A Brief History Of Anxiety - Chapter Six

WHEN MURDERERS SCREAM AT SPIDERS

 

“And Holy To His Dread Is That Dark

Which Will Neither Promise Nor Explain,”

W.H. Auden, “The Age of Anxiety.”

 

 

 

 

My anxiety is a shape-shifter. It visits me in unfamiliar guises. Phobias, in particular, tend to take me by surprise, as they rear up and then fade away depending upon the stresses in my life. One minute, I’ll be going about my business, being the sort of person who likes to fly on airplanes and to marvel at the deceptive fluffiness of clouds, and the next thing I know I’m in a state of white-knuckled panic as the jet I’ve just boarded powers itself off the tarmac. After a few years, that phobia resolves and something else -- some other act or object -- unexpectedly becomes the embodiment of all that is terrifying.

At the moment, there is an envelope on my dining room table that fills me with more discomfiture than any other threat I can conceive of short of standing on the edge of a cliff. The mailman delivered it two weeks ago, and the envelope has been very quietly and persistently menacing me ever since. I’ve taken to serving dinner in the kitchen, and answering the phone upstairs. At night, lying in bed, I think about the envelope, and feel flooded with a cold Atlantic wave of dire prospect. Penury awaits; I know this. Penury, jail time, unspecified explosions and a variety of damning conclusions about my character.

I wouldn’t be surprised if there were physical dimensions, as yet undiscovered by our scientists, in which one could hear the envelope on my dining room table hiss, or tick. Tick, tick, tick... Possibly, in those other dimensions, it is even giving off a pulsing, irradiated glow of green. Nevertheless, here in Rational World, all I can tell you for certain is that the envelope is return-addressed from Revenu Quebec. It is a tax bill.

Where phobia is concerned, to each their own, as they say. Mine is an idiosyncratic terror, but so is paledaphobia, the “fear of bald people,” and asymmetriphobia, “the fear of asymmetrical things.” In their beguiling individuality, phobias are the territory of Oliver Sacks. Consider, for instance, a story that the BBC aired in England recently, about a woman who had grown terrified of peas. After the birth of her daughter, Louise Arnold developed an embarrassing and unmanageable terror of the vegetable. "I've got to stop this,” she told the press, “because I can't bear to be in the same room as peas. There have been occasions where I've been out for a meal and asked the waiter for no peas and had to rush out of the restaurant when they forget. I can't even go to my local pub because they serve peas on the menu. I'd love to lead a normal life and be able to go into the pub and have a drink."

“Sometimes,” Nicky Lidbetter of Britain’s National Phobics Society told the BBC’s correspondent, “when people are at a difficult point in their lives, their subconscious attaches the stress they experience to something, like peas.” Well, certainly, to peas. Why not? I have seen a grown man run shrieking from a basket of peaches. I have watched a woman grow pale and short of breath in the presence of a clown. In parts of Asia there is the phenomenon of koro, characterized by the suffocating suspicion that one’s penis is very slowly shrinking, and being reabsorbed by one’s body. In south India, people have been known to develop the terror that they’re pregnant with a litter of puppies.

When the BBC ran their story, they received a number of posts to their web site. “I have an incredible fear of boats,” one man allowed. “It’s silly and irrational and I realise that, but the bigger the ship, the more terrified I am of the thought of it floating on water or even going out to sea.” Wrote another: “I have a terrible fear of birds, feathers, and anything with wings. Walking around town squares in Europe is frightening and hellish for me -- the thousands of pigeons seem like brainless assassins after my life.”

“I am terrified of scarecrows,” posted Matt, from Kent, “I just find them truly hideous to behold.” Admitted Nadia of Brighton: “I have a phobia of flamingos. If one comes on the television I normally retch.” Someone else described their phobia of gravy, which my husband would relate to; I have it in my power to drive him from the house with a jar of Hellmann’s mayonnaise. At first, years ago, I actually tried to analyse the significance of his reaction to pale-hued condiments. Gradually, however, I came to believe that the object, itself, possesses little relevance beyond its totemic power to contain fear.

Phobia is a coping mechanism. If people who feel disturbed by the prospect of pandemic influenza can devote hours and hours to “hypothetical analytical planning” in order to stave off catastrophe, it is equally probable that one can cope with anxiety by containing it within or assigning it to a single object. Instead of ensnaring threats in a net of facts and plans, one simply allots them a definable location that can be run away from. ‘All that I fear is contained in a pea.’

 

I recently went to see Dr. Stephane Bouchard, a National Research Council fellow who is one of the world’s leading experts on phobia. Bouchard, a trim, casually-attired man who looks a little like the actor Kevin Spacey, works out of a rambling wooden house on the campus of the Universite de Quebec in Gatineau, a short drive from Ottawa. His second-floor office is filled with gadgets, Virtual Reality goggles -- which he uses for exposure therapy -- and a plastic cross-secton model of the human brain.

