Psychology

Let’s Roll

We foresee great peril if governments and societies do not take action now to render nuclear weapons obsolete and to prevent further climate change.
–stephen hawking, physicist and member of the atomic bulletin’s board of sponsors, 2007

I awoke morning after morning with a horrible dread at the pit of my stomach, and with a sense of the insecurity of life that I never knew ­before . . .
–william james, 1902

Given my druthers, I would prefer not to be afraid of the following: phone bills, ovarian cancer, black bears, climate change, walking on golf courses at night, being blundered into by winged insects; unseemly heights, running out of gas, having the mole on my back that I can feel, but not see, secretly morph into a malignant melanoma. Plus, flying. This is a big problem. Also, on occasion, the prospect that the supervolcano underlying Yosemite National Park will erupt and kill us all. Certainly, in addition, unexpected liver failure. And cows. Also, but only occasionally, when I’m really over the edge with anxiety, the fear that the car I’m driving will simply explode.

It is not that these fears aren’t inherently valid, because maybe they are. One must be vigilant. One must struggle continuously with the validity of one’s fears. Yet they vex me because of what I do not fear: crime, bats, ­house fires, social censure, terrorism, breast cancer, trans fats, and any harm coming to my two small children.

“Do I contradict myself? Very well then, I contradict myself,” wrote Walt Whitman, that great American poet who was phobic of spiders. Apparently, I share this odd proclivity for contradiction with forty million adult Americans in any given year. That is an astonishing number. Nearly 20 percent of the adult inhabitants of the Land of the Brave are as anxious as I am, in one way or another, to a clinically significant degree. Phobic, some of them; others, prone to panic attacks; generalized anxiety, which is my label; somatic hysteria, ­post-­traumatic stress disorder, obsessive compulsive ­disorder–an array of thorny cloaks to wear.

I like to imagine ­them–these forty million kindred ner­vous ­souls–experiencing the same juddering sense of alarm that I felt in January 2006 when I noticed that the U.S. Department of Health and Human Ser­vices had issued a bulletin about pandemic influenza. The warning went out via a newly dedicated Web site, pandemicflu.gov, advising the citizenry in all states to stockpile six to eight weeks’ worth of food and water . . . like, nowish.

“But why?” I wondered, with detectable palpitations of the heart. “What’s about to happen?” A Google search suggested terrible things. Vast amounts of suffering and death. Rasping, ­blue-­in-­the-­face plague along the lines of the Great Influenza of 1918. A brand new pandemic that would kill pretty much everyone in the prime of their lives more or less shortly (it ­wasn’t precisely clear when). In the winter of 2006, the virus was still busy trying to figure out how to mutate in order to infect humans more swiftly than birds, but then . . . well. That’s it. You understand? Calamity.

Therefore, proclaimed pandemicflu.gov, which I had stumbled across from a random link on the Drudge Report, you really, really need to stock cans of tuna and Evian water in the basement, because at the appointed time, the clerk at the 7-­Eleven will drop dead and no one will sell you your food.

How do I, and forty million Americans, put this? When you suffer from anxiety, which has been very aptly described as fear in search of a cause, you do not need official encouragement. Go away with your stockpile advisory, because ­here is what it is going to make me do:

“Patricia?” ventured my husband about a month later, having signed for a postal delivery at our door. “Are you all right?”

“Why?” I called down distractedly from my ­third-­floor home office.

“Well,” he said, coming upstairs, his ­even-­tempered voice growing louder with each step, “last week a box with twelve containers of ­freeze-­dried vegetables arrived at the ­house from a company called Survival Acres, and I meant to ask you about it, you know, but I forgot, and now you seem to have purchased a really big tin of powdered butter.”

He darkened the threshold of my office, displaying the newly delivered package. “It says you need to add ­twenty-­seven cups of water.” My dear husband eyed me thoughtfully, poised somewhere between bursting out laughing and giving me a hug.

