Our Brains in the &: Fear, Reward, and Human Behavior

On this “expert in the &” episode, Heather and Dr. Ahmad Hariri, a professor of psychology and neuroscience at Duke University, unpack some complexities of the human brain and how understanding it can help us live more intentional lives. Dr. Hariri shares some brain-circuit basics, along with details on how our neural architecture influences behavior and emotional regulation. This episode also includes a few reminders and tools to help us all hold ourselves with compassion and support us in thriving individually & collectively. Send us your questions… we’re doing a Part 2!

Disclaimer: The views and opinions shared in this episode belong solely to the host and the guest and do not necessarily reflect those of their employer or affiliated organizations.

Host: Heather Gates, MPH, Owner & Strategy Partner, Human-Centered Strategy, LLC
Guest: Dr. Ahmad Hariri, Professor of Psychology & Neuroscience, Duke University

Resources
Michael Pollan on Psychedelics
Secret of Secrets by Dan Brown
Whole Brain Living by Dr. Jill Bolte Taylor
Looking Inside the Disordered Brain by Ahmad Hariri
Dr. Dan Siegel “Brain in the Hand” model
Why Zebras Don't Get Ulcers by Robert Sapolsky's

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Transcript

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Technical Note: Show notes are created with the help of Riverside.FM AI and thoughtfully reviewed by us. They’re meant to capture the spirit of the conversation, though they may not reflect every word exactly.

Heather
Hello, this is Heather Gates and I welcome you to the Stand in the And podcast, where we have honest conversations about the messy complexity of the human experience, where we get stuck and how we find forward in the and of it all where many things are true at once. This podcast is designed especially for those of us who want to make things more beautiful and better for everyone and sometimes need reminding that we are human too. I'm so glad you're here.

Heather 
and start it just so it's.

Ahmad
Do you listen to Radiolab on NPR? No.

Heather 
Do you feel like you're on Radiolab?

Ahmad 
Well, just for a second, the opening is always a recording of two of the guys. Okay. All right. Okay. All right.

Heather 
Every now and then we will include some of the pre-start banter. It is like bloopers of going, should start this, we should stop talking. What? Is there cake? It's Ashley's birthday. That one happened right in the middle of an episode. We do try to keep it. We try to keep everything in and it also is helpful for me to remember this is not live radio.

Ahmad 
Yeah, like bloopers almost.

Ahmad 
It's a UPS guys, see you, farewell.

Ahmad 
Right, yes, we can always edit.

Heather 
We can always take something out or, you know, whatever, and we'll aim for it to be about an hour. And that's just on me to keep tabs of what time it is. yeah, on the door and tell us it's time to go. So I think, I mean, we have a general plan for this, but I really am fine if you are with, just see where the, feel where the riff of this.

Ahmad 
Absolutely. Winging it is ….

Heather 
I love it. Goes because I do think a lot of what we're just talking about is.

Ahmad 
important.

Heather 
So much care. Yeah, just I mean, as you can tell already, I'm infinitely curious about this and talking about it probably sometimes accurately ish. So I'm just grateful to have.

Ahmad 
Yeah, so much, by the way, so much of what we have, if you want to say discovered or cemented or established through science is what we've all known for eons.

Heather 
intuitively now yeah well that's to me but back when I talk about what is human intelligence yeah yes there's something there to me that's more than patterns yeah

Ahmad 
Yes.

Ahmad 
You know, one of the more interesting kind of shifts in thinking about human intelligence for me, Heather, has been this idea that it's existed in psychology for some time, but it was brought to my attention most recently, it's been Michael Pollan's work on psychedelics, basically consciousness. But, you know, there's this phenomenon where people oftentimes through psychedelic trips will...

experience this connectedness with something that's far greater than they are. And so one of the ways that at least Pollan has articulated this is perhaps our brains are not so much generators of content, but receivers. And the psychedelics, which all very interestingly act on the same receptor for serotonin, the 2A receptor, they may be changing the tuning frequency of our brains and giving us for those moments access to information

It's out there, but we just simply, our brains aren't tuned into it broadly and every individual's brain is tuned in differently. This is also in Dan Brown's latest book. There's an element of that that I really liked. I may be giving Dan Brown and Michael Pollan and both too much credit, but I've enjoyed it. I really think they both do such a really powerful job of weaving science into a story and narrative. It's really compelling. At least I find them incredibly compelling.

But this idea that maybe our intelligence is more about the opportunity to either consciously or through some other means be willing to change the tuning frequency of our brains, to listen to something that receives something else.

Heather 
Well, and I'm gonna intro this podcast and we're gonna start it in a second.

Ahmad 
By the way, not a psychedelic advertisement

Heather 
But just when the more I'm also learning more about quantum we talked a little yeah, about quantum computing earlier and just what All that there is to be dialed into but let me pause this because I do need to officially start the podcast. Ashley feel free to use any of that But I do want to yeah, just take a breath

Ahmad 
Good things, good things. Oxygen is definitely something we want to have.

Heather 
Welcome back to the podcast, y'all, where today I'm standing in the and as a UNC graduate on the campus of Duke University with my new friend, Dr. Ahmad Hariri. Thank you so much.

Ahmad 
Oh It’s my pleasure Heather and I'm so glad to be here with you and in person.

Heather 
In person, in this, who even knew, amazing little podcast studio. Yeah, no, I'm not blue generally. I just needed to acknowledge for all of my Tar Heel colleagues that I understand the and that I find myself in today. And that we are our first podcast on the road. So this is our, thank you for being part of the experiment.

Ahmad 
Duke Blue, don't worry.

Ahmad 
I am glad to be a part of it. I hope it ends up being the first of many. I hope so. An experiment that we can learn from.

Heather 
That is the point of experimentation, Is it not? So before we get into it too far, I do want to give you a chance, an invitation to introduce yourself. Okay. If nothing else gives context to some of the remarks that you're going to share today, but how do you want to introduce yourself, whatever feels important.

Ahmad 
Okay, that's great. So my name is Ahmad Hariri. I am a professor of psychology and neuroscience here at Duke where I've been since 2009. And I'm a neuroscientist by training. So I have a PhD in neuroscience. And for my entire career, I have been interested in trying to identify how differences in our brains really shape differences in our behavior. Early on, my work focused on brain structures and brain circuits that help generate our emotional experiences and help us learn about danger and threat. And that kind of evolved into other brain circuits that help us recognize and pursue rewards and positive experiences. 

And then ultimately the circuitry that helps us manage all of the different pulls and draws on our attention. The circuits that really are there to help us make the right decisions at the right time.

And so to do that, I've used functional MRI as well as structural MRI. So a non-invasive way to look at the brain at work. More recently, I would say over the past 10 years, my own program of research has shifted towards aging, understanding how the brain is aging and whether or not the brain can tell us something decades before someone, for example, in their later life develops cognitive decline or dementia we want to know if there are signs in the brain much earlier that we can capitalize on to help put those at-risk individuals on trajectories of better health. 

And so that's what I do in the lab with a team of amazing colleagues and trainees and other scientists. And then I have the privilege of teaching two classes here at Duke. I think the first is the one that maybe brought us together today. It's called Looking Inside the Disordered Brain. And so in that class, I try and lay out the anatomy of three, what I consider foundational circuits in our brains that keep bad things from happening, keep us safe, make good things happen. So, helping us thrive and then executing control. And so those are three circuits. I talk about their anatomy and how that anatomy and how information processing through these circuits can emerge as fear or happiness or things like memory and decision making and cognition. And then we transition to how disruptions within these circuits may contribute to the symptoms of mental illness. So, depression, anxiety, even psychosis and thought disorders.

Heather 
We going to get into circuits here in a minute and I'm hopeful that we're going to talk about the and of some of them not just the or of them

Ahmad 
Exactly. Yes. I've been presenting it as I do class as three circuits. Yeah. But in reality, they're constantly interacting 

Heather 
Okay, so now anybody who has been tracking this podcast knows that as we started the podcast, I put out a question on LinkedIn to say, I want to talk to a neuroscientist or a neuroanatomist about how we are or aren't wired for and so I'm just having a moment right now. yeah, full circle. We did it. I found a person and as life goes, it's... one person connects to another person that connects me to you. 

That's so cool. you know, human intelligence or whatever, we know connection is at the heart of most all of it. And it, it just feels so lovely to, to be here. And I'm grateful that you are up for not only being part of the experiment today, but you know, so often on the podcast, I'm talking to people who I've worked with a long time or

Ahmad 
connections are so cool.

