Anxious: Using the Brain to Understand and Treat Fear and Anxiety

by Joseph E. LeDoux, Jonathan Davis (Narrator)

“[ Anxious ] helps to explain and prevent the kinds of debilitating anxieties all of us face in this increasingly stressful world.” —Daniel J. Levitin, author of  The Organized Mind  and  This Is Your Brain On Music

A comprehensive and accessible exploration of anxiety, from a leading neuroscientist and the author of Synaptic Self

Collectively, anxiety disorders are our most prevalent psychiatric problem, affecting about forty million adults in the United States. In Anxious , Joseph LeDoux, whose NYU lab has been at the forefront of research efforts to understand and treat fear and anxiety, explains the range of these disorders, their origins, and discoveries that can restore sufferers to normalcy.

LeDoux’s groundbreaking premise is that we’ve been thinking about fear and anxiety in the wrong way. These are not innate states waiting to be unleashed from the brain, but experiences that we assemble cognitively. Treatment of these problems must address both their conscious manifestations and underlying non-conscious processes. While knowledge about how the brain works will help us discover new drugs, LeDoux argues that the greatest breakthroughs may come from using brain research to help reshape psychotherapy.

A major work on our most pressing mental health issue, Anxious explains the science behind fear and anxiety disorders.

Genres: Psychology, Nonfiction, Science, Neuroscience, Self Help, Mental Health, Health

466 pages, Hardcover

First published July 14, 2015

Reviews

[Troy Blackford · Rating 3 out of 5]

You could look at this book's title two ways. You could say that it is inaptly named, as over 3/5ths of the book don't even deal with the topic directly, and instead provide the needed background for you to understand the final fifth of the book, which does treat on the topic. Or, conversely, you could say that it has the PERFECT title, because 'Anxious' is exactly how you'll feel as you wade through hundreds of dense, dry pages waiting for the topic to swing back around to anxiety.

The first chunk of the book discusses the physical response of fear. He explains in the beginning that he decided to write a science book 'for popular consumption' after finding the process of writing a college textbook unpleasantly collaborative. That's fine, but don't mistake this book for a 'popular science' book. It is heavily laced with specialist terms. It is, rather, a book for an audience of professional psychologists or upper level psychology students, and it reads like the textbook he wasn't happy with writing.

Much of the middle sixty percent of the book has nothing to do with the topic at hand other than to provide essential background to understanding his theories on anxiety that he presents at the end. This is fine, but I have a feeling there are many who bought a book purporting to be for casual readers, with such a grippingly applicable title as 'Anxious,' because they expected something a bit more accessible and tinged for non-experts. This, instead, is a presentation on theories on how therapists and lab researchers can advance the field of anxiety treatment.

A worthy goal, but selling this as a 'popular science' book is a bit of a scam.

The unconditioned stimulus is having my money taken in a ruse. The conditioned stimulus is buying a book by Joseph E. LeDoux. The unconditioned response is feeling 'had.' And the conditioned response is... increased wariness the next time I see his name on a spine.

[Jim Fix · Rating 1 out of 5]

This book is way, way too difficult for undergraduates, and beyond most graduate students. It is really a very prolonged professional journal article. The first two chapters or so are excellent about our thinking in general. But these are followed by 200 pages of multiple arguments on why scientists should not believe animals have emotions. These become tedious and pedantic, dwindling to long "angel on pinheads"-like arguments. These may mean something for whomever the author is trying to convince, but for most of us, we really have other viewpoints. And 200 pages! And in all of this, Anxiety is really lost. The author gives some suggestions about treatment in the last six pages. If these were recommendations on general health, they would add up to: don't smoke, not too much drinking, and eat your vegetables. For all the arduous reading, I get that?!!

[Marcelo Bujak · Rating 5 out of 5]

This is one of the best books I have ever read. I remember being very excited about it when I began reading it but also to be very surprised at the low rating it had here on Goodreads. Reading people's comments and now having read the book myself have helped me to understand why it was, in myo opinion, underrated

First of all, this book is not for the general public in my opinion. It is very technical and goes way beyond what you see in textbooks of psychology and neuroscience on topics of emotions. It goes as far as theories of consciousness and memory research to discuss anxiety states as autonoetic consciousness states, thus not assuming that mere defensive mechanisms of the brain are solely responsible for anxiety states. If you don't have some knowledge and interest in memory and theories of consicousness and want just a straightforward definition of anxiety, this book is certainly not for you.

