Fight, flight or finished: forced fitness behaviours in Game of Thrones - Semantic Scholar

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Fight, flight or finished: forced fitness behaviours in Game of Thrones - Semantic Scholar
Education reviews

Fight, flight or finished: forced fitness                                                                                  Circulating hormones like testosterone,
                                                                                                                        cortisol, growth hormone, insulin-like
                                                                                                                        growth factors and catecholamines are
behaviours in Game of Thrones                                                                                           very important for responses in muscle
                                                                                                                        to exercise and injury. They are a crucial
Ryan E Rhodes,1,2 E Paul Zehr1,3,4,5,6,7,8                                                                              part of the stress response experienced
                                                                                                                        by pretty much every character inhab-
                                                                                                                        iting GRR Martin’s fantasy world. Even
                                                              purpose and thrumming with the epineph-                   the word ‘stress’—with its Latin root
    Spoiler alert! This paper deals with plot                 rine rush of combat.                                      ‘stringere’ meaning to draw tight, strain,
    points found in the GRR Martin books in                      That thundering of blood, racing heart                 exert or tax—seems to come right out of
    the ‘Song of Ice and Fire’ series and the                 rate, sweating and sense of power are the                 an episode of ‘Game of Thrones’.
    ‘Game of Thrones’ television production                   hallmarks of the fight or flight response—
    seasons 1–6. If you haven’t yet caught up                 the ability our nervous and hormonal
    (and why haven’t you?), please proceed                    systems have to energise us—briefly—for                   Awash in a sea of hormones…
    at your own risk. You have been warned!                   feats of courage, strength and power in                   Thriving and surviving in our world and
                                                              the name of self-preservation. Call it the                Martin’s hinge on the concept of homeo-
                                                              ‘epinephrine rush’, the ‘thrill of the chase’,            stasis in our physiological systems. The
    ‘If you know others and know yourself,                    it is all part of the acute stress response we            concept of homeostasis relates to adaptive
    you will not be imperilled in a hundred                   have when faced with scenarios and situa-                 responses to change that all serve to drive
    battles; if you do not know others but                    tions that demand our complete focus and                  the body back to its comfortable oper-
    know yourself, you win one and lose one;                  attention. And there is no shortage of such               ating range (see figure 1). These include
    if you do not know others and do not
                                                              scenarios in Game of Thrones.                             responses to extreme cold, haemorrhaging
    know yourself, you will be imperilled in
    every single battle’
                                                                 Both the response to fighting and the                  blood loss, traumatic pain and emotional
         ―From ‘The Art of War’ by Sun Tzu                    training for learning to fight rely heavily               distress—basically daily life in pretty
                             (544–496 BC)1                    on the ‘fight or flight’ response. This acti-             much any scene in Game of Thrones from
                                                              vation of the sympathetic nervous system                  just about every season.
    ‘Storms come and go, the big fish eat the                 is the ability you have to respond to exer-                  The stress response concept is part
    little fish, and I keep on paddling.’
                                                              cise stresses, which is a function of the                 of something pioneering physiologist
              ―Varys ‘the Spider’ in the second
              season ‘Game of Thrones’ episode
                                                              level of regulating hormones in your body.                Hans Selye called the ‘general adaptation
          ‘The Night Lands’ that premiered on                 Your state of balance—your physiological                  syndrome’ and which has three stages. The
                                  8 April 2012.               homeostasis—revolves around this.                         first is an ‘alarm reaction’ which mimics

Blood thundering in his ears, Jon Snow
raises his broadsword Longclaw in a
smooth arc of Valyrian steel that abruptly
stops over his head only to then reverse
course in a deadly slash downward onto
the head of the Other and cleaving it in
two. All his senses blazing with clarity, the
bastard son of the late Eddard Stark, now
himself leader of Castle Black, turns to
face his next adversary full of power and

1
 Department of Exercise Science, Physical and Health
Education, University of Victoria, Victoria, British
Columbia, Canada
2
 Behavioural Medicine Laboratory, University of Victoria,
Victoria, British Columbia, Canada
3
 Rehabilitation Neuroscience Laboratory, University of
Victoria, Victoria, British Columbia, Canada
4
 Division of Medical Sciences, University of Victoria,
Victoria, British Columbia, Canada
5
 Island Medical Program, University of Victoria, Victoria,
British Columbia, Canada
6
 Centre for Biomedical Research, British Columbia,
University of Victoria, Victoria, British Columbia, Canada
7
 Division of Neurology, Department of Medicine, Faculty
of Medicine, University of British Columbia, Victoria,
British Columbia, Canada
8
 Department of Human Discovery Science, International
Collaboration on Repair Discoveries (ICORD),
Vancouver, British Columbia, Canada
Correspondence to Dr E Paul Zehr, University of
Victoria, Centre for Biomedical Research,Victoria, V8P
5C2, British Columbia, Canada; ​pzehr@​uvic.​ca               Figure 1     Regulating bodily balance at King’s Landing.

