Finally, at some brute evolutionary level, my anxiety might actually help keep me alive. I am less likely than you bold and heedless people (you fighter pilots and con artists, with your low baseline autonomic arousal) to die in an extreme sporting accident or to provoke a fight that leads to my getting shot.d
In his 1941 essay “The Wound and the Bow,” the literary critic Edmund Wilson writes of the Sophoclean hero Philoctetes, the son of a king, whose suppurating, never-healing snakebite wound on his foot is linked to a gift for unerring accuracy with his bow and arrow—his “malodorous disease” is inseparable from his “superhuman art” for marksmanship.e I have always been drawn to this parable: in it lies, as the novelist Jeanette Winterson put it, “the proximity of wound to gift,” the insight that in weakness and shamefulness is also the potential for transcendence, heroism, or redemption. My anxiety remains an unhealed wound that, at times, holds me back and fills me with shame—but it may also be, at the same time, a source of strength and a bestower of certain blessings.
* * *
* That I even contemplated this, of course, suggests that those decades of therapy with Dr. L. were not terribly effective; my dependencies are now chemical.
† This, by the way, led to a rather complex web of conflicts of interest. On the Sunday in the autumn of 1995 that my mother announced to him she might want a divorce, my father, desperate to save the marriage, stopped drinking completely for the first time in years and, in a gesture that was completely out of character, acquiesced to emergency couples’ counseling. For years before that, my father, despite footing the bill for my sister’s and my shrinks, disdained psychotherapy. “How was your wacko lesson?” he’d ask jeeringly after I’d had an appointment. He did this so often that the term became a part of the family’s lingua franca, and eventually my sister and I were referring without irony to our wacko lessons. (“Mom, can you give me a ride to my wacko lesson on Wednesday?”) In 1995, Dr. L. had recently hung out a shingle—with his new wife, Nurse G.—as a relationship counselor. So my parents began seeing Dr. L. and Nurse G. (who was also a licensed clinical social worker) in intensive couples’ therapy. Which would have been fine except that I—by then in my midtwenties—was still seeing Dr. L. as my principal psychotherapist. So my appointments with Dr. L. started to run something like this:
DR. L.: How are you?
ME: Well, I had kind of a rough week. I had a panic attack when—
DR. L.: How are your parents doing?
ME: What?
DR. L.: Have you talked to your mother or father in the last couple of days? Has your mother said anything about whether she’s still seeing Michael P.?
As it happened, my mother was still seeing Michael P. and in fact would soon be setting up house with him.
Unmoored by my mother’s departure, my father started seeing Dr. L. for psychotherapy on an individual basis. By this point, we might as well have had Dr. L. on family retainer. He had just provided six months of marriage counseling to my parents, was seeing my father at least once a week, and was still seeing me. To make this web of psychopathology even more incestuous, my mother had started seeing Nurse G. on an individual basis.
My own therapy sessions with Dr. L. came to be dominated by his questions about his new star patient, my father. I couldn’t blame Dr. L. for finding my father the more interesting patient. After all, while he’d been seeing me for more than fifteen years, he’d only been seeing my dad for a few months. Being able to talk to my father about his relationship with me, and then to talk to me about my relationship with my father, surely provided an intriguing Rashomon-like fascination for Dr. L. He was seeing my father, his wife was seeing my mother, he and his wife were seeing my mother and father together, and he was seeing me—a kaleidoscopic game of family telephone, with Dr. L. and Nurse G. as the switchboard operators.
My dad entered therapy emotionally wrecked by his separation, profoundly shaken, and drinking heavily. He completed therapy less than two years later, happy, productive, remarried, and deemed (by himself and by Dr. L.) to be much more “self-actualized” and “authentic” than he had been. He was in and out of therapy with Dr. L. in eighteen months. Whereas I was entering my nineteenth year of therapy with Dr. L. and was still as anxious as ever.
