Panic

There's one part of I-90 West where it always happens to me. By this point in the drive I'm far enough away from home and far enough still from my destination to begin feeling deserted and at the mercy of the elements. And then, at a particular curve of the road, I suddenly slam into a wall of unmoving cars, and it dawns on me that it will take at least fifteen minutes to cover the next tenth of a mile. The moment always seems to coincide, by the way, with some shift in the sky overhead, a move from clear New England sunshine to monochromatic gray.  That's when my palms sweat, and I start making tiny coughing sounds and guzzling bottled water. I turn NPR on and off, every five seconds, trying to decide if "Wait Wait... Don't Tell me!" will distract me from the rising terror, or contribute to it by fortifying my sense of forsakenness, as the sound of other people laughing together often seems to do when one is not in on the joke.

I guess it's what they call a "panic attack," and I suppose I am a person who has "panic disorder." Saying this, however, still lacks conviction for me. The reason is that the thing I'm afraid of when I'm in the traffic jam, the thing that I'm trying desperately to forestall by drinking water and fiddling with the radio and forcing out loud, false belly laughs so as to artificially juice my Serotonin levels and singing Protestant hymns in the voice of a female opera contralto at the top of my lungs -- the wolf at the door that all this activity is meant to turn away, is of course the panic attack itself. And once the traffic starts to loosen, once the snake of cars ahead of me finally uncoils, then the fear dissipates, and I think "Good, I avoided the panic attack again, it still hasn't come." But of course, it did come. The frantic effort at evasion was the attack.

I, like most people who struggle with panic, am aware of all the ironies you might be inclined to indicate at this point. You ask: "If you can't name the thing you're actually afraid of, why be afraid?" Please don't think the thought hasn't occurred to me. Please don't think that such words aren't exactly the sort of message I try to hypnotize myself with in my head when I'm in the midst of one of these attacks. I set these and similar words playing in a loop in my brain, to try to drown out the rival record playing from downstairs-- the one that says: "What if you panic so badly here in the middle of this New England highway that you have some sort of medical emergency? What if you panic so badly that you swerve into another car? What if--" oh, I won't bore you with the roster of fears. They are infinitely various, and I'm sure I'll think of many new ones in the years ahead that have not yet occurred to me. They all relate back to the simple fact that I am not absolutely safe.

The thing is, though, that this existential condition of imperfect security is just as true a feature of my life when I am humming along at 60 miles an hour under a beautiful blue sky, as it is when I'm inching through an overcast afternoon down an infinite line of guard rails. And this, again, is one of the things I'm always trying to remind myself of when I feel the panic starting. It is an inner pep talk that has the following cheering refrain: "Josh-- the world has not changed its entire nature since you got into this traffic jam," it says. "The universe has not exchanged one metaphysical essence for another. You didn't just 'realize' once and for all, two seconds ago when you hit this wall of traffic, the terrible hollowness of the human destiny and of all our petty strivings. You didn't suddenly 'understand' the truth of Schopenhauer and of philosophical pessimism. You are just upset because you got into a traffic jam." 

Kingsley Amis gave himself a similar lecture to get over his hangovers. “You are not sickening for anything," he begins each session, "you have not suffered a minor brain lesion, you are not all that bad at your job, your family and friends are not leagued in a conspiracy of barely maintained silence about what a shit you are, you have not come at last to see life as it really is[.]" Rather, and rather simply: "What you have is a hangover." Amis' gnomic conclusion from this effort of self-persuasion is this: "He who truly believes he has a hangover has no hangover." So too, if I were really able to convince myself, on all levels of my being, that nothing really life- and universe-altering has just occurred, that all that is happening is that I am having a panic attack because I am stuck in traffic, then no panic attack would I have. Go and do likewise, says the prophet.

There is some Buddhist text I once encountered through a course that seemed to have something important to say about anxiety. It bids the student, once he has filed away some of his ego by reflecting on what a fundamentally unnecessary bag of liquids and solids he is, to then concentrate on whatever pain he is feeling, and only on this pain. He waits for the pain to come and says: "there is a pain there." And keeps waiting for it to come back, so he can name and acknowledge it again.

There is an implicit "experts only" warning to such instructions, and I've found the practice doesn't do much when one has just stubbed a toe (one will be saying "There is a pain there" every instant in that case). I find it helpful with panic attacks, however, because so much of what is terrifying about them is the fear of the panic itself. If one can therefore restrict one's attention to what one is actually feeling in each moment, rather than in the imagined future, the terror could in theory be dissipated. Easier said than done, though.

