This month, Woman’s Day took on mental wellness as one of its signature causes, reporting that nearly 19 percent of American adults struggle with an anxiety disorder. Bravo, Woman’s Day! Yes, we have to start de-stigmatizing these problems in our nation.
Anxiety gets such a bad rap. We probably want to get rid of anxiety, as a feeling, more than any other. Panic attacks completely hijack the system, social anxieties make it hard for many people to even stand in line at the bank, and common worries can lead to chronic insomnia and, not surprisingly, depression.
As a country, we just can’t tolerate all this anxiety – we hate it, and even with the right medication, it’s still like a dark cloud that hangs over us menacingly.
What is anxiety? One of Freud’s theories of the mind is that we have two drives. He called them the death drive and the libidinal drive. They can also be called the aggressive drive and the constructive drive. We have these two drives, and we need these two drives.
Here’s an example of how the drives work together well. A baby is born and it starts to root against the mother to nurse. This is a function of the aggressive and constructive drive working together perfectly. I love the names that babies are given for the way they nurse. Some are called “nibblers” and others, “barracudas.” Guess which babies were born with more of the aggressive drive? Yes, the barracudas. And of course, some babies can’t figure out how to nurse and they cry a lot. Maybe, this is because their aggressive drive and their constructive drives aren’t working together well.
So the aggressive instinct isn’t bad at all. It is energy in the system, and in the best-case scenario, it can be put to good use. Some people, like Oprah, can really use their aggression constructively and become powerhouses.
If we follow Freud’s model of the energies of the mind, anxiety is free-floating energy that has no place to go. That is, it is aggression without fusion to anything constructive. Only “signal” anxiety informs us helpfully that there is danger in the air, but often, we don’t experience our anxiety as helpful.
And this is especially true when we are in the middle of a panic attack. Or up in the middle of the night, jam-packed with worries that keep us from feeling rested and at peace. In those moments, we are not analyzing what is happening with our drive states, we just feel extremely, overpoweringly agitated.
Understanding drive states helps me as a clinician, though, to shift my attitude from one of loathing anxiety and therefore helping my patients at all costs to be rid of it, to one of embracing anxiety as a necessary function of the life drive. That is, I believe that people who suffer from anxiety are filled with feelings of fear, terror, excessive worry and extreme irritation because they want to live.
Shifting our attitude from one of loathing anxiety and seeing it as a function of depression versus embracing it and seeing it as a function of the life drive, has major implications for how we manage it in the day to day. Let me show you how.
The feelings of helplessness and terror that accompany panic attacks are severe. The complete physical hijacking of our bodies in the midst of a panic attack is bewildering. Many people get very depressed after suffering a panic attack. In fact, the intense terror is very physically depleting.
Because of the physical depletion, in combination with the helplessness experienced by people who have just had a panic attack, hopelessness often sets in, and self-esteem shoots down perilously. Shifting our attitude, so that we embrace anxiety as a function of the life drive, helps us berate ourselves less for having panic attacks. If you don’t feel as bad about yourself, you stand a better chance of focusing on what is important: replenishing yourself with plenty of fluids and food, and developing an action plan to get strong enough to exercise so that some of that energy can be siphoned off.
Thinking that we have to have eight hours of sleep and uninterrupted REM can often add to the anxiety that keeps us awake.
If restfulness and relaxation become unattainable, go with the worry. Intense worry, known clinically as “perseveration” can, at times, lead to working things out. Sometimes, it’s possible to consciously switch our perseveration to a subject that has more constructive elements attached to it, like re-decorating a room or working on a hobby. Attaching the free-floating anxiety to something with a constructive element can be soothing.
Many artists who are unafraid to have crazy sleep schedules do some of their most creative work during the wee hours of the night. It may seem counter-intuitive to encourage wakefulness during the night, but worrying less about conforming to a traditional sleep schedule can ultimately lead to less anxiety.
One way to fuse the aggressive with the constructive drive in cases of social anxiety is to decide to go with energies and believe that the world really is a terrifying place. Instead of fighting the feeling, plan what you would do if something terrible happened. Letting yourself imagine what it would be like to be in a compromised situation with another person may better prepare you for the feelings. Use outings to the bank and post office as a way to gauge the dangers rather than to deny them.
Working with a therapist who is experienced and comfortable with anxiety can go a long way towards easing some of the fears about the fear. In cases where depression or obsessional thinking factor in heavily, there are many different approaches that can be successful.
Here’s the clincher: when you interview potential therapists, you can actually use your feelings of anxiety to measure whether he or she is the right therapist for you. If you feel less anxious after a session, the chemistry is right. Conversely, if you experience more anxiety, it could signal that that the therapist is not able to provide an emotional environment that will be therapeutic, even if they seem knowledgeable and experienced.
Learning to use our feelings, go with them and even learn from them is never easy when it comes to being in pain. But ultimately, learning how to make better friends with feelings that control us paves the path for us being able, ultimately, to control them.
Claudia Luiz, Ed.M., Cert. Psya., LMHC #6053, is a psychoanalyst in private practice with offices in Brookline and Westwood. She works with children, adults, couples and groups. She can be reached at cluiz@post.harvard.edu, at 617-947-4838 or via her Web site at www.claudialuiz.com.