A few years ago, my wife asked my father what had happened when he graduated from therapy with Dr. L. Had Dr. L. said anything about me when he did? He had. Dr. L., my father recalled, had told him that I wasn’t anywhere near ready to graduate and that I had “serious issues” I still needed help with.
Which, I suppose, was manifestly the case. But wasn’t one of those issues the fact that my own father—whose stern critical assessments of my life and work over the years had likely contributed to the leakiness of my self-esteem—had, in borrowing my therapist and advancing from temporary basket case to cured in no time at all as I languished in purgatorial neurotic stasis, confirmed yet again my general inferiority and incompetence? When my father graduated, I felt like a schoolchild whose younger sibling has just sped past him in the accelerated class: my father, starting therapy years (decades!) after me, shot through quickly to graduation with honors, while I, trapped in remedial classes, repeated third grade for the nineteenth time.
‡ My father’s anger. Among the darker moments of my childhood was this: One night when I was fourteen, I woke up at three in the morning with one of my bouts of screaming panic. Hearing me cry, my father lost control. He stormed into my room, trailed by my mother, and started hitting me repeatedly, telling me to shut up. This made me cry harder. “You twerp, you pathetic little twerp!” he shouted as he picked me up and threw me. I hit the wall and slid to the floor. As I lay there, racked by sobbing while my father looked down at me, I could see my mother standing impassively in the doorway. I have a predisposition toward feeling lonely even when surrounded by friends and family; in that moment, I felt more lonely than ever before or since. (Here, for confirmation-of-memory purposes, is an entry from my dad’s diary, which he began keeping after my mother left him and which he kindly shared with me a few years ago: “At about age 11, however, Scott began to become very anxious and was particularly phobic about vomiting. He began to manifest some behavioral oddities that Anne detected and which I denied. Anne was right, and, acerbically reviling my psychological blindness, Dr. Sherry [a pediatric psychiatrist] recommended an evaluation at McLean. This process led into Scott’s now extended psychotherapy with Dr. [L.]. The initial rigmarole was terrible, however. Scott got much worse and in particular couldn’t sleep at night. He had to take Thorazine and imipramine. In frustration I often got verbally and even physically abusive.”)
§ This comports with the Bowlby-Ainsworth attachment theory concept of the secure base.
‖ Consider also such nervous invalid intellectuals as David Hume, James Boswell, John Stuart Mill, George Miller Beard, William James, Alice James, Gustave Flaubert, John Ruskin, Herbert Spencer, Edmund Gosse, Michael Faraday, Arnold Toynbee, Charlotte Perkins Gilman, and Virginia Woolf, every single one of whom suffered debilitating nervous prostration early (and sometimes late) in their careers. During young adulthood, David Hume, who would become one of the bright stars of the Scottish Enlightenment, abandoned his studies in the law and entered upon a far more precarious career in philosophy. In the spring of 1729, following a period of intense intellectual exertion, Hume broke down. He felt, as he later wrote in a letter to a doctor documenting his ills, physically exhausted and emotionally distraught; he couldn’t concentrate on the book he was trying to write (which would eventually become the famous Treatise of Human Nature), and he suffered terrible stomach pains, rashes, and heart palpitations that incapacitated him for the better part of five years. Much in the way Darwin later would, Hume sampled the full range of remedies on offer in the hope of finding a cure for what he called his nervous “distemper”: he took water treatments at spas and went for walks and rides in the country; he took the “Course of Bitters and Anti-hysteric Pills”
and “an English Pint of Claret Wine every Day” prescribed by his family’s physician. Writing to another doctor in search of succor, Hume asked “whether among all those Scholars you have been acquainted with you have ever known any affected in this manner? Whether I can ever hope for a Recovery? Whether I must long wait for it? Whether my Recovery will ever be perfect, and my Spirits regain their former Spring and Vigor, so as to endure the Fatigue of deep and abstruse thinking?” In the event, Hume did recover: after he published A Treatise of Human Nature in 1739, he seems not to have suffered further, and he went on to become perhaps the most important philosopher ever to write in English.
