My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind

by Scott Stossel

  In the ensuing decades, hundreds of other animal experiments have supported these findings. Robert Hinde, an ethologist at Cambridge University, showed that when infant monkeys were separated from their mothers for only a few days, they were still more timid than control monkeys when placed in a novel situation five months later. A subsequent paper by Harry Harlow observed that certain key maternal styles—such as “near total acceptance of her infant (the infant can do no wrong)” and close supervision of the infant’s “beginning sallies beyond her arm’s reach”—were predictive of well-adjusted adult monkeys. Recent studies of rhesus monkeys have found that the “initiation of ventral contact” (or hugging, in plain English) reduces sympathetic nervous system arousal; those monkeys that received fewer hugs from their mothers were less likely to explore the environment—and were more likely to display anxious or depressive behavior as adults. In other words, when monkey mothers coddled and protected their babies, those babies grew up healthy and happy—which is precisely what Mary Ainsworth noted in her meticulous long-term observations of mother-infant interactions among humans.

  Remember when you are tempted to pet your child that mother love is a dangerous instrument.

  —JOHN WATSON, Psychological Care of Infant and Child (1928)

  The experiments of Harlow, Hinde, and their contemporaries had been fairly crude; the separations they forced were severe, and the situations they set up were not analogous to real life. But in 1984, a group of researchers at Columbia University devised a way of approximating more closely the range of separation and attachment behaviors that occur in the wild.

  The idea behind the variable foraging demand (VFD) paradigm, as the researchers called it, was that changing the availability of the mother’s food supply could produce changes in the way she interacted with her offspring. (Primatologists already knew this from extensive observations in the wild.) In what have become known as VFD experiments, researchers manipulate how easy or hard it is for monkey mothers to get food: during low-foraging-demand periods, food is left freely exposed in containers strewn around the primates’ enclosure; during high-foraging-demand periods, food is more difficult to get, buried in wood chips or hidden under sawdust. In a typical VFD experiment, a two-week period during which food is easy to find is followed by a two-week period when it’s hard to find.

  Unsurprisingly, the mothers are more stressed, and less available to tend to their offspring, during high-foraging-demand periods than they are during low-foraging-demand periods. Bonnet macaques whose mothers are subjected to extended high-foraging-demand periods have, on average, more social and physical problems growing up. But episodes of variable foraging demand turn out to be even more stressful than extended high-foraging-demand periods—that is, the mothers are more stressed when food is unpredictably unavailable than when it is consistently hard to find.

  Jeremy Coplan, the director of neuropsychopharmacology at State University of New York Downstate Medical Center, has been conducting VFD experiments for fifteen years. He says that these experiments appear to induce a “functional emotional separation” between mother and infant. The stressed mother becomes “psychologically unavailable” to her infant, in the way that a stressed-out human mother (like Amalia Freud) might become distracted and inattentive to her children.

  The shifts in behavior might appear subtle—the stressed mothers still respond to the babies, they just tend to do so more slowly and less effectively than the unstressed mothers—but the effects can be potent. In a series of experiments, Coplan and his colleagues found that the children of the VFD mothers had higher levels of stress hormones in their blood than the children of the non-VFD mothers—an indication that the mother’s anxiety was being transmitted to the child. The remarkable thing was the duration of the correlation between the mother’s anxiety and the child’s stress hormones: when Coplan examined those original VFD children ten years after the first experiment, their levels of stress hormones were still higher than those of a control group. When they were injected with anxiety-provoking chemicals, their responses were hyperreactive compared with other monkeys’. Evidently, these VFD monkeys had become permanently more anxious: they were less social, more withdrawing, and more likely to display subordinate behavior; they also showed an elevated level of autonomic nervous system activity and a compromised immune response. Here was powerful physiological evidence of what Bowlby had argued half a century earlier: early child-rearing experiences—not just the obviously traumatic ones but subtle ones—have psychological and physical effects on the well-being of the child that persist even into adulthood. Coplan’s team concluded that even brief disruptions in the mother-child relationship can alter the development of neural systems “central to the expression of adult anxiety disorders.”l

  Versions of this experiment repeated many times over the last twenty years have continually found similar results: brief periods of childhood stress, and even mild strains on the mother-child relationship, can have lasting consequences on a primate’s neurochemistry.m There’s even some evidence that the grandchildren of the VFD mothers will have elevated cortisol levels from birth, as the effects of those brief early weeks of mild stress get transmitted from generation to generation.

  Researchers have found analogous evidence in the descendants of trauma victims: the children and even grandchildren of Holocaust survivors exhibit greater psychophysiological evidence of stress and anxious arousal—such as elevated levels of various stress hormones—than do ethnically similar children and grandchildren of cohorts who were not exposed to the Holocaust. When these grandchildren are shown stressful images having nothing directly to do with the Holocaust—for instance, of violence in Somalia—they display more extreme responses, both in behavior and physiology, than do their peers. As John Livingstone, a psychiatrist who specializes in treating trauma victims, told me, “It’s as though traumatic experiences get plastered into the tissues of the body and passed along to the next generation.”

