Friday, 23 July 2021

does anxiety have a meaning?

Does anxiety have a meaning? I now recognise that, when I started out training as a psychologist, a tacit message I then imbibed was that it doesn't. Here's how I learned to think of it: Anxiety is just an aversive experience, an unwanted condition. It has a certain physiological, autonomic, cognitive and sensory character. Its reduction should be the central aim of such treatment as is provided to those who present because of it. In short it's simply something to be got rid of, managed, treated - with mindfulness, exercise, medication, whathaveyou. 

This, sometimes, is surely the right way of thinking about it - think of such anxiety as stems from, say, alcohol misuse, thyroid problems, and some trauma-generated anxiety. CBT, I think, often takes this view: the aim of treatment is to reduce anxiety by altering core beliefs, defusing from fraught thoughts, reinterpreting bodily sensations, etc. The patient may come into therapy thinking their anxiety has a meaning (e.g. "I’m going mad / dying"). The aim of therapy, however, is pretty much to convince the patient that it has no significance, carries no message, at all. It's just a set of bodily sensations and neurobiological activations that are receiving an optional and misinformed interpretation. A psychodynamic therapy may be similar: anxiety is caused by inner conflict - so to achieve the therapeutic goal of reducing the anxiety, address the conflict. Your superego's giving you gyp - so learn to challenge it and develop a gentler self-relation.

I now think that this way of thinking about anxiety can have considerable costs. What it ignores is the way in which anxiety may be taken to disclose valuable truths about your life and mind, which truths have a significance far beyond their anxiogenic character. A patient recently relayed to me a Joseph Campbell quote:

It is by going down into the abyss that we recover the treasures of life. Where you stumble, there lies your treasure. The very cave you are afraid to enter turns out to be the source of what you are looking for.

On such a view, anxiety is giving us a useful clue as regards our individuation. It's showing us where growth is required. Where is it that I have an inner conflict, which conflict I will do well to transcend not simply because it's anxiogenic, but rather because it is ennobling and mature, dignified and individuating, to do so? Being a divided self is intrinsically undignified; it reduces our capacity for truth telling. It reduces our self-possession, and leaves us liable to being buffeted by fate. To manage the anxiety which stems from inner division we deploy defences that damage or suppress ourselves and others. Anxiety provides valuable information about where the treasures of life, the source of what you're looking for, is. Listen to it, turn toward it whilst understanding what it tells of your as-yet un-met challenges, meet such challenges as become you, thereby living a life more attuned to your noble values. 


Such conflict anxiety is just one form anxiety takes. Another form is existential: my anxiety here constitutes the shaking apart of my insecure self when I'm facing life challenges such as isolation, illness, social socially holding my own, etc. Here too it can provide a valuable signal - that we're not yet fit to face all the facts of life. That we have some resilience to build, some exposure to undergo, a zone of proximal development to expand, facts to face, courage to build, shame to overcome, self-possession to develop, and integrity to muster. 


In what sense, then, does anxiety have a meaning? I think it's clear that the meaning isn't 'intrinsic'. That is to say, the meaning it enjoys is really a function of our living a life in an existential mode. It derives from our living it under the aspect of - to borrow another phrase from Campbell - the hero's journey. It implies we're actually interested in realising ourselves, individuating, become who we can be, growth, strengthening ourselves to better protect others, facing our fears, facing our failings, taking moral courage and making amends where we need to, desisting from letting ourselves and others down in a way which currently produces a diffuse guilty anxiety, and so on. Against such a set of values, anxiety has a valuable meaning for us. It shows us where to look.


The real tragedy of the view of anxiety with which I  started out, then, is not I think a function of anything it has to say about anxiety per se. It's rather the utter absence of an existential perspective that trots along with it, the absence of goals beyond the blandly affective ones of 'feeling better'. And yet it's almost a truism of psychology that 'feeling better' is rarely helpfully set as a goal in life, that hedonism is a dud, and that happiness comes from the pursuit of meaning in life rather than vice versa.