The political philosopher John Stuart Mill endured a similar nervous breakdown. In the fall of 1826, when he was twenty years old, Mill experienced a complete emotional collapse, which he would years later recount in the famous fifth chapter, “A Crisis in My Mental History,” of his autobiography. Through the “melancholy winter” of that year, he was, he writes, in an unrelenting state of “depression,” “dejection,” and “dulled nerves.” He found himself so paralyzed by his “irrepressible self-consciousness” that he could scarcely function. (This puts one in mind of the novelist David Foster Wallace, another genius done in by his acute anxiety.) After eighteen months of this unremitting misery, Mill wrote, “a small ray of light broke in upon my gloom” while he was reading the memoirs of a French historian: he needed, he decided, to become less repressed and analytic and to develop his emotional and aesthetic faculties. The arduous education imposed on him by his “grim and exacting” father had, he realized, robbed him of a normal childhood and of an inner emotional life. “The cultivation of the feelings became one of the cardinal points in my ethical and philosophical creed,” he wrote. By becoming more attuned to his emotions (which he cultivated by, for instance, reading the poetry of Wordsworth), he was evidently able to leave anxiety and depression behind.
a Ernest Jones, the original guardian of Freud’s legacy, once claimed that only “uninteresting details” had been excised from the collection of Freud’s letters he published. But among those strategically omitted letters were some 130 to his friend Wilhelm Fliess, many of them consisting of a litany of neurotic, hypochondriacal complaint.
“I have not been free of symptoms for as much as half a day, and my mood and ability to work are really at a low ebb,” Freud wrote Fliess in early May 1894. The omitted letters are full of symptom reports, repeated over and over again. By his own account, Freud suffered migraine headaches, pains all over his body, all kinds of stomach distress, and endless heart palpitations that led him to predict in one letter that he would die in his early fifties of a “ruptured heart.” His (failed) attempts to wean himself from cigar smoking would cause a resurgence of physical symptoms: “I feel aged, sluggish, not healthy.” When his father died in 1896, he reported a seemingly phobic preoccupation with death, what he called his “death delirium.”
This is hardly the image of the stoical, self-assured master of the mind that he sought to project. “It is too distressing for a medical man who spends every hour of the day struggling to gain an understanding of the neuroses not to know whether he is suffering from a justifiable or a hypochondriacal mild depression,” Freud told Fleiss. His letters are replete with melancholic, self-lacerating thoughts: he believes that he will die in obscurity, that his work is “rubbish,” that all his labors will amount to nothing. At times, it seems he cannot possibly survive, let alone thrive, in the field he has chosen. “I have been through some kind of neurotic experience,” he wrote on June 22, 1897, plagued by “twilight thoughts, veiled doubts, with barely a ray of light here or there.”
“I still do not know what has been happening to me,” he noted a couple of weeks later. “Something from the deepest depths of my own neurosis set itself against any advance in the understanding of the neuroses.”
In August 1897, Freud wrote to Fliess from Bad Aussee, Austria, where he was vacationing with his family. Freud was not happy: he was “in a period of bad humor” and “tormented by grave doubts about my theory of the neuroses.” His vacation was doing nothing toward “diminishing the agitation in my head and feelings.” Despite his growing practice, Freud wrote, “the chief patient I am preoccupied with is myself.” The following summer, on another vacation, he reported unhappily that his work was progressing poorly and that he was bereft of motivation. “The secret of this restlessness is hysteria,” he concluded remarkably, assigning to himself the affliction that he had staked his career on curing.
b “Anxiety is an important component of motivated cognition, essential for efficient functioning in situations that require caution, self-discipline and the general anticipation of threat,” the researchers wrote.
c The Air Force reportedly has the highest divorce rate in the U. S. armed services, and nine out of ten fighter-pilot divorces are initiated by wives.
d On the other hand, I’m more likely to die prematurely from some stress-related disease.
e Wilson’s essay is about how art and psychological suffering are linked in writers like Sophocles, Charles Dickens, Ernest Hemingway, James Joyce, and Edith Wharton.