576                                                          Rhodes RE, Zehr EP. Br J Sports Med May 2019 Vol 53 No 9
Fight, flight or finished: forced fitness behaviours in Game of Thrones - Semantic Scholar
Education reviews

Figure 2    Some characters who show adaptability to fight (or not so much) to the finish.

the ‘fight or flight’ response. The second                 either spell continued existence or certain         Jaime Lannister, eldest son of Lord
stage is one where adaptation occurs, and                  death in Game of Thrones. George R R             Tywin, the powerful Lord of Casterly Rock
there is an adjustment and resistance to the               Martin’s world is a brutal survival of the       and patriarch to the House Lannister, is
stressor so that the effect of the stressor is             fittest landscape, where characters have to      generally considered the best swordsman
reduced. If adaptation is insufficient or if               possess keen senses or they are dispatched       and one of the bravest men in the Seven
the stressor is too large, we enter the third              to their deaths. Those characters who            Kingdoms. Due to these skills, he became
stage which is one of exhaustion and cell                  adapt can thrive, but those who fail to          the youngest member of the Kingsguard in
death.                                                     adapt are finished.                              history. While his martial prowess has kept
   A lot of how the bodies of the charac-                     Of course, like any theatre of war and        him alive in many battles throughout West-
ters in Martins’ Game of Thrones respond                   politics, victory requires good luck and the     eros, his murder of the Mad King Aerys
to daily exercise stress, stress response and              support of background teammates. It also         branded him the notorious Kingslayer.
various hormones. Tiny formations at the                   does not hurt to be on the winning side          This has served to further fuel his lethal or
base of your brain called the pituitary and                of magical forces in the Seven Kingdoms          treacherous reputation depending on how
the pineal gland are important in all this.                or across the seas in Essos, Qarth and           one views the act.
So is testosterone and is likely one of the                Dothrak. Nevertheless, many of the very             Gregor Clegane is the elder brother of
hormones that you think of immediately.                    best and most decisive moments in Game           Sandor Clegane (the Hound) and a landed
   Testosterone is a very important medi-                  of Thrones come down to individual char-         knight who serves Lord Tywin Lannister
ator for how the body responds and adapts                  acter actions that follow fight, flight or       on retainer. He is considered the largest
to exercise stress, and levels of circulating              finished consequences. While Game of             man in Westeros and called ‘the Moun-
testosterone are elevated during and                       Thrones features a vast number of these          tain’ based on his enormous bulk and
after exercise. As with growth hormone,                    through its pages and on screen, below           height. This size is also complemented
the effects are largest with more stren-                   we highlight exemplars of each (see              by a ferocity and savagery that has made
uous and prolonged exercise. Central in                    figure 1 and 2).                                 him the most feared individual in the
all of this are the catecholamines—those                                                                    Seven Kingdoms. Gregor is suspected (and
substances like epinephrine—that give us                                                                    observed) in several murders and torture
such a rush and the power to perform in                    Fight                                            throughout the Westerlands. In combat,
fight or flight. They also have the power                  Physical ability and fighting prowess are        his strength gives him a huge advantage
to make us want more and more of them                      generally essential characteristics for          over almost any opponent, able to over-
in our bodies.                                             survival in the ever warring Seven King-         power his enemies with brute force rather
                                                           doms of Westeros and beyond. While               than rely on his skill. The combination of
Fight, flight or finished as it                            Varys ‘The Spider’ and Petyr ‘Littlefinger’      these battle tactics and his fearsome repu-
applies to some ‘Game of Thrones’                          Baelish do show that there are other ways        tation has allowed him to ‘survive’ thus far
characters                                                 to survive in this world with almost no          in Game of Thrones.