Second, if you suffer from anxiety and seek a self-help book, this book is not for you either since it is much more concerned with the scientific debate surrounding anxiety. I recommend, in this case, some cognitive therapy books made specially for patients, such as "anxiety free" or "the worry cure" by Robert Leahy.

As a graduate student in Psychology, this was very helpful for me and gave me immensely valuable ideias for my research project. I highly recommend it to everyone interested in the scientific study of anxiety from a cognitive neuroscience standpoint.

[Bernie Gourley · Rating 5 out of 5]

This book examines the neuroscience of anxiety, though psychology also makes a prominent appearance in the discussion – particularly toward the end of the book. It’s written by one of the top researchers in the field emotional neuroscience, though LeDoux discusses the work of other labs, comparing and contrasting their work with that of his own, and thus giving an idea of the fault lines in the field. (By that I mean more the questions that remain in dispute, not who hates whom.)

The book addresses a number of key questions such as: How does brain activity result in the emotional experience? How do conscious emotional feelings relate to and interact with non-conscious responses to threatening stimuli? Is the human emotional experience a hand over from animal ancestors or a uniquely human condition? How effective are drug-based versus psycho-therapeutic approaches to anxiety disorders? What has been learned about extinguishing anxious responses to threatening stimuli? Needless to say, this book doesn’t answer all the questions, as many of the questions – particularly those regarding consciousness – remain to be definitively answered. It does offer a great overview of the state of understanding in the present day.

I won’t present a chapter by chapter outline, but rather a look at the book’s general flow. LeDoux starts by laying groundwork, and in this case that means clarifying the relationship between fear and anxiety. While the former often captures the imagination because of its dramatic and traumatic causes, the latter is more of a concern as its grinding long-term effects can cripple the immune system and have other adverse effects. The early chapters also discuss what has been learned about how emotions are formed in the brain and how views about this have changed over time.

Chapter five is where LeDoux explores the relationship between animal emotionality and human emotional life. This is an important subject as it relates to the question of whether research with animals can teach us anything relevant to the human experience. As it has become progressively more difficult to conduct any research that causes human subjects any emotional distress, this question may be instrumental to making progress in the field.

Chapters six through eight are interconnected by the question of consciousness. Chapter six discusses the nature of consciousness, which remains one of the most slippery and least understood concepts in the natural world. Chapter seven delves into memory and consciousness – an important topic as anxious responses can be viewed as learned responses and this begs the question of unlearning. Memory will later be revisited with respect to the question of whether it’s possible to erase painful or anxiety-inducing memories (ala, “Eternal Sunshine of the Spotless Mind”) – based on work that came out of LeDoux’s lab – and, if so, whether it’s a good idea. The final consciousness chapter gets into consciousness of emotion, specifically (as opposed to all the other thoughts and feelings of which one can be consciously aware.)

The last three chapters are also interconnected by movement from the question of how is anxiety felt / experienced to the question of what one can do about it. The first of these chapters discusses an epidemic of anxiety (entitled “40 million anxious minds,” and that refers to the US alone) and what has been learned about drug-based treatments. As it happens, drug-based treatments haven’t proven reliably effective, leaving plenty of room for other approaches, e.g. psychotherapy. This fact is the basis for the last two chapters that discuss different approaches to extinguishing the connection between a stimulus and the anxious response. The first of theses chapters (ch.10) is more general and the last chapter dives deep into the research that has been done in recent years. Chapter 11 also offers a nice discussion of how breath exercises and meditation can be instrumental in reducing the adverse effects of anxiety.

As would be expected of a scholarly work, the book is heavily annotated, has an extensive bibliography, and uses a great number of graphics in an attempt to lend clarity.

I would put this work in the same category as the works of Robert Sapolsky. That is to say, it resides in a space between the level of detail usually seen in works of popular science and that which is seen in textbooks for specialists. That is to say, LeDoux does get into some detail and this isn’t a light read for anyone without a heavy-duty background in biological sciences. That said, if you have a basic scientific literacy (and / or don’t care too much about the fine detail), it’s by no means impossibly dense. When it’s not diving into the various brain regions and neuronal pathways, it’s quite readable.

