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The Nature of Anxiety by Arthur Janov, M.D. Talk about it
Whereas the stress response is a feeling of being constantly under pressure, anxiety is an immediate, diffuse, debilitating fear, an anticipation of some impending danger and a feeling that one cannot deal with even the smallest of things. Of the two, anxiety is the more acute, the more immediate, and the more harrowing. The symptoms of anxiety are clear. There is the terrible, amorphous feeling of nameless dread, a sense of impending doom together with a racing heart. There is also a wobbly, shaky feeling, accompanied by chronic sleeplessness. There may be "butterflies in the stomach," choking and smothering sensations, and feelings of being crushed. There is often the feeling that one is going crazy. The system is totally galvanized, and nothing seems to calm it. Although anxiety is the central focus of many psychotherapies, it is perhaps the least understood of all psychiatric phenomena. Carol Tavris, writing in Science Digest (February 1986, p. 46) says that anxiety disorders "may be the most common mental health problem in the United States today."The National Institute for Mental Health believes that anxiety is the number one mental health problem for women, and number two for men. Clearly, the incidence of anxiety has reached epidemic proportions. What professionals seem to know about anxiety with any certainty is that it can be diminished with tranquilizers and painkillers. This is a clear indication that anxiety is somehow related to pain. When we turn our attention to the question of the physiological character of anxiety, we find that recent research has provided some interesting clues. Pure terror seems to be organized in several places low in the neuraxis, including the aforementioned locus ceruleus. Deep in the brain stem is also where we believe that early traumas are registered. Electronic stimulation of the locus ceruleus produces what seems to be an aggravated anxiety attack-pure, nameless, ineffable terror. It is a state without words. Anxiety is an instinctive mechanism for survival. It is a form of terror, a terror that has no rational stimulus in the present. Clearly, it comes from the past, often without warning. The question is, "What is it?". To understand anxiety we shall have to quickly review early imprints. Anxiety is primarily a visceral reaction involving the heart, lungs, colon, stomach, and urinary tract. These organs are known as midline responses and are the first to mature during development in the womb. Events in the womb and during birth are registered in the nervous system that controls these visceral organs. That is, we react with the most adequate nervous system available when trauma strikes. What is available and is fully adequate during our womb life is the midline nervous system; i.e., the first line. We know that the typical anxiety reactions are early because of the visceral reactions, such as "butterflies" in the stomach, difficulty in breathing, palpitations, the need to urinate frequently, dizziness, diarrhea, and hyperventilation. Anxiety is a first-line phenomenon. It begins its existence as a reaction to real events that were life-endangering It feels exactly like what the fetus and newborn were feeling originally. It is global and nameless, because the fetus and neonate do not have words. This is coupled with a feeling of impending doom. Anxiety is no more than the precise response to the early trauma now filtered. Anxiety is more the property of the sympath who feels the mobilization aspect of the early imprint, while depression is more often found in the parasympath. Depression, as I have pointed out, is the result of massive, global repression where endorphin levels are high initially, then get "used up" as the depression lingers on. It results from a shutting down against pain, whereas anxiety is the terror resulting in a mad flight away from the possibility of death. That is why when the sympath is unable to act out, is closeted inside, and cannot keep busy, he feels the anxiety. The parasympath feels anxiety when repression begins to fail and he is in direct contact with abject helplessness and hopelessness. Thus, as I have mentioned, the parasympath faced with a bureaucrat who controls his life, where he can do nothing to escape the tight rules and regulations, where he is totally in someone else's hands, where totally helplessness is the order of the day, becomes anxious. Or he gets anxious when he must reach out, must be assertive, face crowds, speak out his needs, etc. None of that makes the sympath anxious. Anxiety will occur later in life depending on three factors:
The anxious person anticipates doom. The doom is looming now as an imprint because the person has no knowledge of the memory and is at a loss to understand what he is suffering from. The doom is ancient history. One thing is certain: a present feeling always has an origin somewhere. We just need to find where. The reason that anxiety is a survival mechanism is that it warns and mobilizes the system into action against a perceived threat. The terror that is at the base of anxiety is always there. It is only when the defense system weakens that it manages an occasional trip to the surface. That is why some painkilling drugs manage to handle anxiety effectively. What these drugs do, by and large, is alter the transmission ability of the neurons to send messages of pain to higher centers. They usually affect the reticular activating system down low in the brain, which is in charge of alerting the entire brain to danger (discussed in a moment). The drugs cut the message off "at the pass" and thus the mind is not flooded with impulses over which it has no control. The drugs affect the lower centers but have a profound affect on thought processes; this is one more way we know about where the force