It is always thus. I catch him off guard. Ask anyone who suffers from what John Keats called “wakeful anguish,” and they will assure you that their affliction isn’t visible to the naked eye. The chronically anxious aren’t physically timid, or cringing. We don’t quake in our boots or whimper aloud as we board airplanes. In folklore and anecdote, the anxious have been conflated with the immature and emotionally uninhibited as “ner­vous Nellies,” but the perception is a prejudice. Our fears are private, arbitrary, idiosyncratic, and very often masked. Anxiety rages undetected in the mind, both secretive and wild.

Friends and acquaintances, children, even lovers can be fooled. Who knew that Charles Darwin was struggling to suppress a rising sense of panic in his later years? Who glimpsed the dread felt by Alfred Lord Tennyson, or by W. B. Yeats? Is a ­face-­clutching terror evident in the bold joy of Aretha Franklin as she sings, or in the elegant play of David Beckham? Yet both contend all the time with a fraught sense of balancing on the cliff’s edge. I know of one CEO who gets paralyzed with terror whenever he enters a tunnel, but I doubt his business associates have noticed this when they’ve driven together in a limo from LaGuardia beneath the East River and into Manhattan. Another accomplished professional of my acquaintance spends her downtime silently making contingency plans for the tornado she’s certain will hit her ­house in Montreal. One friend is a gregarious charmer, a man who soars at his job in Chicago, all the while governed by his phobia that something will snap off his toes.

You ­can’t claim to spot an anxious person a mile away. The signals aren’t that strong. Anxious people don’t even recognize one another. Apprehension runs through us like an underground current; it electrifies when no one is watching.

By March 2006, the government of New Zealand had embarked upon a ­house-­by-­house mailing to all of its nationals, asking them to think seriously about an imminent outbreak of death and pestilence. I knew this because, rather than contend with the financial issues that ­were actually causing my anxiety, I had become a daily visitor to a Web site called Flu Wiki. ­Here could be found a great milling together of fiercely articulate and ­freaked-­out people from around the world, posting to discussion topics like “What Will We Do with the Bodies?” It was like an informal or unacknowledged meeting space for Neurotics Anonymous. The conversations ranged widely, from scientific discourses on virus mutation to historic analysis of pandemics, to tips for home fuel ­storage–on the presumption that ­self-­quarantine would be the only effective protection from contracting the virus.

“I’ve washed my hands so much this week they’re bleeding,” a Texan mother of seven posted to the Flu Wiki one eve­ning. She was ­self-­reliant and in control. She had already bought birthday and Christmas presents for her youngsters so that they would enjoy all their rituals while in quarantine. She had thought of every possibility. For anxiety is engaged in endless subsets of “what if?” and “if then.” The essence of the condition is an intolerance of uncertainty. A need, as the psychologist Maria Miceli has said, “for absolute predictive control.” The mother from Texas was a frequent poster to the site, and seemed to function as a maternal figure for the others. She confessed to being exhausted. I might have suggested that she had a touch of Obsessive Compulsive Disorder, what with washing her hands until they bled, but any post that implied that the community was ­disordered–and such posts appeared now and ­then–was swiftly batted away by a chorus of boos.

I read “Cooking with Canned Goods Only” with interest, feeling a certain nostalgia for pioneer days as depicted in Little ­House on the Prairie, when fears ­were succinct and clear and Pa had a gun. But I didn’t warm to the more jangly ­post-­apocalyptic topic “How to Prevent Home Invasions,” which was based on the notion that people who had failed to prepare for the pandemic would begin searching desperately and aggressively for food. All 262 suggestions on this classic American thread ­were inventive in an earnest, homemade kind of way, as if Martha Stewart had developed a psychosis and put out a special issue of her magazine: crafts and cupcakes for The Followed. “Roll up towels ­etc. and tie them all up in plastic bags to look like the shape of a dead body and put skunk oil on it,” one poster suggested. “Maybe lay the ‘dead body’ on pavement, or somewhere, so that the ‘blood’ that seems to be seeping from it is noticed.”

