MR. KOJO NNAMDIFrom WAMU 88.5 at American University in Washington welcome to "The Kojo Nnamdi Show," connecting your neighborhood with the world. It's been famously said that the only thing we have to fear is fear itself, but for most of us that's more than enough when confronting a phobia of snakes, coping with social anxiety or finding ourselves in a pulse-quickening encounter with a stranger in a dark parking garage. There seems to be plenty to be afraid of but there's a fine line between fear that's useful triggering a response that can save you from harm and false alarms.

MR. KOJO NNAMDIHere to help us better understand this primal emotion and how we react to it in our modern society is Joseph Bienvenu. He is a professor of psychiatry and behavioral sciences and director of the anxiety disorders clinic at Johns Hopkins. Dr. Bienvenu, thank you for joining us.

DR. JOSEPH BIENVENUThanks for having me.

NNAMDIAlso in studio with us is Mary Ellen O'Toole. She is a retired FBI profiler who teaches at the FBI National Academy. She's author of the book "Dangerous Instincts: How Gut Feelings Betray Us" with Alisa Bowman. Her blog Criminal Minds can be found at Psychology Today online. Mary Ellen O'Toole, thank you for joining us.

MS. MARY ELLEN O'TOOLEMy pleasure. Thank you.

NNAMDIAlso with us in studio is Jaimal Yogis. He is an author, journalist and outdoorsman. His latest book is "The Fear Project: What Our Most Primal Emotion Taught Me About Survival, Success, Surfing and Love." Jaimal, thank you for joining us.

MR. JAIMAL YOGISThank you.

NNAMDIYou too can join this conversation. Give us a call, 800-433-8850. You can send email to kojo@wamu.org. Send us a Tweet at kojoshow or simply go to our website kojoshow.org and join the conversation there. Joe, I'll start with you. I'm curious, first, about how you define fear and whether you think there's a distinction to be made between fear and anxiety or between fear and worry.

BIENVENUYes. I think that's a common question and one that we teach our medical students and residents about. I think the emotion fear and the emotion anxiety are similar. Sometimes people like to distinguish the two saying that fear is directed at something that's actually dangerous, whereas anxiety may be more free floating or may be recognized by the person as not helpful and not appropriate for the situation.

NNAMDIIf I'm out on a hike and I see a snake, what happens in my brain and body even before I make the connection with what I see and the possible threat it poses?

BIENVENUYeah, that's a really fascinating thing about humans, as well as other animals. You don't have to be taught that snakes are potentially dangerous. You know, you can take an infant cat and put a snack looking thing on the floor and it will jump away from it. And I like the way you phrased it because you don't have to process, oh that's a snake. It could bit me, poison me and I could die here in the woods.

BIENVENUThere's immediate relay through the Thalamus, a kind of a relay station in the brain to a part of the brain called the amygdala, which sends out all kinds of warnings to the body to increase the heart rate, to give blood to the skeletal muscles so that we can run or fight. It increases cortisol, the stress hormone. And all of these things are coordinated through the amygdala, as well as laying down fear-related memories in some circumstances. And so it's -- there's usually a bit of a delay before the cortex says, oh snake, bad.

NNAMDIAnd that's how you define split second. But here's Jaimal. Jaimal, you talk to a lot of researchers about how our brains have and have not evolved in the way we process fear. What did you learn about how our conscious and unconscious brains interact when we're scared?

YOGISYeah, it's interesting. As Joe was saying we can have this immediate unconscious response to fear. That's why it's fun to see a horror movie and we'll throw our popcorn into the air before the conscious brain catches up and says, oh I'm just at a movie. And at that point the adrenaline and the faster heartbeat rate becomes a little bit like a drug. It's like having a cup of coffee because you can catch up and say, okay I'm safe. But, oh, I was just surprised again by another leap out from the guy with the knife and so it becomes fun.

YOGISBut where it doesn't become fun is when a future oriented thought, say of a threat or a possible negative outcome, pings that ancient system, that amygdala system that basically functions the same in squirrels and lizards, and it says, let's have the same response that we would have to an immediate threat, meaning faster heart rate, a little sweat on the skin, a narrowing of the focus. And when you're, say giving a speech and you're behind the podium and that fear becomes too intense because you're imagining what if I fail, what if I fail, then it's really debilitating and can be a performance detractor.