Heather 
you know, are happy to help me get this started. So to be basically a stranger to me. And we did, so we did have a first conversation about this and talked forever. And I said, please, can we just get on the microphone and talk neuroscience to my audience? Because as you know, I get very excited about this topic. And I love what you said, even in your introduction of this quest almost to understand how the brain impacts

What we're up to. So really functional application of how it shapes the human experience. Before we get too deep into science, it is a tradition on the podcast for to honor our own humanity. You, although brilliant neuroscientists also are human on the planet. So I'm going to ask you as you are just humaning today. And you're standing in. As in what maybe many things feel true to you at the same time. I'm happy to go first because I will also participate unless you already know what you want to say.

So what I'm going to say is the and that I'm standing in today, I was going to say on a Monday, but it is not a Monday. So maybe that tells you.

Ahmad 
I'd for you to go first.

Ahmad 
Hey at it's not Wednesday.

Heather 
All right. I right now in life, I think I'm standing in the and of effort and ease, which presents to me as, probably my natural tendency is effort and is reach. So I have things I'm excited about that I'm reaching toward and also feel newly settled into.

Ahmad 
Mm. Mm.

Heather 
I'm gonna call it ease. did a podcast recently that had something to do with surrender, which feels like a foreign concept to me. But I do feel a bit of ease with the flow. We talked at lunch about transitions that are around and upon my life. So I feel nestled in, in a not resistant way, because I do want us to talk today about.

The and as many things are true. Sometimes I feel a lot of resistance around that and tangle and sometimes it's few. I have some acceptance around. So I'm standing in effort and ease. I think as I show up

Ahmad 
It's hard for me not to just, plagiarize that. I will, but I'll, maybe I'll put a little bit as you were describing your tension between effort and ease. I can so relate to that because I think my default is look, is to always look for the easiest path. Right.

Heather 
Okay. Nice. Great. That's why we're here together, to balance the planet.

Ahmad 
Right. So, you know, speaking of which, think someone who doesn't do what I do, hasn't spent so much time in education and training like I have, may look at me and think, oh, my goodness, look at what tremendous effort this person has put forth. And certainly there's effort there. But it was also, it felt easy for me. I think it would have been much harder for me to pursue a career that was outside of science because it would have been harder. I mean, who knows? Maybe I could have been...

We were joking earlier that I played the trombone. I was going to be in a Ska band. But that would have been so much harder for me because it wasn't something that came naturally. having said that, I guess my and today is finding myself in a gray kind of thunder cloud looking for the silver lining. And that's really a professional comment. Our research has kind of hit a few bumps in the road over the last year.

Ahmad 
And they've been really hard and demoralizing, not just for myself, but our entire team. But I always look for an opportunity to really lean into the science, the discovery, the fun, the excitement, despite what has been really a long irritant in terms of getting to that science. Right? So I'm sure is this true for you in your work, Heather. 

You know, there are lots of things that have to be done that nobody wants to do. Someone has to do that happens to me. You become the PI of a lab. You're expected to get the grants.

Heather 
Right, it's not the fun science part.

Ahmad 
And, know, in the best moments, that's a pretty bankless kind of job. It's certainly not a very fulfilling job. It's only there for me to get to the science. It's a means. It's a means. that's where I find myself today. Yes, exactly. Exactly. So because I know that the science is there and I want us all, our whole team, to desperately get back to just focusing on the science.

Heather 
It's a means. Having to effort on the means.

Ahmad 
And hopefully we'll be able to do that in the near future.

Heather 
of the tension between the two and the tension between what I really want to be spending my time on.

Ahmad 
in what I could do right now so much more easily than continue to fight and put forth effort to maintain all of the infrastructure that allows us to do the science. You know, it's something that I think about more now than I have ever before. And I don't know how I feel about it, to be honest with you. I feel like it's early for me to really think about.

Heather 
Yeah.

Ahmad 
Do I want to wind down my program of research and focus more on teaching? And I certainly envision that at some point in my future, but not this soon. So hopefully, we'll be able to reconnect and I'll still be able to. Yes, yeah, I'd love to be able to give you a positive update

Heather
Give us an update on that. I think it's interesting what the tension, so when we experience that tension, especially on the edge of our natural tendency, we're in the and, what then that prompts in us from a, what is the resolution to the tension? How long can we hold the tension if we can honor a purposefulness around it? And then I wonder if it is the brain's tendency to try to resolve the dissonance and what does that mean? Is it? Push through it faster and we'll get to the fun science is it maybe I need to be somewhere different. all that the tent, it's just interesting. I keep thinking about the friction even from like sand and a oyster that makes a pearl. Or in biology sometimes those irritants that there is a way that the body will push them out.

Ahmad 
Yes, right.

Heather 
So is it the pushing them out or is it the holding them in because it is the irritant that creates the more beautiful thing on the other side? So just the nature of tension is interesting to me from a neuroscience perspective. 

So we'll connect the story back. Thank you for sharing because I it's just so helpful, especially when we have what I would call experts in the and to say, y'all the experts are people too. Let's not forget we all are standing in an and and navigating a tension and trying to figure it out just like everybody else. 

So yes, you graciously responded to an email because I got connected through a student of yours who somewhat a colleague connected me to because I said at the time, I should say for my audience in case they don't know, I have a degree in biomedical science that I got in the late 90s. Things have changed a little. Turns out I try to pay attention.

And not as if I knew everything I needed to at that point. And I have some fundamentals. I do want to try not on the podcast to be too nerdy about hemispheric specialization and other things that are going to feel complicated to say and digest.

The thing that got me, aside from thinking about the and specifically was, and I may have mentioned this to you, I don't remember, but I think it was a book that I read called Whole Brain Living by Dr. Jill Balty Taylor. And I think it was in that book where she talks about somebody around that time that I was learning about that, spoke about how the amygdala is not a single structure. And I'm sorry to whoever taught me anatomy in the 90s that I did not pick up on that.

but I thought we had an amygdala. I did not know that there was an amygdala or however you would say the plural, messing it up. Amygdalae is a weird, right? We say amygdala and it's so interesting, right? Just given our use of language, I think a lot of people think we have an amygdala and it's one almond shaped structure in the middle of the brain, but there's one on each side. There is, And everybody I could find to listen to me for about a week, I was like, wait, but did you know?

Heather 
We have two amygdala. And they're like, okay. I was like, so what if that means we're getting different responses on either side because of the anatomy. So I think I came to you maybe was like, hi, I'm Heather. There's two amygdala. What do need to know? How does that mean we're wired for And? And the conversation actually, when we found, got to each other, took us more to discussion around circuits. But basically I was still like, Dr. Hariri, are we wired for the and or not, or how does that work? So I think I just want you to tell me, tell us how you see this notion of the and where I would say many things can feel be and feel true at once. What is happening?

Ahmad 
Yeah. I think perhaps a really effective way to have this conversation Heather, hopefully for your audience as well, but for us at least, we're the only ones in the booth right now, is to start with the amygdala, right? So not only is the amygdala present in both hemispheres, both halves of the brain, as are essentially all brain structures, they're really mirrors of each other in the right and left half, but beyond there being two amygdalas or amygdalae, the very notion of a amygdala is inaccurate. So the amygdala is actually at least 13 different smaller structures that are very close to each other physically and highly interconnected with each other.

Heather 
See, there you go. It's not even like the eye sitting in the pain. It's like a community.

Ahmad 
It is, this is, we were talking earlier about how the human brain and really all brains are there to recognize patterns. So the early anatomists, they not only recognize that, this chunk of brain looks like an almond, and I don't know, maybe they were hungry, that's why they were just thinking about food. So they called it, right? In Latin, they use further shorthand, right? Shortcuts. They saw it as one thing. And until we were able to look more closely,

Heather 
Yeah, sure. Who knows?

Ahmad 
We thought of it as one thing and then as our methods, as the science evolved and became more sophisticated, we realized, there are actually many different things that are called nuclei. And so when you have neurons that together are processing some information and producing some action, in the brain we call the nuclei. They're just basically neighborhoods of lots of neurons, often millions of neurons.

Heather 
That's crazy just to wrap your head around. When we say a group, we're talking millions. So it just is humbling and beautiful to me for us to just honor this thing, organ, it's brain and organ, that we're carrying around every day with millions, billions of neurons.

