Fear, Dissociation, Neuroscience, and Horror Studies: A Conversation with Greg Siegle

“It's hard to be brave alone. It's easier to have a community.”
3/11/2025
At the time of this interview, Greg Siegle is a leading researcher and Director of the Program in Cognitive and Affective Neuroscience as well as a professor of Psychiatry and Translational Sciences at the University of Pittsburgh School of Medicine. His work spans psychiatry, neuroscience, and, intriguingly, horror studies, where he examines the intersection of fear, emotion, and psychological resilience. Our discussion explores his research on how fear functions in the brain, the potential for horror as a therapeutic tool, and the role of immersive technologies like virtual reality (VR) in mental health treatments.

​Greg Siegle is a core member of the Horror Studies Working Group (HSWG) and has contributed significantly to the academic conversation around horror, particularly in clinical and cognitive sciences.

Cassandra Gray (CG): I've been really excited to do this interview because in our first meeting, when you started talking about your research, it sounded fascinating, especially with the rise of video games and VR. I feel like dissociation in horror is a very cool topic.

Greg Siegle (GS): Yeah, dissociation is an interesting area. So, are you focusing on that specifically?

(CG): The article I was working on was mainly focusing on video games and how fear and feelings of tension help in a therapeutic way.

(GS): Yeah, and when you say help in a therapeutic way, what do you mean?

(CG): For me personally, it helps calm me down. I find a lot of comfort in horror, which honestly got me looked at as weird while growing up, but I find a great sense of ease in it.

(GS): Suppose it's not weird. I want to start with, this isn't weird at all, at least to me. In the first set of our studies we did, it turns out you have socially anxious people who have trouble looking at other humans because they're afraid of being judged negatively by them. In contrast, they are okay going to haunted houses because when they face a zombie they know that zombie is going to judge them as food, right? Yeah, and it's going to judge them negatively as weak and all this but I don't care. It's not actually something bad about me if the zombie sees me as a weak food source. I'm no worse than any other human. So what we did is we took people who were socially anxious, and we put them in VR with a whole bunch of zombies They laughed, they screamed, but they were really happy about it. It was easy. Then we gradually stripped away the makeup and we stripped away the aggression, and all of a sudden they were in a train full of people reading newspapers, looking up at them on occasion. If we started with them on a train full of people looking at them on occasion while reading newspapers -- totally anxiety-provoking. When we instead start with people who are zombies what we've got is, "Oh, I've survived so much worse. These people are not actually even a threat." and they can be calm in that situation. So what you experience when you take on the fantasy horror universe, paradoxically, that's exactly what it's supposed to be, and then you can come back and the world isn't that hard.

(CG): Wow! That’s incredible.

(GS): Let me tell you about the one we just finished because I wanted to give you a sort of full sense for it. I see people who are actively suicidal and I give them the option to pick up a gun and shoot themselves in VR if they want to. We found that almost none of the suicidal people actually shot themselves. They all looked at the gun, they picked it up, and almost all of them put it back down. Then they said, "Now I don't need to kill myself," and their suicidality was reduced for weeks and months after. They actually confronted the thing. They got so close, and they got to what was a boogie man that they were avoiding. They were like, "Yeah, I just don't need that," and so I think that books are not enough to do that a lot of the time. You need what, in psychology, we call exposure.

(CG): Wow, yeah. That’s very interesting. So you’d say immersion plays a big role?

(GS): Absolutely. I would say immersion plays a big role. The video games, the VRs, and the 2D video games might even be enough, but I think having an element of choice and an element of interactivity is a big deal.

(CG): Your examples are kind of similar to tolerance and anxiety level in regard to adaptive difficulty in video game. Would you say that's influenced your work in any way?

(GS): We have done some of this work where I've used adaptive difficulty with tolerance of, basically, frustration. Usually, if you just start at the very hard level, people just cry, they get very upset, and it's not therapeutic. If you do it gradually and do it in an adaptive way with the difficulty, then they're always at a flow state. They're always right at the border of their confidence, and I keep people at 60% correct. At that level, they're always trying, but they feel like they're winning enough to actually progress. They can keep challenging their fears and keep challenging themselves.