I’d recommend this book for anyone who is interested in a detailed look at how anxiety arises and how it can be quelled.

[Michelle · Rating 3 out of 5]

Author neuroscientist a distinguished professor at New York University, Dr. Joseph E. Ledoux presents "Anxious: Using The Brain to Understand and Treat Fear and Anxiety" this is an authoratitive technical reference with statistics, scientific data and studies, also diagrams and illustrations and the author's observations concerning the topics of brain studies and the relation to a world of fear and anxiety. Dr. Ledoux is also the author of "Synaptic Self: How Our Brains Become Who We Are" (2003) and "The Emotional Brain: The Mysterious Underpinnings of Emotional Life" (1998), he lives in Brooklyn, NY.

Mental health professional agree that anxiety and related disorders are the highest and most problematic concerns affecting 40 million Americans. In eleven informative chapters all aspects related to the study of anxiety related to cultural anxiety and fear, the emotional and defensive brain, brain reaction to danger, inherited emotional states from animals and ancestors, memory- the affects of consciousness and emotions. The later chapters deal with diagnostic, and the problems with antianxiety drug research, scientific classifications in the DSM, and changing the anxious brain and therapy related to laboratory study/research.

The book has to be read in small doses and is orientated more towards student or expert research or technical studies, rather than the average reader. It still has many interesting parts and with the illustration, graphs, charts etc. the material is easier to understand and less dull. I learned a great deal about anxious people and real/imagined threats, worry related anxiety disorders affect women more than men, and cognitive behavior techniques can improve and treat symptoms of anxiety disorders.
Many thanks and much appreciation Viking Books/Penguin Random House for the ARC of this book for the purpose of review.

[Jonathan · Rating 4 out of 5]

I certainly agree with his key point - that the use of the word "fear" to describe both the non-conscious defence systems in the brain as well as the conscious emotion has led to a bit of a mess.

You can basically get the whole point of the book in this article:

https://www.cns.nyu.edu/ledoux/pdf/Le...

[Margaret · Rating 3 out of 5]

I won this book on Goodreads Firstreads in exchange for a review. I wanted to read this book because from the synopsis I thought that it was a self-help book for people suffering from anxiety. As someone with Hasimhimoto's syndrome, my hormones often "mess" with my brain and cause anxiety, including panic attacks. Not fun! Well. This book seems to be more along the lines of a textbook on the history and study of anxiety. I'm not saying that it wasn't interesting in its own way, but it just wasn't helpful. At all. I felt like I was back in school and should have been highlighting passages and taking notes for a quiz! You may want to consider this book if you are looking for a textbook for a class you are teaching, but if you are a layperson, not so much.

[Shelley · Rating 5 out of 5]

I found this as an audiobook at the library and expected it to be an easy read that a lay-person (AKA non-psychologist) could understand. Boy, was I pleasantly surprised that it instead was a book for an already knowledgeable professional. This book details the physiological and neurological processes that create, develop, and perpetuate anxiety, and was heavy on neuroanatomy and neuroscience, as it was written by a man who has studied such. If you are looking for a self-help book, go elsewhere. If you are looking for a scientific basis for understanding and treating anxiety, this is for you.

[Ioana Crețu · Rating 5 out of 5]

„Mult din ceea ce face creierul este realizat în mod inconștient. Mințile noastre conștiente construiesc apoi o explicație a ceea ce trăim. Conștiința este o relatare despre sine, construită din fragmente de informații la care avem acces conștient direct (percepții și amintiri) și din consecințele observabile sau «monitorizabile» ale proceselor inconștiente.”.