You should never trust my will as a blogger to generalize from the individual to the universal, meanwhile, but I suspect there are other afflictions that can be partially mitigated by this same exercise. Joan Didion's description of migraine (which-- significantly-- is also an affliction that stems from low Serotonin), strikes a familiar note for me, as does her method of coping. "I lie down and let it happen," she writes. "At first every small apprehension if magnified, every anxiety a pounding terror. Then the pain comes, and I concentrate only on that. Right there is the usefulness of migraine, there in the imposed yoga, the concentration on the pain."

*****

To be subject to panic attacks or depression, or any of the galaxy of other related ailments, is to be at once unduly convinced of one's powerlessness and perversely and exaggeratedly certain of one's agency. On the one hand, a panic attack can seem to come from nowhere. Places in which one felt perfectly secure a week ago suddenly become the focus of terrible daydreams and evil thoughts. A day that started out full of extravagant promise can become, after the afternoon rolling in of rain clouds and the post-lunch slowing of one's heart rate and metabolism, a plodding march into dusk. Those small arguments and evidences I adduce to myself over my morning coffee to prove that my future is bright and my goals are being met -- the ones that seem so airtight and irrefutable in that first hour of daylight -- can suddenly and mysteriously desert me at approximately 2:15 PM, especially if I am somewhere between Central Square and Kendall on the MBTA. 

Here is the sense of powerlessness, which is one of the two Janus faces of panic. One finds one is at the mercy of something that can step into one's life in ways that defy all expectation -- and explanation. "[I]t [...] occurred to me that the fright on this particular morning was going to present itself as an inability to drive this Budget Rent-A-Car across the Carquinas Bridge," says Joan Didion in another essay. She writes with surprise at the deeds and transformations of her panic, as if it were a force wholly outside herself-- and that is often how it appears. 

One eventually comes to realize from this that it is the fear that is the real thing, and not the various dangers one had previously identified as its "sources." One can be afraid of flying one day, of Lyme disease the next, of botulism or lead paint on the one after that. The fears intermingle and overtake -- maybe even replace -- one another. The true substance, the Form underlying the particular manifestations that appear before our senses, is the fear. What the fear is of is always secondary. 

Sometimes, for me, it's fear of a bridge, as it is for Didion, though it is more likely to be of some enclosed space I must occupy for some reason-- the cabin of an airplane, or a subway car. Certain kinds of nice restaurants used to do it to me as well, and I'm no fun at all in darkened bars, especially if they have loud music playing. When I first started grad school, it got so bad that even elevators began to frighten me, and I could not ride them one floor up without fingering a cylinder of doctor-prescribed Xanax in my pocket, to continually prove to myself it was there. The medication ("Take once a day as needed...") had a sort of talismanic effect on me, the power of which derived merely from its presence -- "as a last resort" -- rather than from its actually being used. For a while this Xanax strategy worked on the elevator, until my fears decided to pounce on the idea that if I was trapped in an elevator and started panicking, then I would not be able to take the medication because I would not have any water with me. So for a time I carried a bottle of water everywhere too (hence my capacity to guzzle while stuck in the traffic jam -- see above). 

There is no theoretical limit to this. I could carry around the entire outdoor camping and sporting goods department from REI with me and still never be perfectly secure from existential dread or the possibility of sudden death. One can always pull some further rug out from under one's sense of safety, if one tries hard enough. One can remove another floor or pull the stop of another trap door an infinite number of times, so one falls a bit further each time than one previously thought possible. The insight of panic, the true and indisputable fact of the universe that it uses as a weapon against us, is that there is no final floor underneath -- no last rung of certainty. One is not absolutely safe at the ultimate level, whether from philosophic despair or physical annihilation, anywhere one goes. 

And in this lies the perverse sense of agency I was talking about -- the second face of panic. Because as much as panic feels as if it were a force beyond us -- Didion's "the fright" -- it simultaneous feels like an entirely natural response to the human condition. If we haven't yet developed an unusually strong capacity for stepping outside of ourselves and peering down at our emotions from that vantage point, then panic never seems just to be "panic" -- it seems to be a reasonable emotional response to some ghastly truth we've just unearthed, and toward which the rest of humanity is obscenely, unpardonably indifferent. This is what is truly insane about all insanities. From the outside, they appear "irrational," inexplicable even. Part of what is terrifying about mental illness to those peering over the edge of it is the thought that it could take them over, possess them, from the outside. A character in a Siegfried Sassoon poem warns himself relentlessly: "[I]t's been proved that soldiers don't go mad/ Unless they lose control of ugly thoughts /That drive them out to jabber among the trees."  But in a strange way, panic can do something even more frightening -- it can seem precisely not like a force outside ourselves, but simply a product of our rational minds discerning for once the awful truth of things.

