July 6, 2011 § 45 Comments
“…if you are not like everybody else, then you are abnormal, if you are abnormal , then you are sick. These three categories, not being like everybody else, not being normal and being sick are in fact very different but have been reduced to the same thing.” Michel Foucault
Perhaps you noticed it, too. The word ‘anxiety’ appearing more and more in conversation, ads and media. People talking, not about ‘being anxious,’ (a moment that can pass) but about ‘having anxiety’ (a permanent affliction).
In “The Age of Anxiety,” a poem written in 1947, W.H. Auden links modern angst with man’s quest to find substance and identity in a shifting and increasingly industrialized world: …It is getting late / Shall we ever be asked for? Are we simply / not wanted at all?
Writer-philosopher Albert Camus dubbed the 20th century “The Century of Fear.” One wonders what he would say about the 21st.
Writer Herman Hesse, exploring the age of angst in his novel Steppenwolf, attributes the feelings of isolation and loneliness in his protagonist to the breakdown of repressive bourgeoisie values, which let loose the wild, irrational forces within man without offering a new standard or value system for support, thereby creating an uneasy limbo, lacking guidance and direction.
Though the subject has been explored for centuries by writers and philosophers, social anxiety disorder did not officially exist until it appeared in 1980’s Diagnostic and Statistical Manual, the DSM-III — the psychiatrist’s bible of psychological afflictions — under the name “social phobia,” the same book which once classified homosexuality as a mental disorder.
Not that the problem didn’t exist before — it was the ancient Greeks, after all, who coined the word agoraphobic — but during the latter half of the 20th century, anxiety seems to have shifted culturally from a covert issue to an overt one.
By the 1990’s pharmaceutical companies received F.D.A. approval to treat social anxiety and poured tens of millions of dollars into advertising its existence. In 2002, Anxiety Disorders Association of America reported that 19.1 million (or 13%) of adults ages 18-54 were affected with a form of anxiety disorder. Now the percentage has climbed to 40 million (or 18%) of the population.
The current version of the DSM-IV describes diagnosis as warranted when anxiety “interferes significantly with work performance” (italics mine) or if the sufferer shows marked distress about it.
So in other words, according to the DSM, if you can’t adjust to your life as an employee, you may have a disorder. If it affects your productivity within the system, that’s the true indicator of a problem.
Of course, this makes sense on an individual basis — why wouldn’t job performance be an issue for individual workers? We all have bills to pay.
But on a broader level, from the perspective of analyzing cultural trends and messages, it strikes me as eerily dystopian that humans should be viewed like malfunctioning robots who need repair because their efficiency has faltered, rather then looking into possible problems with the work places themselves (environment, demands, etc).
Not “Maybe we need more breaks to maximize efficiency,” but “Maybe you have a problem. Take a pill and get back to work.”
There is a lack of humanity in the description, an emphasis on product over person.
Before having the medical meaning we give it, or that at least we like to suppose it has, confinement [of the insane] was required by something quite different from any concern with curing the sick. What made it necessary was an imperative of labor. Our philanthropy prefers to recognize the signs of a benevolence towards sickness where there is only a condemnation of idleness.
I want to be clear that I am not criticizing individuals for taking anxiety medication. I am not telling anyone to stop taking their medication or saying it’s weak or wrong to do so. It’s a personal choice. We need all the help we can get, and I understand that medication is one form of help for many people.
My interrogation, rather, is aimed at our perception of anxiety as a society — our knee-jerk reaction of repression over investigation, of labeling the feeling a disorder, rather than seeing it as a potential initiation into deeper mastery of one’s will and character, or as a symptom of an imbalanced social system.
“I would say that learning to know anxiety is an adventure which every man has to affront if he would not go to perdition, either by not having known anxiety or by sinking under it. He therefore who has learned rightly to be anxious has learned the most important thing.”
In that context, there begins to appear something ominous about the medication of such a feeling, which may be uncomfortable, but also suggests the presence of our own grand possibility. If anxiety is a natural reaction to the experience of our own overwhelming freedom, what will it mean to repress that sensation?