Intenția cărții este aceea de a reprezenta o sinteză a largului subiect al anxietății; deși această sarcină poate fi mult prea vastă pentru un singur volum și copleșitoare, abordarea lui LeDoux are câteva aspecte remarcabile.
Dintru început am admirat firul roșu al construcției lui și necesitatea de a iniția discuția despre starea de anxietate cu alte subiecte mai generale și esențiale înțelegerii fenomenului, precum definiția conștiinței, sistemele de supraviețuire, teorii actuale ale emoțiilor, referințe filosofice despre anxietate și altele. Deși aici nu a intrat în multe detalii, a creat fundamentul pe care dezvoltă mai apoi cunoștințele derivate din cercetările (de până-n 2015 când a fost publicată cartea) din psihologie și neuroștiințe (domeniul în care s-a specializat). Iar în privința acestora din urmă vine cu multe explicații și amănunte, multe amănunte, utile pentru argumentele ce le susține, ceea ce face ca pe alocuri să fie greu de urmărit prin hățișul de informații minuțioase.
M-a plimbat prin multe zone, iar de-a lungul cărții am tot fost uimită de modalitatea în care și-a construit scrierea și de direcțiile pe care le-a ales, chiar de mă străduiam să țin pasul. Oricare angajament de a sintetiza e dificil de dus la capăt, dar rezultatul concretizat în „Anxios” e admirabil.
Critica adusă medicației anxiolitice conține argumente convingătoare.

[Alkalia · Rating 2 out of 5]

Ja już tak mam z neuronauką i podejściem poznawczo-behawioralnym, że trudno mi się zachwycić. Mam poczucie, że ta książka spokojnie mogłaby miec 250 stron zamiast 550. Co do meritum, LeDoux przytacza bardzo ciekawe badania prowadzone z Gazzingą na grupie osób z rozszczepieniem mózgu. Gdy naukowcy prawa półkulę stymulowali do tego, by człowiek wstał, pomachał, wzdrygnął się, to lewa półkula badanych na pytanie "dlaczego pomachała?" zaczynała konfabulowac. W efekcie człowiek zmyślał sobie jakieś racjonalne wytłumaczenie "np. Zobaczyłam znajomego za oknem". Te badania pokazały, że po zachowaniach nie można wprost wnioskować o uczuciach i emocjach. Jak widać, ludzki umysł potrafi dopowiedzieć sobie jakieś uzasadnienie. I to uzasadnienie do końca wiadomo skąd się bierze. Z pewnością do reakcji obronnej z ciała (na zagrożenie) potrzebna jest aktywność ciała migdałowatego. Na podstawie tego mechanizmu może powstawać uczucie strachu, ale do jego zaistnienia potrzebne są też obszary mózgu (przodomózgowie i kory), które odpowiadają za rozumienie (np. Rozumienie mowy). Tak więc zdaniem LeDoux emocje powstają trochę jak zupa, której baza to: funkcje uwagi, funkcje pamięci i zwrotna reakcja cielesna. To, co czujemy zależy od proporcji. Jeśli mamy w pamięci dużo wspomnień i obserwacji powiązanych z traumatyczna sytuacją to od naszej funkcji uwagi zależy czy trigger bodziec odpali reakcje lekową. Jeśli mamy PTSD to czasem delikatny ból mięśni czy brzucha może wywołać u nas reakcje lękową. To jest core tego, co LeDoux nazywał emocjonalnym mózgiem. LeDoux był wobec tego bardzo sceptyczny wobec badań na zwierzętach, bo uważał że jeśli szczur reaguje na coś stuporem to wcale nie musi oznaczać to tego że czuje ludzki lęk/strach. Zapewne czuje (na swój szczurzy sposób) zagrożenie. Mamy tendencję do ekstrapolowania naszego ludzkiego sposobu przeżywania świata na zwierzęta. Ostatnie dwa rozdziały to rekomendacje dla psychoterapeutów. Garść informacji o tym, że aktywne unikanie sytuacji lękowych wcale nie jest złe. Jeśli ktos ma lek społeczny i nagle na imprezie czuje się gorzej to powinien wyjść i odpocząć na chwilę, zamiast na siłę siedzieć. Ważne jest to by wrócić bo powrót stwarza nam okazję by znów poczuć się lepiej i odnieść zwycięstwo nad lękiem. Takie pozytywne wzmacnianie jest bardzo ważne. Podobnie jak ważna jest ekspozycja na lękowe sytuacje. Im częstsza ekspozycja i w bardziej zróżnicowanych warunkach, tym większa szansa że lęk nie nawróci. Zanim zaczniemy eksponować się na takie sytuacje powinno się na terapii rozebrać na czynniki pierwsze sytuację lękowe. Jeśli poznamy to zdarzenie które jako pierwsze zaimplikowało zaburzenia lękowe to poznamy zdarzenia które mu towarzyszyły i teraz aktywują np. ataki paniki. Pozbywamy się jednego takie zdarzenia na raz. Nie wszystkich na raz. A pozbawiamy się ich w takich sposób by dana osoba przestała te neutralne bodźce traktować jak zagrożenie. Konkluzja jest taka że osoby lękowe mogą oduczyć się lęku. Trzeba ćwiczyć. Częścią tego ćwiczenia jest ekspozycja i terapia poznawczo-behawioralna. LeDoux nazywa ją krotką ścieżką, bo korzysta pamięci roboczy i procesów wygaszania które dość bezpośrednio zaczynają działać na ciało migdałowate. Pozostałe terapię oparte na rozmowie również działają na ciało migdałowate ale bardziej okrężnymi ścieżkami.

