Kierkegaard called anxiety “the dizziness of freedom” and believed that it serves to power rather than hinder creativity. For Darwin, it was a paralyzing lifelong struggle — he accomplished his breakthroughs not because of anxiety but despite it. “Anxiety,” Anaïs Nin wrote in her diary, “makes others feel as you might when a drowning man holds on to you.”
Anxiety belongs to the broader complex relationship between creativity and mental illness, and although the causal direction of that relationship might forever evade us, it is strangely assuring to know that other minds — especially minds of above-average intelligence and creative ability — have been savaged by this blunt-toothed beast.
Such solidary consolation is what Montreal-based designer and illustrator Catherine Lepage offers in Thin Slices of Anxiety: Observations and Advice to Ease a Worried Mind (public library) — an illustrated meditation on what it’s like to live enslaved by one’s own worries and what one can do to break free.
Through a backdoor of disarming and almost lighthearted honesty, Lepage takes us on a guided tour of this heavyhearted prison of the psyche, its symptoms, and its side effects — from the trap of people-pleasing to the toxic allure of conformity to the sense of outsiderdom.
Reflecting on her lifelong on-again, off-again relationship with this cyclical companion, Lepage distills the common pattern and extracts from it the four habits most certain to set the Rube Goldberg machine of anxiety into action.
Laced with the meta-stressors familiar to anyone afflicted with anxiety — shame for being gripped by anxiety in the first place, self-blame for putting oneself in situations known to trigger it, exasperation upon realizing that its predictable trajectory of anguish is underway yet being unable to stop it — the book radiates a wistful yet warm assurance that these overwhelming emotional states, as all-consuming and singular as they seem, mark our membership in a larger fellowship of tribulation in which we are never as alone as we may feel.
Under the self-conscious heading “Cheesy Quotes to Remember” — for, lest we forget, self-consciousness is one of anxiety’s most persistent symptoms — Lepage offers a number of truths so helpful and true that we tend to dismiss them as truisms, bounced off the maladaptive psychological shield of our cynicism.
Complement the wonderful Thin Slices of Anxiety with Scott Stossel on the culture and costs of anxiety, Harvard social scientist Amy Cuddy on how to combat its causes, and philosopher Alan Watts on the antidote to our age of anxiety, then revisit artist Bobby Baker’s eleven-year visual diary of living with mental illness.
“A purely disembodied human emotion is a nonentity,” William James asserted in his revolutionary 1884 theory of how our bodies affect our feelings. Two generations later, Rilke wrote in a beautiful letter of advice to a young woman: “I am not one of those who neglect the body in order to make of it a sacrificial offering for the soul, since my soul would thoroughly dislike being served in such a fashion.” And yet in the century since, we’ve made little progress on making sense — much less making use — of the inextricable dialogue between the physical body and the psychoemotional interior landscape we shorthand as “soul.”
Nowhere is this relationship more essential yet more endangered than in our healing from trauma, and no one has provided a more illuminating, sympathetic, and constructive approach to such healing than Boston-based Dutch psychiatrist and pioneering PTSD researcher Bessel van der Kolk. In The Body Keeps the Score: Brain, Mind, and Body in the Healing of Trauma (public library), he explores “the extreme disconnection from the body that so many people with histories of trauma and neglect experience” and the most fertile paths to recovery by drawing on his own work and a wealth of other research in three main areas of study: neuroscience, which deals with how mental processes function within the brain; developmental psychopathology, concerned with how painful experiences impact the development of mind and brain; and interpersonal neurobiology, which examines how our own behavior affects the psychoemotional and neurobiological states of those close to us.
Art by Simona Ciraolo from Hug Me
Trauma, Van der Kolk notes, affects not only those who have suffered it but also those who surround them and, especially, those who love them. He writes:
One does not have be a combat soldier, or visit a refugee camp in Syria or the Congo to encounter trauma. Trauma happens to us, our friends, our families, and our neighbors. Research by the Centers for Disease Control and Prevention has shown that one in five Americans was sexually molested as a child; one in four was beaten by a parent to the point of a mark being left on their body; and one in three couples engages in physical violence. A quarter of us grew up with alcoholic relatives, and one out of eight witnessed their mother being beaten or hit.