that drives the cortical, thinking mind comes from. Another way we know about the source of the racing mind, bizarre ideas, and scattered thought patterns is when the patient relives those very early traumas, all of that automatically ceases. With it goes the periodic, sudden bouts of anxiety that have plagued the person for years. In our therapy when early pains are rising towards consciousness, there is almost invariably an anxiety attack. The terror involved in anxiety is consciousness. Early conscious connection meant feeling the complete abject terror. That is why, when feelings are on the rise, producing an anxiety state, there is often a heart beat of over 200, a blood pressure also over 200, and signs of an organism in great danger. A newborn strangled on the cord is terrified. There is no comprehension, just pure terror. He reacts with the capacity he has. The heart is pumping, the temperature is rising, hormones are churning, all of which we see when we lift the lid of repression in our therapy. This is a state of anxiety. That is how we know what anxiety is and where it comes from. All anxiety is free-floating at the time of the trauma; it is neither conceptualized nor understood. There were no possible defenses against it. Death lay just beyond. Later, with the capacity to focus and symbolize we can channel anxiety. It can become a phobia-a focused anxiety attack. Too often, the phobia is then treated as if it were the real problem. Phobia clinics abound in the United States. Phobia is a problem that can be controlled by avoiding the situation. And that current situation is nearly always a symbol for the original trauma. Thus, the fear of elevators (the fear of being contained, crushed, squeezed, having insufficient air, being unable to see out, etc.) is a way of manipulating an original trauma symbolically. That is usually the raison d 'etre for phobias. A very traumatic birth process with long labor may show itself in the form of a fear of leaving any comfortable place; hence the later phobia of leaving home. It is a fear of "going out. " The thought of leaving home makes the phobic person react as if an electrode were placed on the locus ceruleus. In everyday life, this kind of phobic-anxiety is controlled in small imperceptible ways, such as not going out to meet people, not trying new things, not leaving the situation you're in-be it a job or a marriage -no matter how painful. This is because unconsciously there is more pain involved in leaving than in staying. Leaving triggers off the original primal event with all of its terror. Not being outgoing can be an aspect of this same problem. I once treated a jet pilot for a phobia he developed in cloud banks. When he put himself back mentally into the clouds he became terrified. He could not sense motion. He spent hours and hours reliving a birth trauma where not being able to move (he was blocked by a tumor in the canal) meant death. Cloud banks simply triggered the old fear. One could have analyzed this terror for months on end without relating it to its true cause. Birth was never even suggested to him (who could have dreamed that up?), but the technique of mentally placing himself back in the cloud banks elicited an early sensation that was pure dread. Giving himself over fully to that dread put him back into the original terror. One should not treat a phobia as a thing unto itself any more than one should treat a dream that way. The story in the dream is the mind's way of explaining the fear. Artists use images to paint their fears. The same is true with phobias. What is important to understand, however, is that the feeling in a dream or phobia is always right. The story is symbolic. Go after the feeling, not the apparent focus. Sylvia I have always lived by lists. I have a general one for use day by day, and another one for weekends. Despite this seeming organization I am a messy person. I never feel "caught up" or that I have it all together. My purse is jam packed with "essentials "which I almost never need but can 't let go of because I never was taken care of as a kid, my father left us and Mom went to work, I never developed a trust in myself. I don't trust myself to remember and I'm terrified to make a mistake; so I compile list after list, but usually manage to lose or misplace them. At least, lists reassure me. I am upset if someone comes early or unexpectedly. It disturbs my routine. I don't easily adapt to change. I need warning - like I didn't get when I was born, experiencing excruciating pain. I need to feel in control of every situation. My preset ideas take precedence over my feelings. I need to have a certain regimentation and will stick to something no matter what the inconvenience or discomfort. I hate and love rules. I detest unstructured social situations where I might meet strangers and don 't know what to say. If ear that I can 't gauge how I or they will react (and then I feel stuck as I was originally at birth, and later in my crazy home). My constant worry is not being able to take care of things properly. It is part of the helplessness I felt as a child. In school I worried all of the time about losing my books, umbrella, keys, etc. I needed my mother to help me and make me feel secure. She was away at work, leaving me feeling like it was all too much for me to take care of myself. I was too little. When I receive instructions it must be absolutely clear and precise and in logical order. I always have to start at "A" if I 'm interrupted . When my teacher told me something nice I felt desperate, like I could not hold onto his words. So I wrote them down and kept them in my purse. For weeks I had to take the paper out and look at it hand feel good. It was like getting a shot of love each time. Obviously, I was holding back feeling so bad about myself I see now how many of my hundreds of rituals are designed to keep those bad feelings