Think about what happens when you suddenly hear a loud noise or someone suddenly jumps out at you as a surprise. What is it that immediately happens? Your hands probably jump to your face as your eyes tightly scrunch up, your shoulders shrug, and the rest of your body assumes a position of universal flexion, kind of like a fetus. This is known as the startle reflex. As a result of evolutionary rewiring, this reflex has been ingrained into our brain, as a means of protecting ourselves from unexpected danger. The main purpose of this reflex is to protect our face, eyes, neck and front of our body which constitute the closest access to vital organs needed for survival. This reflex is controlled by the brain stem which also controls other instinctive processes such as breathing and heart rate. No wonder when startled our heart rate and respiratory rates also increase accordingly. Despite being important for survival, this reflex can also be overactive in certain individuals, causing disruption of daily activities. This is known as hyperekplexia. Though drugs have been shown to be somewhat effective in controlling symptoms, the most effective mode of therapy is through cognitive psychotherapy focusing on decreasing anxiety through exposure.