Wednesday 31 July 2013

Heed the new age of anxiety rather than bemoaning it | Darian Leader

Crying business woman A new report claims a massive increase in anxiety disorders in the UK. Photograph: Alamy

If the postwar age of anxiety was supposed to have ended 30 or 40 years ago, a swath of media articles now suggest a dramatic comeback. A new and widely reported study claims a massive increase in anxiety disorders in the UK, with an estimated 8.2 million sufferers compared to 2.3 million in 2007. The pressures of modern life, we are told, must play a large part here, with job stress aggravating the difficulties of urban populations.

The focus on socio-economic conditions is surely a good thing. In the 1980s, Thatcherism encouraged a redrafting of work-related problems as psychological ones. As each person became a unit of economic competition, it wasn't the market's fault if they didn't get a job but their own. Injustice in the marketplace was glossed over as individual failure.

Hundreds of books and articles have questioned this without gaining media exposure, so why the visibility of the new research? I was puzzled to find not a single sentence in the report linking the supposed increase in anxiety to social causes. In fact, there was no explanation at all, and the headline-grabbing prevalence rate for the UK was estimated from Iceland, Norway and Switzerland.

Here, we find a perfect expression of the new mental hygiene movement. Anxiety is grouped together with dementia, stroke and neuromuscular conditions as a "brain disorder", and the authors urge an approach that uses "comparable methodologies for both mental and neurological illness". Disorders are listed in terms of their cost to the economy rather than to individual lives, families and communities.

The monetary equation explains the press the report received. In this accountancy of distress, anxiety disorders are reckoned to cost around £10bn a year, with about a half of this due to lost productivity and early retirement.

The subtext to human suffering here is of course the economy. Getting people back to work is what matters, with intervention aimed at excising unwanted symptoms that get in the way of maximum productivity. Rather than seeing such symptoms as signs that something is wrong at a more fundamental level, they are read as local disturbances that cutting edge drugs will get rid of.

Aside from the absurdity of seeing anxiety as a brain disorder, the logic here is circular. It may be the very equation of human worth with economic productivity that frames the problem. As human beings are increasingly identified with units of energy in the marketplace, is it so surprising that they fall ill, refusing the values of productivity and efficiency that society imposes on them?

The pressures and expectations of the market weigh heavily on everyone. The erosion of long-term stability in employment means that people are expected to throw themselves into any job they find. Every minor task or training exercise must be met with absolute enthusiasm, as if motivation were something that could be turned on or off at will.

Such behaviour is impossible to sustain, and exacts its toll: depressive feelings, physical and emotional exhaustion at the expenditure of energy on projects we care little about. Motivation loses its roots in our childhood interests and ideals, and becomes something external to us. Hence the oscillation between hyper-motivation and depletion characteristic of the contemporary worker.

Anxiety can play a similar role. At its most basic level, anxiety is the sensation that something is demanded of one. An exam at school or a work deadline can generate this feeling, as can a fruitless visit to a jobcentre. There is the pervasive sense of an expectation or impending judgment. The fact that human beings have become what Nina Power calls "walking CVs" can only exacerbate such problems. We are obliged to list and magnify our abilities to meet the impossible demands of the marketplace. Added to this is the ever increasing pressure to conform to a norm of physical and mental health.

The imperative to remove anxiety may do more harm than good. Freud noticed the protective function of anxiety as an indication of danger. He distinguished it from shock, the encounter with a violence or sexuality that we had not been prepared for. The first question to ask is less "How can we get rid of anxiety?" than "What function does anxiety have?" Take the example of childhood phobias. Clinicians know that the protracted phobias that occur between the ages of three and six are usually best left untreated. They show that the child is reorganising their world, creating new limits and boundaries through the animal or place they are afraid of. When this is done, the phobia will disappear. The child has transformed anxiety into fear. Fear is always fear of something, but anxiety involves a more nameless dread, as writers like Gogol and Maupassant have often reminded us. The causal diagnostic approach lumps fear and anxiety together, yet if someone has succeeded in becoming afraid of something it means that they have been able to treat their anxiety.

This inflects the question of the socio-economic framework of anxiety. If the competitive field of employment can intensify the feeling of demands and expectations, when we explore individual cases we find that something more is at stake. It may take time to discover, but there is always a specific figure beyond the demand – a boss, a partner, a bureaucrat. There is the acute sense that they want something from us but we don't know how they see us. This makes it more difficult to respond.

This is perhaps anxiety at its purest. Lacan compared it to being confronted with a giant praying mantis while wearing a mask – a mask the wearer can't see. We have no way of knowing if the mask makes us look like prey. If we knew we could take evasive action, but not knowing leaves us paralysed. This is illustrated beautifully in the Pixar movie Brave. To escape the spiralling demands of her mother, a girl uses magic to turn her into a bear. She must then change her back, yet every time she encounters the bear she has no way of knowing whether the bear sees her as a beloved daughter or merely a piece of meat to be devoured.These processes are unconscious, but anxiety won't be. We feel it but cannot grasp its cause. This opacity is exploited by offering the label of "anxiety disorder" and explained in terms of brain circuitry.

Careful listening and dialogue can help the person gain an understanding of their situation, but there can never be any guarantee that anxiety won't come back – less invasively perhaps and less destructively, but occupying nonetheless a crucial place in human life.

Anxiety is the sign that we have temporarily lost the persona and reference points we count on in daily life. Suddenly we are alone and in danger. In this sense, anxiety never lies. Before rushing to get rid of it, we must reflect on what it is there to do and what it would mean to live without it. Rather than bemoaning a new age of anxiety, we need to examine more closely the anxieties of our age.


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