Acta Scientific Neurology (ASNE) (ISSN: 2582-1121)

Research Article Volume 5 Issue 2

The Components of Puzzle of Existential Fear: An Integrated Neuro-psycho-ecological Model of Understanding Experiences During the Covid-19 Pandemics/b>

Suela Ndoja*

Clinical Psychologist-Division of Psychoclinical Service, Italian Albanian Association “Progetto Speranza”, Shkoder, Albania

*Corresponding Author: Suela Ndoja, Clinical Psychologist-Division of Psychoclinical Service, Italian Albanian Association “Progetto Speranza”, Shkoder, Albania.

Received: October 19, 2021; Published: January 07, 2022


The COVID-19 pandemic represents an extraordinary challenge to psychologists, social, public and health care institutions and policymakers. The paper outlines an integrated neuro-psycho-ecological model interpretation of such a puzzle of understanding experiences during pandemic. Our sense of self and others is threatened by the danger of i) being infected, ii) infecting other people, and (iii) the loss of social relation. This abnormal situation has an impact on us as subjectivities being intrinsically related with others and the world, leading to different neuronal and psychological responses based on our basic feelings, as that of fear. It is argued that fear experiences during the COVID-19 pandemic are organized on the neuro-psycho-ecological level around five interrelated dialectical domains, namely (1) fear system of circuits motivated to freeze and flee in apparent frights, (2) fear of infection per se, (3) fear of infecting the significant others/ fear for significant others, (4) fear of being infecting from the world/ of infecting the world, (5) fear of eco-system. These domains represent the neuronal, bodily, interpersonal and behavioral features of fear, respectively. Nowadays reading life because of daily confrontation with the death and connected existential fears is at the same time the threat and the value of this time. There are proposed some strategic points of addressing these fears and minimizing their impact by improving vital scenarios to live in a health way in our global village.

Keywords: Components of Puzzle; Existential Fear; Understanding Experiences; COVID-19; Coronavirus; Integrated Neuro-psycho-ecological Model


