Weekend Reads

Photo by Lia Leslie

If anxiety is a normal human reaction to (real or perceived) danger that helps keep us alert and alive, what makes it turn the corner into a problem – something that gets in the way of our day to day lives?  What does anxiety look and feel like and how can we best treat it when it comes knocking.

Lenika Cruz, of The Atlantic, had her first panic attack right before beginning a new work-from-home job. Telecommuting seemed like a dream, but it set up the perfect environment for agoraphobia to take root, grow and thrive. Listen in while Lenika tells us her story and how she’s making her life bigger every day.

Check out this interview with Dr. Reid Wilson as he talks about anxiety, resisting and how learning about the laws of physics can help us find freedom. And, if you haven’t seen his blog posts on the Psychology Today site, here’s the link.

Love this one from Lynn Lyons where she discusses her own challenges with anxiety and how sharing her story helped a client open up and make huge strides in his life.

Learning to Master Panic is a great article by Dr. Janet Klosko of the Cognitive Therapy Center of Long Island. In it, she does a fantastic job of describing the experience & symptoms of panic, why people resist and avoid and ways to systematically go toward the fear with their sights set on freedom.

A love letter from my Dad

*My Dad sent me this with permission to post. I know of some people who, after sharing their experiences with family, came to find out that one of their parents, aunt, uncle, cousin, etc. struggled with anxiety and they never knew. When we put our vulnerabilities out in the open with people we trust, some really lovely connections can occur.*

This is Kristin’s Dad writing. And I relate so intimately to the experiences she describes because I’ve been there and still am sometimes there myself. She comes by it all honestly via biological inheritance; genetics has an odd sense of humor. It reminds me of Mark Twain’s line about getting tarred, feathered and run out of town on a rail. He said something like, “If it weren’t for the honor of the thing, I would have just has soon passed up the experience.” More on that in a bit.

The year was 1957, I was almost 13 years old, it was early on a Sunday morning and I was out on my bike, delivering the Chicago Herald American. It was sunny, the weather was mild and there was nothing in the world to suggest to me that this would be any different from the hundreds of times I’d done my paper route in the past. I had covered the stretch of 112th Place and had just crossed State Street over by Cooney Mortuary – maybe you know the place – when I suddenly felt like I was in a dream – like everything around me was muted and slightly unreal. And then I recall this welling feeling of panic that I was going to die. I can even recall shouting, to see if this was, perhaps, a dream. It wasn’t. But my recollection is that it went away by the time I got home and I said nothing to anyone about it. But a few weeks later, another shoe dropped. I woke up on a Saturday morning with the sensation that I couldn’t feel myself breathing. The panic along with this one drove me downstairs where I blurted the news to my folks. I can’t imagine to this day how jarring and alien this must have been for them but my Dad, who was always good in a crisis, must have instinctively known that getting me calm was a first step to figuring out what was going on, presumably medically. And I remember that a couple of glasses of water and his reassuring arm around my shoulder somehow convinced me that my breathing was OK and that I wasn’t going to die. At least that morning! That summer we went to California and my folks almost turned around and went home when I had a pretty nasty attack of it in Salt Lake City. Fortunately, they didn’t; the trip still carries many wonderful memories.

The thing was, though, this was the 50’s. And no one seemed to know much of anything about Panic Disorders. After maybe a year of episodic attacks, my father, with his engineer’s way of looking at things, was determined to make a logical and planned assault on the problem. When our family doctor said he didn’t know what this was, Dad took me down to the prestigious University of Chicago Medical Campus for a full work-up. This didn’t quite pan out the way the Old Man planned. They did somewhat of a work-up but, while Panic Disorder wasn’t well recognized in those days, anxiety and phobias were. The 1958 medical establishment answer, of course, was psychoanalytic psychotherapy. And so, I started seeing a psychiatrist at the University of Chicago who, in Freud’s best style, sat there, gazed intently at me – and said almost nothing for 50 minutes at a pop. We stared at each other all summer long and, amazingly, I got better. What I know now, with a doctorate in psychology and a job as the clinical director of a large community mental health system, is that the real cure wasn’t Dr. T’s blank slate act. The “cure” lay in getting on a CTA bus by myself, transferring buses a couple of times, and making the weekly trip down to the University, despite my fears that I’d have an attack along the way. That, and the normal remitting and exacerbating course of a disorder that makes guest appearances and then disappears for months or years at a time. But what I did then on the bus – and what Kristin is doing 50 years later over bridges – carries the same principle of taking it on, practicing, flooding, desensitizing and using cognitive reframes. I would have much preferred an “aha” moment in exploratory psychotherapy, where the key from some childhood experience would be handed to me and the door unlocked. Kicking yourself in the ass and making yourself go beat the snot out of the gorilla, daily, is much less elegant and a hell of a lot more work. Unfortunately, it’s effective.