YOGISThere are times when that arousal can also be a performance enhancer if you know how to channel it. That's why I think athletes in the Olympics will break a record on the most stressful fear-inducing day of their lives because they've become experts at this. They say, oh I have a little extra energy right now from the stress, but I'm going to embrace it. I'm going to fall back on positive memories and use this energy in the moment rather than reacting to the fear negatively.

YOGISSo I often take a spin on that we have nothing to fear but fear itself quote and say, well, in some ways we have nothing to fear but the fear of fear. Because it's really a reaction to fear that -- a conscious reaction to fear that determines whether it will be unhelpful or helpful.

NNAMDIMary Ellen, because fear is driven by so many factors we can't fully consciously control, how can we constructively harness that fear and use it to our advantage?

O'TOOLEWell, in the work that I have done with the FBI and with violent crimes, probably the strongest lesson that I have learned and I've shared with people is that oftentimes people don't know when to be fearful. And they don't know how to spot a potential threat. And they will, for example, engage in relationships ongoing with someone who ultimately will hurt them or hurt their child.

O'TOOLEAnd we use superficial indicators of someone who may be threatening to us a week, two weeks or six months down the road. And when it happens we're stunned and we say, how did that happen. Or we may be in a relationship with someone for 20 years and it gets progressively worse. And rather than say, I saw it 20 years ago, what we tend to say, which is rationalization, geez, he's really changed. That's not the man that I married. When in fact, how we view those individuals and how we view whether or not they pose a threat is really how we interpret it. And oftentimes we're wrong.

NNAMDIYou know, I have so many friends who say to me, I can read people. I know people. Big mistake, huh?

O'TOOLEWhenever I hear that I usually ask them, well tell me how you do that? And they'll say, well -- and now it becomes somewhat mystical -- well, I don't know. It's always been this thing I've had since I was younger. And I say, well what do you look for? Well, I'm not sure. I just kind of feel it. So it's really -- it's kind of this nebulous, mystical process. And then usually what they'll say is -- I'll ask them about a relationship.

O'TOOLEAnd in one case I asked this young man, I said, you read well. You've had it for a long time. How's your personal life? He answered the question, he said, well I just met this girl in Las Vegas and she's great and she moved in with me with her two children. But now her boyfriend is also moving in with us. And I'm thinking, what part of this equation did you not see or do you not get? But he's a good read of people.

NNAMDIHey, he can read people. 800-433-8850. We're discussing fear. What are you afraid of? Have you come to terms with your phobias or worries? How'd you do it? And if you haven't, how do they affect your life? Give us a call at 800-433-8850. You can send email to kojo@wamu.org or send us a Tweet at kojoshow. Joe Bienvenu, fear can be an asset but it can also be a problem for people who have phobias and anxiety disorders. When does fear go from being rational and beneficial to being a hindrance?

BIENVENUSo because of my work I come into contact with many people whose lives are kind of derailed by fear. In most cases they recognize that their fear is irrational. Like the person with obsessive compulsive disorder who knows that touching a doorknob is relatively safe but imagines the worst can scenario, that there's HIV on the doorknob and they're going to develop AIDS. And then they can't get it out of their heads and they have to go get checked. But if they get checked too early maybe it was too early and it wasn't detectable at that point.

BIENVENUAnd so they recognize that this is ridiculous. But as Jaimal was saying, you know, it's the primitive parts of our brains that are really driving this. And I tell my patients, it's your lizard brain. You know that this is not really dangerous but your lizard brain doesn't know that. And similarly with people with panic disorder, they literally have a fear of fear. They have a fear of those physical and psychological sensations that occur when a panic attack happens. And so they will do lots of things and give up lots of things to try to prevent this from occurring.

NNAMDILooking at the list of conditions that you treat, it's kind of surprising to realize how central fear tends to be to just about all of them. How do you see it manifest?

BIENVENUSo -- and they can be quite different from each other in terms of the symptoms of fear, the physical sensations associated with fear. Like the rapid heart rate, the sweating, those are really similar across the conditions. But what people are afraid of can be very diffuse as in generalized anxiety, worries about, you know, the economy, about family health, about relationships to just a fear of -- or rational fear of dogs, for example. Much more circumscribed. And people with those specific phobias, we call them, really aren't nearly as disabled as, for example, somebody with severe social phobia.

