We should heed the new age of anxiety rather than bemoaning it

A study calculating the cost of widespread stress and exhaustion fails to explore what really lies behind the prevalence of anxiety and what can be learned from it

By Darian Leader  /  The Guardian, LONDON

Wed, Jul 31, 2013 - Page 9

If the post-war age of anxiety was supposed to have ended 30 or 40 years ago, a swath of media articles now suggest it has made a dramatic comeback.

A new and widely cited study claims a massive increase in anxiety disorders in the UK’s 60 million-strong population, with an estimated 8.2 million suffering from anxiety, compared with 2.3 million in 2007. We are told that the pressures of modern life must play a large part here, with job stress aggravating the difficulties of urban populations.

The focus on socioeconomic conditions is surely a good thing.

In the 1980s, Thatcherism encouraged a redrafting of work-related problems as psychological ones in the UK. As each person became a unit of economic competition, it was not the market’s fault if they did not 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. There was no explanation at all and the headline-grabbing prevalence rate for the UK was estimated from Iceland, Norway and Switzerland figures.

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 of the study 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 estimated to cost the UK about £10 billion (US$15.3 billion) a year, about half of which is the result of 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 behavior is impossible to sustain and exacts its toll: depressive feelings, as well as 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 that is so 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 job center. There is the pervasive sense of an expectation or impending judgement. That human beings have become what philosopher 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.

Sigmund 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 reorganizing 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. 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 socioeconomic 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 do not know how they see us. This makes it more difficult to respond.

This is perhaps anxiety at its purest. Jacques Lacan compared it to being confronted with a giant praying mantis while wearing a mask — a mask the wearer cannot 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 paralyzed. These processes are unconscious, but anxiety will not 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 will not 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.

Darian Leader is a psychoanalyst and author.