[Maher Razouk · Rating 5 out of 5]

القلق
.
.
على الرغم من تاريخها الطويل ، لم يتم التفكير في كلمة "القلق" في المقام الأول على أنها حالة ذهنية مضطربة ومقلقة ومصدر لعلم النفس المرضي حتى أوائل القرن العشرين. بدأ هذا عندما جعل سيغموند فرويد من القلق محوراً لنظريته في التحليل النفسي عن الاضطرابات النفسية. القلق هو أصل معظم الأمراض العقلية ، إن لم يكن كلها ، وهو أساسي لأي فهم للعقل البشري: "ليس هناك شك في أن مشكلة القلق هي لغز سيكون حله مُلزماً بإلقاء كم هائل من الضوء على وجودنا العقلي كله". لقد رأى القلق كحالة طبيعية ومفيدة ولكنه أيضًا سمة مشتركة بين المشكلات العقلية التي ابتلي بها الناس في الحياة اليومية. منذ ذلك الحين ، كان يُنظر إلى القلق على أنه حالة ذهنية تتميز بالتوتر والفزع والألم والخوف.

كان القلق، بالنسبة لفرويد، أولاً وقبل كل شيء «شيئًا محسوسًا»، حالة خاصة من عدم الرضا. مثل اليونانيين، حرص على تمييز (القلق) عن (الخوف).

قال فرويد إن القلق يتعلق بالحالة نفسها، ويتجاهل الشيء الذي يثيرها، في حين أن الخوف يلفت الانتباه بدقة إلى الموضوع. وعلى وجه التحديد، أشار فرويد إلى أن القلق يصف حالة من توقع الخطر أو الاستعداد له، والخوف منه، على الرغم من أن المصدر الفعلي للضرر قد يكون غير معروف ؛ ومع ذلك، فإن الخوف يتطلب موضوعًا محددًا يجب أن نكون خائفين منه. كما ميز بين القلق الأساسي، الذي له هدف مباشر (الخوف بشكل أساسي)، والقلق من المخاوف، الذي لا جدال فيه وينطوي على شعور أكثر انتشارًا ، وعدم يقين بأن الضرر قد يحدث في المستقبل (القلق بشكل أساسي).
.
Joseph LeDoux
Anxious
Translated By #Maher_Razouk

[Jackson Enright · Rating 5 out of 5]

Truly excellent book

[Jonathan]

Note to self: you only read the last two chapters, but they were helpful chapters.

[Davia Finch · Rating 4 out of 5]

This is a great science book. It gets pretty technical at times, and requires a bit of careful reading, and it's most definitely not a self-help book, but it did a good job explaining some interesting brain circuitry and its relevance to the treatment of anxiety disorders. Also an interesting discussion of consciousness. His arguments are aimed mostly at other professionals (scientists, therapists) but it's accessible enough for the general reader if you're interested in the science and don't mind making a bit of an effort.

[Christine Zibas · Rating 2 out of 5]

I rarely give up on a book, but I am disappointed to say that I had to with this one. While the topic is of interest to many people, including myself (anxiety being a relatively common mental illness) and while there needs to be a book for the layman (which, I believe, was the author's intent), this is likely not the book general readers were hoping for.

If LeDoux was hoping to connect to his greater audience, he turned them away nearly from the beginning. The introduction is poorly written. Chapter 1 begins well, but then quickly descends into excruciating detail about animal (rats) experimentation. This is further reinforced (or I would suggest, eroded) by scientific jargon to the degree that the general audience has to parse many pages to come away with a few meaningful generalizations.