While the fight or flight response                         physical ability, skill in combat is a massive      Brienne of Tarth begins the Game of
describes the energy systems provided by                   advantage to survival. Three characters          Thrones series as a Kingsguard of Renly
our nervous and hormone systems, we                        epitomise the use of fighting skills as a        Baratheon after winning a tournament. She
can extend this to an analogy of survival                  means of survival in combat and future           possesses similar attributes to both Gregor
conduct in Westeros. The fight or flight                   intimidation, thus reducing the need to          Clegane and Jaime Lannister in that her
system guides behaviour in ways that                       prove oneself at every possible conflict.        height and size are well above normal,

Rhodes RE, Zehr EP. Br J Sports Med May 2019 Vol 53 No 9                                                                                             577
Education reviews
and she has honed superior martial skills.      within the Seven Kingdoms. This mix of            as when he assumes the role of the Hand
While her service to various families in        qualities has allowed her to survive in the       of the King. Stark is deceived and subse-
Westeros has changed across time, she has       story thus far.                                   quently outplayed by almost everyone at
survived through her fighting prowess,             Tyrion Lannister is the second son of          the King’s court as he—alone—considers
physical stature and good fortune.              Tywin Lannister and younger brother to            duty and justice as one and the same. He
                                                Jaime and Cersei Lannister. He was born           eventually finds himself outmatched in
                                                a dwarf, and his mother died during his           battle and far behind in his understanding
Fight and flight                                birth, which are both sources of persecu-         of the political forces in King’s Landing,
While skill in combat and battlefield           tion and problems. Given the importance           which ultimately results in his death.
bravery are often necessary to survive in       of physicality in the Game of Thrones                Joffrey Baratheon claimed the throne
Westeros, the ability to anticipate conflict    world, his father and others of high and          from his legal father, Robert, but he was
and manoeuvre out of harm’s way proves          low birthrights frequently belittle him.          actually the illegitimate son of Jaime
to be equally important in the Game of          Furthermore, his sister and father blame          and Cersei Lannister. Joffrey repeat-
Thrones. This ‘flight’ behaviour is the hall-   him for the death of his mother. Survival         edly demonstrated poor fight and flight
mark of survival skills for characters who      for Tyrion across the Game of Thrones story       behaviours before and throughout his
know when they are outmatched in phys-          has been from his intelligence and wit. He        troubled reign. Ultimately, he survives
ical prowess at certain points of conflict.     has a gift for determining the motives of         in Game of Thrones as long as he does
Many characters show intellect and              others and using this to his advantage as         simply due to his noble heritage and the
cunning throughout the Game of Thrones          well as his understanding of both sides           assortment of vicious and clever charac-
story, but four popular characters have         to any conflict. Tyrion uses these skills to      ters who seek to retain him on the throne
represented a strong mix of battlefield         manoeuvre out of numerous certain death           for their own ends. In terms of his lack of
bravery and manipulation when survival          situations (eg, death sentences, corruption       fighting bravery, Joffrey is bested by Arya
in on the line.                                 as hand of the king); however, he is also a       Stark early in the story during a swordplay
   Jon Snow is the bastard son of Eddard        brave character who will engage in combat         scuffle and proves no match for leading
Stark, and his illegitimate status makes        when this is the choice for survival and to       the Battle of Blackwater. He showed
him an outsider to the Starks in Winter-        retain a brave reputation (eg, the Battle of      little courage during upheavals in King’s
fell. Based on this status, he chooses to       Blackwater, battle with the Starks).              Landing among the crowds and frequently
join the Night’s Watch. Yet his wealthy            Arya Stark is the youngest daughter of         relied on his Kingsguard to remove him
upbringing, combat training and educa-          Eddard Stark. She represents one of the           from danger. King Joffrey also shows no
tion with the Starks of Winterfell place        best examples of how survival in Game of          sense of when to avoid conflict and abso-
him as an outsider to those of the Night’s      Thrones is based on quick decision making         lutely no mastery of subterfuge or decep-
Watch. Cast as the outsider throughout his      of when to flee from danger and when to           tion. His taunts of his uncle Tyrion, the
life, Jon Snow has had to use his martial       take a stand. Arya begins her story arc as a      torture of Sansa Stark and other members/
skills and his wits to survive across various   feisty child with no interest in diplomacy        guests of the court, as well as the belittling
situations. When taken captive beyond           or leadership but soon finds herself on the       of many common folk were all made in
the wall, Jon has even needed to switch         run after the execution of her father. Using      the open. Although Joffrey succumbs to
allegiance, show humility and engage in         disguise, building strong allies and devel-       a poison that could have dispatched any
subterfuge in order to ensure his survival      oping her fighting skills from the Faceless       monarch, his behaviours ensured that
when he is outmatched. Snow, however,           Man, Arya has become one of the stron-            almost anyone in King’s Landing had
is a strong leader who also understands         gest survivors of the Stark family.               motive to remove Joffrey from the throne.