  1. Bedford J., et al. “COVID-19: towards controlling of a pandemic”. Lancet10229 (2020): 1015-1018.
  2. Polizzi C., et al. “Stress and Coping in the Time of COVID-19: Pathways to Resilience and Recovery”. Clinical Neuropsychiatry2 (2020): 59-62.
  3. Graber JA and Brooks-Gunn J. “Transitions and turning points: Navigating the passage from childhood through adolescence”. Developmental Psychology4 (1996): 768.
  4. Hawryluck L., et al. “SARS control and psychological effects of quarantine, Toronto, Canada”. Emerging Infectious Diseases7 (2004): 1206-1212.
  5. Wang C., et al. “Immediate Psychological Responses and Associated Factors during the Initial Stage of the 2019 Coronavirus Disease (COVID-19) Epidemic among the General Population in China”. International Journal of Environmental Research and Public Health5 (2019).
  6. Forner CC. “A Missing Ingredient in a Time of Fear: Carers are not the Bucket”. Clinical Neuropsychiatry2 (2020): 80-84.
  7. Porcelli P. “Fear, anxiety and health-related consequences after the COVID-19 epidemic”. Clinical Neuropsychiatry2 (2020): 103-111.
  8. Porges SW. “The COVID-19 Pandemic is a paradoxical challenge to our nervous system: a Polyvagal Perspective”. Clinical Neuropsychiatry2 (2020): 135-138.
  9. Presti G., et al. “The Dynamics of Fear at the Time of COVID-19: A Contextual Behavioral Science Perspective”. Clinical Neuropsychiatry2 (2020): 65-71.
  10. Damasio A. “The Strange Order of Things. Life, Feeling, and the Making of Cultures”. New York: Pantheon Books (2018).
  11. Freud S. “Inhibitions, symptoms and anxiety. The Standard Edition of the Complete Psychological Works of Sigmund Freud. London: The Hogarth Press”. according to researcher Steel et al 20 (1926): 87-156.
  12. Steele H. “COVID-19, Fear and the Future: An Attachment Perspective”. Clinical Neuropsychiatry2 (2020): 97-99.
  13. Smith R., et al. “An Embodied Neurocomputational Framework for Organically Integrating Biopsychosocial Processes: An Application to the Role of Social Support in Health and Disease”. Psychosomatic Medicine 81 (2019): 125-145.
  14. Van den Bergh O., et al. “Symptoms and the Body: Taking the Inferential Leap”. Neuroscience and Biobehavioral Reviews 74 (2017): 185-203.
  15. LeDoux J. “The emotional brain”. New York: Simon and Schuster (1996).
  16. Presti G., et al. “The Dynamics of Fear at the Time of COVID-19: A Contextual Behavioral Science Perspective”. Clinical Neuropsychiatry2 (2020): 65-71.
  17. Rescorla RA. “Associative relations in instrumental learning: The eighteenth Bartlett memorial lecture”. The Quarterly Journal of Experimental Psychology1 (1991): 1-23.
  18. Mobbs D., et al. “The ecology of human fear: Survival optimization and the nervous system”. Frontiers in Neuroscience 9 (2015): 55.
  19. Northoff G. “Is the self a higher-order or fundamental function of the brain? The “basis model of self-specificity” and its encoding by the brain’s spontaneous activity”. Cognitive Neuroscience1-4 (2016): 203-222.
  20. Northoff G. “How Is Our Self Altered in Psychiatric Disorders? A Neurophenomenal Approach to Psychopathological Symptoms”. Psychopathology6 (2014): 365-376.
  21. Panksepp J. “The psychoneurology of fear: Evolutionary perspectives and the role of animal models in understanding human anxiety”. In G. D. Burroës, M. Roth, and R. Noyes Jr. (Eds.) Handbook of Anxiety (1990): 3-58.
  22. , et al. “The basic neuroscience of emotional experiences in mammals: The case of subcortical FEAR circuitry and implications for clinical anxiety”. Applied Animal Behaviour Science 129.1 (2011): 1-17.
  23. Davis M., et al. “Phasic vs Sustained Fear in Rats and Humans: Role of the Extended Amygdala in Fear vs Anxiety”. Neuropsychopharmacology1 (2009): 105-135.
  24. Nashold BS., et al. Sensations Evoked by Stimulation in the Midbrain of Man”. Journal of Neurosurgery1 (1969): 14-24.
  25. Panksepp J. “Textbook of Biological Psychiatry”. Hoboken, NJ, United States: Wiley
  26. Troisi A. “Fear of COVID-19: insights from evolutionary behavioral science”. Clinical Neuropsychiatry2 (2004): 72-75.
  27. Tversky A and AMP Kahneman D. “Availability: A heuristic for judging frequency and probability”. Cognitive Psychology2 (1973): 207-232.
  28. Schimmenti A., et al. “The four horsemen of fear: An integrated model of understanding fear experiences during the COVID-19 pandemic”. Clinical Neuropsychiatry2 (2020): 41-45.
  29. Starcevic V. “Cyberchondria: Challenges of Problematic Online Searches for Health-Related Information”. Psychotherapy and Psychosomatics3 (2017): 129-133.
  30. Stern DN. “The Interpersonal World of the Infant: A View from Psychoanalysis and Developmental Psychology”. New York, NY: Basic Books (1985).
  31. Van der Kolk B. “The Body Keeps the Score: Mind, Brain and Body in the Transformation of Trauma”. New York, NY: Penguin Random House (2015).