(CG): So, yeah, exactly that. Staying on the track of VR, do you think the realism aspect could have any negative or unintended psychological effects?

(GS): I wish I was worried about that back in the day, I just haven't seen it. I keep looking. The IRB is making me keep looking. When we actually went to the IRB (Institutional Review Board) with, "I'm going to let suicidal people pick up what looks like a gun or give them the option to virtually drop off a bridge" we also have careful framing in place. We tell them, "Think about this as a suicidal act. If you do it, and it's acting out the thing you've been worried about: don't do it lightly." What we see is people climb up on the bridge and they walk out and they don't do it. I'm not worried about the "realisticness" of it. I think that's exposure. The IRB was worried, "Aren't you going to make it less difficult for people to actually kill themselves?" It turns out that even if it does that, people just don’t want to do it.

(CG): That’s actually beautiful to hear. Talking to friends and family especially those who struggle with that and have said similar things, you get to that point and realize, "I don't know about doing this anymore." It’s very interesting. In your personal opinion, do you think technology, especially AI, VR, etc. will continue to shape emotional processing as it continues to grow in horror?

(GS): Right. so I can tell you there are a bunch of places. The big one with AI is we're learning people's tells. We're learning what you're "Scared" is. I can tune a stimulator to your "Scared" and your physiology. I can artificially make your own personal boogeyman, which is going to be terrible. Just think, I have an AI whose job it is to scare you, and it gets to read your text messages.

 (CG): <laughs> Oh my gosh! Horrific.

(GS): I think horror is going to get much more horrific very quickly. It kind of already did. I think that the therapeutic potential of it, though, is going to mirror that, which is, we will be able to personalize things and the more idiosyncratic we get, the better we do. There are also some technologies that I'm very excited about, which I haven't told the rest of the Horror Studies Working Group about yet, but I'm really into direct brain stimulation. We can simulate the fear center in your brain and all of a sudden you're afraid. You don't know why. I can make things whiz along the back of your visual field or make you hear things that sound like hallucinated voices with just brain stimulation. That's horrific stuff. It's amazing the kinds of things I want to do to actually help people, because I can bring their brain to a scared state and move it back and just train them what their brain is like when it's getting less scared.

(CG): I see, yes, that's very cool. I was going to ask you if you think mechanics like that and video games help a lot with exposure therapy, like the limited visibility, the sounds, the threats that you can't see—things like that, but I feel like that sort of just touched on it. <laughs>

(GS): Oh yeah. I think it really helps. There's this known difference between brain reactions to angry faces and fearful faces. It turns out that your fear centers react more to a fearful face than to an angry face, and this is interesting because it’s the angry person who would actually hurt you. The fearful person is afraid of something, you don't know what, and that's when your fear centers are like, "Wait, that's bad." You know, it's the ambiguity of seeing somebody else who's afraid that actually gets you.

(CG): Do you think there are any misconceptions people may have when it comes to this type of research that you're doing?

(GS): Yeah, so many. The big one is people somehow think that, as you say, it's weird. They think that realism is dangerous. They think that exposure is dangerous. They also think that emotions are bad. In my world, that's the biggest misconception. So I would way rather somebody be having an intense emotion than be dissociated. Dissociation is really hard to crack, but having an emotion -- I can work with an emotion. So for me, the scariest people who come into my lab are the ones who say, "I feel nothing. I'm totally numb." So it's like, "Let's first get you to a place where you actually feel something, then maybe I can reduce some of the fear." These people have been written about forever, and so in my lab, we use all the scales in the opposite direction from anybody else. Everybody else says it's better to set anxiety low. For my people, I deal with almost exclusively highly traumatized, most highly minoritized, and intersectionally minoritized people for whom opting out or not engaging is the requirement. Getting them to be able to inhabit their bodies, oh my gosh -- that's the big win. The current study I have going on is a Black mental health study, and it's with Pitt and Emory., Frankly, being in their body is not safe. This is what they told me, and we got funded for a study where people are just supposed to monitor their breathing and be in touch with that, and they cry and they scream about it. We got funded the week that George Floyd was murdered, and people were like, "Yeah, you want me to think about my breathing? That is so not safe." I know we’re not going to do safe, but opting out and dissociating here is going to have you opting out and dissociating in your life. Let's sit with this now, and we'll make the environment as safe as we can. So, yeah, that's the big misconception: feeling isn't a bad thing. Yet, it is for a lot of narratives. Sorry, I know that got dark very fast.