NNAMDIGot to take -- no, we're not going to take a break. Let's take a few calls before we take a break. We'll start with -- oh, please don your headphones -- we'll start with Vivian in Manassas, Va. Vivian, you're on the air. Go ahead, please.

VIVIANHi. I wanted to talk more about the beneficial aspects of fear as a response to your environment. I had done some wilderness -- deep wilderness travel and I came to appreciate the usefulness of fear in terms of being able to navigate an environment that was very foreign to me. I did have a (word?) trail at night in the bottom of the Grand Canyon. And I was aware that my sense of smell was kicked up to an unbelievable extent. I was able to smell a water source that was a mile off. My hearing was very sharp. My night vision was incredible. Can you talk about that?

NNAMDIJaimal Yogis.

YOGISThere are a lot of benefits to fear as long as it doesn't -- we don't fall back on that freezing response. I mean, fight or flight should really be called flight or freeze. And the freezing is probably a remnant of early, early mammals maybe freezing or needing to camouflage or play dead. But these days that deer-in-the-headlights response doesn't seem to work very well. The benefits as far as sense arousal, I can't speak to scientifically but I am aware that when they do studies on police officers and such that under the gun people react very differently. And the one thing that we do know is they tend to react automatically.

YOGISAnd where some people are able to fall back on their training and muscle memory, others freeze, others reports experiences of tunnel vision where they zeroed in on one particular dangerous aspect. And others -- that's a common one, narrowing a focus but I'd be curious to hear from the other two guests.

NNAMDIJoe.

BIENVENUYeah, I was thinking, yeah, that heightened sense -- those heightened senses I guess in a low-light environment as you were talking about in the Grand Canyon, I've definitely had that experience out walking at night. And it does feel like an adrenaline surge is going on. And one thing we see with the anxiety disorders, particularly social phobia, is that people become hyper aroused.

BIENVENUAnd as Jaimal was saying, you're giving a talk and then you lose your train of thought. Your brain is not efficient because you're too aroused and you can't focus. You can't think of an answer to a question that you would normally know and it can be completely overwhelming. But that's when the heightened arousal gets way beyond what you're talking about.

NNAMDIIn Mary Ellen -- I mean, in Vivian's case, Mary Ellen, her sense of fear seems to have sharpened her faculties in that situation. Talk about that.

O'TOOLEIt does sound like her fear sharpened her senses. But I'll put a little bit different spin on that and I will say this, when you're -- I think that's great that you have the confidence to go out to someplace like the Grand Canyon. I spoke yesterday. I have a terrible fear of heights so that would certainly not be something that I could do.

O'TOOLEBut as you're looking at engaging in certain kind of behaviors, what I would reinforce is the idea that there are parts of going to someplace like the Grand Canyon where there may be a kind of overconfidence. And you're not really taking into consideration that you're there by yourself. If something were to happen do you have any kind of backup? There are -- what would you do if a stranger comes up to you? What would you say? Do you assume that they are as well intentioned as you are?

O'TOOLESo I hear that from a lot of people that I've worked with over the years. Gosh, it was great. I was out there and I was enjoying nature and I was really in tune with nature. And then something happened. And so it's having this ability to enjoy those heightened senses but to also be pragmatic just in terms of taking caution because of where you are.

NNAMDIVivian, is it possible that the same fear that you feel heightened your senses may have -- can also lead to overconfidence?

VIVIANI wouldn't put it that way. I've been all over Alaska and other parts of the lower 48. And there are rules that if you are experienced in this kind of thing that you should pay attention to. But what I've come to appreciate is that me as a species live in artificial constructed environment. And so we've dampened down some of our senses. And I think fear plays a role in kicking those back up to match the environment you're in.

NNAMDIOkay. Thank you very much for your call. You mentioned, Jaimal, the flight and freeze. You point out that you have a tendency to have freeze as your default reaction. How have you worked around that in your surfing and other parts of your life?

YOGISWell, I don't always freeze but the times that I have been really badly injured in surfing were moments when I was at the crest of a wave. And rather than making a decision to go or not go, I basically froze up and then I fell in an awkward way where I wasn't relaxed. And so I was more likely to get injured and I did. And the way to get around that is basically training. And you don't know if you're going to freeze when you're in a situation when you're under the gun until you're there. And you still don't know. Even if you've trained you might freeze.

