things down, but sometimes I wish we weren’t covering these stories at all.”

I was looking for just this kind of direct admission from a cardcarrying member of the media. Media people I’ve met are serious and sincere, which doesn’t mean they always see risk in a proper context. Newspapers issue daily corrections but do not routinely acknowledge when threats that are reported don’t materialize. In studying fear, I have come to believe that it has a tendency to reignite itself. Once a fear fire is extinguished, another one takes its place. There are fear seekers in our society, and these groups are always expanding in number and infecting new members. People are especially susceptible on the coasts, where fear of terrorism is greatest, but there are plenty of worriers in between.

In parts of the world where wars and acts of terrorism have been more commonplace, America has the reputation of being a country with a soft underbelly. In Israel most people manage to live relatively normal lives despite frequent suicide bombings and constant military conflict. This is because statistically, a walk to the supermarket in Israel is still far more likely to be uneventful than unsafe, and the public has come to understand and accept the small level of individual risk. As a result, in Israel and in other societies whose citizens live with similar uncertainties, people become desensitized to the chance of terrorism over time; the threat gradually becomes less immediate, and thus more in keeping with the statistical probability of terrorism actually taking place.

Still, even in Israel the threat of terrorism has had a cumulative effect on health. Desensitization, as I will show throughout this book, is not a cure, and people in Israel live stressful lives. Suicide bombings that occurred there in 2001 have been shown to have an impact on the perceived sense of safety in 2002.

A study that appeared in the journal Psychosomatic Medicine in July 2004 showed that Israeli women who expressed fear of terrorism had twice as high a level of an enzyme that correlates with heart disease, compared with their less fearful compatriots. It is not necessary to have a psychiatric disorder in order to be made ill by fear. This is the essential distinction between the well described diagnoses of anxiety and phobia and the new fear disease that can victimize anyone. And superimposing fears on a population that is already riddled with phobias and anxieties can induce paralysis.

The symptoms of fear, the maladaptive kind, include an exaggerated sense of vulnerability, fear of a danger that doesn’t exist, or fear out of proportion to the risk. Like any illness, the illness of fear interferes with function. Fear victims are revved up in fight or flight mode. Their bodies ask them, how is a person to be protected from an ever-growing threat without being on the alert?

Stress hormones — adrenaline, catecholamines, and cortisol — are secreted in excess amounts. These counterregulatory hormones cause the liver to make more sugar and create more and more energy, which builds up without outlet. To this, nervous sedentary people add more stimulants such as coffee, which revs them up further. People don’t eat well, sleep well, or experience sufficient pleasure because they are always on the alert.

With fear infecting and reinfecting us, our pill-happy culture looks for treatments rather than cures. Whether this pill is propranolol, Valium, Prozac, or another new brew, we are told that without it, we will be compelled to live in terror. Rather than examine why we are unnecessarily afraid, rather than ripping out this weed of fear by its roots, we attempt to neutralize it with postmodern concoctions.

In addition to pills, we seek the ultimate vaccine. In a study from Israel in May 2004, Jonathan Kipnis gave a chemical cocktail to panicked mice and found that by bolstering their beleaguered neurons, the mice were once again able to perform their usual tasks. The implication of these results — if they prove applicable to humans — is that immunologically engineered “vaccines” may help to make people impervious to panic. But it is one thing to employ sophisticated technologies to bolster an overworked nerve fiber in a troubled brain, it is another to bottle the latest preventative and market it widely to treat all fear. Instead of learning how to assess risk realistically, we will try to treat fear with the latest in immunology.

Traditional vaccines already provide us with an apparent shield against our fear of illness. In the fall of 2004, many of the people who trampled over each other in line to get a flu shot at a time of sudden shortage were more at risk of exhaustion than of flu. But as with the faraway roar of the lion, the widely held belief that people are at great risk of the flu is a media creation. So too is the perception that a simple inoculation removes that risk.

The public pendulum swings from dependency on a supposed panacea to panic when a vaccine is found to be flawed or is no longer available. The government makes fear a central part of its agenda, trying to weigh in as our protector. In the process of being

so “protected,” we learn about dangers we didn’t know existed. The real danger of being manipulated in this way is to our health.

I learned firsthand of the devastating reach of governmental fear mongering when, at the request of Senator Chuck Grassley, I examined the response to the 2001 anthrax mailings. The Centers for Disease Control (CDC) attached itself to the media megaphone and made us all feel afraid to open our mail. This response was a way of covering up the miscommunication and mishandling of the evidence by all the federal agencies involved.

The anthrax scare established a precedent for public health hysteria that has been racheted up with each new bug du jour, to the point where the public feels threatened by every possible source of contagion. Smallpox extended the hype to a bug that is no longer infecting anyone. SARS was the first panic to involve the worldwide health community and petrify Asia and Canada along with the United States. The flu scare turned an overlooked disease into a sensation overnight.

The government was sometimes a greater danger than the supposed threat. In its haste to protect us from chemical and biological weapons, for example, the government built expensive high-security laboratories to study these potential weapons. But a study published in February 2001 found that of twenty-one known germ attacks, most were conducted not by terrorists but by government researchers-turned-terrorists who had gained access to human pathogens.

And until it becomes an election issue, our leaders practically ignore the risk of nuclear terrorism, where a terrorist smuggling a suitcase onto a plane or boat can get past the porous safety net and cause great harm. As Harvard scholar Graham Allison wrote in his book Nuclear Terrorism, this is one worst-case scenario that we aren’t doing enough to prevent.

As I interviewed people for this book, I found many who were wistful for the “good old days.” Perhaps our greatest immunity against panic has always come from go-to people in charge of our safety: the policemen, firefighters, and emergency medical technicians.

But these comforting presences are being forced to compete with the all-purpose information glut. Tiny bites of data are always within reach via the Internet, the television, and the radio. Many of my patients complain that they don’t know where to go to find answers that don’t frighten them. Our personal narratives are gradually giving way more and more to the discourse of risk and danger.

Excerpted from “False Alarm: The Truth About the Epidemic of Fear” by Marc Siegel. Copyright © 2005 by Marc Siegel. Published by John Wiley & Sons, Inc. All rights reserved. No part of this excerpt can be used without permission of the publisher.

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