There's no harm in proof, but LeDoux (true to his academic nature) quotes studies and sources prolifically that are of little interest to the layman. Then all of the findings are repeated in graphic form. This continued throughout the early portion of the book at least (I did read several chapters). The little insight I gained into anxiety and fear (and their differences) was more than overwhelmed by lengthy explanations that dragged the subject matter down.

If you are an academic, you will surely find much to like about this work. For the rest of us, I don't think many readers have the stamina to make it to the end.

[Synthia Salomon · Rating 5 out of 5]

I was able to share this book with a couple of people who experience anxiety. I was able to recognize a person suffering from anxiety’s coping mechanisms. Coping mechanisms can appear as being withdrawn or rude. This was on on-time helpful read. “Anxiety disorders are complex to diagnose and to treat because anxiety involves so many different kinds of processes in our brains. People with anxiety disorders are hypervigilant about danger and threats, meaning their automatic survival systems are on high alert. But anxiety is also a feeling that we process consciously. Effective treatment will need to engage with all of these different ways that anxiety manifests in our bodies and minds. 

Actionable advice:

If you want to remember something, take a nap.

The next time you want to make sure you remember something – for example, a lecture – schedule in a nap right after it. Memories need between four and six hours to become fully formed in our minds. It’s important to not only take notes during the lecture, but also to set aside some peaceful time for reflection afterward. Or better yet, take a nap! While you’re sleeping, your brain will be hard at work preserving the memory of everything you’ve learned.”

[Bartosz Moszczeński · Rating 2 out of 5]

I felt like reading totally impractical, way too long scientific paper on the topic (and sometimes far from the topic). Expected much more from the title and author experience.

2 stars instead of 1 for just one reason - if someone is writing a thesis on the related topic, this book is a goldmine.

If you're looking for research around whether animals have emotions and what kind, you'll find a lot there. And I mean A LOT. For casual readers, you can sum it up with one sentence, if I remember correctly "We have not empirically proven, that animals have the same way of experiencing emotions as humans (because of a near impossible way of researching their consciousness) so we should not assume they do." Of course this applies for further human research purposes, not for animal care.

[Quinns Pheh · Rating 3 out of 5]

According to this book, anxiety disorders are complex to diagnose and treat because anxiety involves many brain processes. People with anxiety disorders are incredibly cautious about danger and threats, always on high alert. However, anxiety is also a feeling that we process consciously. Effective treatment will need to engage with all different ways that anxiety manifests in our bodies and minds. Also, if you want to remember something, take a nap. While you are sleeping, your brain will be busy preserving the memory of everything you've learned.

[Diana-Michaela Shaffner · Rating 2 out of 5]

At first glance, this book might seem like something a person struggling with anxiety could find useful. However, this is not the case. The book is a textbook for professionals who are interested in the history of psychological sciences and many other dry non-applicable long winded chapters. A reader who needs advice on how to handle anxiety or understand it in others will not find any use in this book.

[Brendan Keene · Rating 1 out of 5]

This book is marketed as one thing and it is actually something else. I was under the assumption as I'm sure many were as well that this book would provide tips and tools as ways to treat and cope with anxiousness.

Instead what we receive is a 300 page academic article with many medical terms, study after study and barley any actual real world hands on advice for the average person.

I would pass on this unless you are a neuro student...

[Angie Boyter · Rating 2 out of 5]

See my Amazon review: http://www.amazon.com/review/RG7DPNF8...

[Suzanne · Rating 4 out of 5]

I received this book free through Goodreads First Reads. This book will be a great supplement for a psychology curriculum or for anyone that has a strong interest in psychology and the brain.

[Mariana · Rating 4 out of 5]

Too technical. I want more treatment options.

[Lona · Rating 4 out of 5]

I found this in the library and because I'm interested in learning more about different processes, going on in the brain, I wanted to read it. Please be aware, that I'm an absolute amateur when it comes to neurology before you read my rewiev. It may also be, that my english isn't perfect, because I'm no native speaker.