YOGISBut the best way to counteract that is to be in that situation again and again and again, or some situation like it and say -- so your senses -- you just fall back on muscle memory and your lizard brain says, you know, we know how to do this. And if you can't be in the situation -- for example, I surf Mavericks in the book, which is this terribly scary Mount Everest-like wave, and I couldn't be in that situation to get ready to know if I would freeze. But I could watch videos and visualize myself there again and again and again in as great a detail as possible so that I would hopefully not freeze.

NNAMDIBefore I go to a break, we got an email from Connie in Warrenton, Va. who says, "As a former military service member how does training influence and change fear, especially as one gets accustomed to adrenaline rushes?"

YOGISWell, the military have shown that there is really no limit to how we can learn to function well in extremely high pressure situations. Most people, when they have a psychologically induced heart rate of 180 beats per minute or higher, they lose motor -- they lose fine motor control, threading a needle and such. But really well-trained Navy SEALS in situations where their heart rates get to this level can still be very accurate in shooting. And it's just because they've trained. They've trained harder.

YOGISAnd NASCAR racers have shown the same sorts of traits. So -- but these people have trained an unbelievable amount. So we're still testing out the limits of what's possible. But most of us, when we're at that level, it's a panic attack or we're, you know, defecating in our pants or something.

NNAMDIWell, when our engineer Aaron starts standing up I start to panic because I know it's time for us to take a break. We're going to take a short break. When we come back we'll continue this conversation on fear. If you have called, stay on the line. We will get to your calls. But the lines are currently busy, so if you'd like to join the conversation send us an email to kojo@wamu.org. Send us a Tweet at kojoshow or simply go to our website kojoshow.org and join the conversation there. I'm Kojo Nnamdi.

NNAMDIWelcome back to our conversation on fear. We're talking with Mary Ellen O'Toole. She's a retired FBI profiler who teaches at the FBI National Academy. She's author of the book "Dangerous Instincts: How Gut Feelings Betray Us" with Alisa Bowman. Her blog Criminal Minds can be found at Psychology Today online. Also joining us in studio is Jaimal Yogis. He is an author, journalist and outdoorsman. His latest book is "The Fear Project: What Our Most Primal Emotion Taught Me About Survival, Success, Surfing and Love."

NNAMDIAnd Joseph Bienvenu is a professor of psychiatry and behavior sciences and director of the Anxiety Disorders Clinic at Johns Hopkins. Joe, you have overcome fears as well, including a fear of public speaking, one of the most common phobias that there is. How did you get up the nerve to do things like appear on a radio show?

BIENVENUYes. Well, I think it was gradual. And probably in high school and college and medical school I avoided public speaking if I could in any way. And one of my colleagues in my med school class left an advertisement for the Dale Carnegie course on my desk.

NNAMDIWinning Friends and Influencing People.

BIENVENUThat's right. So I actually took the course and that was extremely helpful. And it was amazing to me how many even businessmen -- you know, you think of businessmen as being the most extroverted folks there are -- but how many of them really -- they loved interacting with people but they didn't like to be behind the podium or standing up in front of an audience. And, you're right, social phobia is the most common of the phobias. And it is a phobia when it gets in your way, like it influences your decisions.

BIENVENUThat is, you have an ambition to do something but you give it up because it would involve facing a certain kind of a fear. So for me it was giving lots of talks and practicing and being over prepared when I give lectures.

NNAMDIAnd speaking of freezing, Mary Ellen, which we talked about with Jaimal earlier, it's my understanding that you once froze at both a bad time and a bad place. What happened during your training at the FBI Academy?

O'TOOLEWell, actually there were two situations. As a new agent trainee one of the requirements is to shimmy up a freefalling rope, like a firefighter would train to do. And I got about halfway up the rope and I couldn't go up, I could not go down, I really froze. I couldn't do anything. And I had my whole class down looking at me, all my instructors, so all of this happened in front of a group of people. It was humiliating. They had to come up the rope and kind of ease me down to the ground. I mean, it was the most shameful experience.