​(CG): No, I love this. This is amazing. I was just going to going to ask if you had any thoughts—if you thought there were any cultural or generational differences?

(GS): Oh, yes, absolutely. You know, the big one I've been working on for the last five years has been with the Black community and the relationships to bodies in that community, just because so many people tell me, you know, and seeing the research where Black men in society are just not allowed to be angry. So many of them have so many reasons to be angry. So when they come into my lab and they say, "I was abused and I’m not allowed to be angry at this, so I dissociate." For me it's like, "Oh, what if we do the horrible thing and we expose you to thoughts of this abuse? And we put you back in that situation, virtual reality or whatever, and say, you're allowed to be angry now, you're allowed to throw things." In my lab, you're allowed to throw things. You're allowed to scream. We have you in a soundproof room, and I just say, "You're not going to hurt anybody, and you can take as long as you need afterward and calm down." Having a space where you're actually allowed to react, and I'm going to tell you that standard movie theaters are not that space, right?

(CG): Yeah, I agree.

(GS): So you can go to a horror movie, but you're not allowed to actually react. I worked at the scare house and you're not allowed to hit the actors -- you get thrown out.

(CG): Yeah, that's my biggest thing. I can't go, that's the main reason I don't go. <laughs>

(GS): Yeah exactly, so I think people need a space where they can actually allow themselves to react and not just be told to shush all the time. For certain cultural groups who are used to being told shush, that's really hard.

(CG): Would you mind giving some background on your academics and what got you interested in horror in general?

(GS): Yeah, of course. So my academic background, I was an artificial intelligence guy in the 1990s and I learned that the stuff I was doing was being used to build more accurate missiles and kill people more effectively, and so I got out. Then I was like, "Where can I use all this technology that I've been creating?" So, that got me into psychiatry, and I got a degree in Clinical Psychology and a postdoc in Neuroscience, and I haven't really looked back. I was making all these models that I wanted to validate, and so I had to measure brains to do it. So I was measuring the brains of depressed people as they ruminated, and what we found was that depressed people are very good at vetting themselves. Something will happen, but then twenty minutes later they're still thinking about it. I got very interested and what is going on in our heads that makes us loop and it builds these things up in our heads. I guess that's where sort of the horror came in. It turns out if you shock a rat's foot that rat's fear center in its brain is still active for the next four hours, even though there's no danger of shocking. This stuff doesn't stop for us. So I got into scaring people and seeing how emotional circuitry just turns and turns and who shuts off and stuff like that. Then Margee Kerr, who used to run the scare house basement and has a PhD in sociology, was writing a book on fear and came into my office to learn what research had to say and we just got to collaborating. She taught me everything I know about horror and scaring people for real. I got to the scare house basement which was great, but I'm like, "Wait, you're not actually even shocking people. You're threatening to do it, but you don't actually shock people." And they're like "No, we never thought that was ethical." I'm like, "We do it in my life all the time." <laughs> So we made this scare house scarier by opening it to at least what the research world was doing. <laughs> I had them get into paralyzing people, shocking them, and all sorts of fun stuff. I couldn't look back after that. I had this other thing where I was trying to get into PTSD, and their stories are just so much more than any story will ever be. These are real things people have experienced, and so, that's where I got into VR battle theaters and stuff. Then I got in with horror. I can do the weak sauce versions with horror, and the people actually confront things that are sort of relevant to their traumas. Now I have students who bring stuff to me because I don't get scared of it. The person who wanted to do that, you know, VR suicide study was like, "Nobody else would touch this stuff as an intervention." I was like, "Let's do it." She wanted to see what would happen, and I'm like, "No, this is treatment." She's like, "Nobody will ever accept that," but they did.

