If one day you suddenly fell awkwardly to hear your leg crack into pieces, aside from an acute feeling of horror and panic, the first thought you may to yourself is, ‘I need to fix this right away, someone please help!’ Indeed, such a reaction is expected when such a painful and catastrophic has occurred. When someone experiences a physical injury, the expected and conditioned response is to seek medical assistance and try to make the symptoms and disability subside. Because of the advent of medical technology and supporting infrastructure, we have developed a collective expectation that when we are hurt, someone can fix it.
While medical technology and availability of services makes us think that help for any discomfort is readily available, it is my contention that not all things we experience as negative or injurious can or should be dealt with in the same way.
Anxiety is something that proposes some very distinct differences in comparison to how we tend to deal with every other kind of injury or problem. It seems quite obvious to me, anyway, that a broken bone or laceration is something that justifiably merits the expectation of immediate medical attention. However, what comes with this expectation is an implicit assumption that medicine can fix it and that a broken leg is indeed – a medical problem that can and should be solved using medical solutions. My argument here is that we should not be treating anxiety in the same way and that anxiety is something different altogether. That said, since 1980 when the Diagnostic and Statistics Manual of Mental Disorders (3rd Edition) was published, the concept of anxiety as a medical problem, the awareness of anxiety as a medical problem has flourished to become one of the most prevalent medical issues in our society. Before the decision to medicalize it was made, anxiety was thought of many different ways and called many different things (e.g. neurasthenia, neurosis, melancholia etc.) and was not necessarily medicalized to the extent it is nowadays. Since the publication of this diagnostic manual in 1980, the terms that we use to describe anxiety that have become ubiquitous to everyday life (e.g. ‘panic disorder’, ‘generalized anxiety disorder’, ‘obsessive-compulsive disorder’ etc.) The result of creating a specific framework of diagnoses has been an increase in diagnosis, treatment, and costs. The result of this medicalization has also taught people that anxiety is something that is best treated using the medical system and that perhaps anxiety should be considered as something we must avoid, make go away, or is generally negative and awful.
Before I support my assertions (in the subsequent parts of this series) that anxiety should not considered a be prima facie medical condition, I need to account for that it may seem insensitive or even callous to say that someone who is in a state of acute anxiety should not immediately seek out a medical intervention to make it subside. Most people are conditioned to think that making anxiety go away at all cost is the ‘right’ thing to do. But as I will propose, when it comes to anxiety, unlike a broken leg – and because of the very nature of anxiety – the worst thing one can do is do anything with the particular aim to make it go away. This is because trying to make it go away actually intensifies it and is then a counterproductive strategy. If it is true that trying and striving to make anxiety go away intensifies it, then it stands to reason that doing nothing in the place of something is a prudent way to proceed when encountered with anxiety, if and only if the intention is to make anxiety subside.
In conclusion to part one of this series, anxiety has become medicalized (for various reasons I will not discuss in this series) and the result of this is that people can now have a diagnosis attached to their anxiety. This diagnosis, while appealing, carries with it various suppressed assumptions – that anxiety is a medical condition that requires medical treatment; that anxiety is something we should avoid or make go away etc. We have been conditioned to think that anxiety is not unlike other issues such as a broken leg and that we ought to treat it in the same way.
While this post is not intended to discourage or lead people away from medical services to deal with anxiety, the argument I intend to make in this series is that the more you ‘awfulize’ anxiety and strive to make it subside, anxiety intensifies. If this is true, then doing anything to make it subside with the explicit intention of making it subside (e.g. avoiding things, people, situations, ritualizing, diagnosing on the internet, etc) actually provide anxiety with the fuel it needs to flourish. If the aim is to reduce anxiety altogether, then the trick is to do nothing about it at all.
Please stay tuned for part II of this educational series on the Philosophy and Ethics of Anxiety. In part II, I will talk about the paradox of anxiety and how making it go away is actually making it stay and how to develop skills to do nothing in the place of something.