Ahmad 
Yes, yes, very much an organ

Ahmad 
billions of neurons. And that's not even the most impressive aspect of the hardware. It's the connections that are made between these billions of neurons, which number in the trillions. So everything that we think about as being a product of our brain is really the product of massive amounts of communication across trillions of synapses in real time.

Heather 
It's amazing.

Ahmad 
Yeah, it is amazing. It is awe-inspiring. For me, I've never been more interested in anything in my life than the brain. You know, people can look at the stars and without doubt, there's so much wonder and awe when we look out beyond our planet. But I feel even more awe and kind of wonder thinking about what is happening inside each of our skulls.

Heather 
I do too, and that's why I can feel that in you and I'm so glad you're here. Okay, I distracted us. You were talking about the amygdala. Do you still call the amygdala the amygdala even though it's a community?

Ahmad 
So it depends on, you know,

Heather 
I mean, keep me honest, if I want to still be referring to things accurately, do I still say amygdala or do you call it like a region of...

Ahmad 
No, no, no. So I think in terms of day-to-day conversation, the amygdala does a perfect job. But for example, in my class, very early on, even the first lecture, I like to kind of drop the kids into deep end and say, hey, this what we're doing. You're going to swim with me and we're going to have a great time or maybe we should change classes. I introduced them to least three separate

Heather 
Yeah, right.

Ahmad 
nuclei or sub structures within the amygdala. Okay, we'll separate we'll cut it down to just two. Okay. Okay, one of them will refer to as the BLA. This still does the initials. It stands for basolateral amygdala. That's a lot. So let's just talk about the BLA. So the BLA receives input from all of our senses and many other sources of information including our what we call our interoception. So our awareness of our bodily states. I'm hungry, my stomach is grumbling, my heart is racing because I'm fearful or nervous, my palms are sweating. That all is captured by this idea of interoception, basically detecting our internal states. Those signals go to the BLA. Everything you see, hear, taste, touch, smell, right to the BLA. And then the BLA is also where some of our experiences converge.

So if you for example, are shocked by static electricity or you touch a hot stove or anything happens that causes pain, that signal also goes to the BLA.

Heather 
in a real time or in memory of.

Ahmad 
No, no, in very much real time. And so if two things occur simultaneously, they coincide, so let's say you hear something and you experience a static shock, that information, the sound and the pain signal that shock creates converge on the BLA. And when they do that, they strengthen the connections of specific neurons within the BLA.

We sometimes refer to these as fear neurons and that's the fundamental basis of how we learn to be afraid of certain things and how we can use Clues in our environment to predict something bad is going to happen and in doing so Hopefully avoid that bad thing altogether. Okay, so that's this is the BLA and the BLA Accomplishes what many of us think of as fight or flight? By sending signals to other parts of the brain

Heather 
Is the BLA a structure or circuit?

Ahmad 
It's a structure within a larger circuit. So one of the important downstream structures at the BLA signals is called the central nucleus of the amygdala or CEA. I know it's impossible to do this without a lot of jargon. then, so the CEA and many other downstream structures in our brainstem and our hypothalamus.

are how the BLA, having learned that this sound is associated with something bad happening, so kind of the fundamentals of conditioning, how it changes our physiology and also our behavioral states, our attention, our arousal, to be able to motivate us to mobilize our resources to confront some threat or avoid some threat. Okay, so this is the core role of the amygdala, is a hub of a circuit in learning

learning how to keep us safe, right? In recognizing danger and keeping us safe from those dangerous things in the world. Now, what does this have to do with the and? The BLA is also critically important for learning about good things that are happening and recognizing cues in our environment that are associated with positive outcomes, reward, food, water, friendship.

Sex all of these things that are critical for survival as is avoiding, you know death basically, right? You need to survive but you also need to thrive The BLA is actually communicating the sensory information in both circuits So in a circuit that is designed to keep us safe by recognizing danger and creating fear The BLA is centrally involved as it is in the circuit that allows us to then recognize things that predict good outcomes and positive experiences and motivates us to seek out those things. 

So in this one small structure in the brain, which by the way is shared by every animal with a backbone, this is a very ancient structure, you have these very two, two.

Ahmad 
constructs two processes, two phenomenon that are superficially or at least in not even superficially, but the way they're expressed couldn't be more different. Right. Running away from something you can think about it versus running towards something. The signaling, the learning that's occurring is all in one structure.

Heather 
So when I feel like I have my foot on the brakes and the gas at the same time, it's like, of course, BLA. I don't have, I don't, it's not a, yeah, it just, like this is its job.

Ahmad 
Right. It is its job and it does it really well. It does it really well. And I think that's because it's been around for so long, right? From really the very beginnings of vertebrate animals that it wouldn't still be with us if it didn't do a job and didn't do a job very well. Right? So now the amygdala is oftentimes thrown out as the cause of anxiety, the cause of depression, the cause of PTSD, yada, yada, yada, yada. I think that's

Completely wrong. Right. think the amygdala does the job. It's meant to do and does it very well But it's not up to the amygdala to figure out is this a good thing? Is this a bad thing? Should I go here? Should I not that is the job of what we refer to as the prefrontal cortex

Heather 
Right, because it's a more when we think BLA. So let me just kind of catch myself up. BLA is a part of the amygdala.

Ahmad 
Yeah, but in many ways when we're talking about learning about danger and reward, it is the core part of the amygdala that is facilitating both types

Heather 
But it's still, it goes together. It's a piece of that amygdala is a bunch of different things. It's one of the things.

Ahmad 
And arguably the most important part of it when we talk about reward and threat and fear.

Heather 
Okay, it's the core. And when we think amygdala, I think primitive as far as kind of levels of complexity or advancement in our brain. So BLA being piece of the amygdala, threat and reward, we have it in common with other animals. And it's taking in, this is back to why don't think AI can replace intelligence completely. Because when you say it's doing

Ahmad 
Right.

Heather 
interoception, we are then going to be doing decision-making and pattern recognition from our sensory experience, that is a uniquely embodied thing. Absolutely. So we have this base primitive inputs that are then detecting threat and reward. Yes. Yes. And then where does it go? Okay. Because you said it's not that it goes somewhere else. So then it's, it's moving a level up on the elevator. Yeah. Yeah. To a prefrontal cortex, which is more exactly. I think of the thinking brain. Yeah. Yeah. So take us from there.

Ahmad 
Exactly. got it. let me make one terrifying point. Whether the information that's converging on the BLA ultimately results in fear or threat related behaviors like fight or flight, or in positive behaviors, happiness, reward, is all about how the information is then communicated forward. So, for the fear pathway, that those neurons in the amygdala that have learned these patterns, these associations, the amygdala, by the way, the BLA or any other nucleus is all about learning. They're foundations for learning and putting information together for establishing pattern. That's its job. It's his job. Whether you're talking about a bird, a fish, a mouse, a monkey, a man.

Heather 
That's a job.

Heather 
It's a pattern. When the lion comes, this happens. now I'm going to know that I'm going to, when we say know that, but we're going to have that baked into the kind of quote memory of what those kind of neuro connections are.

Ahmad 
Exactly. So it's interesting to know that because there's an argument and I

Heather 
Yeah, I think I did air quotes. I don't know what we mean by learning and knowing from a neuron synapse point.

Ahmad 
Yeah, so it's happening certainly in terms of this learning and by learning what I'm trying to kind of capture is the ability of our brains and in this case the BLA of the amygdala to connect information together and use those connections to make changes downstream that are ultimately going to help us survive. Yeah now all this information processing in the amygdala

isn't really reaching our consciousness. In other words, what's happening there, we're not quite yet aware of it. It's once those signals start to go forward to other brain structures, in particular the prefrontal cortex, but also, for example, we talked about interoception, there are structures in the brain, again, one on each side called the insula, where we start to register what's happening to our body.

Heather 
Because certainly some of that would need to be an immediate. Yeah. I need a pathway like, the lion is here. I don't have time to ponder and like discern and do those things. So there's something in there that's real fast

Ahmad 
So that's it. So it's a very important point that you bring up. And we consider it almost a nuance for the general kind of understanding of how the brain is shaping behavior. And that is there are indeed lots of things that happen in the absence of any learning and certainly not requiring the amygdala to play any role. But we think of those as reflexes. So when you pull your hand away from a hot stove or something that causes, I feel pain,

Heather 
I see.