(CG): Thats incredible honestly. You mentioned Margee Kerr and your collaborations with her, have discussions with other faculty and students influenced your perspective when it comes to this research

(GS): Yeah, I mean very much—we always have a "Be Brave" thing. If somebody feels like they're upset or scared about it, we use that negative affect and say, "What's scaring us about it? Why is that scary? Is it something to go back away from or something to embrace because it's scary?" Those discussions with my students and other faculty have been amazing. Margee, especially. The student who's doing the suicide stuff is an assistant professor out in Florida. We set up a lab there for her to do VR suicide in Florida after she got out of my lab with it. It's hard to be brave alone. It's easier to have a community. That's why I love our Horror Studies Working Group. These people are not scared by the stuff I bring up.

(CG): I think that's one of the reasons I was so excited to join this group as well, it's just a bunch of horror nerds. There's a lot to love there. I was wondering actually how you got involved in the HSWG.

(GS): Yeah, the HSWG connection came about because I'm doing a lot of studying of fear and ecological settings...

Greg then went on to discuss his article with Margee Kerr and why they see the Horror Studies Center as an important bridge between science and the humanities. He explained that fear plays a surprisingly central role in many disciplines, yet it’s often overlooked or not studied in depth. For example, doctors have little training in understanding how fear affects their interactions with patients, and scientists studying mental health frequently struggle to create fear-inducing stimuli that feel real or relevant.

He highlighted how horror scholars and creators, whether from literature, film, or media studies, could offer valuable insight into crafting more effective fear-related research. Right now, fear experiments often rely on outdated images or low-intensity stimuli that don’t truly capture what makes something scary. Collaborating with horror experts could eventually lead to better tools for studying fear in these environments, whether in neuroscience labs or clinical settings.

Greg also pointed out an interesting paradox, exposure therapy, a common treatment for anxiety disorders, has a high dropout rate, yet people voluntarily seek out horror in books, movies, and haunted houses. He suggested that there’s something about how horror engages and motivates people that the mental health field could learn from. If therapists could include some of those elements, whether through storytelling, humor, or interactivity, treatment might become more engaging and effective. Ultimately, he sees the Horror Studies Center as an opportunity for a two-way conversation. Scientists can help explain what happens in our brains when we experience fear, while horror scholars can offer insight into why certain things scare us and how those fears evolve over time. By working together, they can push both fields forward in new and exciting ways.

As we wrapped up the interview, I admitted that fear had been the driving force behind our entire conversation. It had been present in every moment, not just in our discussion of fear, but in my own anxiety when socializing, but something Greg said really stuck with me. He reminded me that curiosity and passion should never be met with judgment, especially in academia:

(GS): So one way to think of this, is like, you're a student now, right? And if a professor is not willing to sit down with an interested, inspired student and say, "This is what excites me," what are we doing here? And if that professor comes in and the student says, "I'm inspired about this," and the professor judges them at that point, what are we doing? You would cut off the next generation and that would be bad.

His words resonated deeply, not just in the context of horror studies, but in the more general sense of learning, growing, and facing fears. After all, if fear can bring scholars and scientists together in the pursuit of knowledge, maybe it can also push us, as individuals, toward something greater. It challenges us, haunts us, and, if we let it, transforms us. Like the best horror stories, fear isn’t just something to be survived, it’s something that reveals who we truly are.

(CG): And, the last question I have for you, <drumrolls> what’s your favorite scary movie?

(GS): Oh, I’m going to be so boring. <grabs a framed poster that reads, “All work and no play makes Jack a dull boy”> I really have so much love for The Shining! I think they got so much right in the sense that we are the scariest to ourselves, and when we become scary to ourselves, we become scary to other people.