Notice: This little piece is tongue-in-cheek, but not really, but maybe yes. It is dedicated, for some reason, to my sister.
A fair number of clients present solely with “anxiety.” It may be pointed out later in their therapy that depression is obvious, too, but that’s not their primary concern. No – it’s having the heebie-jeebies, the willies, being frightened of nothing and scared shitless, worried about the real, the rare, the remote and the ridiculous. They are on fire, walkin’, talkin’, flexing it up on my couch: panicky loosey-goosey and jackhammer dance-o-rama.
They feel jittery on the inside and then believe their life is jittery. Freaking out “to the manner born.”**
It is always serious. And it is a blockbuster. Some big study, back when I took a few psych courses preparatory to my Master’s program, said that anxiety – not depression – was the “number one” mental health problem in the United States. That still startles me a little. It seems so much more natural to picture the whole world depressed rather than skittish.
Somehow – and you know it’s true – depression seems like a legitimately stuck disorder, embedded deep and long, even as the depressive character; while anxiety feels like it should just be momentary, PRN to an occasion then passing. This is affirmed in the existence of Depressive Personality Disorder*** (DSM-IV axes for further study) and the absence of Anxious Personality Disorder. Actually, I have proposed an AnxPD, which I established in individuals who never grew up psychologically as they lived under the thumb of sick caregivers and remained fey dependents through their adulthood.****
The rest, though, normal people with jobs and families and mundane ADLs*****, and trepidation (a client’s favorite word for it) running on the inside. “Oh, come on,” I want to say with sweet sardonicism. “Can’t you take that sensation, see that it applies to nothing in your life now, and construe it as some residue of past crap, like indigestion from last night’s dinner?” Or: “Can’t you get angry at it, tell it to eat shit, over-power it because you are more powerful in your life?” This should be a rock-paper-scissors finesse. Depression covers anger like a thick blanket, but anger should cover fear. You hear a bump in the night and you ignore it or intrepidly check it out with a big knife in your hand.
But no. The person is beside himself: He is not all there. The understanding I convey is that this anxiety comes from childhood, when it was still fear and fear prevented identity******: I have no one to lean on – the crux of anxious insecurity – so I can’t grow a self. There was not a formed person yet because he had no purchase in a bond. Fear became his nature, and that led to self-soothing, the only bulwark against sensing his identity flaw. All the self-soothing behaviors found to stave off identity panic: obsessive-compulsive rituals, music, masturbation, school, imaginary good parents, thinking, alcohol, cigarettes, jobs, attitudes and philosophies, hatreds and other delusions. They are very versatile, because we use them for depression, too.
That is my understanding. But I realize that if I really understood anxiety, I would know why I was a vessel of anxiety throughout my childhood but do not experience it now outside of brief, instant situations. Somehow a steadfast theme – of Edenic goodness or confidence or some other molecule? – replaced it. I recommend that, but can’t explain it.
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* Actually, probably #346.
** https://www.phrases.org.uk/meanings/to-the-manner-born.html
**** https://pessimisticshrink.blogspot.com/2013/11/normal-0-false-false-false-en-us-x-none_22.html
***** “Activities of Daily Living,” one of the drabbest concepts in the mental status exam.
****** https://pessimisticshrink.blogspot.com/2015/01/idiosyncrasies-2-storm-of-eye.html
your blog is helpful.
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