and my anxiety away. I never had anyone at home to reassure me. My rituals, at least, serve that function I love exams in school because I can look at the grades and "know that I 'm good and not bad. That 's why I was teacher's pet. Everyone else hated exams. Not me. When I'm alone my mind works overtime going over my latest schemes to make life better. I worry about it so much that I hardly notice it. It's a way of life. If someone hurts my feelings I obsess about it constantly; what I should have said or done, what I 'm going to say. I go over and over the shortcomings of my boss, which is identical to what I did with my mother. I felt disgust for her at abandoning me, and at the same time need her desperately. The clearest example of this resolves around romance and sex. If I develop a crush on someone I spend my waking hours thinking about him, working out hundreds of fantasies of how me will be together (gazes, hugs, kisses, romance, and sex). I now see how these fantasies are spun out of a longing in my body to be held and loved. It's half pleasure, half pain. It goes to the longing I had for my mother when I was little. As my needs come up I get more and more obsessive in my thoughts. I flirt outrageously during these times. I literally feel like an animal in heat. I needed love from my mother with every bone in my body; as early as the crib I could feel it. And no one ever came to soothe me. I have to set up situations now where I can recreate the feeling of longing I had for my mother; so I obsess about men. Now my need has become romantic The more I feel my early need, the less I obsess romantically about men in my life. My need becomes what it is, a need for my mother who was never around. I think I had all of these basic feelings and then my household was so compulsive that I learned to channel them into obsessions. Dinner was always on time or my father would be irritable. He would open my bedroom door each morning and say, "five more minutes". Then, "Time to get up! " then, "One more minute!" etc. Everything at home was regimented, including vacations, birthdays, and holidays. My dad would be ready first, then according to his schedule he would stand at the bottom of the stairs and count to ten slowly. We had to be downstairs by "ten. " I see how chaotic I feel inside. Trying to make some order outside reassures me. I think if there is chaos outside it is too much for me. Part of me feels so out of control that I have to control everything. I feel like if I don 't try to keep it all together I 'm going to fly apart. My birth and my home like were pure chaos. I needed stability and routine; so I make it everywhere I go. If I take a tranquilizer that stops all those feelings from coming up, I can briefly feel like I 'm together. When the pill wears off I obsess to keep myself together. Happily, I am no longer the obsessive I used to be. In most situations I can be spontaneous and don 't get freaked out by unpredictable things. I don 't need routine to make me feel stable and lists to make me feel secure. I have felt the real reason I felt that way. The New Primal Scream by Dr Janov Chapter 10--Stress, Anxiety, and Tension: Symptoms of Disease The Nature of Tension Fear provokes the defense system into action producing all the varied machinations to keep the need away. Fear is an automatic response that is part of the survival mechanism. It prepares the organism to ward off the blow in the same way that we tense up when we are going to get an injection. When the system cannot ward off the Pain successfully, there is conscious fear-i.e., anxiety. Fear, too, is usually not consciously felt. It becomes part of the general pool of tension. Anxiety is felt but not correctly focused fear. Anxiety is evoked when the defense system is weakened, allowing the feared feeling to rise near consciousness. Because the feeling is not connected, the anxiety is often unfocused. The basis of anxiety is the fear of not being loved. Most of us stave off anxiety by developing the kinds of personalities that keep us from feeling how unloved we are. Personality develops as protection. The function of personality is to fulfill the child's need. This means he is going to try to be what "they" want so that he can finally be loved. Trying to be "them" is what makes tension. Being oneself is what eliminates it. Being oneself means to be whole-to be connected body and mind. Let us suppose that a young boy needs to be held by his father but his father thinks that "men" do not hold and kiss. The boy, trying to be a man for his father, denies his need and acts rugged. This rugged personality both produces and binds tension. Then this boy grows up and has an ulcer and is sent for psychotherapy. Sometime soon in his treatment I call him a fag. Now he is anxious. I have found him out-that is, I have put my finger on his suppressed need which may have turned into latent homosexual feelings. He may become angry at my name-calling, but that anger is a cover for the real hurt-a defense against feeling his real need. His anger is a way of releasing tension. The reason that the boy became rugged in the first place was to be loved by his father, but this motivation has long since been buried. Not allowing him to be rugged is to face him with the loss of love and approval- the Primal hopelessness. Any behavior in the present which is based on past-denied (unconscious) feelings is symbolic. That is, the person is trying through some present confrontation to fulfill an old need. Any present behavior based on these unconscious needs I call symbolic acting out. In this sense, the personality is the symbolic acting out in the neurotic. Arthur Janov founded a school of therapy To read more on Arthur Janov and Primal Therapy, A skeptical perspective of Primal Therapy can be found through here. Talk about it:
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