  32. Bowlby J. “A secure base. Clinical applications of attachment theory”. London, UK: Routledge (1988).
  33. Hayes SC., et al. “Relational Frame Theory: A Post-Skinnerian account of human language and cognition”. New York: Plenum Press (2001).
  34. Bromberg PM. “Standing in the spaces: Essays on clinical process trauma and dissociation”. Routledge.
  35. Davidson D. “Essay on Actions and Events”. Oxford, UK: Oxford University Press (1980).
  36. Schore AN. “Attachment and the regulation of the right brain”. Attachment and Human Development1 (2000): 23-47.
  37. Scalabrini A., et al. “The self and its world: a neuro-ecological and temporo-spatial account of existential fear”. Clinical Neuropsychiatry2 (2020): 46-58.
  38. Pfeifer JH and Peake SJ. “Self-development: Integrating cognitive, socioemotional, and neuroimaging perspectives”. Developmental1 (2012): 55-69.
  39. Trevarthen C. “Intrinsic motives for companionship in understanding: their origin, development, and significance for infant mental health”. Infant Mental Health Journal 22 (2001): 95-131.
  40. Tronick E. “The Neurobehavioral and Social-emotional Development of Infants and Children”. New York, NY, United States of America: W. W. Norton and Company (2007).
  41. Darwin C. “The Descent of Man and Selection in Relation to Sex”. London: John Murrey (1871).
  42. Curtis VA. “Infection-avoidance behaviour in humans and other animals”. Trends in Immunology10 (2014): 457- 464.
  43. Weinstein N. “Unrealistic optimism about our future life events”. Journal of Personality and Social Psychology 39 (1980): 806-820.
  44. Stern DN. “The Interpersonal World of The Infant”. Amsterdam, Netherlands: Adfo Books (2000).
  45. Gazzillo F., et al. “Effectiveness is the gold standard of clinical research”. Research in Psychotherapy: Psychopathology, Process and Outcome (2017).
  46. Steele H and Steele M. On the origins of reflective functioning. In F. Busch (Ed). “Mentalization: Theoretical considerations, research findings, and clinical implications”. Psychoanalytic Inquiry Book Series 29 (2008): 133-158.
  47. Fonagy P., et al. “The capacity for understanding mental states: The reflective self in parent and child and its significance for security of attachment”. Infant Mental Health Journal 12 (1991): 201-218.
  48. Kashdan TB and Rottenberg J. “Psychological flexibility as a fundamental aspect of health”. Clinical Psychology Review7 (2010): 865-878.
  49. Salvatore S. “Cultural Psychology as the Science of Sensemaking: A Semiotic-cultural Framework for Psychology. In A. Rosa and J. Valsiner (Eds). The Cambridge handbook of sociocultural psychology. Cambridge, UK: Cambridge University Press (2018): 38-47
  50. Salvatore S. “Social Life of the Sign: Sensemaking in Society”. In J. Valsiner (Ed.), The Oxford Handbook of Culture and Psychology, Oxford, NY: Oxford University Press (2012): 241-254.
  51. Wilson A and Weinstein L. “Language, thought, and interiorization A Vygotskian and psychoanalytic perspective”. Contemporary Psychoanalysis1 (1990): 24-40.
  52. Roisman GI. “The role of adult attachment security in nonromantic, non-attachment-related first interactions between same-sex strangers”. Attachment and Human Development4 (2006): 341-352.
  53. Pallini S., et al. “The relation of attachment security status to effortful self-regulation: A meta-analysis”. Psychological Bulletin 1 Cognitive Neuroscience1 (2018): 55-69.
  54. Allen JG and Fonagy P. “The handbook of mentalization-based treatment”. New York, NY: John Wiley and Sons Inc (2006).
  55. Midgley N., et al. “Mentalization-based treatment for children: A timelimited approach”. Washington, DC: American Psychological Association (2017).
  56. Lemma A., et al. “Brief Dynamic Interpersonal Therapy. A Clinician’s Guide”. Oxford, UK: Oxford University Press
  57. McEwen BS. “Stress and hippocampal plasticity”. Annual review of neuroscience 1 (1990): 105-122.
  58. Pakpour AH and Griffiths MD. “The fear of COVID-19 and its role in preventive behaviors”. Journal of Concurrent Disorders (2020).
  59. Anderson RM., et al. “How will country-based mitigation measures influence the course of the COVID-19 epidemic?” The Lancet10228 (2020): 931-934.
  60. Bronfenbrenner U. “The ecology of human development: Experiments by nature and design”. Cambridge, MA: Harvard University Press (1979).


Citation: Suela Ndoja. “The Components of Puzzle of Existential Fear: An Integrated Neuro-psycho-ecological Model of Understanding Experiences During the Covid-19 Pandemics" Acta Scientific Neurology 5.2 (2022): 11-22.


Copyright: © 2022 Suela Ndoja. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Acceptance rate32%
Acceptance to publication20-30 days

Indexed In

News and Events

Contact US