That question may sound provocative, but it has fascinated scientists for decades. Despite the billions of dollars spent each year on antidepressant drugs, a striking body of research suggests that much, and possibly all, of their benefit may come not from chemistry, but from expectation: the simple belief that the pill will help. 1,2 That phenomenon has a name: the placebo effect.
The prototypical psychopath is pictured as callous, unemotional, impulsive, and fearless. While psychopaths may seem fearless, it does not mean they are not fearful. Fearlessness is not always the opposite of fearfulness. From my own observation, the psychopathic female is especially fearful and anxious. Psychopaths can experience fear Psychopathy researchers Sylco Hoppenbrouwers, Berend Bulten, and Inti Brazil analyzed 16 research reports relating to psychopathy that included measures of fear.
Most people say they want to live to a ripe old age. But that isn't really true. What people really want is to live to a ripe, old age in good mental and physical health. Some of us actually get to live this dream. These folks are known as super-agers and they make it well into their 80s not just in decent physical shape, but also with minds at least as sharp as people 30 years younger.
The first time I discovered the social lubricant magic of alcohol was at a high school party. The music was loud, and I was anxious. A friend handed me a beer, told me it would help me loosen up. And it did. From then on, I learned to turn to alcohol for a little confidence boost every time the discomfort of social anxiety rises.
No matter what their gods were, what they did for a living, what they wore, the songs they sang, everything varies except love, and everybody loves. So I became convinced that this was a real thing, that we were built somehow to form partnerships. And then the day came when I thought to myself, "Well, then it must be something in the brain."
Optimism lives in a curious in-between space. It isn't an outcome so much as an expectation about one. Yet optimism and pessimism each have immediate consequences for mental health. When we expect good things, daily life feels safer and more enjoyable. Persistent pessimism, on the other hand, breeds emptiness and depression. As a psychiatrist, I often meet people who undermine their own positive feelings.
When I think about why a physiological explanation for human behavior is more interesting to me than a philosophical one, I always say that the philosophical, or as it evolves in the 20th century, you get the psychological, and they're sort of the same thing for a little while. Psychology's incredibly useful science, but in a lot of cases, it's an outside-in science. The brain is actually an inside-out mechanism.
"I throw up every day before work now. When I hear his voice, I shake. I can't sleep, and I've lost weight. This job is killing me!" she cried. Kathy worked for a bullying boss whose recent tirades escalated to an unbearable level. The last straw for Kathy occurred when her boss stomped up behind her and slammed a large report binder on her desk, startling her.