O'TOOLEAnd the other experience was jumping off the FBI diving board. We had to do that as well, and then you're supposed to jump in the water and blow up your cargo pants and float away with them. I thought, I can do that part but jumping off that diving board, once again I just -- I'm very afraid of heights and it came through. And it was very embarrassing for me.

NNAMDIWell, you somehow managed to come through it anyway.

O'TOOLEI did.

NNAMDIOn to the telephones. Here's an Amid in Silver Spring, Md. Amid, you're on the air. Go ahead, please.

AMIDHi Kojo. My question is I have a fear of snakes since I was a child. And I recently wanted to get over it and went online, read what kind of poisonous snake we have in Maryland, how to distinguish from poisonous and un-poisonous. And went to zoo but the more I read about it now start coming in my dream and waking me up. And what's the best way to come over this phobia.

NNAMDIJaimal, you can talk about snakes, sharks.

YOGISWell, you're not alone, Amid. Snakes are the most common phobia for -- maybe besides social phobia. Even Eskimos who are not around snakes get sweaty palms when they see pictures of snakes. And so it's very common. It's also tough to desensitize the fear of snakes. Generally speaking exposure therapy is the best way to deal with a phobia, but it has to be done in baby steps.

YOGISSo there's a systematic desensitization technique where you would rate your lowest fear, say looking at a photo of a snake with no other stimulus around, and you would first approach that. And you might do some meditation or even take an anti-anxiety medication before doing it, so there's a positive association made with that snake. Once you get past that you move on to stage B which might be seeing a snake at a zoo. And you work your way up to holding a snake.

YOGISNow this is complex and needs to be done differently for the particular person. And so it's helpful to actually look up someone who specializes in systematic desensitization exposure therapy and not -- most PhDs are not actually trained in it so it can be difficult to find. But, Joe, I'd be curious to hear if you know more.

BIENVENUYes. So typically clinical psychologists who specialize in anxiety are some of the best folks. And people vary in their training but I agree completely. Gradual exposure is the best way to treat most animal phobias, including snake phobias. And of course the snake you were holding at the top of your hierarchy would be a nonpoisonous snake or a poisonous snake with no fangs or something like that.

BIENVENUBecause when you're doing exposure you're not actually exposing yourselves to things that -- yourself to something that's inherently dangerous. Just something that would provoke the anxiety response. And you stay in that situation for at least 20 or 30 minutes, or until your anxiety decreases by half. And you get this sense of mastery after doing that. And a comfort level, you become habituated to the snake. It...

NNAMDIWell...

BIENVENUWell, I was just going to say...

NNAMDIPlease go ahead.

BIENVENU...Maryland and around the D.C. area is a terrific place to be to find therapists. Three are a couple of websites that I could recommend. One is Association for Behavior and Cognitive Therapists. ABCT.org has a find-a-therapist link. And Anxiety Disorders Association of America also has one, ADAA.org. So I use those websites frequently looking for specialists.

NNAMDIAmid, thank you very much for your call. We go on now to Martin in Fairfax, Va. Hi, Martin.

MARTINHey guys, thanks for taking my call. My question is -- I'm actually on the way to a meeting right now and I have a fear of sweating, you know. I do basically meetings all over the place and when I get there I start sweating. And, you know, I'm focused at the other person looking at my forehead saying, oh look at that sweat. And next thing you know I can't control my sweat and I forget what I say. So I wonder if this is a problem or, you know, what I could do to fix this.

NNAMDIGo ahead, Joe.

BIENVENUYes. I think we see folks who have excessive sweating in social situations, or it could be in any situation. but it affects how they feel, their level of self consciousness in social situations. So I think, you know, just -- you're going to a meeting now so from a practical perspective I think it's helpful to try to focus on what you're meeting about and what your goals are for the meeting and what the other person wants from you. And recognize that the person is not meeting with you in order to judge you or scrutinize you, but actually to have whatever kind of transaction you guys had planned.

BIENVENUBut you can do exposure to excessive sweating. You know, we've done it, you know, using water bottles on people's underarms and having them come and give an impromptu talk to a group of people they'd never seen before. So that would be relatively high on a hierarchy but you can desensitize yourself to that.

NNAMDIThank you very much for your call. Joe, for those of us who are chronic worriers or who have a fear of flying, how can fears like that be overcome?

