As you can see in the picture, "Anxiety," is the title of this past Sunday's New York Times magazine cover story. The thought bubble above the woman's head is not legible but it says, "Am I going to be laid off? If the black and white picture of the worried woman with the yellow background and bold title weren't enough to catch my attention, the woman's thought rang true for sure: it's a fear I'm hearing in my therapy practice every day now. Underneath the headline in smaller black lettering the author invites us to explore whether anxiety is reactive or simply reflective of our brain wiring.
When I read this, I immediately flashed on a host of clients I've worked with over the years who most certainly were hard-wired to worry. Their external circumstances and interpersonal relationships didn't seem to jibe with their level of anxiety. The article's author, Robin Marantz Henig, cites a number of longitudinal studies that arrive at the conclusion that overly fretful babies become overly anxious adults. The histories of the subjects of the studies are similar to the histories I've heard in my psychotherapy practice over the years. For certain people excessive anxiety waxed and waned over the course of their lifetime and persisted even during the best of times.
The story is well written and solidly grounded in scientific theory but presents a danger of too easily promoting resignation for those who live with this type of chronic anxiety. This is a report well worth reading because the writer accurately documents historical data and brain patterns that accompany anxiety disorders and remains evenhanded when she notes that "temperament is important but life intervenes." The story, however, is potentially hazardous because highly anxious people are going to read it and likely say to themselves, "There's nothing I can do about my anxiety. I was born that way."
Even the phrase "life intervenes" promotes a gloomy response because it's as passive as brain wiring: they both are things that happen to people and have nothing to do with potential actions to adaptively manage a brain that is wired for worry. Life events may be as inevitable and immutable as brain wiring, but personal power and resilience can be optimized if an individual chooses to do so. Any concept of free choice, free will and strong character might have left the reader feeling empowered and hopeful. On the other hand, issues like moral fiber and spirit might not merit inclusion in an article that attempts to be scientific. These were my thoughts when I read the article on Saturday night and, sure enough, a client who'd read the same piece emailed me early Sunday morning declaring, "If I'm born like this, there's really nothing I can do to change that. I'm just unlucky, I guess." Fortunately, I believe, for her, I emailed her back, explaining my belief that "we make our own luck and even if we don't, we retain the power to choose our attitude towards life's conditions and toward ourselves." Even more important," I wrote, "you're blessed with an abundance of strengths including, but not limited to, an inborn willingness to struggle and persevere and sweat your way through the inevitable bad times."
My intervention related to the unexplored variable that is presented when psychology and neurology both hit a dead end: character. We can choose to sculpt our own character traits and overcome even the worst of circumstances. Character can be defined by the virtues and qualities associated with it: integrity, self-discipline, interest in others, gratitude and determination. These qualities are consciously built over time with how we've coped with difficult situations. Beyond that, part of character is willingness to get help combined with the grace to receive it.
Victor Frankl was a Viennese psychotherapist who founded a school of therapy called logotherapy. Its meaning derives from the Greek word "logos," to make meaning out of something. The central premise of logotherapy is that while we cannot control what happens to us in our lives, we can choose our attitude toward life's conditions and toward ourselves. The path to recovery, according to logotherapy, is literally to learn to make meaning out of whatever circumstances come our way in life - learn to reflect profitably on our experience so that we can frame it in a way that both mirrors reality and serves our most cherished aims.
Frankl, a young psychiatrist in Vienna was interned in a Nazi concentration camp between 1942 and 1945. Partly because of this experience, Frankl developed his theories of logotherapy. He certainly confirms the lessons I've learned as a psychotherapist and these lessons are exceedingly useful in that they empower us rather than promote resignation into depression and a personal identity based on having been born with an anxiety wired brain. Making meaning, giving back to the world, strong character, determination and moral fiber can and will be the central determining factor in what each of us does with our brain wiring and the circumstances of our lives.