Lest anyone on Flu Wiki begin to wonder if we ­were paying “selective attention to threat,” as researchers say those of us with anxiety are prone to do, one could always find a supportive quotation from bird flu experts. According to the epidemiologist Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, for example, if the pandemic hit that winter, “I don’t know what we could do about it except say, ‘We’re screwed.’”

Of course. But ­we’re screwed anyway. As I write this in the winter of 2007, scientists in London have just moved the hand on their Doomsday Clock one minute closer to midnight in order to symbolize the approach of civilization’s end. I’m not sure what they want me to do in response to this dramatic ceremonial gesture, other than sigh deeply and lie down. Cover myself with crumbled autumnal leaves, ­perhaps, as I once witnessed an injured squirrel do in my backyard on a ­bone-­damp November morning, remarkably effacing itself.

At least, in prepping for a flu pandemic, I can store tins of butter and plot my family’s flight from an urban center. What exactly am I supposed to do about “civilization’s end”? The scientists who operate the Doomsday Clock are practicing a ­self-­defeating rhetoric that actually appeals more to the depressed than to the anxious. Anxiety distinguishes itself from depression by expressing a grim and slender hope that one will manage to prevail. The depressed drop their briefcases, sink to their knees, and say “fuck it.” The anxious pick and choose between the many vague, ­world-­ending scenarios offered to them these days and seek out the ones they can plan around. To respond to the Doomsday Clock requires tracking down shadowy figures in international arms dealing in remote corners of central Asia and somehow preventing them from selling nuclear weapons or ­else the world will end; the threat of bird flu calls for a ­whole bunch of shopping at Target.

There are several ways to cope with dread, but I specialize in what psychologist Maria Miceli calls “hypothetical analytical planning.” This is where you lie in bed at night and run through as many prospective scenarios as you can imagine and then rehearse them in French, or from the vantage point of a cat. “One’s power over events is closely dependent on one’s power to foresee,” Miceli notes, “because if I cannot foresee, I cannot act.” In order to be able to take the preventive actions required, I have to proceed in the laborious and demanding task of formulating the various hypotheses about the possible courses that events could take. And since those courses are pretty much infinite, the anxiety is never solved and simply deepens, like grooves being laid down in vinyl.

What if I ­can’t fit
The powdered butter and dehydrated dinners
Into my Mazda? Along with the dogs and children?
Will we stay ­here? In the basement?
If the dogs need to go out, how will they come back in
Without bringing the virus into the home on their feet?
They might
Step in avian feces.
Shall I purchase booties?

In these times we speak a great deal about fear: the politics of fear, the culture of fear, the “gift” of fear, the fear of fear. But fear and anxiety are vitally different experiences, and it is actually anxiety that characterizes our age. Fear is invoked by immediate threat, and galvanizes a response. A bear chases you: you run away. A car hurtles out of control: you leap off the road. Terrorists hijack your flight and aim it at Washington: you say, “Let’s roll.”

“Fear sharpens the senses,” observed the German psychiatrist Kurt Goldstein, “anxiety paralyzes them.”

We perceive these two responses as if they marked a difference in character, but it’s really a difference in plight. It isn’t that there are some people prone to paralytic anxiety and others prone to clarifying courage. On the contrary. Recent MRI research has demonstrated that the same people who suffer from anxiety disorders have a totally normal ­response–in how the part of the brain known as the amygdala lights up when ­cued–to real danger. In other words, on United 93, the neurotics would have been right up there with everyone ­else in responding briskly and bravely to the clear and present threat.

The signature vexation of anxiety is that it is objectless. It washes over one in formless waves, pulls one under until the pressure and constriction are tangible and panic rears: I’m in deep, I’m going to drown. What is so incredibly harrowing, as the psychoanalyst Karen Horney once noted, is “the feeling of diffuseness and uncertainty, and the experience of helplessness toward the threat.”

From the Hardcover edition.