“One-third of phobics,” he said, “have had an actual experience with what they fear. So, this is conditioning, or vicarious learning.” Also known in the literature as traumatic phobia. An example might be a fear of dogs based on being bitten, or having seen someone else snarled at or attacked. (About six per cent of North Americans have an “incapacitating” fear of animals.) In terms of my bills phobia, it might be argued that the initial trauma was the day that a man who would only identify himself as “Mr. Hobbs” called me about a forgotten American Express bill while I was breast-feeding my newborn son. He then phoned my neighbour Bob, hassled Ambrose at work, and had his supervisor threaten to put me in jail unless I marched over to a Money Mart, right now, presumably with my nursing bra still flapping open. All this, Mr. Hobbs did in 24 hours. It was incredibly aggressive and jarring. Not to mention illegal. And ever after, this fear of bills.

Bouchard continues: “Another third of phobics hear about something, like a plane crash or a shark attack, and make a link between that information and an unknown yet perceived threat.” Here, I think of my daughter, developing her apprehensiveness about a stranger coming through the window shortly after she heard about an abducted child -- hers being a solitary version, I guess, of everyone in America developing an irrational anxiety about serial killers which journalists like me helped inflame. Shark phobias rose sharply after Jaws came out. God knows what the current crop of horror films are doing. Certainly, we are seeing an increase in weather-related phobias. Professors at the University of Texas in Austin reported in 2005 that their new students from California were all petrified of tornadoes, even though they hadn’t shown any overt concern about earthquakes in their own state.

“Then, with one-third,” Dr. Bouchard concluded, shrugging, “we don’t have a clue where it comes from.” Some objects lurk, in a manner that is sufficiently iconic of danger that the object will do. My cousins are all terrified of the submerged trees known as deadheads in the bay at their childhood cottage, which they came to call The Logs. To this day, none of them can approach The Logs without a heightened sense of dread. An evolutionary psychologist might say that in their very still and lurking posture, The Logs resemble crocodiles or other ancient enemies.

Aaron Beck, the founding director of the Center for Cognitive Therapy in Philadelphia, has done research to suggest that phobias manifest themselves according to psychological themes. For example, a fear of social rejection would be one theme, and might assume the guise of anxiety about public speaking, or of being in crowds. In North America, this kind of phobia typically involves a fear of being scorned or humiliated, whereas in Asia, it involves a fear of giving offense, so it might materialize as a phobia of body odor, or using a public washroom. Other themes that Beck identifies have to do with moving through spaces -- heights, bridges, dark forests, caves -- or with injury and bleeding. “These findings,” Beck says, “indicate that a person who fears height is likely to also fear tunnels but not necessarily being ignored.”

Beck also describes the phenomenon of “spreading phobias” -- where an initial fear cascades into several others, “the linkage being the similarity in consequences or danger rather than in the objects” themselves. You watch Jaws, and develop a phobia of sharks. The horror spreads to baths, and swimming pools and finally to water in general. Toward the end of my sojourn as a crime journalist, my phobias spread like a madness. At the family cottage, the one where my heart had been broken years earlier by A., I found myself unable to sleep, so frightened did I feel about the quiet forest dark. I took to arming myself with a kitchen knife, tucked under the mattress just in case. I was phobic of predators, both animal and human. I could not step outside the cottage after nightfall without a juddering, heart-thudding sense of alarm. In the ensuing years, as my life grew more peaceful and solid beneath my feet, these menaces entirely receded.

 

People can have the same phobias, for completely different underlying reasons. A fear of flying, for instance, can relate to acrophobia, (fear of heights) or to claustrophobia, (fear of confined spaces) or to a displaced and more profoundly threatening anxiety, as in the case of a friend of mine whose grief and anxiety after his mother died manifested itself as a phobia of air travel. Similarly, people can have multiple and apparently distinct phobias that are, in fact, connected by a common underlying theme. Beck cites the case of a man who “feared going through swinging doors, driving his car, and disclosing business secrets.” It emerged that “the common denominator” in these scenarios was that “he feared he might harm someone, either directly or indirectly.”

Last year, Clara made a sock puppet, to which she affixed about thirty of the little black-and-white googly eyes you can buy at a craft store. She called the puppet Aliena. Her father thought it brilliantly imaginative, and assigned Aliena pride of place on his desk. Every time I walked into Ambrose’s office, I would stumble visually across the puppet and have to look wildly away, lifting up my arm to shelter my gaze. ‘The eyes! Those eyes! Good lord!’