Over the years, I have had long periods of full remission, mixed periods of on and off stuff and periods where it has tormented me a great deal and made me fear that I’d lose my ability to function or make a living. I have not always fought the good fight and have avoided things far too often. Note that Kristin hit the nail on the head when she identified shame as factor that intensifies and broadens the illness. The script goes something like this: “I ran away from it. I am an awful coward. If people only knew how little courage I have, it would disgust them.” Given the stigma, you now begin to lie so that people won’t know your shameful secret. And, of course, you find yourself deeper in self loathing because you are now labeling yourself – unfairly, of course – not only a coward, but a liar, too. Yet so often in the face of the intensity of panic and the anticipation of its return, avoidance and lies have seemed like a price worth paying in the moment. Unfortunately, the interest on that credit card payment comes due and compounds itself.

But you must recognize your triumphs, too. When Kris and her brother were growing up I went through an awful period of agoraphobia associated with the panic and a dread of getting on I-95 for the wall-to-wall traffic into DC, where I worked as a reporter. Weekends I rarely ventured out of the apartment, finding comfort in my books and home hobbies like amateur radio. During the week, there were days that I called in sick and made excuses to my bosses. But most of the time, I gritted my teeth and endured feeling trapped in the middle of that traffic. What choice was there, really? I had to support my family. It wasn’t noble, it was necessity. And, for all of that, it helped me back into periods of remission, even though I didn’t fully understand the therapeutic part of it way back then.

Over the years, I have had to confront a variety of challenging situations like that and find, in my older age, I confront less – with the somewhat flawed rationalization that I’ve paid my dues and am going on strike against the damned malady. I don’t fly anymore and I climb stairs instead of riding elevators. I avoid big bridges. The flying keeps me from visiting places overseas but, while I regret the impact it has on my family, I don’t personally feel like I’m missing a vital experience. I like road trips and I like trains. As for the stairs, I’m in better physical shape, courtesy of my phobias. Thanks, phobias. My best to the gorilla! This is not an endorsement for selective avoidance – just truth in advertising. Besides, I take on the things I need to take on. I’m not crazy about public speaking, but addressed an assembly of 350 clinicians recently and am emceeing an event this coming Friday. I had to throw those items in because, despite what I tell my patients, I have more than a trace of hypocrisy about stigma and caring what others might think of me. I’ll go back to my Old Man, God rest his soul, and his wisdom. “Kid,” he’d say, “Do what I say, not what I do!”

By the way, I want to take a quick side track here on another matter. I loved Kristin’s comment about the friend who semi-jokingly asked her about hallucinations. It shows the great perceived divide out there between the putatively sane people and the putatively crazy people. But the divide is phony. What I mean is that people in America are so terrified by the concept of mental illness – and that they might catch it – that they conjure up a monolithic image that looks something like Norman Bates – and they whistle through the graveyard convincing themselves that, of course, they are different. Well, I’m here to tell you that mental illness takes on many different forms, is never monolithic and that all of us have our pieces of idiosyncratic thought and behavior. Lincoln, Churchill, Mozart all had mental illnesses and enriched our lives immeasurably and irreversibly. The great psychiatrist Harry Stack Sullivan was fond of saying, “We are all of us more human than otherwise.” Meaning there is no clear demarcation. Thank God. Get over it, America. Especially film makers who get rich playing to our fears.

At the outset, I mentioned Mark Twain and said that, given the choice at birth, most of us might well have chosen to avoid a lifetime of periodic panic attacks and phobias – – – were it not for the honor of the thing. Well friends, I am biased, but I will assert that there is great honor in the thing. I am absolutely convinced that the majority of people with anxiety disorders are among the most intelligent, creative people around. Almost by definition, it is the intellect and creativity that magnify the biology – dull people don’t create all those elaborate, “what-if” mental scenarios that feed Kristin’s gorilla. There’s an out-of-print book, called “Be Glad You’re Neurotic.” We don’t use that diagnosis anymore, but you’d love the book.

People with panic and anxiety disorders, in my experience, tend to have finely honed senses of humor, plenty of compassion for suffering in others and an uncelebrated and quiet courage in facing daily battles that are often invisible to people around them. Doesn’t that describe people you’d like to be around and have as close friends? Look in that mirror for a while and take it in. For every avoidance, there are far more uncounted successes – uncounted by people with the disorder. As a matter of fact, we grow and develop into people of substance and character from the struggles of our challenges.

In closing, you’ll permit me the parental prerogative, I hope, of bragging on my daughter. An undergraduate degree in writing, a master’s degree in social work, professional work after graduation in a settlement house in the community helping people in great need, birth educator, doula, spouse and one terrific mom to three lovely children. Woman of character and substance. When I saw this blog, it just blew me away. Talk about creativity, courage and giving help and meaning to others! My love for her and pride in the human being she has become is boundless. I write this with a big silly grin of button-bursting emotion on my face. You go, daughter! You’re the best!

Love always, Dad.