  By now scores of studies support the idea that the quantity and quality of a mother’s affection toward her children has a potent effect on the level of anxiety those children will experience later in life. A recent study published in the Journal of Epidemiology and Community Health followed 462 babies from their birth in the early 1960s in Providence, Rhode Island, through their midthirties. When the study subjects were infants, researchers observed their interactions with their mothers and rated the mothers’ level of affection on a scale ranging from “negative” to “extravagant.” (Most mothers—85 percent of them—were rated “warm,” or normal.) When psychologists interviewed the study subjects thirty-four years later, those whose mothers had shown affection that was “extravagant” or “caressing” (the second highest level) were less likely to be anxious or to experience psychosomatic symptoms than their peers.

  This would seem to suggest that John Bowlby was right—that if you want to raise a well-adjusted, nonanxious child, the best approach is not the one prescribed by the ur-behaviorist John Watson, who once averred, “Remember when you are tempted to pet your child that mother love is a dangerous instrument.” In his famous 1928 book on child rearing, Watson warned that a mother’s affection could have dangerous effects on a child’s developing character. “Never hug and kiss them, never let them sit in your lap,” he wrote. “If you must, kiss them once on the forehead when they say good night. Shake hands with them in the morning. Give them a pat on the head if they have made an extraordinarily good job of a difficult task.” Treat children, in other words, “as though they were young adults.” Bowlby, who had himself been treated that way as a boy, believed more or less the opposite: if you want to instill a secure base in the child and a resistance to anxiety and depression, be unstinting in the provision of love and affection.

  By 1973, when he published his classic Separation: Anxiety and Anger, Bowlby was convinced that almost all forms of clinical anxiety in adultsn could be traced to difficult early-childhood experiences with the pr
imary attachment figure—almost always the mother. Recent research continues to add to the substantial pile of evidence supporting this idea. In 2006, new results from the forty-year longitudinal Minnesota Study of Risk and Adaptation from Birth to Adulthood found that infants with insecure attachments were significantly more likely than infants with secure or avoidant attachments to develop anxiety disorders as adolescents. Insecure attachment in infancy leads to fears of abandonment in later childhood and adulthood and gives rise to a coping strategy based on “chronic vigilance”—those babies who anxiously scan the environment to monitor the presence of their erratically available mothers tend to become adults who are forever anxiously scanning the environment for possible threats.

  Bowlby’s attachment theory has an elegant simplicity and a plausible, easily understood evolutionary basis. If your parents provided a secure base when you were an infant and you were able to internalize it, then you will be more likely to go through life with a sense of safety and psychological security. If your parents failed to provide one, or if they did provide one but it was disrupted by trauma or separation, then you are more likely to endure a life of anxiety and discontent.

  They fuck you up, your mum and dad.

  They may not mean to, but they do.

  —from PHILIP LARKIN, “THIS BE THE VERSE” (1971)

  I recently came across a diary that I kept briefly in the summer of 1981, when I was eleven years old. Some months earlier I had started seeing the child psychiatrist who would treat me for twenty-five years, Dr. L., who was trained as a Freudian. At his instigation, I was using the diary to free-associate in pursuit of the root cause of my emotional problems. I must say it was somewhat dispiriting for my early middle-aged self to discover my eleven-year-old self already so anxious and self-absorbed, wondering on the pages of the journal which source bore greater responsibility for my abiding anxiety and discontent: Was it the tyrannical camp counselor who had, when I was six, yelled at me and sent me—alone among the merry campers of the Sachem tribe at the Belmont Day Camp—to the baby pool because I was shaking and crying, afraid to get into the big pool on my own? Or was it the neighbor who had, when I was four, slapped me in the face in front of all my preschool peers when I broke down into hysterical sobs at the birthday party for her son Gilbert because I was scared and wanted my mommy?

  Evidently, my narcissism and quest for self-knowledge are endlessly recursive: I dig back into the past at age forty-three, seeking the roots of my anxiety, and discover … myself, at age eleven, digging back into the past, seeking the roots of my anxiety.

  We had just returned from a family vacation, and much of the diary is an enumeration of the fears and perceived injustices I had endured on the trip.

  1. Afraid of motion sickness on plane.

  2. 1st night homesickness, can’t sleep.

  3. Don’t like the food.

  4. Restaurant: mummy getting mad and not talking to me because I complained about wanting to go home.

  5. Afraid of unsanitariness.

  6. Afraid thin air in mountains will make me sick.

  7. Daddy forcing me to eat. Getting mad when I eat and not letting me eat when I complain …

  8. Dad not listening to me, and hitting me when I persisted in asking.

  9. I was really scared and upset when I saw what may have been throw up on the rug downstairs. I felt awful and scared.

  10. On the plane ride back, person throws up. I am terrified. Feel sad, depressed, and scared.

  The trip diary ends: “I just feel like hiding my head and being hugged and loved by my mummy and daddy but they are not sympathetic about my fear at all.”

  Not long ago, I e-mailed my mother a transcription of the diary and then called to ask if she thought that she had expressed more or less affection for my sister and me than her peers had for their children.