First thing: The tagline "Using the Brain to Understand and Treat Fear and Anxiety " is a little misleading here, because if there's one thing I understood by reading this, it is how complicated it is to comprehend fear and anxiety. But on the other hand this is what I found fascinating. LeDoux first defines the concepts of fear and anxiety and the difference between those two, then what F&A are NOT and then he describes different disorders. In the following, he takes a look on the studies, especially the difficulties when it comes to the attempts to understand human emotions by animal testing. Here he goes into detail: Does animals have a self-awareness and human-like emotions? It's a question that takes the biggest part of the book, because that awareness seems to be fundamental for the development of feelings like fear and anxiety. Semingly it's not even proven that animals have thiat kind of self-awareness. Important: LeDoux emphasises, that this is NEVER an excuse to abuse animals, because it's a fact that they are indeed capable of feeling pain/threatened. For science, the analysis of this special question seems to be very important, because, as LeDoux writes, if we pretend animals does function like humans, most of the results of animal testings are vague. The differend between emotions and - I hope that's the right translation for that one - survival circuits in the brain definitely matter here.

Of course the human brain itself get's it's share of the cake too. There are many examples for scientific tests on animals and humans I found interesting to read about. In the last part of the book LeDoux comes to medication and therapies - here he has to mention that he's not really familiar with therapy. It was interesting to read, but because he was very accurate with scientific precisesness before I think the lack of familiarity it's not the best basis. Anyway... he describes the different forms of therapy here, how they work with the brain and how effectife or uneffective they can be. Under the keyword medication, he mentions again how vague animal testing is and how medication can be supporting - but never as a final solution.

It was a very interesting read, altogether. As an amateur with no previous knowledge I think I didn't memorize every medical term and brain circuit, but I think I have a better understanding how the brain works and what self-awareness is, and last but not least how difficult it is to really understand the functions of the brain and feelings like F&A. So LeDoux did a good job in explaining the topic to an amateur like me and I sure will read more about neurology and the brain.

Bottom line: The tagline may be misleading, but it was very interesting to read anyway, especially if you're not only interested in fear and anxiety, but it the brain itself.

[Joseph Schrock · Rating 4 out of 5]

I found my reading of this book somewhat cognitively demanding in places, sometimes boring, and yet quite informative.

I bought the book with hopes that I might get clues into how my brain is functioning such that residues of childhood emotional abuse still linger in my subconscious 70 years later. Yes, these after-effects cause my hands to tremble substantially. This book provided no help for me in finding out where in my brain memories of emotional pain and anguish linger such as to cause nervous disorders so many decades later. Yet, the book offered much information about brain functions related to anxiety.

I have some reservations about the author’s inclination to doubt that lower animals, even monkeys and chimps, have what he calls “mental state consciousness”, as opposed to “creature consciousness”. I believe that animals have some degree of mental state consciousness – at least awareness of pain, but maybe not awareness that they are aware (i.e., self-awareness). Given animals’ inability to speak and self-report, it’s difficult to prove what levels of consciousness they have.

As seems nearly universal these days for neuroscientists, Dr. LeDoux apparently takes it as nearly axiomatic that consciousness is a product of the brain. On page 112, he states the following:

“There was a time when mental meant nonphysical, but we are past that belief. Mental processes and states are physical products of the brain.”

Well, materialists are past the belief in nonphysical mentality, but not all of us are materialists. Dr. LeDoux might do well to read some of the books by Nobel Laureate neuroscientist John Eccles. That might give him a wake-up call. Among Dr. Eccles’ brilliant books is “How the Self Controls Its Brain”.

Although Dr. LeDoux’s book helped me only marginally, the book was worth reading – notwithstanding the materialist dogmas presumed to be unquestionable by the author.

[Brier Stucky · Rating 4 out of 5]

A look at anxiety from a neurological perspective that doesn't discount the findings of psychotherapy. What I appreciated most about LeDoux's book is that he does not reduce anxiety to merely a neurological phenomenon, as some in his field do. Rather, he argues for a distinction between brain circuit responses and conscious feeling. For example, rather than referring to the circuits in the amygdala as "fear" circuits (a conscious emotion), LeDoux uses the team "threat detection circuit". The change may seem minor, but it is important in its effort to not relegate the experience of anxiety to a neurological after effect, but rather honor it as an experience. For someone who works in treating cognitive experiences of anxiety, I find it important to discuss anxiety at a cognitive level while being informed about it's neurological underpinnings. Because LeDoux strikes this balance, his book is much more applicable to those outside of the field of neuroscience.