Some might take issue with the fact that I am not drawing a distinct line between philosophical anxiety and physiological/psychological anxiety. I am aware that our society sees them as different issues — one as garden-variety-human-condition-angst, which everyone experiences to some degree, and the other as the more pathological, in-need-of-medication-chemical-imbalance anxiety. This is because I don’t believe they are different. Rather, I think they are gradations of the same experience.
I see the varying interpretations of anxiety by different fields as exactly that: interpretations. The difference between, say, a poet’s description of an elephant and a zoologist’s. The elephant remains the same.
Just because one field has identified the chemicals related to the feeling does not mean the chemicals are the beginning, or the end, of the story.
Social anxiety is often linked with introverts — incidentally, a much misunderstood personality type within our modern culture.
“The day may come,” says Susan Cain in her recent New York Times article, “Shyness: An Evolutionary Tactic?” “when we have pills that ‘cure’ shyness and turn introverts into social butterflies […] [But] the act of treating shyness as an illness obscures the value of that temperament.”
As a culture we need both the shy, sensitive introverts to ponder the deeper meanings of things and the assertive, bold extraverts to take action and get things done. Diversity in a species is an evolutionary advantage.
Case in point: evolutionary biologist David Sloan Wilson performed a simple but telling experiment on a school of unknowing pumpkinseed sun fish. About 15-20 % of animals display introvert characteristics of caution (interestingly, the same percentage as in humans,) called “sitters,” compared to the more curious, assertive “rover” types…
The biologist lowered a metal trap into the water and a large number of “rover” sunfish went inside to investigate — only to be caught. While the more tentative “sitter” sunfish, who sat back and watched, remained free.
“Had Professor Wilson’s traps posed a real threat, only the sitters would have survived,” points out Cain. “But had the sitters taken Zoloft and become more like bold rovers, the entire family of pumpkinseed sunfish would have been wiped out. ‘Anxiety’ about the trap saved the fishes’ lives.”
Wilson then caught all the sunfish and took them back to his lab. The rovers acclimated faster, eating a full five days earlier than their sitter brethren. In this case, the rovers had the evolutionary advantage.
“There is no single best … personality,” Professor Wilson concludes in his book, “Evolution for Everyone,” “but rather a diversity of personalities maintained by natural selection.”
Yet we live in a culture which treats the sitter personality as freakish. “Just do it!” our slogans roar. Action is prized over contemplation, assertiveness over timidity. One way we manifest this bias as a society is by encouraging perfectly healthy shy people to see their tendencies as problematic, needing to be cured.
Studies show that introverts, who tend to digest information thoroughly, do better in school than their extroverted peers, despite having the same I.Q. The careful, sensitive temperament from which both shyness and anxiety can spring is not only rich in observational skill, insight and inner vision, it may well be essential to the survival of our species — a point well illustrated by our friends the pumpkinseed sunfish.
As science journalist Winifred Gallagher points out: “The glory of the disposition that stops to consider stimuli rather than rushing to engage with them is its long association with intellectual and artistic achievement. Neither E=mc2 nor ‘Paradise Lost’ was dashed off by a party animal.”
I’m not saying that people who take medication are doing so to “conform to the status quo,” (obviously they are doing it to feel better and to function more effectively in their life) but the increase of medication use in the Western world does suggest the possibility of an increasingly homogenized human experience.
Though some might argue that such “increased homogeny” is just fine if it entails a more well-adjusted life experience, I am suspicious of terms like “well adjusted,” because they require that we hold a yardstick up against the majority to measure the minority; it fails to account for individual temperament or the gifts that come with eccentricity.
Back to the original thought: being anxious vs having anxiety. This is a shift of language I have witnessed in my lifetime. And what a consequence the simple replacement of “having” with “being” implies: one is an emotion that passes through you, another is something you are stuck with, a state, part of your personality, even your identity.
And could it have anything to do with the multi-million dollar pharmaceutical companies filling the airwaves with the language of “having?”
What great symphonies, works of literature and philosophies would not have been created had the sensitive temperaments creating them been medicated? And what will our society look like in 100 years if it continues down its current trajectory?