  “About the same,” she said. Then she thought for a moment. “Actually,” she said, “I consciously withheld affection.”

  Stunned, I asked her why.

  “I thought it was for your own good,” she said, and went on to explain.

  Her own mother, my grandmother Elaine Hanford, had expressed ample affection for my mother and her sister and had always been present for them, physically and otherwise. Elaine built her life around catering to her daughters’ needs. Every day when my mother came home from elementary school for lunch, Elaine was there to make it for her. My mother felt loved and cared for—and coddled. And so when she started to struggle with panic attacks and agoraphobia and emetophobia and other phobias as a young adult, she wondered if maybe her anxiety was so intense because she had felt too loved and safe in her mother’s abundant care. So in an effort to spare my sister and me the anxiety she endured, she denied us the outward expressions of unconditional love she had received.

  John Watson would have approved.

  But while my mother spared us affection, she didn’t spare us overprotection. Overprotection and withheld affection can be a pernicious combination. It can lead to feeling not only unloved (because you’re not receiving affection) but also incompetent and helpless (because someone’s doing everything for you and assuming you can’t do it yourself).

  My mother physically dressed me until I was nine or ten years old; after that, she picked out my clothes for me every night until I was fifteen. She ran my baths for me until I was in high school. By middle school, many of my friends were taking public transportation to downtown Boston to hang out, staying home alone during school vacations while their parents were at work, and shopping for (and buying and riding) motorbikes. Even if I had been inclined to take the subway to Boston or to ride motorbikes—and, believe me, I wasn’t—I wouldn’t have been allowed to: I wasn’t permitted to walk more than a few streets away from our suburban neighborhood because there were streets my mother deemed too busy to cross and neighborhoods she deemed too dangerous to traverse. (This in a sleepy commuter suburb where a violent crime was a once-in-a-decade affair.) Anytime my sister and I were home while my parents were at work, we had the company of a babysitter. By the time I was a young teenager, this was getting a bit weird—as I realized one day when I discovered, to our mutual discomfort, that the babysitter was my age (thirteen).

  My mother did all this out of genuine anxious concern. And I welcomed the excess of solicitude: it kept me swaddled in a comforting dependency. As embarrassing as it was to be told in front of my peers that I couldn’t walk downtown with them unless my mother came with us, I didn’t want her to relinquish her protective embrace. The dyad between mother and child implicates the behavior of each—I craved overprotection; she offered it. But our relationship deprived me of autonomy or a sense of self-efficacy, and so I was a clingy and dependent elementary school student, and then a clingy and dependent teenager, and I then grew up to be—as my long-suffering wife will tell you—a dependent and anxious adult.

  “Adults with agoraphobia are more likely to rate their parents as low on affection and high on overprotection.” (That’s from a 2008 paper, “Attachment and Psychopathology in Adulthood.”) “Adults with agoraphobia report more childhood separation anxiety than a control group.” (A 1985 study published in The American Journal of Psychiatry.) “[Infants with insecure] attachments [are] significantly more likely than infants with secure attachments to be diagnosed with anxiety disorders.” (A 1997 study published in the Journal of the American Academy of Child and Adolescent Psychiatry.) “Your parents—anxious, overprotective mother and alcoholic, emotionally absent father—were a classically anxiety-producing combination.” (That’s from my first psychiatrist, Dr. L., whom I recently tracked down and interviewed, nearly thirty years after my first appointments with him.) And then there’s the neurobiological evidence for all this: “Human adults who reported extremely low-quality relationships with their parents evidenced significantly more release of dopamine in the ventral striatum [a portion of subcortical material deep in the forebrain] and a higher increase in salivary cortisol [a s
tress hormone] during a stressful event than individuals who reported extremely high-quality parental relations. Such an effect suggests that early human caregiving may similarly affect the development of systems that underlie stress reactivity.” (A 2006 study published in Psychological Science.) As I write this, I have in my office a stack of articles nearly two feet high reinforcing these and related findings. Which proves that my anxiety is largely a function of my childhood relationship with my mother.

  Except, of course, that it doesn’t prove anything of the sort.

  * * *

  * The strong predictive association between a childhood fear of dogs and adult dysfunction might mean that a dog phobia somehow causes later social phobia, depression, or drug addiction. Or it might mean that a childhood fear of dogs and adult depression tend to be produced by the same kinds of environmental circumstances—an impoverished inner-city childhood, say, where dangerous pit bulls are a real threat and where early trauma or deprivation can lay the neural groundwork for later depression. Or it might mean that a fear of dogs and adult depression or drug addiction are different behavioral markers of a shared genetic underpinning—the same genetic coding that predisposes you to fear dogs might also predispose you to depression. Or, finally, maybe a childhood fear of dogs is actually the very same thing as adult panic disorder or depression. That is, it might be that childhood phobia and adult depression are the same disease, unfolding over the life cycle through different developmental stages, each stage expressing different symptoms. As I’ve noted, specific phobias tend to appear early in life—half of all people who will ever have a phobia in their lives first develop it between the ages of six and sixteen—so perhaps a dog phobia is simply the first symptom of a broader disorder, the way a sore throat can augur the onset of a cold.