It takes tremendous energy to keep functioning while carrying the memory of terror, and the shame of utter weakness and vulnerability.
In trauma survivors, Van der Kolk notes, the parts of the brain that have evolved to monitor for danger remain overactivated and even the slightest sign of danger, real or misperceived, can trigger an acute stress response accompanied by intense unpleasant emotions and overwhelming sensations. Such posttraumatic reactions make it difficult for survivors to connect with other people, since closeness often triggers the sense of danger. And yet the very thing we come to most dread after experiencing trauma — close contact with other people — is also the thing we most need in order to regain psychoemotional solidity and begin healing. Van der Kolk writes:
Being able to feel safe with other people is probably the single most important aspect of mental health; safe connections are fundamental to meaningful and satisfying lives.
This, he points out, is why we’ve evolved a refined mechanism for detecting danger — we’re incredibly attuned to even the subtlest emotional shifts in those around us and, even if we don’t always heed these intuitive readings, we can read another person’s friendliness or hostility on the basis of such imperceptible cues as brow tension, lip curvature, and body angles. But one of the most pernicious effects of trauma is that it disrupts this ability to accurately read others, rendering the trauma survivor either less able to detect danger or more likely to misperceive danger where there is none.
Art by Wolf Erlbruch from Duck, Death and the Tulip
Paradoxically, what normalizes and repairs our ability to read danger and safety correctly is human connection. Van der Kolk writes:
Social support is not the same as merely being in the presence of others. The critical issue is reciprocity: being truly heard and seen by the people around us, feeling that we are held in someone else’s mind and heart. For our physiology to calm down, heal, and grow we need a visceral feeling of safety. No doctor can write a prescription for friendship and love: These are complex and hard-earned capacities. You don’t need a history of trauma to feel self-conscious and even panicked at a party with strangers — but trauma can turn the whole world into a gathering of aliens.
Beginning to adequately address trauma requires a cultural shift away from the disease model on which twentieth-century psychology and psychiatry were built. (That model has seeded a number of cultural deformities, affecting everything from our longtime denial of the robust relationship between stress and physical illness to the way we make sense of our romantic failures.) Trauma and its psychological consequences, Van der Kolk argues, is not a mental disease but an adaptation. He writes:
The brain-disease model overlooks four fundamental truths: (1) our capacity to destroy one another is matched by our capacity to heal one another. Restoring relationships and community is central to restoring well-being; (2) language gives us the power to change ourselves and others by communicating our experiences, helping us to define what we know, and finding a common sense of meaning; (3) we have the ability to regulate our own physiology, including some of the so-called involuntary functions of the body and brain, through such basic activities as breathing, moving, and touching; and (4) we can change social conditions to create environments in which children and adults can feel safe and where they can thrive.
When we ignore these quintessential dimensions of humanity, we deprive people of ways to heal from trauma and restore their autonomy. Being a patient, rather than a participant in one’s healing process, separates suffering people from their community and alienates them from an inner sense of self.
One of Salvador Dalí’s illustrations for the essays of Montaigne
The most essential aspect of healing, Van der Kolk asserts, is learning to fully inhabit that inner sense of self in all of its dimensions — not only emotional and psychological, but bodily — which are inseparable from one another. He explains:
The natural state of mammals is to be somewhat on guard. However, in order to feel emotionally close to another human being, our defensive system must temporarily shut down. In order to play, mate, and nurture our young, the brain needs to turn off its natural vigilance.
Many traumatized individuals are too hypervigilant to enjoy the ordinary pleasures that life has to offer, while others are too numb to absorb new experiences — or to be alert to signs of real danger.
