[This is an interesting, but weird, little anecdote from what is literally a breathtaking, and life-altering, book (for this Silverback, anyway). SB SM]
“In the United States, a girl whom psychologists would name S. M. was born … with a rare genetic condition called Urbach-Wiethe disease. The condition caused cell mutations and a buildup of fatty material throughout her body, giving her skin a lumpy and puffy appearance and making her voice hoarse. When S. M. was ten, the deposits had spread into her brain. For reasons nobody understands, the disease left most regions unharmed, but destroyed her amygdalae.
“S. M. could see, feel, hear, think, and taste just like anyone else. She had a normal IQ, memory, and perception. But as S. M. entered her late teenage years, her sense of fear diminished. She would approach total strangers, stand a few inches from their faces, and describe her most intimate sexual secrets, never afraid of embarrassment or rejection. She’d walk outside in a violent thunderstorm to chat with a neighbor, never worrying she’d be battered by debris. She’d eat food if it was around, but wouldn’t bother stocking up if the cupboards were bare. S. M. had no fear of growing hungry.
“She even lost the ability to recognize fear in the faces of those around her. S. M. could easily register happiness, confusion, or the sadness of friends and family, but didn’t have a clue when someone was scared or threatened. Worries, stress, and anxiety all dissolved along with her amygdalae.
“One day, when S. M. was in her 40s, a man in a pickup truck pulled up and asked her to go on a date. She got in, and the man drove her to an abandoned barn, threw her on the ground, and tore off her clothes. Suddenly, a dog ran into the barn, and the man became nervous that people might be close behind. He zipped up his pants and dusted himself off. S. M. casually got up and followed the man back to his car. She asked to be driven home.
“Dr. Justin Feinstein met S. M. in 2006 while getting a PhD in clinical neuropsychology at the University of Iowa. Feinstein specialized in anxieties, specifically in how to get over them. He knew that fear was the core of all anxieties: a fear of gaining weight led to anorexia; fear of crowds led to agoraphobia; fear of losing control led to panic attacks. Anxieties were an oversensitivity to perceived fear, be it spiders, the opposite sex, confined spaces, whatever. On a neuronal level, anxieties and phobias were caused by overreactive amygdalae.
“Researchers had spent two decades studying S. M., trying to understand her condition, and trying to scare her. They showed S. M. films of humans eating excrement, took her to theme-park haunted houses, and put slithering snakes on her arms. Nothing worked.
“Determined, Feinstein dug deeper and found a study in which human subjects were administered a single breath of carbon dioxide. Even with a small amount, patients reported feelings of suffocation, as if they’d been forced to hold their breath for several minutes. Their oxygen levels hadn’t changed and the subjects knew they were never in danger, but many still suffered debilitating panic attacks that lasted for minutes. This wasn’t a reaction to a perceived fear or an external threat; it wasn’t psychological. The gas was physically triggering some other mechanism in their brains and bodies.
“Feinstein and a group of neurosurgeons, psychologists, and research assistants set up an experiment at a laboratory at the University of Iowa hospital. They brought S. M. in and sat her down at a desk, fitting an inhaler mask over her face, connected to an inhaler bag that contained a few lungfuls of 35 percent carbon dioxide and the rest room air. They explained to S. M. that the carbon dioxide would not damage her body, her tissues and brain would have plenty of oxygen. She would never be in any danger. Hearing this, S. M. looked the way she always looked: bored.
“‘We weren’t expecting anything to happen,’ Feinstein told me. ‘Nobody was.’ A few moments later, Feinstein released the carbon dioxide mix into the mouthpiece. S. M. inhaled.
Right away, her droopy eyes grew wider. Her shoulder muscles tensed, her breathing became labored. She grabbed at the desk. ‘Help me!’ she yelled through the mouthpiece. S. M. lifted an arm and waved it as if she were drowning. ‘I can’t!’ she screamed. ‘I can’t breathe!’ A researcher yanked the mask off, but it didn’t help. S. M. jerked wildly and gasped. A minute or so later, she dropped her arms and returned to breathing slowly and calmly.
“A single puff of carbon dioxide did to S. M. what no snakes, horror movies, or thunderstorms could. For the first time in 30 years, she’d felt fear, a full-fledged panic attack. Her amygdalae hadn’t grown back. Her brain was the same as it had always been. But some dormant switch had suddenly been flipped.
“S. M. refused to inhale carbon dioxide again. Years later, the mere idea of it stressed her out. So Feinstein and his researchers confirmed the results with two German twins who also suffered from Urbach-Wiethe disease. The twins had lost their amygdalae, and neither had felt fear in a decade. A single inhalation of carbon dioxide quickly changed that when both suffered the same debilitating anxiety, panic, and crushing fear as S. M.
“The textbooks were wrong. The amygdalae were not the only ‘alarm circuit of fear.’ There was another, deeper circuit in our bodies that was generating perhaps a more powerful sense of danger than anything the amygdalae alone could muster. It was shared not only by S. M., the German twins, and the few dozen others with Urbach-Wiethe disease, but by everyone and almost every living thing—all people, animals, even insects and bacteria.
“It was the deep fear and crushing anxiety that comes from the feeling of not being able to take another breath.”
| author: James Nestor | |
| title: Breath: The New Science of a Lost Art | |
| publisher: Riverhead Books | |
| date: | |
| page(s): 166-169 |