Ahmad 
That's happening between your fingers and your spinal cord. That is not even getting to the central nerve. That's not getting to the brain. Because those are things that you just can't afford to take the time to learn because you're going to die. So, reflexes are completely different and not subject to the same learning that we think about in terms of higher order behavior.

Heather 
Interesting.

Heather 
Okay, so we're talking about higher order. That's just important, right? Reflex versus higher order of behavior. Because there are some things that to me feel like when I think of human interaction that I might say that sure feels like a reflex.

Ahmad 
Oh, you bet, you bet. Even if it's not a spinal reflex, is very much akin to a reflex because it's based on a very simple form of learning, right? Or assumptions about the environment that triggers a response that is inherently not informed by our higher order cognitive processes, right? They really are much more simple actions. So fear is even so,

Ahmad 
Let me take a step back. The hot stove, right? You your hand away if you touch it. That's a reflex. But if you see these old fashioned electric burners, you remember they kind of glow orange.

Heather 
Yeah, I think I have one in my right.

Ahmad 
Or if you see a flame, right? You've learned over time that that means that thing is hot. Don't touch it. Now looking at that red glowing, know, stove top isn't causing you any pain. You've made the association, right? So that's

Heather 
It's more like learning coming back down the other way.

Ahmad 
You got it. You got it. And one of the things that is really lovely about the human brain and believe it or not, even brains of other animals, including mice, is that we don't only learn about danger through experience. Well, I don't know if that might be another conversation. No, well, yes, epigenetics is pretty cool. That's another time.

Heather 
This is about epigenetics. Okay, that's another time.

Ahmad 
But basically what we can do is we can learn by observing others right so you See someone burn their hand on a stove and and you're remember your amygdala is getting signals all the time Constantly it's seeing it's getting information about that red glowing stovetop And so it can learn indirectly through the experience of others That that red stove means danger

Heather 
Yeah. Even through story.

Ahmad
So you've taken to the third level. The first level, you got it. That's the and. the first level is direct experience. It would suck to only be able to learn about bad things through direct experience. The second level is through observation, which is also like, who are we going to be observing more often than not? Our friends, our family. It's not

Ahmad 
you pleasant to see a friend or family member touch the stove or be bitten or whatever, right? Then the third, and this is the level that I think may separate the human brain from other brains, is that we can just be taught completely indirectly that something is dangerous, right? So, in my classes, I throw a...

Heather 
indirectly and perhaps incorrectly.

Ahmad 
That well exactly right and it all really depends on who's teaching you and what they're teaching you Because the underlying brain circuitry to learn is the same and it has the same capacity for learning You know when you were mentioning that you were at the beach with friends and depending on where you are. You might see warning signs about undertow or rip currents or even sharks, right? Now you read that and you think at least I do maybe I'm a little bit of a chicken

I'm not going in the water. But I've never, thank God, been bitten by a shark or seen anyone bitten by a shark. I've heard the stories and I've been told that sharks, if they do bite you, can cause a lot of damage. And that's it. That's enough for my amygdala to then be able to take that information that's a warning, a sign that says warning, sharks have been spotted in these waters. And the amygdala can...

Heather 
like I trust you. Yeah.

Ahmad 
change my physiology, can increase my heart rate, deepen my breathing, cause my palms to sweat to the point where it motivates me. My interpretation of that is, hey, this is a potentially dangerous place or situation and I avoid, I choose to avoid it.

Heather 
Well, let's talk though about, so if the BLA is receiving that, so all of that runs to BLA originally. You said also other inputs that are lovely. So let's just play this out. I'm reading the sign about the current and the sharks, and I see the beautiful water, and I feel the sun on my skin, and I feel my toes in the sand, and that part of me.

Ahmad 
It's like... to do a calculus, right? You're doing...

Heather 
I am standing in the and of shark danger and I don't know if this is more about discernment and decision making, but just to say, if I'm tracking this example, I'm going to be maybe at that level, not consciously even, or maybe I am conscious. Is this where from BLA then to higher level thinking and prefrontal cortex, I then am aware that I am in a little bit of a mixed message situation about what I'm going to choose to do. Is that how that plays out?

Ahmad 
Exactly. Yeah. this is, and I think the example that you provide is perfect. So on one hand, there are neurons and circuits within the BLA. Remember, we're talking about millions of neurons. That's crazy. That have learned the association between these warning signs and being bitten, Being the victim of a shark attack or getting pulled into a rip current, right? So that's happening because you're at the beach, you see the sign, maybe the water, the surf looks particularly strong today.

There are other neurons in the BLA that have made the connection between surf and sand and sun and joy, right? Just rolling in the waves, maybe surfing, maybe, you know, whatever it is. And so they're both those, those parallel in many ways pathways are being activated at the same time by the same context and stimuli. Now that is ultimately going to reach your prefrontal cortex.

Heather 
Joy.

Ahmad 
Very quickly, oftentimes my students ask, well, you know, because I present the flow of information serially and very, very kind of astutely, they ask, well, what's the timing? And the reality is that everything that we break down into these sequential steps is happening on the order of milliseconds. Right. So the timing is incredibly fast, so fast that we're really not aware of it. One of the important things that happens when either of those BLA pathways is activated

the good and the bad, is it creates broader arousal throughout the rest of the brain. So both systems are positioned where they can increase the signaling of the Citicoline, what we call cholinergic tone. And what a Citicoline does for all of the neurons in our brain is it makes them more responsive to input. Whatever input, waking up, exactly, hey, hey, hey, you know what, maybe you should be paying attention to what's happening out here, right? I need you. The amygdala is basically,

Heather 
It's just waking everything up.

Ahmad 
asking the prefrontal cortex.

Heather 
Just received in a memo from the BLA. You got it. Wake up class.

Ahmad 
Wake up and now it's up to you.

Heather 
What are do about it?

Ahmad 
You know is it really does it really look like a risky day to be out in the water? I mean, I man it's been weeks and I drove three hours to be at the beach. I really want to be in the water. All right, I'm going to go ahead. I'm going to take the risk, the calculated risk to be in the water despite the warning. Okay. Now that's one scenario. The other is that, Hey, I know it's going to be a lot of time and effort to get out here, but I would rather be safe than sorry but that decision is not being made by the in-mate. That's prefrontal cortex. That's the prefrontal cortex.

Heather 
Where is what's that? Because when we met before, you said the and is right here.

Ahmad 
Yeah, exactly. the prefrontal cortex.

Heather 
I'm tapping on my like third eye region.

Ahmad 
Which is exactly where I'm going to take us next because the prefrontal cortex also isn't one thing. There are at least three important areas of the prefrontal cortex that are going to be helping us ultimately make this decision. The first is the medial prefrontal cortex. I'll simplify it to two. The amygdala is a deep brain structure, highly conserved across species, ancient, and it's learning

You know, what are the things in and around us that are signaling and have in our past experiences, signal good things or bad things are going to happen. All right. And then how do we leverage that information to make good things happen more often and to keep bad things from happening? So it's doing that. But if you, especially if you're in a position where you have this tension, you have some signals that are related to good and some related to bad.

The amygdala can't resolve that tension. It doesn't even have the right connections to do that. So one of the things that happens in the medical prefrontal cortex is inputs from the amygdala, inputs from the reward circuitry, inputs from even the insula that's registering what we're feeling in our bodies, as well as inputs from our hippocampus, which is encoding, creating memories of all of these things. They are converging on the medial prefrontal cortex. And it's really in the medial prefrontal cortex that we think that our conscious awareness emerges. So the idea that something feels good or feels bad is not happening in the amygdala. It's happening in the medial prefrontal cortex. And so the medial prefrontal cortex is in many ways the great integrator.

So it's integrating what I like to refer to as these bottom-up signals about what's going on outside of us and and How what we're experiencing on the outside is affecting our inside? but it also is integrating the plans that are coming from what we call the dorsal lateral prefrontal cortex so right over here basically and It's that what we use shorthand DLP FC to describe

Ahmad 
dorsolateral prefrontal cortex, that is where the key cognitive functions are being maintained. So what we call working memory, right? So let me take a step back. Attention, right? So where am I directing my sensory resources and other resources? What am I attending to in the environment? So I see that warning sign that, you know, they're rip currents or sharks in the ocean. I'm attending to whatever might be out there. Maybe I see evidence of a strong current or I see the telltale dorsal fin of a shark. But I'm attending to that ocean now in a way that I wasn't before. And same thing happens where you're like, it's sunny, the surf's looks, maybe able to get some good, you know, good.