BIENVENUSo the fear of flying is interesting. We were talking about this earlier. It is not necessarily a fear of crashing, although some people, that is what they're afraid of. So the turbulence will upset them, storms will upset them and that sort of thing. Sometimes people are afraid to fly because they don't like being in a situation from which it's difficult to escape or impossible to escape in fact. You're in a pressurized tube.

BIENVENUIf you open the door it's going to suck everybody out and the stewardesses wouldn't let you -- or the flight attendants wouldn't let you get to the door. So they don't want to be in that situation where they can't get out and breathe. And then still others are -- have a fear of heights that is related to flying. People with panic disorder don't want to be in a situation where they can't get up and run out and get their breath and collect their thoughts.

NNAMDIHow do you deal with it? Therapy?

BIENVENUSo -- yes. So the same kind of treatment exposure therapy. If the fear is of panic attacks, then one kind of treatment is actually to bring on some symptoms of anxiety like dizziness by spinning around in a chair. For some people, that's a real trigger for a panic attack, or breathing through a straw if shortness of breath is a trigger, or running up and down stairs if palpitations are a trigger. And if you do that in a controlled environment, it is much less anxiety inducing, and so you can habituate to the symptoms one at a time such that if a spontaneous attack occurs, it's not so bad.

NNAMDIJaimal, you spoke to a number of researchers working on projects that could help us better understand and control our fear responses. Tell us about the interplay between heart rate and fear.

YOGISYeah. I did go to this interesting research institute called the Heart Math Institute, and what they were looking at is heart rate variability. And so it seems like our heart rates are fairly constant but it turns out they're rather erratic. Mine's probably going from 50 beats per minute to about 80 beats per minute and then back again, and that's fairly common for a 33 year old. It's resilient, and it shows I'm able to shift between stress and relaxation fairly quickly and easily.

YOGISBut basically what they found here is that when we're in a frayed state or a frustrated state or an angry state, that heart rate variability tends to bounce around in erratic patterns that look like an erratic mountain range. But when we're in a place of appreciation or calm or love, that the heart rate variability tends to be more regular, and the pattern looks more like sloping waves. And so what this is showing basically is that -- how closely our thoughts are related to our heart rate and our physiology.

YOGISBut there's also a reverse process, where if you can breathe steadily, say four breaths -- four count in, four count out, that you start to change your heart rate instantly, and that can actually affect your thought process. So this a bottom up case where you're essentially telling your lizard brain actually things are safe because I'm breathing differently, and then the lizard brain slows down those fear impulses and you can start to turn the situation around. So learning some sort of breathing technique and/or positive visualization, or positive thinking, can really help in these fearful situations.

YOGISIt doesn't work for everyone, but I'll just comment, along with the exposure therapy, if breathing and positive thinking isn't working, being with somebody you love, being able to hold someone's hand on an airplane, that will also change heart rate variability. It also releases oxytocin in the system which has been shown to alleviate the fear response.

NNAMDIGot to take another short break. When we come back, we'll continue this conversation on fear. If you've called, hang onto the line. We'll try our best to get to your calls, or you can send us a tweet @kojoshow. I'm Kojo Nnamdi.

NNAMDIWelcome back. It's a conversation about fear with Jaimal Yogas. He is author, journalist, and outdoorsman. His latest book is "The Fear Project: What Our Most Primal Emotion Taught Me About Survival, Success, Surfing, and Love." Joseph Bienvenu is a professor of psychiatry and behavioral sciences and director of the Anxiety Disorders Clinic at Johns Hopkins, and Mary Ellen O'Toole is a retired FBI profiler who teaches at the FBI National Academy. She's also author of the book "Dangerous Instincts: How Gut Feelings Betray Us," with Alisa Bowman.

NNAMDIHer blog, "Criminal Minds," well, you can find that at Psychology Today Online. Mary Ellen, your job for a long time was to work with and understand people most of us would consider the scariest people there are, serial killers, rapists, other dangerous criminals. What did you learn about fear from doing that work, and -- well, did you find that work frightening?

O'TOOLEI did not find the work frightening, and I found that sitting across the table and speaking to some of these individuals who had committed just incredible acts of violence, for example, the Green River Killer who pled guilty to 49 homicides, they can be incredibly charming and extroverted and very glib, and if you did not know what they did, you would think this person is just absolutely one of the nice people that I've met.