the importance of conveying bravery
and battle prowess to his followers in the
Night’s Watch. While his mix of fight and       Finished                                          Does watching and reading Game
flight qualities has not always ensured         It would be hard to find a rival for the          of Thrones activate our own
loyalty from all, he has found enough           sheer number of lead characters regularly         fight or flight systems? Mirror,
allies to survive (or at least be revived) in   dispatched in the Game of Thrones. Some           mirror in the brain—can seeing
the story thus far.                             come to an end through bad luck or high           shape thinking?
   Daenerys Targaryen is the child of King      magic, but several characters simply fail at      Back in the early 90s, di Pellegrino and
Aerys II and was smuggled to safety during      fighting or fleeing from various conflicts—       colleagues at the University of Parma, Italy,
the fall of the king’s reign and demise,        they fail at survival. While there are lots       made a chance observation that revolu-
which takes place before Game of Thrones        to choose from, two cases are particularly        tionised neuroscience.2 It had been known
(season 1). Although Daenerys begins the        strong exemplars of the failure to engage         for a long time that neurons (premotor
Game of Thrones story as a naive character,     in the correct flight or fight behaviours.        cortex) in the part of the brain that sends
who is seemingly exploited by her brother,         Eddard ‘Ned’ Stark was the Lord of             inputs to the final output centre for move-
she gradually learns how to become an           Winterfell, and his noble line stretched          ment (motor cortex) were active to tune
effective leader and conqueror as she seeks     back 8000 years in the North of Westeros.         movements. While recording from this
to regain her family’s kingdom. Daenerys        He had proven himself a very capable              part of the brain in macaque monkeys, the
shows a mixture of swift punishment to          warrior and soldier during the Targaryen          Italian researchers discovered that those
usurpers and merciful conquests when            campaign and thus a friend of the eventual        same neurons in the premotor cortex
freeing slave-based cities. She develops a      new King (Robert Baratheon) of Westeros.          active during a monkey’s own movement
strong understanding of how to use diplo-       While his battle prowess and honour kept          were also active during observation of
macy, sexuality or force (including an army     him alive during that campaign, his rigid         another monkey doing the same action!
and three dragons under her command) to         sense of the boundaries between right and            Thus, the concept of the ‘mirror neuron’
obtain and secure her survival beyond and       wrong prove disastrous in King’s Landing          system was born, a name that came from

578                                                                                            Rhodes RE, Zehr EP. Br J Sports Med May 2019 Vol 53 No 9
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the way that a visually observed move-                     students of similar abilities). Still, vicarious   our basic needs for fight or flight from
ment seemed to be reflected in the brain                   experiences are likely to occur through            our living room, we would all be served
representation of the same movement                        popular media with great frequency, and the        well to get out and have some safe adven-
in the one doing the observing. Since                      thrills of brutal adventure shows are likely       tures of our own from time to time.
this discovery, extensive and convincing                   to fulfil certain human needs. Edward Deci
evidence of this ‘mirror neuron’ system                    and Richard Ryan,7 for example, suggest
and related neurons has accumulated in                     that behaviours are performed to fulfil three      Addicted to life in the
many non-human animals. In humans, the                     basic human needs that ultimately create           Middle Ages?