Heather 
We've woken your brain up to pay attention to all of that

Ahmad 
Exactly. And that's the acidic-coiling network, the way. The cholinergic tone, we call it. So the DLPFC is attending to the information now in a way that's much more precise, much more detailed. And then it takes that information and it starts to make decisions based on it using what we call working memory. So working memory is one way to think about it is like our mental notepad, scratch pad. The way we used to... you know, like so many things no longer relevant, but nice to describe learning a person's phone number as being a great example of working memory, right? Like you meet someone like, what's your phone number? You were, you were first.

Heather 
Stick it in the Rolodex.

Ahmad 
And then you get somewhere you write it down. Yeah So attention working memory and then the last element of what we call executive control is response selection Okay, this is this is you know Exactly right and that that is ultimately The DLP FC's role to say I'm gonna get in the water

Heather 
This is where I'm gonna make a decision.

Ahmad 
I'm going to take the risk because the reward is so potentially great for me that I'm willing to take the risk or it's a DLP FC says, you know what? It's too risky. It's too risky. So when I come back another day.

Heather 
When I think about that series of events, almost like I'm going to set up and knock down dominoes. And I think about the experience of feeling the tension of the and. It feels like it could almost be at many of those levels because there are times where, great, I'm alert to it all. And I don't know, we get kind of stuck in, I don't know. I don't know if I want to do this or this.

So that experience. Also sometimes in the and, I feel like what we're talking about is being stuck on the outside of the and. And I don't know how that applies to this model where I might just see the fear side. And all I can register, it's like the circuit that is fear maybe is so strong that it out signals the other one.

Ahmad 
And that's in fact what happens

Heather 
That I can't, so when I talk about all of these where we're standing in various ands, I say, gosh, I lean this way or I get stuck outside of the and or when people get stuck in false dichotomy to say, is it this or this? It's perhaps one side. And I don't know if we even need to get into how this happens, but it just feels true experientially without knowing what the brain's doing. That the anxiety and the fear side of doing a podcast is so loud. Right, right. that whatever needed to come out of the BLA to get to the prefrontal cortex, like just tinkered out.

Ahmad
That's exactly what we observe. So if we create an experiment where you take, we can just do it with a person, right? And you ask someone, please don't eat for 24 hours before you come to the lab for the experiment. So you know that they're gonna be hungry or maybe even don't drink. We could take it to an even more extreme. when we study addiction and...

Heather 
It still is pretty extreme to me already.

Ahmad 
you know, abstinence, oftentimes what we do is we ask smokers to not smoke for 24 hours. Yeah. And that is really hard. So now you're talking about someone who is in many ways, every circuit in their brain is now orchestrated towards getting that cigarette, getting that nicotine, right? And then you put them in a situation where they can get nicotine, but it's only if they go through something very aversive.

Like, okay, you can have a cigarette, but in order to get that cigarette, you're going to have to be exposed to a shock. I'm kind of making this up. No, it's not. I promise it's not. It's a pretty reasonable, I don't think it's an unreasonable kind of situation. Granted, it's contrived for a laboratory, but we can kind of extrapolate it to our real world experiences. So what we find is that in those situations, fear will win out.

Heather 
I'm like, this what you're doing?

Ahmad 
But the default is fear because fundamentally it's more important. Exactly. ultimately allows us one more day or maybe one more hour.

Heather 
So that just feels so everybody, if we've lost you so far, sorry. It's been enthusiastic. But this point that we are wired both for fear and reward or pleasure. And if given a choice, fear will win because it is more likely to help keep us alive. And that is all our brains are trying to do.

Ahmad 
Exactly. Or rather when faced with... survival or Thriving, right? Yeah.

Heather 
When faced with survival, we're going to pick survival. This is so important, I think, because if this is, and you said this, I don't know if it was before we started recording officially or not, but the environment that our brain is wired to keep us alive in and to have fear when, when it needs to for survival is not actually much related to the environment we find ourselves in now, yet fear can still feel dominant. 

So sometimes when I'm talking to people, say, yeah, what we're trying to do here in this organization or in this community where we're gonna have to on purpose make ourselves uncomfortable to do this thing is outside of our natural wiring because our natural wiring is gonna is gonna lead fear and try to keep us safe. 

So I so often folks in my audience are having to lead teams and self against all that synapse energy. It's like danger, danger, danger to help somehow pave the other side that says reward and maybe not even reward for me, but reward for the greater good. And that we're having to push against millions yet maybe billions of connections that are trying to nudge us otherwise. 

So this idea that we're wired for and is important and that our brain is more wired for survival than it is some of the things we're actually trying to be about when we think of it from top down. maybe this is, right, because when we talk about amygdala kind of bottom up, like from primitive to thoughtfulness.

In my more top down and I'll just say like thinking advanced brain that can set intentions that says we need to do better for community. That sometimes bottom up and top down is another and that might crash into each other.

Ahmad 
Well, and think about, Heather, the fact that the very top down control that you need to regulate that fear is also the top down or control that you need to lead the team through whatever exercise or planning. So now your already limited resources are being spread even thinner.

Because you're managing your own anxiety or fear about what may go wrong what might go wrong and you know is this I gonna do a good job? I ready all the doubts that we have right all you know all of our lives you are managing those with exactly the same resources that you need to be able to do the the training or the to give your talk or to explain data or predict some forecast market

Heather 
Yeah. Because when you say resources, what you're talking about is brain real estate.

Ahmad 
Yeah, one of the things I've tried to establish from the get-go in my classes is that we are all limited resources. We don't have infinite resources. We can't do simultaneously 16 different things or at least we can't do them as well as we would I really want to do if we could address them serially. So we have to prioritize. And I was gonna say even even with regards to survival there are priorities, right? So don't get eaten. Don't get killed in number one. Okay, then it's eat

so you don't starve and die that way, and then it's reproduce. So even when you have clearly what are elements of survival, there's still a prioritization, a stratification of what has to happen right now versus what can be delayed for the future.

Heather 
And just, I mean, it sounds simple to say that, but how that plays out from a day-to-day human experience and the very real thoughts that come up of, if I do that, how will it threaten my job that does impact my safety and my family? And we're wrestling in all of these things. So again, and the brain is wired to help us wrestle with them.

Right. It's not necessarily a chat bot that you're going to push it all in and get a summary out of is we are navigating in our brains. Yeah. Not because you're broken, but because this is how it's wired. Yeah. To help us make sure we're taking in all the information to make the best decision possible. Yeah. And I guess it just feels like we might could use, you know, sometimes an upgrade. Yes. In the software that would help us get a more accurate,

Ahmad 
Absolutely.

Heather 
take on how real threat is that we're assessing and acknowledging. I mean, we're talking about this as if it's the same for everybody, but we know there's variability from person to person, from the life experience that goes into understanding threat. I think of trauma when I think of all of the different factors that shape this. I think I sit here taking this in to just feel, I guess again, humbled by the complexity.

And normalized when I'm thinking, gosh, I'm having all these thoughts and feelings about this. What's wrong with me? I'm like, nothing. That's how it's wired. And then it just points me to, think, and maybe spend a minute here is, so what do I do with that? Right? When I'm trying to just exist and human, make decisions, you know, even from the conversation so far, what you said about the resources that we have. And if I'm anxious and fearful and I need to be thinking, I think it is it Dan Siegel, hand-brain model talks about like, we kind of have to calm down that fear response inside of it so that we can use the real estate for the thinking and the function. I think there's been a fair amount of conversation around that piece. I just wonder. I mean, maybe knowing what you know even of all of this, how does that change how you understand and navigate the and?

Ahmad 
Yeah, well, so one of the things just to address your question, the one thing that I try and allow myself is to accept that it's part of my biology, right? To not be overly judgmental. It's not me, it's every human, it's every, in many ways, every animal that is experiencing these

Heather 
Yes.

Ahmad 
competing draws on their attention and their actions. And we always have to, well, I hope that we're always striving to make the best decisions in the moment, right? But we're not always gonna make those decisions. And sometimes our decisions are gonna be overwhelmed by these bottom-up forces. Just don't judge yourself too harshly if you can't manage them all the time. No one can. And so on that note, I wanted to emphasize that we have a much harder job than other animals do. 