NNAMDIEspecially if you think you can read people.

O'TOOLEEspecially if you think you can read people. And it becomes totally understandable how people can become victims to those individuals who really do have psychopathic traits and can come across as so normal and so non-threatening.

NNAMDIMaybe the best case scenario for an adrenaline seeker who bores easily is taking on extreme sports. Others might seek an outlet in criminal activity. Did you find those factors drove a lot of the people you profiled?

O'TOOLEWell, many of the people that I profiled, or the cases that I worked with, did have psychopathic traits, and one of the 20 psychopathic traits is the need for thrill and stimulation seeking. So you could actually see how these individuals, whether they were white collar psychopaths or sexually deviant psychopaths, they had to import some element of thrill and excitement in their crime scenes which were really unnecessary to completing the crime.

O'TOOLESo going into a bank robbery you can really just pass a note to the victim teller and you can get the money. But not if you're a psychopath who thrives on stimulation and thrill seeking. That's the individual that has to go in and do a takeover or jump over the counter or yell and scream. So that -- being able to see those distinctions in crime scenes were really helpful to those of us who worked in profiling, because it separated out crimes, for example, committed by psychopaths versus non-psychopaths.

NNAMDIWell, Jaimal, you get your adrenaline rush in another way. Some people like you might be thought of us adrenaline junkies. They ski dangerous slopes or surf intense waves, or their job requires them to go toward danger as first responders. Did you find any common driving force in the people you talk to who do that stuff, or do different things tend to drive them?

YOGISIt's actually a pretty diverse profile of extreme sports athletes. Some are -- one big wave surfer I profiled in the book is a cancer doctor who's in his 60s and he's very meticulous and cautious. He's the guy who's charting every current and wants to know every detail about the wave he's going to surf, much like he's taking on a surgery. There are others who are more the brazen teenager type who want to just go into the unknown, and they want to be labeled as the craziest guy, and they want -- and they might tend to fit that adrenaline junkie profile of susceptible to drug addiction and things as well.

YOGISBut there's a large spectrum, but the one thing that I think we have in common is this desire for novelty, to be in a new situation, and there is some evidence that people -- these high-sensation-seeking individuals as psychologists sometimes call us, or wired a little bit differently in that our brains give us a bigger squire of pleasure, dopamine, when we do something new and possibly a little bit risky. That could be a new sexual encounter, a new sport, a new weird type of food in a foreign country that might, you know, make you sick, but could be really good.

YOGISBut it's that novelty. And interestingly, I mean, all humans, I think are risk-taking species. We wouldn't be this alpha species on the planet if we hadn't really like risk, and if risk wasn't a way that we learn and develop our brains. But there are times when it goes too far and Mary Ellen's talk, you know, that thrill seeking in criminal is a perfect example of when a thrill-seeking trait was associated with a criminal act rather than having a healthy outlet, at least healthier for society if not to the individual.

NNAMDIOnto Sarah in Linthicum, Md. Sarah, you're on the air. Go ahead, please.

SARAHHi. Can you please tell me if, as a child you display some anxieties and they seem to get a little bit worse and worse, is it possible to go see somebody and have it -- learn new skills or do something so that they minimize and eventually go away?

NNAMDIJoe Bienvenu, I think that's the whole point, isn't it?

BIENVENUYes. Absolutely. And I think it's a very important question. And when we're talking about young children, or even, you know, preadolescence and during adolescence, parents can do a lot to help their children. And so one can intervene early, and very often it's helpful for mothers and fathers to be involved as well to encourage brave behavior by their children taking chances, as well as doing controlled exposure as we've been talking about, and thinking in a different way about challenges that would cause anxiety. But certainly my colleagues in child psychiatry at Johns Hopkins have a lot of experience in this.

NNAMDIThank you very much for your call, Sarah, and good luck to you. Onto -- or to whoever you're calling on behalf of. Here's Marian in Bethesda, Md. Marian, you're on the air. Go ahead, please.

