14 DAY TRIAL // "The dread of having something hanging over your head is worse than the thing that you are dreading. Most people don't like waiting for an unpleasant outcome, and want to get it over with as soon as possible," explains Gregory Berns, an associate professor in the Department of Psychiatry and Behavioral Sciences at Emory University School of Medicine.
The team of Emory neuroscientists led by Berns used functional magnetic resonance imaging (fMRI) to determine the areas of the brain that are activated when someone experiences fear of something specific.
Researchers scanned the brains of participants while they received a series of 96 low voltage shocks to the foot, with different levels of intensity and different time delays up to the shock. Each of the participants in the study was previously screened to determine their maximal pain threshold.
Before each shock, they were told how painful the shock would be (as a percent of their threshold) and how long they would have to wait for it. After the scanning procedure, they were given the opportunity to choose to receive either more pain sooner or less pain later.
Most of the 32 participants preferred to speed up the waiting period even if this meant receiving more painful shocks, and 28% of them considered the experience of waiting so dreadful that they were willing to take much more pain just to get it over with faster.
Where does it happen?
The scans showed that brain activity related to dread was localized in the areas of the brain associated with pain, more specifically in the parts of the pain network linked to attention. This is important because it suggests that dread is not as simple as anxiety, which is an emotion controlled by different brain regions. Anxiety refers to a certain unspecified fear, while in case of dreading you know that a certain specific unpleasant experience will come. This can explain for instance why people hate so much going to the dentist - it's not so much the pain itself as it is the waiting of that predictable pain.
The findings also showed that extreme dreaders, who really hated waiting for the pain, had more activity in the part of the brain devoted to attention, and this activity was seen much earlier in each trial compared to the mild dreaders.
"Taken together, the anatomical locations of dread responses suggest that the subjective experience of dread that ultimately drives an individual's behavior comes from the attention devoted to the expected physical response, and not simply a fear or anxiety response," explains Dr. Berns. "The key factor seems to be that extreme dreaders devoted more attention toward the part of their body that was about to be shocked. This is important because it means that dread is not quite the same as fear or anxiety."
Diverting attention
It also means that dread can be mitigated by diverting attention.
"The dread associated with things like medical procedures or public speaking, while real, can probably be alleviated by diverting one's attention during the waiting period," says Dr. Berns. "There may be many ways to do this, ranging from meditation to sports, or even a movie. The benefits could be substantial if it means that we act more rationally in terms of getting healthcare, or simply decreasing the psychological toll of dread and anxiety."