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In a recent New York Times Magazine article, Benoit Denizet-Lewis explores the question, “Why are more American teenagers than ever suffering from severe anxiety?” He refers to the annual survey of students conducted by the American College Health Association, which found a significant increase of undergraduates reporting “overwhelming anxiety” in the previous year (62 percent in 2016, up from 50 percent in 2011). A related survey reported in the article was conducted by the Higher Education Research Institute at U.C.L.A. In 1985, they asked incoming college freshmen if they “felt overwhelmed by all I had to do” during the previous year. 18 percent said they did in 1985. In 2010, this percentage grew to 29 percent, and last year, that number was at 41 percent. Additional findings of teen mental health deserve reflection, including double the hospital admissions for suicidal adolescents in the past 10 years (and suicide being a leading cause of death for young people). Denizet-Lewis’s article explores crucial questions, including a central issue facing parents, educators, and mental health professionals: how far do you push teenagers to face their fears and to what extent do our protective impulses make things worse?
In addition to these questions, it is also worth wondering how anxiety, particularly in its more normative and universal form, develops in childhood and is embedded in the experience of family life. It is also worth considering what factors might contribute to its worsening as well as its resolution. A discussion of universal, so-called normal anxiety may shed light on its more severe forms.
In the DSM-5’s taxonomy, anxiety is distinguished from fear, the former being defined as the anticipation of future threat and the latter as the emotional response to real or perceived imminent threat. The two states overlap and the various anxiety disorders described in the DSM-5 vary in the relative contributions of fear and anxiety. For example, fear is more associated with bursts of autonomic nervous system arousal and features prominently in panic attacks. Furthermore, it is both the excess and persistence of the symptoms that distinguish anxiety disorders from developmentally normative fear and anxiety. Indeed, being fearful and realistically worried is part of our nature. Whatever else it has done, anxiety has served us well in pushing us forward, imbuing us to detect threat, and keeping us close to our loved ones.
Freud offered speculations about the origins of our anxiety in childhood. An initial theory was that we experience libidinal wishes and impulses that are at once highly pleasurable and full of dangerous possibilities. Our psyche defends itself against such stimuli through repression. We perform a kind of psychological alchemy, transforming forbidden impulses and wishes into anxiety. In this way, what we most want we most fear. Anxiety is secondary to more primal emotions. Interestingly, Freud’s views evolved and he put forward a revision to this theory in his 1926 essay, Inhibitions, Symptoms, and Anxiety. In this essay, Freud advanced a theory about the state of helplessness in infancy. As described by the psychoanalyst Josh Cohen:
Perhaps the problem was that he’d been observing anxiety through the lens of a clinician inquiring into the neuroses, guided by the question ‘Why would you be anxious?’ Whereas if you observe anxiety through the lens of the universal experiences of birth and early infancy, you might be more likely to ask yourself the opposite question: ‘Why wouldn’t you be anxious?’ Looked at from this angle, suggests Freud, anxiety is seen to be a product of the infant’s mental helplessness which is a natural counterpart of its biological helplessness. Anxiety isn’t, in other words, a derivative of a more primary state of mind, but an essential condition and inescapable destiny.
Extending Freud’s ideas about helplessness further, the British psychoanalyst Donald Winnicott wrote about how the infant transforms helplessness into a state of omnipotence. If the mother is “good enough” in nurturing the infant in this state of vulnerability and dependence—providing warmth and safety but not intrusion—the child will retain some level of omnipotence in the gradual disillusionment that comes with healthy development. With this also comes the possibility of a creative life. Summarizing this state of affairs, Cohen wrote, “Life will be forever haunted by the psychic and physical helplessness into which you’re born, and which you’re never really allowed to surpass. The infant you’ll always be never lets you forget how much you have to be anxious about, how often and easily your experience can exceed your capacity to master it.” Far from being a pessimistic view, however, such anxiety fuels our ambition, pushes us toward one another, and fosters a sense of wonder and humility.
What might be happening among young people who are reporting higher levels of anxiety? The truth of our dependence and vulnerability is tough to face. Adolescents are both exhilarated and terrified by their mounting independence and autonomy. To be sure, there are many influences that come into play: fear of failure combined with a high press for achievement, social media, and high levels of personal ambition. There are also real risks and dangers for many young people: economic stress, bullying, discrimination, abuse, and violence. When it comes to resilience factors, teenagers vary tremendously in the psychological, social, and cultural resources at their disposal. Still, irrational dread can burden anyone. Complicating the picture are the meta-messages given to teens about their need for safety and protection from stress, unwittingly sent by well-meaning school officials and other adults in their orbit. Such protection may serve to keep teenagers feeling helpless and incapable of coping. Since anxiety is fueled by avoidance, its diminishment depends on being met head-on.
© 2017 Bruce C. Poulsen