MARIANHi. I -- waiting on hold produced a lot of anxiety and adrenaline. I hope I can be articulate. But I know that the pianist Glenn Gould said that he used to practice the piano with a vacuum cleaner going, because the act of blocking out the vacuum cleaner helped his concentrate on the piano. And I recently had an experience where I almost -- I was driving down the highway, and I almost was involved in a really bad accident, and like a lot of good drivers, I never pay attention to driving, I just drive, and I like sometimes get from point A to point B and I'm actually listening to WAMU or something like that.

MARIANAnd I had -- I was at a near miss where the car in front of me had to swerve to avoid the accident, and I also had to swerve to avoid the accident, but the whole time I was listening to the radio, and I didn't the tiniest bit of adrenaline, no shaking afterwards or anything. And I'm wondering if there is any research involved in how to get people to go to that autopilot so they can function in dangerous situations like people in the military where they can voluntarily be on autopilot and also functioning on a high level. And I'll take my answer off the phone because my kids are making a racket.

NNAMDIMary Ellen, care to respond to that?

O'TOOLEWell, when I heard the term "autopilot," and being able to function in a very tactical way, that's a concern for me. I think being on autopilot in a situation that could be dangerous is not what you want to do, and I would put driving on the Washington D.C. interstate system around here as being a dangerous situation. But I don't mean to be lighthearted about this, but again, being on autopilot means that your concentration is on something else, and yet you've said you're in a dangerous situation.

O'TOOLEThose two don't go together for me. So whether you're on Interstate 495, or you're parking your car late at night in a very poorly-lit parking garage, you don't want to be on autopilot. You want all of your cognitive skills in place and focused. There are times when maybe you can go and be on autopilot, but I would be very careful about picking the situation where you would allow that to happen.

NNAMDII guess Jaimal?

YOGISI'll just add that there are times, however, for example, when too much conscious cognitive control can actually get in the way of a motor process. For example, the reason athletes sometimes choke in really high-pressure situations is that they are adding too much conscious control. A basketball player knows how to make a free-throw shot. All he has to do is be on autopilot, but if it's the big game...

NNAMDIWhen he starts thinking about it.

YOGISRight. You over think, and there are ways actually, listening to music, whistling, counting backwards. Sian Beilock at the University of Chicago has done some fascinating research. All these things can occupy the prefrontal cortex and keep it from interfering with a process that actually should be on auto. I do agree with Mary Ellen that you want all of your cognitive strength, but sometimes there are parts of the brain that can make you actually fumble, and it just depends on whether your driving skills are really good and that you can trust them.

NNAMDIThank you very much for your call, Marian. I think we have time for Diane in Laurel, Md. Hi, Diane.

DIANEHi, Kojo. I'll just take about maybe 45 seconds for my comment here. I've been listening to this very intently today, and I can tell you from my life experience, in overcoming all of these fears, your logic and intellect is really your saving grace. I'd like to ping bong off the man that had the fear of snakes. I was going through a really bad situation in my life where I was combating suicide and persecution and a whole bunch of other stuff. And so I wanted to get rid of all of my fears and so I went to snakes to save me, and they did save me. I purchased some ball pythons from PetSmart and from some local breeders here in Maryland.

NNAMDIQuickly, we've got about ten seconds. How did they save you?

DIANEOkay. The point is, is that the snakes -- I used the intellect of learning the education about the snakes, and I learned about the snakes and it got rid of all of the fears of them, and ...

NNAMDIWell, we're running out of time quickly, but I'm going to ask our resident psychiatrist here, Joseph Bienvenu, how effective is that kind of technique?

BIENVENUI would guess that it really would depend on the person, but that having pets actually is anxiolytic, it means it reduces anxiety and, you know, my wife always points out she loves cats that -- they help you live longer.

NNAMDIAnd I'm afraid that's all the time we have. Joseph Bienvenu is a professor of psychiatry and behavioral sciences and director of the Anxiety Disorders Clinic at Johns Hopkins. Mary Ellen O'Toole is a retired FBI profiler who teaches at the FBI National Academy. She's author of the book "Dangerous Instincts: How Gut Feelings Betray Us," with Alisa Bowman. You can find her blog, "Criminal Minds" at the Psychology Today Online website.

NNAMDIAnd Jaimal Yogas is an author, journalist, and outdoorsman. His latest book is "The Fear Project: What Our Most Primal Emotion Taught Me About Survival, Success, Surfing, and Love." Thank you all for listening. I'm Kojo Nnamdi.