CHAPTER 12
Resilience
Anxiety cannot be avoided, but it can be reduced. The problem of the management of anxiety is that of reducing anxiety to normal levels, and then to use this normal anxiety as stimulation to increase one’s awareness, vigilance, zest for living.
—ROLLO MAY, The Meaning of Anxiety (1950)
The essayist, poet, and lexicographer Samuel Johnson was, famously, a melancholic intellectual in the classic mode, suffering badly from what Robert Burton called the “Disease of the learned.” In 1729, when he was twenty years old, Johnson found himself “overwhelmed with an horrible hypochondria, with perpetual irritation, fretfulness, and impatience; and with a dejection, gloom, and despair, which made existence misery,” as James Boswell reported in his Life of Samuel Johnson. “From this dismal malady he never afterwards was perfectly relieved.” (“That it was, in some degree, occasioned by a defect in his nervous system appears highly probable,” Boswell surmised.) It was, as another biographer records, “an appalling state of mind, in which feelings of intense anxiety alternated with feelings of utter hopelessness.” Many contemporaries noted Johnson’s strange tics and twitches, which suggests he may have had OCD. He also seemed to have what would today be called agoraphobia. (He once wrote to the local magistrate asking to be excused from jury duty because “he came very near fainting … in all public places.”) Johnson himself refers to his “morbid melancholy” and was ever worried that his dejection would tip over into full-blown madness. In addition to dipping regularly into Burton’s Anatomy of Melancholy, Johnson read widely in both classic and contemporary medical texts.
Desperate to hold on to his sanity, Johnson—like Burton before him—seized on the idea that idleness and slothful habits were breeding grounds for anxiety and madness and that the best way to combat them was with steady occupation and regular habits, such as rising at the same time early each morning. “Imagination,” he would say, “never takes such firm possession of the mind, as when it is found empty and unoccupied.” So he was always at pains to occupy himself and to try to impose a regimen on his daily habits. What most endears Johnson to me is his lifelong, and plainly futile, attempts to start getting up earlier in the morning. A representative sampling from his journals:
September 7, 1738: “O Lord, enable me … in redeeming the time which I have spent in Sloth.”
January 1, 1753: “To rise early To lose no time.”
July 13, 1755: “I will once more form a scheme of life … (1) to rise early.”
Easter Eve 1757: “Almighty God … Enable me to shake off sloth.”
Easter Day 1759: “Give me thy Grace to break the chain of evil custom. Enable me to shake off idleness and Sloth.”
September 18, 1760: “Resolved … To rise early … To oppose laziness.”
April 21, 1764: “
My purpose is from this time (1) To reject … idle thoughts. To provide some useful amusement for leisure time. (2) To avoid Idleness. To rise early.”
The next day (3:00 a.m.): “Deliver me from the distresses of vain terrour … Against loose thoughts and idleness.”
September 18, 1764: “I resolve to rise early, Not later than six if I can.”
Easter Sunday 1765: “I resolve to rise at eight … I purpose to rise at eight because though I shall not yet rise early it will be much earlier than I now rise, for I often lye till two.”
January 1, 1769: “I am not yet in a state to form many resolutions; I purpose and hope to rise … at eight, and by degrees at six.”
January 1, 1774 (2:00 a.m.): “To rise at eight … The chief cause of my deficiency has been a life immethodical and unsettled, which breaks all purposes … and perhaps leaves too much leisure to imagination.”
Good Friday 1775: “When I look back upon resoluti[ons] of improvement and amendments, which have year after year been broken … why do I yet try to resolve again? I try because Reformation is necessary and despair is criminal … My purpose is from Easter day to rise early, not later than eight.”
January 2, 1781: “I will not despair.… My hope is (1) to rise at eight, or sooner.… (5) to avoid idleness.”
Johnson never was able to sustain his early rising, and he spent many nights working until nearly dawn or roaming the streets of London tormented by his fears and phobias.*
My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind Page 40