And this is something that brings me back to the pioneering work of Robert Sapolsky, who is a neuroscientist and through his field studies of baboons in Africa and other animals in a book that he wrote many years ago called, Why Don't Zebras Get Ulcers? What Sapolsky really wanted to draw our attention to is the difference between acute stress, which is really important in our survival and chronic stress. 

So zebras don't get ulcers because zebras are eaten by lions. They're not standing around the savanna day after day worried because they're either going to survive or they're not. It's really so simple that it's brilliant, right? So we are dealing with chronic stressors in a way that is historic and no other animal that I know of outside of the preclinical models of create, try and study chronic stress for us exists because you're either going to make it or you're not. The only chronic stress I can really think about in animals is in domesticated animals. It's this chronic stress that we create for them.

Heather
Right, it's just the contagious stress from a stress owner.

Ahmad 
Or limiting their ability to express their instinctual behaviors, right? I have a dog and cat, and they can't just express their instinctual behavior. I have to rein it in, and that creates a stress for them.

Heather 
Yeah, I think it creates a stress for us too.

Ahmad 
Absolutely. So we're dealing with this chronic stress and it's artificial. So again, you did a really lovely job, Heather, describing how our brains evolved in a very different context where we were going to a watering hole and with maybe a few other humans in our tribe and we might encounter predators. And so the everything that we now have and we work with was present in these early humans and used to basically determine, where's the watering hole? Is it safe to go there now? And while I'm there, is it safe to drink? If not, I need to run away. Do I detect a predator? 

Those were the things that we really had to do for our survival and what our brains were really ideally designed to do. Now, you put them in these very modern contexts where we no longer have these pressures.

Unfortunately, these kinds of luxuries aren't presented to every person on the planet. But for Western kind of industrialized people, we don't really think about predation anyway. We may, and unfortunately, many of us still struggle with food and housing. Don't get me wrong, I'm not suggesting that everybody just has a lazy day of it. But it's very rare that you have to worry about predation right, of being killed. There are contexts, right? So PTSD and combat and... And one of the of the curious things, I should say one of the, I think more interesting things that we can study is...

Ahmad 
those kinds of environments that really put us back in a very primitive survival mode, like in the Middle East right now, or in Ukraine, or other parts of the world that are at war. Do we see the same levels of psychopathology of mental illness that we see in otherwise peaceful times? I've argued that a lot of what we consider mental illness emerges when…

We basically have so much time and we have this apparatus, we have this hardware, and it just has to apply its programming to something. And so it creates problems, it recognizes things as problems when in fact they're not, but they're interpreted by our brains and through our brains, our bodies, as if it's a lion, right? That's waiting at the watering hole and it's going to eat us.

Heather 
That resonates with me just personally. Yeah, me too. I say that, I mean, I'm sure I've told family, I said, my brain is wired. Yeah. Or just I'd probably say it's my brain's gonna churn. It's very churning. Yeah. I can choose projects and learn new things and put it in a direction or it's gonna spin out in a different way, but it's gonna spin. It is, yeah. I feel very wired.

for taking in context, problem solving, it's hard to, you know, and I think you talk to people about it, it's just hard to turn, I can't go to sleep at night, I can't turn quote my brain off. And I don't, mean, I'm sure there's variability. Yeah, no can do. So the brain's a curious thing. I mean, it's so powerful and it is how we can do what we can do. And also sometimes,

Ahmad 
Never do yoga because it's just let your air off your mind.

Heather 
does feel like, can I please get an off switch or what are ways to help it be in service to my modern day priorities. And I too, just like you, want to understand the privilege of problems that I'm solving in a day. I am food secure. I am in a primarily safe environment.

I do feel it differently when I travel alone or right there are times where you feel safety hit differently. So not to say we need to all of those parts of us are important. And so often we are spending more of our time in that other executive kind of place. So yeah, think, you know, just to kind of come back to given that we know all of this.

Ahmad 
Yeah.

Heather 
what shall we do with it or how does it help us human differently? And one of them, and I love what you said about just non-judgmentally understanding that your biology is doing what your biology does. What else comes up for you, Amon? Is there anything else you would let us hold as far as how to, I don't even want to say how to make peace with, but just how to.

Ahmad 
Thanks.

Heather 
And optimize doesn't feel right either. But how do we work with the jillion neurons in the best way possible? And I don't even know if that's the right question. Are there things that we can do that help? I think probably pain as a human experience is inevitable in some ways. And I think there's some struggle that we could remove. How do we not struggle against ourselves?

Ahmad 
Yeah, I actually don't know if we ever can or if we should stop struggling

Heather 
Yeah, or maybe that's it. Maybe it's normalizing that.

Ahmad 
the nature of the struggle and the understanding of where that struggle comes from. And perhaps even more importantly, that it's our struggle. It's not your struggle or my struggle. Everyone is experiencing the struggle. It's a universal condition, human condition, if not animal condition. So a couple of things that I would love to share and perhaps others may find it a starting point.

Heather 
Say that, say more.

Ahmad 
to work with the multiplicity that is our brain and our minds. So one is that we have tremendous control, the capacity at least, for controlling these bottom-up signals, these forces that drive us to fear or, you know...

Heather 
So not reflex, we can't control reflex, but this other level of this BLA fear.

Ahmad 
So every brain has within it the circuitry that generates the fear and through that the fight-or-flight response or generates the strong motivation and desire for reward and positive experiences. But it also has, remember, this amazing prefrontal cortex that can integrate competing signals, right? So going back to our earlier example, you're getting a signal that you're hungry, but you're also getting signals that,

This is a place where last time I was almost eaten alive. Right? So now you're getting these competing drives. It's the prefrontal cortex that first integrates that. like, I'm hungry, but I'm also afraid. What do I do? Do I go after the food or do I play it safe and avoid the danger? And like we already established more often than not, the default will become to avoid the danger. And it's the prefrontal, it's the dorsal lateral prefrontal cortex is ultimately going to be

position to make that decision. And a few things that we know about our general emotional experiences is that labeling them can engage the prefrontal cortex, including the dorsolateral prefrontal cortex. And just through that engagement can help reduce and silence the amygdala and the fear signal that it's generating.

Heather 
So the brain, when we get that to that elevator level, open the door to say, I see you, fear. Exactly. And then fear can drop back down. Yeah. Instead of having to jump around and say, do you see me? Are you paying attention? Are we activating? Do we have the tension, whatever you call it, the brain's awake?

Ahmad 
Exactly the coloner to tell him to sit.

Heather 
It's to turn to go, I see you, label it, and then it can relapse.

Ahmad 
You got it. You got it. Now, that's easier said than done, right? 100%. But in fact, I feel like it's such a core component of psychotherapy, of cognitive behavioral therapy, is learning to recognize the emotions that you're experiencing in a nonjudgmental way, and then to manage those emotions and labeling, look, everything we do. And I'm not bright enough to really even imagine a consciousness without language.

Everything is through languages, labels, right, as words. And those come from the very parts of our brain that are positioned to inhibit and control these bottom-up drives like fear. Or, you know, on the reward side, people with addictions pursue rewards or motivated for rewards that are maladaptive, that cause lots of problems, right? But you can control that too, through the same top-down circuit, even through labeling.

So that's just one thing to think about. One of the worst things we know that a person can do, especially with negative emotions, is to suppress them. It's just to shove them inside.

Heather 
And when we say suppressed, I'm going to say like, pretend they're not there or ignore them.

Ahmad 
Right. Or, you know, you could even start to engage in certain labeling, like, I'm not really bothered by this. This isn't really a big deal. Those oftentimes are not helpful.

Heather 
that feels still like suppressing. Right.

Ahmad 
It's really using what psychologists call cognitive reappraisal. Okay, like, okay, this is something really bad that's happened, but reappraising it in a way that minimizes the negative emotional impact, right? At least in that moment.

Heather 
So let me try on something with you that maybe is related to this. So I have shared the story on a prior podcast, but a tool that I've used personally when I feel fearful and often fear will come to me and it feels or anxious energy and has a lot of spiral around it. So I would say, 10, 15 years ago, my approach would have been turn away. Like I don't wanna feel it, push away. So that probably falls into what you're saying is the suppression.

Ahmad 
More suppression, yeah.

Heather 
Now, I sometimes, aside from turn toward fear and get curious about it, I sometimes say, let's open the fear suitcase. So I think of it as like fear has brought me some luggage. And now I'm gonna open up your prefrontal And I'm awake. And so now, from a, I'm acknowledging it, I'm gonna open the fear suitcase and I often will draw this out visually and go, okay, what's in here? I'm afraid.