Many people feel safe as long as they can limit their social contact to superficial conversations, but actual physical contact can trigger intense reactions. However … achieving any sort of deep intimacy — a close embrace, sleeping with a mate, and sex — requires allowing oneself to experience immobilization without fear. It is especially challenging for traumatized people to discern when they are actually safe and to be able to activate their defenses when they are in danger. This requires having experiences that can restore the sense of physical safety.
One place where our culture fails, Van der Kolk argues, is in integrating this physical aspect with the psychoemotional infrastructure of experience — a failure spanning from our clinical methods of treating trauma to our education system. (More than half a century ago, Aldous Huxley wrote beautifully about the need for an integrated mind-body system of education.) Education, Van der Kolk notes, tends to engage the cognitive capacities of the mind rather than the bodily-emotional engagement system, which makes for an ultimately incomplete model of human experience. In a sobering passage that should be etched onto the wall of every Department of Education the world over, he writes:
Despite the well-documented effects of anger, fear, and anxiety on the ability to reason, many programs continue to ignore the need to engage the safety system of the brain before trying to promote new ways of thinking. The last things that should be cut from school schedules are chorus, physical education, recess, and anything else involving movement, play, and joyful engagement. When children are oppositional, defensive, numbed out, or enraged, it’s also important to recognize that such “bad behavior” may repeat action patterns that were established to survive serious threats, even if they are intensely upsetting or off-putting.
Illustration by Brown from My Teacher Is a Monster
With an eye to heartening counterpoints like a karate program for rape survivors and a theater program in Boston’s inner-city schools, he considers the reasons and the urgency for engaging the body in healing:
The body keeps the score: If the memory of trauma is encoded in the viscera, in heartbreaking and gut-wrenching emotions, in autoimmune disorders and skeletal/muscular problems, and if mind/brain/visceral communication is the royal road to emotion regulation, this demands a radical shift in our therapeutic assumptions.
Drawing on his work with patients who have survived a variety of traumatic experiences — from plane crashes to rape to torture — Van der Kolk considers the great challenge of those of us living with trauma:
When our senses become muffled, we no longer feel fully alive.
In response to the trauma itself, and in coping with the dread that persisted long afterward, these patients had learned to shut down the brain areas that transmit the visceral feelings and emotions that accompany and define terror. Yet in everyday life, those same brain areas are responsible for registering the entire range of emotions and sensations that form the foundation of our self-awareness, our sense of who we are. What we witnessed here was a tragic adaptation: In an effort to shut off terrifying sensations, they also deadened their capacity to feel fully alive.
Art by Oliver Jeffers from The Heart and the Bottle, a tender illustrated parable of what happens when we deny our difficult emotions
While this dissociation from the body is an adaptive response to trauma, the troublesome day-to-day anguish comes from the retriggering of this remembered response by stimuli that don’t remotely warrant it. Van der Kolk examines the interior machinery at play:
The elementary self system in the brain stem and limbic system is massively activated when people are faced with the threat of annihilation, which results in an overwhelming sense of fear and terror accompanied by intense physiological arousal. To people who are reliving a trauma, nothing makes sense; they are trapped in a life-or-death situation, a state of paralyzing fear or blind rage. Mind and body are constantly aroused, as if they are in imminent danger. They startle in response to the slightest noises and are frustrated by small irritations. Their sleep is chronically disturbed, and food often loses its sensual pleasures. This in turn can trigger desperate attempts to shut those feelings down by freezing and dissociation.
In a passage that calls to mind philosopher Martha Nussbaum’s excellent subsequent writings on the nuanced relationship between agency and victimhood, Van der Kolk adds:
Agency starts with what scientists call interoception, our awareness of our subtle sensory, body-based feelings: the greater that awareness, the greater our potential to control our lives. Knowing what we feel is the first step to knowing why we feel that way. If we are aware of the constant changes in our inner and outer environment, we can mobilize to manage them.
But one of the most pernicious effects of trauma, Van der Kolk notes, is that it disrupts our ability to know what we feel — that is, to trust our gut feelings — and this mistrust makes us misperceive threat where there i
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