evidence is less direct but very compel-                   passionate motivation and flourishing:             Being alive and staying alive in Martin’s
ling that we also have elements of mirror                  autonomy, competence and relatedness.              landscape means performing at a high
neuron activity in our brains.3                               The need for autonomy refers to the             level on a daily basis. Battles, attacks,
   Here, the relevance of the mirror                       desire to be self-initiating in personal           traps and ambushes are regular occur-
neuron system is that they are activated                   behaviour. This suggests that the freedom          rences. And the rush of dealing with each
by actions regardless of whether you                       to choose our entertainment itself is              and every one, while very stressful, could
are doing something, anticipating doing                    important. Despite our fascination with the        also be very addictive. It has been known
something or watching someone else do                      subject matter, Game of Thrones is not for         for quite some time that our human brains
something. Mirror neurons basically help                   everyone! The need for competence reflects         are ‘wired’ for many addictive behaviours
enable us to predict the consequences of                   a desire to interact effectively within an envi-   that notably include drugs like cocaine,
our own actions. This raises the possibility               ronment. This is likely a critical factor in the   nicotine and alcohol and also activities
that this system might contribute to our                   appeal of vicarious experience in Game of          like exercise.
(in)ability to understand the meaning of                   Thrones as we see heroes vanquish villains            In a way, we really are wired for work
the actions of others.                                     and sit on the edge of our seats as we read        and exactly where in the brain comes from
   Since understanding what others do                      whether Tyrion will escape what seems like         some work on those ubiquitous laboratory
is central to all our social interactions—                 certain death. Finally, the need for related-      mice. Back in 2003, Justin Rhodes, a zool-
and paramount in Game of Thrones—                          ness reflects the fact that individuals want to    ogist at University of Wisconsin-Madison,
this has implications for understanding                    feel connected to others.8 Game of Thrones,        and his colleagues studied two strains of
and communication between individuals.                     at this juncture, represents a cultural event      mice, one that had the ‘normal’ interest
Perhaps this system is extremely highly                    where fans can interact through discussion         in running on a wheel and one that were
functional in those who are success-                       of the material.                                   bred to be extra motivated to run.16 17 He
fully thriving in Game of Thrones (such                       Finally, watching or reading Game of            and his team observed and monitored the
as Tyrion Lancaster) and very poorly                       Thrones may provide a kind of catharsis            two groups for 6 days of exercise bouts
functional in those who were so ineptly                    to activate our flight or fight systems from       and found that the ‘extra motivated’ group
dysfunctional (such as Joffrey Baratheon)?                 the safety of the couch. Catharsis comes           had run about three times the distance of
   Clearly, George R R Martin’s rich                       from the Greek, meaning ‘purification’             the other group.
detail, interesting landscapes and dynamic                 or ‘cleansing’,9 and was originally applied           The interesting thing is what they did
yet tragic characters move viewers and                     to understanding emotional and aesthetic           next—they blocked half of the running
readers on many levels. One possible                       creation through art forms. The term               wheels from working so it then became
mechanism for the appeal is the vicarious                  has now been used in several different             impossible for half the mice in either
experiences Game of Thrones provides.                      streams to describe the experience of deep         group to exercise. They then examined
Albert Bandura, one of the most influ-                     emotion brought on via some other, rather          activity in brain circuits that are related
ential psychologists of the 20th century,                  than authentic, means.                             to ‘reward’ activity in the brain. These are
demonstrated how people can gain much                         There is definitely much debate in              the same reward circuits that are so power-
from observing others.4 5 While personal                   whether media can help abate aggres-               fully activated by opiates like cocaine and
mastery or failure experiences are consid-                 sion or whether it actually contrib-               morphine. These regions are also highly
ered the single most powerful influence                    utes to it.10 11 One thing is for certain,         activated when rodents become addicted
on our thoughts and future actions, vicar-                 however; the vicarious experience of               to opiates and then denied their ‘fix’—
ious experience through watching the                       activating your flight or fight systems            they crave the drug.
actions of others—particularly those we                    from the couch will not have the same                 Basically, the mice could not get the
can make a connection with—is thought                      behavioural health outcomes as acti-               running fix needed to activate the cascades
to be the next most powerful form of                       vating this system in real life. The conse-        of neurohormones in the brain that would
influence. Thus, if we identify with Jon                   quences of sustained sedentary behaviour           activate the reward circuitry. They were
Snow’s aggression as he clashes with wild-                 has been described as ‘the new smoking’            addicted to running but blocked from
lings or Tyrion Lannister’s shame as he is                 in terms of its overall poor health side           doing it. How much this exactly parallels
being insulted by his father, these experi-                effects.12 13 All-cause mortality, cardio-         our human brain circuits remains to be
ences may be very influential on our own                   vascular disease and cancer mortality              fully explored.