Okay, that actually is a legit fear and we need to think about that because that probably could happen. And then there's a bunch of things that are pretend that are not feel real, but you real it gives me a chance to be with it. really do. I said we gotta unpack this. So I say like open the fear suitcase. So everything you're saying.

Ahmad 
Time to unpack it.

Ahmad 
No, I think that is an incredibly powerful way to describe it and to put it into practice. Yes, to apply it. And I'm just curious, have you found that this approach helps you mitigate the fear and move past?

Heather 
Tremendously and in a couple of ways because what it does for me is Because sometimes I think when we talk about fear we say fear is bad and we don't we're trying to get away from it. Everything that we've just said is fears here for a reason. Yeah, and it can be a flag for me to go there are some things that you are not paying attention to that you should so it helps me sort out where and it switches from fear to more?

Concerns that I need to get differently curious about so it helps move it into action. It helps me triage almost to say exactly. These are the fears that feel indeed possible that I need to I haven't really followed up on that sufficiently and instead of just going maybe it'll go away to go No, I'm gonna sit with the itchiness of this right and with the fear of it and read the fine print on that agreement and see if we're covered or not or whatever it is. And then some of it is more, I would say, it helps me pull out kind of the fake news. Yeah. You know, to go, that's not even my story. I don't actually believe that. I'm not sure where that or that question is not answerable right now. It just helps. I'm really unpack it and go, you know, dirty socks here, clothes I want to wear here. These need to be ironed. It sorts it out. Yeah.

And then the sorting allows me to better let go of some things. Like these we're going to give away or donate. These need some attention. So it narrows down, but I do try to use fear as a signal. But then it does, like as you're describing it, it's like, it's almost like I'm receiving it from BLA and opening it up from the prefrontal cortex to say, let's now that we can get the whole brain online and use a larger set of information. Exactly. Yeah. So it resonates with me personally what you just said about that. And that is the tool that I use there.

Ahmad 
Even if the and of the unpacking, maybe you're not exactly sat left satisfied or have a clear plan of action. Exactly. That process alone, incidentally almost, has quieted the amygdala and allowed you, in many ways. Exactly. I think of it as in my mind, say, you've got to take a beat. Just take a beat.

Heather 
You're definitely not as activated.

Heather 
Just catch your breath a little bit.

Ahmad 
Right, so stimulants, for example, in kids and adults with ADHD, what they do really more than anything else is they buy you just a little sliver of time between your thoughts and impulses in your actions.

Heather 
Mmm.

Heather 
So let's pause right there. And I just said pause and that's actually what I want to talk about. I'll send you, I'll make sure you get one. I may have showed it to you, but we have made little pause buttons. and this is exactly. I don't remember who even said it, but the space between stimulus and response is a choice. And so this language around our goal really is how do we respond, not react.

Ahmad 
Exactly.

Heather 
And so all that you're describing today is that we are wired to do both of those things.

Ahmad 
But one comes first, right? Reaction comes first.

Heather 
Reaction would come first, so...

Ahmad 
in terms of how the brain is processing information and signaling.

Heather 
So somehow we have to get, and this is, maybe you have a tip on this, because sometimes it feels like it's all moving too fast. You can't get in there enough to give it space. Because I think what we know is, my gosh, you just said something that activated me on a best day when I'm well rested. It would be hard. It would be hard, but I would feel activated and I would say, I need a minute and go walk around the building and I'd get a glass of water and I'd come back and I could respond.

But there are other days where just whatever the conditions are and maybe to your example earlier is the real estate is just occupied. Like I think of sometimes feeling like a saturated sponge from the bottom of the sink. It can't hold anything else. So when it's saturated, it cant hold, it's going to receive and absorb no more impulses to filter. just like.

Ahmad 
Exactly. Yeah, because, you know, in our modern worlds, although we don't face the same imminent threats to life and limb as our ancestors did, we face all sorts of stressors.

Heather 
And probably the volume and information. So when I think about the volume of information, so if it's true that our brains only have so much they can absorb at once and we are filling it all day long. So some of it may be a tool is just being thoughtful about what we let in. And I mean, these are all things that we talk about regularly is being mindful of social media, scroll or doom scrolling or whatever. All of that is pouring in to the sponge.

Ahmad 
Yeah, it takes practice. really does. so sometimes that practice is best with a trainer, right, with a therapist who can give you and help you acquire the tools and help you exercise those tools until they become really effective at regulating your own experiences and emotions. And I'll just take a moment there to, yeah, make sure that everyone is clear that I think that the amygdala and its component parts and fear and reward are absolutely essential to life. And in no way would I ever want those things to go away. What we need is to be able to better manage those things. And so this brings me to kind of another thing I wanted to share and it really is the and. the very many of the same circuits that we can use in the way that we've discussed to regulate and control our fears, right? Can be actually in a way hijacked to further generate fear.

And this ties back into what we described very early on in the podcast, which is that third level of fear learning is just through instruction right, so our brains are capable of representing experiences that we don't have directly and so they can empathy, right? Imagination you got it. So, for some people they get hung up on the negatives, right so something happened this morning. Maybe someone honked at me because I went to take a right and right the light was red. Whatever right something relatively trivial when you look back on it, but it can get you

Heather 
Yeah, imagination.

Ahmad 
really worked up in the moment. And for some individuals, they can't break out of this ruminative or perseverative state of mind. They just keep thinking about it and keep thinking about it. And what happens, we know now, or at least we have some evidence for, is that many of the same areas of the prefrontal cortex that we talked about as being so important for regulating and controlling our fears can actually start sending signals to the amygdala.

that act as proxies for the pain or other types of aversive and noxious and horrible things that may actually happen to our bodies. And that's really, so I really think that is a core component of depression and perseveration, even contributes to obsessive and compulsive behaviors. Because what we're doing is we're taking this prefrontal cortex and the circuitry within that prefrontal cortex. And now we're unfortunately applying it in a way that makes things worse.

Heather 
So instead of I'm going to use tools that help settle that primitive brain structure. to turn it up. Yeah. And like I said, I'm somebody who has to be careful about where my brain is churning and can be, let me send things back down the elevator to the amygdala.

Ahmad 
Im going to jack it up! Now through my thoughts!

Ahmad 
and not necessarily quiet down.

Heather 
No. For sure. Yeah, I don't think we're activated enough. That's why unpacking the fear suitcase side makes me kind of tease out what is, what needs to stay here and what are we kind of, I don't want to say manufacturing because it all feels real, but I am somebody that I can imagine all the things that might go wrong and quickly get into, I would call it, it feels like a spiral, but that must be, and it's not a downright rig.

Ahmad 
right.

Heather 
It’s the up regulation or maybe it's the upregulation of the- Exactly. But upregulating something that so far we've been talking about trying to downregulate- You got it. And maybe as we zoom out another place where we've talked about the and between things, just the back and forth between all of this is a no wonder that sometimes you feel like you have your foot on the brake and the gas. Yeah.

Ahmad 
In case, would be upregulation.

Heather 
that you're swimming in a sea of questions, that you feel overwhelmed. Or sometimes, and again, I don't know if we have time to get all the way into it, but like I said, that the fear side is so big and powerful that I can't see the whole and, so we're inside and outside of it. So it almost just, feels validating that if this experience of humaning feels like a lot.

Yeah. Like there's a lot churning in there. Right. All in service to trying to do its best to keep us alive. You know, it just, we have a lot of potent computing capability.

Ahmad 
Yes, so to recognize the mismatch, right? That's one of the things that I think has emerged is that our brains are in many ways mismatched for our lives. But that doesn't mean that we can't find ways to create a better matching.

Heather 
It just needs some other tools because part of that, think the so what of that to me is let's acknowledge and we're not going to judge ourselves, but for the regular biological experience that we're having. Right. And then we're also going to acknowledge that perhaps our brains as complex as they are, aren't quite dialed up tightly enough for the exact complexity that we're in right now. So what is the conscious then approach?

The mindful approach that goes along with that, such that letting our brains run on autopilot on their, like, what is it, in computers, with their just like base model software, is gonna need some additional, probably gonna come from, and we can use all of it. We've said it comes top down from brain, but there's a lot we can also do with our brains and our bodies to help complement the organ that is kind of, you know, I don't know whether it's the center of it all or whether it's a piece, however you might think of that. That's another philosophical conversation for another day.

Ahmad 
Right.