Clusters seem to disgust me. Not flocks -- I don’t mind hordes of birds or bats. When my Sheltie scoots after the pigeons in the park and they take to the air, I do not, personally, experience them as “brainless assassins after my life.” No, it’s the vision of witless and aggressive reproduction that I find unnerving. Dandelions, mushrooms, googely eyes. Buzz off with the mindless profusion. I can’t stand that sense of things just...popping up all over the place. This is a subject of great interest to the scholar William Miller, author of The Anatomy of Disgust. There are horrors that have more to do with disgust than with fear, although the two emotions are closely intermingled. What disgusts us isn’t necessarily something we feel is going to harm us -- we just want to distance ourselves, to recoil. We don’t want what Miller calls “thick, greasy life” to be on us, or in us. Certain substances raise the prospect of contamination or invasion. “The disgusting can possess us,” says Miller, “fill us with creepy, almost eerie feelings of being not quite in control.” Hence, some people’s aversions to mayonnaise and gravy and pond scum, or in my case to multiplying clusters.

Another aspect of the disgusting that Miller contemplates has to do with the partibility of the human body. The body can be pulled apart. Drawn and quartered. Loosened by decay. Few things are more disgusting in one’s mouth than a human hair, because it signifies this bodily disintigration. Miller cites a study, in which toddlers were observed placing all manner of unlikely objects in their mouths; they were happy to eat pooh and paint and other odds and ends, but showed aversion to a single strand of hair. On this point, Miller challenges Freud about his analysis of “castration fear.” It isn’t just the penis men fear losing, Miller argues, but also their fingers and toes. A classic anxiety dream features the crumbling of one’s teeth. We fear falling apart.

It is interesting that the two diseases most intensely feared in recent history have been cancer, and leprosy. One evokes that nameless dread of aggressive, unpredictable invasion or spread; the other speaks to the horror of partibility. (Consider that during the time of European leper colonies, everyone was riddled with infectious disease of one kind or another, but only the lepers were shunned.)

The British historian Joanna Bourke likewise points out that “cancer phobia” is a phenomenon that has really flared up in the last century. In 1896, according to her research, “when people were asked what disease they feared, only 5 per cent named cancer, while between a quarter and a third drew attention to the scary nature of each of the following ailments: smallpox, lockjaw, consumption and hydrophobia.” (The latter being the advanced stages of rabies.) “In the fear stakes,” Bourke continues, “being crushed in a rail accident or during an earthquake, drowning, being burned alive, hit by lightning, or contracting diptheria, leprosy or pneumonia all ranked higher than cancer.”

Fifty years later, 70 per cent of respondents in one British survey identified cancer as their greatest fear. Very few people, by contrast, fear the heart disease and car accidents that are as likely to kill them. “Part of the pervasive anxiety about cancer,” Bourke speculates, “was related to the invisibility of a ‘cause.’” Cancer was, and is, a spectre that stalks us without reason. That is something that Westerners in particular find highly alarming.

In general, women have more phobias than men. Two-thirds of animal phobics are women, even though they’re no more likely to be stung, gored or bitten than men. (Mind you, I recently discovered that T.S. Eliot shared my phobia of cows, which I found to be quite thrillingly consoling.) I asked Stephane Bouchard why this might be. “We don’t have a clear answer,” he told me. “Usually, we raise little girls to be more aware of their emotions, and they seem to become more sensitive to messages from the amygdala. You see it in brain scans. It’s also possible that society is more permissive toward women’s avoidance behaviours. Men are forced to work through their anxieties because avoidance is less tolerated in them. More men than women consult with therapists about social phobia, for this same reason.”

It is certainly the case that phobias can be worked through, although that may simply mean that one’s anxiety shifts to a different place. Some phobias are simply more in the way, as it were, and need resolving. I can fear cows until they come home, it doesn’t really matter unless I work on a ranch. But I had to get over fear of flying, because I needed to travel, so I continued to fly, availing myself each time of a handful of those mini bottles of wine the flight attendants sell, until one day I noticed that the fear had gone. I had paid no attention to the plane taking off, and remained absorbed in the novel I was reading. The key, very simply, was exposure, and the tool used by Bouchard and other psychologists for this purpose is a chair, and a pair of Virtual Reality goggles.

“The aim of Virtual Reality Therapy,” he explains, “ is to change the association between the stimuli and the threat. In VRT, you just need enough stimuli to trigger the emotional part of the brain to make it credible. The quality of VR environments sucks. But it doesn’t matter to the phobic. It’s a really fast emotional process. See these black cables?” He motions to some equipment cables coiling around the floor near his desk. “The shape and colour will go to the amygdala and trigger an anxious response in a snake phobic before the information goes to the prefrontal lobe.”

He’s right, it’s fascinating: if I look at the graphics provided for Virtual Thunderstorm or Virtual Airplane, I am merely interested and even faintly amused by how rudimentary the scenery looks. But, Virtual Heights instantly provokes a swooning sense of vertigo. Suddenly, the aesthetics are irrelevant. I have the actual, bodily sensation of falling, (which is known as “somatic imaging.”) Unfortunately, Dr. Bouchard and his colleagues have yet to develop a virtual environment featuring tax officials handing out statements, reminder notices and threats to garnishee my wages.