thoughts, feelings and actions.                            are 1.2 times more likely among those                 But if you simply flip exercise with
   Bandura’s6 theory is typically not exam-                who engage in prolonged sedentary                  fighting to stay alive or fleeing for your
ined within the context of popular televi-                 behaviour.14 The effects also get a lot            life as happens in Game of Thrones, you
sion or literature. Indeed, much of the work               larger for those who do not engage                 make the argument that everyone in
on the power of vicarious experience is in                 in any moderate to vigorous physical               those times was actually in need of the
health behaviour intervention (eg, exercise                activity as this is associated with over           stress fix to feel ‘normal’. Maybe this is
classes with similar others), psychotherapy                25 chronic conditions and poor mental              why they constantly seek conflict and
(eg, watching a person similar to you handle               health outcomes.15 Overall, this suggests          intrigue—to keep the reward circuitry
a spider) or education (eg, classrooms with                that while Game of Thrones may fulfil              fully functional!

Rhodes RE, Zehr EP. Br J Sports Med May 2019 Vol 53 No 9                                                                                              579
Education reviews
   This also may explain why we love to        Open access This is an open access article                      7 Deci EL, Ryan RM. Intrinsic motivation and self-
read the books and watch the shows so          distributed in accordance with the terms of the                   determination in human behavior. New York: Plenum
                                               Creative Commons Attribution (CC BY 4.0) license,                 Press, 1985.
much. We get a vicarious fix of the stress                                                                     8 Baumeister RF, Leary MR. The need to belong: desire
                                               which permits others to distribute, remix, adapt and
and thrills that happen to the characters      build upon this work, for commercial use, provided                for interpersonal attachments as a fundamental
without the real danger. Whether we are        the original work is properly cited. See: http://​                human motivation. Psychol Bull 1995;117:497–529.
the control mice of Justin Rhodes’ study       creativecommons.​org/​licenses/​by/​4.​0/                       9 Merriam Webster. Merriam-Webster's Encyclopedia of
or the exercise-addicted ones is up to our                                                                       Literature (Internet): Catharsis, 1995.
                                               © Article author(s) (or their employer(s) unless               10 Bushman BJ, Baumeister RF, Stack AD. Catharsis,
own personal history and genetics. But         otherwise stated in the text of the article) 2019. All            aggression, and persuasive influence: self-fulfilling
understanding that the fitness behaviours      rights reserved. No commercial use is permitted unless            or self-defeating prophecies? J Pers Soc Psychol
forced onto the characters in the Game of      otherwise expressly granted.                                      1999;76:367–76.
Thrones are actually still biologically part                                                                  11 Baron RA, Richardson DR. Catharsis: does ‘getting it
of our makeup is an important realisa-                                                                           out of one's system’ really help? Human Aggression:
                                                                                                                 Springer, 2004.
tion. Those same forced fitness behaviours
                                               To cite Rhodes RE, Zehr EP. Br J Sports Med                    12 Healy GN, Dunstan DW, Salmon J, et al. Objectively
that keep our favourite characters from        2019;53:576–580.                                                  measured light-intensity physical activity is
meeting unfortunate early ends could also                                                                        independently associated with 2-h plasma glucose.
                                               Accepted 4 July 2017
be usefully channelled by us to increase       Published Online First 13 September 2017
                                                                                                                 Diabetes Care 2007;30:1384–9.
our own activity time.                                                                                        13 Ford ES, Kohl HW, Mokdad AH, et al. Sedentary
                                               Br J Sports Med 2019;53:576–580.                                  behavior, physical activity, and the metabolic
   So, maybe the next time we rewatch
                                               doi:10.1136/bjsports-2017-098170                                  syndrome among U.S. adults. Obes Res
an episode we might do it from the (dis)                                                                         2005;13:608–14.
comfort of a treadmill or stationary bike.                                                                    14 Biswas A, Oh PI, Faulkner GE, et al. Sedentary time
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