Ahmad 
And what is the center, as we said earlier, is the center of some big radio tower that's receiving signals?

Heather 
In an ecosystem. and you know, we're so centered on, you know, kind of the powerfulness of the brain and us as an entity. And I had a conversation with a friend the other day where I was kind of nerding about gut bacteria. And I was like, we're just an ecosystem, even of ourselves. So humbled by the human experience. For sure. For sure. And what it means before we wrap up, because I know that you and I could talk until tomorrow.

Ahmad 
Easily, easily.

Heather 
But any other tips or just takeaways you want to leave with us about how to human moving board when you're not here in our ear? Yeah, I would.

Ahmad 
to share at least one more thing for now. And that I think ties into being kind and allowing our experiences to unfold and not being too harsh to judge the nature of those experiences or feelings. And in that context, and back to this idea of taking a beat, I know right now there's a, I think...

a well-warranted move in psychiatry towards de-prescribing because I do think that for many people, they're on multiple psychiatric medications and they may not necessarily need to be, right? And so I appreciate that there are situations where someone who may have benefited from a psychiatric drug may no longer be benefiting and in which case we need to learn how to de-prescribe.

So with that said, there are in many cases individuals who can at least initially create that beat, take that beat with the help of psychiatric drugs. So the serotonin reuptake inhibitors, SSRIs like Prozac being the first of its kind. In my mind and in the data that we've collected and others have collected, what I think SSRIs actually do is quiet pharmacologically through the chemistry, the reactivity of the amygdala. So the volume is turned down a little bit by an SSRI.

Heather 
on both the threat and the reward side?

Ahmad 
We know more about the threat. We know more about the threat. doesn't seem like, so there's a symptom, of course, a of depression called anhedonia, where you no longer find pleasure in activities that you once really enjoyed. SSRIs don't seem to have quite as big of a signal there, but they can turn on the volume of the amygdala. And in doing so, I think why that's important for some individuals, not everybody, is it is it buys you that beat to then engage in a way that could ultimately equip you with the cognitive, the top-down resources to regulate that amygdala, even if its volume is turned back up. But when it's up for some individuals, it really is almost impossible for them to engage in a way of thinking, of reappraising that is ultimately beneficial. They're just overwhelmed.

Heather 
their amygdala and I don't know the mechanism there but these situations where it just feels like your amygdala has the volume turned up.

Ahmad 
And you mentioned individual differences, which has been the core of our research for many years now. We have different volumes.

Heather 
Just innately, because I would say I'm somebody, and I used to actually have to refer to my amygdala as Amy to like Amy. I think we're dialed up too high right now. But I think just in my base model, inherited brain system, I have a very active Amy.

Ahmad 
And you know what? Good for you. You should. But ideally, you also have an equally capable and active prefrontal cortex.

Heather 
Oh, nice. Well, that's, mean, I'd like to think that's how I figured it out is that can still do that. I'm like, great. Here's another fear suitcase from Amy. And now we're going to sit down and unpack it. But I guess it's when you feel like there's a mismatch there and you need.

Ahmad 
Exactly. the mismatch into, let's say, one of the silly analogies I've used in the past is imagine driving a car, right? So let's say someone has an F1 race car for an amygdala, right? Now, if Lewis Hamilton or Max Verstappen or one of these F1 professional driver gets behind the wheel, they're going to be able to control that car and drive it fast and get around corners and be safe for the most part, right? 

So there's a matching of a very fast, a very powerful car with a very capable driver. High amygdala, high prefrontal cortex. But let's say you put a 13-year-old kid behind that car or someone who's just not a very good driver or has, it's not even about their driving skill. They have no experience with this powerful machine. They're going to go right into the barriers. They're going to go right off the road and crash.

This is a mismatch, right? You can, in a way that you can train to become a better driver through practice and experience, you can become better at regulating what is naturally a more powerful amygdala.

Heather 
This feels so true. Yeah, I'm going to get emotional. It feels so true to me that that's what has my journey has been and I've just not had it articulated.

Ahmad 
Yeah, but the important thing is don't, and this comes back to a comment I made a while ago, which is don't blame the amygdala. Be thankful that you have a powerful amygdala. Now, if it turns out that you haven't had the opportunity to develop the prefrontal cortex to manage that, right, you don't have the driving skills to keep it on the... Road. So you can basically put in a lower octane fuel.

Heather 
Now what are we?

Heather 
And there are other tools. are other tools. Descriptions, other things. Exactly.

Ahmad 
That's what the SSRIs can potentially do. And the way stimulants essentially, they alter dopamine signaling in a way that allows someone with ADHD to have just one more moment of a pause between thought and action, impulse and response. And SSRI can do that with the amygdala. And so over time, especially if you engage in regular therapy in developing your skills and it could be yoga or mindfulness. There's so many ways all of it I agree the more approaches the better then you could you could eventually basically come off the SSRI. Yeah, and you in your amygdala as far as we know will go back to its kind of set volume, but now you can control it better

Heather 
All I can think of right now, there's somebody looking in the window. have seven, eight minutes, but the people outside are looking at their watches. So we have expired our time here. I just, I want to say, you know, just as you described different states of being for people, no shame in the brain.

Ahmad 
That was our time.

Heather 
You know, I guess there's no shame in this game or something like that. That's right. But no shame in the brain. Right. Part of this journey is understanding how your unique brain works. haven't talked about neurodivergence. There's a lot that is anatomically probably consistent across us and the circuitry generally works the same and very differently across us. maybe part of as we close is just an invitation. Yeah.

Ahmad 
differently.

Heather 
to start to think about how to honor or learn more about not only your own circuitry, but how your gears are turned up or down. And to be reassured that there are tools and supports, whether it be therapy or a medication or yoga or combination of all the things that this kindness, non-judgmentalness this almost I am humbled by what all is possible.

Ahmad 
Exactly. And be open to discussing it. I think that ultimately, if you have an ally, whether it's a therapist or a friend or a family member, the more the merrier, right? Right. You can express yourself through language in a way that will naturally quell and quiet the fear and anxiety that you otherwise are feeling.

Heather 
Yeah, so often on this podcast, whatever and we're standing in, will leave people with stay curious. Yeah. And that feels like a piece of this too. Stay curious and connected. Yes, yes. And with those two, just, I continue to be hopeful about what we can normalize to bring a little more ease to the effort sometimes.

Ahmad 
Yeah, absolutely.

Ahmad
And more accepting of ourselves and others. Absolutely. maybe one day we can, I think it'd be really fun to talk about all of these differences in anxiety and impulsivity and other aspects of our behavior in the context of neurodivergence and in the context of our really social lives and how I would argue that there is lots of room for this kind of diversity in behaviors and anxiety and impulsivity and so many things that ultimately help us as a group do better than we would ever do otherwise.

Heather 
I love this. Yeah. Right. If we continue to think about us not only as an individual, but as an ecosystem. That's right. So what is our collective and the power of that? Right. Right. The power and the beauty that comes from these different ways of being and brains. And value.

Ahmad 
value that someone who may have a very focused interest, a stereotypic interest, and perhaps less socially engaged, what they can bring. And you never know when you might need that exact type of person to solve some problem.

Heather 
I love the and of that when we think about the and that is collective humanity. So there you go. I you just invited yourself back. So I'm so grateful. Thank you to Duke University for allowing. No, it's not. I really am not competitive that way. I'm a facilitator and always.

Ahmad 
Well, that's all I want. love you.

Ahmad
It's hard for you to

Heather 
in the and of all the organizations. I am loyal to people, not logos for the most part. But it has been such a joy with y'all. Thanks for hanging in everybody for our pondering on neuroscience. I hope it was interesting to you. Yeah, makes sense at some level. Yeah, can't wait. And if y'all have questions about brain stuff, I do think this is an interesting place where I can...

Heather 
help connect or if we do an episode two on those topics, but then if people have specific questions that they're curious about, it would be really fun to be able to fuel that curiosity.

Ahmad 
I would love to be able to try and answer any questions that the audience has.

Heather 
Perfect. y'all know how to find me. You can email us at connect@standintheand.com and I look forward to the next conversation. Thank you so much.

Ahmad 
My pleasure.

Heather 
The Stand in the And podcast is supported by Human-Centered Strategy, where we help leaders and teams build connection and strategy and complexity so that everyone can flourish. To learn more or to work with us, please visit us online at humancenteredstrategy.com or message me on LinkedIn.