The book is technical, as several reviewers have noted. It drags for a bit as LeDoux gets lost in the weeds among differing theories of consciousness. I think that those who have little to no interest in neuroscience would do better to look elsewhere, perhaps Rollo May's The Meaning of Anxiety". For myself, I found LeDoux's writing interesting and helpful overall, even if I did skim some of the more technical sections. My biggest complaint is the treatment section of the book which is essentially centered around exposure therapy. While I do not doubt exposure as a powerful means to treat anxiety, I would have liked to see a discussion of other forms of treatment.

[Hendrik Strauss · Rating 5 out of 5]

Deep dive into the neuroscience of emotions, focused on fear and anxiety.
Relates emotions to theories of consciousness.
Treatment methods are discussed in light of the presented data and worked out theory.
LeDoux is a great scientist and this breaths through every page.
Propably the wrong call to listen to the book, instead of reading it. Instead of 13 hours, it took me 40 to finish the audiobook and I haven't comprehended fully every detail.
Reread worthy for sure.
Though I am a beginner in the field of neuroscience it was possible to follow the argumentation as everything is related to experimental results.
Enhanced my understanding in a myriad of different topics, emotions above all.

Recommended for students or practioners of the related fields aswell as laypeople seeking clarity of emotional responses.
Some basics of how the brain works should sit or this book might be overpowering.
This is due to its quality of not cutting corners in purpose of simplicity when explanatory value would get lost.
Which is great.

[Kristi · Rating 2 out of 5]

Had I not been an NIMH fellow in a PhD program in clinical psychology which included extensive physiological study of the brain and taught psychology at a college for many years, I would have been completely lost by this book's approach. As an incest survivor with PTSD, I was hoping for the treatment results, not the psychological navel gazing. Most of the information duplicated what I already knew, but I was bored by being taken all the way back to Kant, Thorndike, William James, and of course Freud. I was not impressed by the analyses and battles regarding consciousness, unconsciousness, and nonconsciousness ad nauseum. What does the distinction contribute to "treatment". I gave up more than half-way through because there was no practical content "to Treat Fear and Anxiety". as the title promises. Disappointing even for a trained psychologist. 2 stars for the accuracy of brain activity and the history of psychological debate about the experiential vs innate responses of fear and anxiety. Zero stars for utility. Kristi & Abby Tabby

[Thomas Port · Rating 2 out of 5]

I've had a few incidents recently that I found myself to be in situations I had been able to deal with comfortably before that I was overly anxious, this extremely unsettling feeling left me to try and seek self-help to combat my anxieties and prevent this from happening again.

Suffice to say, this book left me more anxious as I realised that the majority of it would be an in-depth study into Brain chemistry and it's effects on anxiety and fear. Not a user guide on how to combat anxiety, which I thought it was. The first two chapters I enjoyed, the next 200 pages I didn't understand and the last chapter was ok.

Put it simply; this is not a beginners book. If you, like me are interested in combating anxiety I'd recommend the Waking Up App by Sam Harris. I've used this every day since my first panic attack and the beginner's course assisted me through some quite challenging times.

[Gabriel Gomide · Rating 4 out of 5]

Esse livro é muito bom, mas deve ser aproximado da maneira que ele é. LeDoux, o autor, é um dos principais autores na área de neurociência afetiva, esse livro é uma grande revisão de como as emoções funcionam cognitivamente, utilizando a ansiedade como um framing device.

Ele é um livro para pessoas que já sabem sobre psicologia, e, se bobear, nem isso basta, mas sim especializados em neurociência ou neurociência afetiva. O que eu quero dizer com isso é que é denso, trata de questões teóricas profundas e bem específicas da área. Eu não achei isso ruim, meus trabalhos são principalmente sobre memoria e emoção, mas imagino que alguém que estiver esperando algo mais voltado à ansiedade como transtorno ou como formas de tratamento fique decepcionado.

Se eu fosse comparar com outros livros semelhantes eu diria que ele não é um "Behave" do Sapolski, ou um "O homem que confundiu a sua mulher com um chapéu" do Sacks, mas está mais próximo de um "Episodic Memory" do Baddeley.