*****

Curiously, though, the defeat of panic, to the extent it ever comes, arises from both of the same convictions that seem to give it strength -- namely the sense of one's powerlessness in the face of one's fear and of one's simultaneous agency over it. Such at least has been my experience. If the conviction of being powerless, at the mercy of some unbidden force, is part of the reason for the fearsomeness of panic, it can also bring about panic's downfall, as we saw above. Once I realized that I was prone to panic, I was able to see -- at least part of the time, and in limited flashes -- that the attacks were not actually reasoned responses to external stimuli. I could set off that inner pep talk described above, to remind myself that whatever I was thinking or feeling at that moment was not the final truth; it was not the last word on the meaning of existence or the nature of humanity; it was just panic. And more importantly, it was panic that would pass. Whatever dismal view of things I had entertained while under its influence would pass away with it. 

One of the best literary depictions of anxiety I've come across appears rather unexpectedly in an old ghost story by M.R. James, "Oh Whistle and I'll Come to You My Lad." The story's protagonist is trying to get to sleep in a seaside inn, which is also home that night to a lot of eery creakings and other sounds. James writes:

"Awake he remained [...] long enough to fancy (as I am afraid I often do myself under such conditions) that he was the victim of all manner of fatal disorders: he would lie counting the beats of his heart, convinced that it was going to stop work every moment, and would entertain grave suspicions of his lungs, brain, liver, etc. - suspicions which he was sure would be dispelled by the return of daylight, but which until then refused to be put aside."

The point is that there is no reason at all why heart and lungs should work better in the daylight than they do at night. The fact that one does not worry about them at the former hour, therefore, suggests that both one's daytime conviction of immortality and one's nighttime terrors of sudden death are not actually founded in reason. Each will pass away in its time.

This hope for eventual reprieve -- this belief in the impermanence of fear -- is the truly crucial thing to convince oneself of, because panic is nothing more, nothing other, than the loss of hope. It is the moment of realizing you don't have enough oxygen to reach the surface, that the fire has reached and consumed the only remaining stairwell. It is the frantic clawing at the temple wall after the emperor has sealed you inside, so that you should accompany him on his journey to the afterlife. The defeat of panic, then, is simply the regaining of hope-- in this case, the faith that one will feel better the next day, one will feel less afraid, even though the reasons by which one will justify such feelings the next morning do not presently seem available.

So too, the sense of frightening agency -- and thus, of terrible responsibility-- that is induced by panic can be defeated by its own strength -- a kind of psycho-emotional jiu jitsu. For if we recognize panic as something that proceeds from within us, rather than being imposed on us by the outside world in its many snares and terrors, then we can intervene intellectually in its progress. We can create another, spectator self that stands outside of the panicking one and watches what it is doing  -- with indulgence and maybe even a sense of humor. More on that below.

****

Have I learned anything from having panic? One does not wish to claim any hidden benefits, let me be clear, to psychological afflictions. That is part of what lodges them even deeper in the mind, and what makes us want to hold on to them at times when we might have the power -- and certainly every reason -- to let them go. The truth is that panic has not made me smarter or better or more creative. By filling my head at times with toxic thoughts and images, in fact, it may have made me less of all three.

Besides, I distrust all breakthroughs and "Ah-Ha! moments." So many of them seem certain at first, until one finds that one's original problems are still waiting for one as soon as the adrenaline wears off or a disappointment sets in. I'm skeptical about the benefits of learning lessons. In the movies, I always seem to prefer the characters before they learn their lessons.

In my case, I know only that I feel panic at present much less often than I used to. This is true to such an extent that I now recall some of my earlier attacks as the madness they were. The fact that I could hardly stand to ride an elevator one floor up seems as incomprehensible to me right now as it probably does to you. But I hesitate to declare that I have found a "solution" to my panic. So often such brave declarations are really just a form of bad self-coaching, rather than sincere advice to the world, or the authentic self-report of someone who has fought a deadly adversary and won. All I can say is that I have fewer episodes of panic when I am in periods of general happiness and security in my life, among which I would count the last year and a half. To the extent I find ways of having and extending more such periods, I likewise win a victory against the panic.

I can also share with you my various survival methods, my ways of skirting the emotional landmines, in the hope they might be helpful to you as well. Mere methods of evading emotional peril should never be poo-pooed. "I am a depressive," says Roger of the John Updike novel, "It is very important for my mental wellbeing that I keep my thoughts directed away from areas of contemplation that might entangle me and pull me down." It doesn't sound like a heroic doctrine -- it sounds, in fact, like the quintessentially unheroic doctrine-- but it actually requires great courage to live in accordance with it. There are times when it requires a great deal more guts to say "no" to something one knows will lead to unhappiness, than it does to acquiesce to it. This is what is not generally understood by all those healthy, non-anxious presences out there, who think you should just "face your fears" where panic is concerned. They do not realize that the various fears are only the surface of the matter-- the underlying substance is the panic, which can metastasize and spread and assume ever-protean shapes without ever being defeated in itself. Escaping the panic may not therefore end up involving the facing of one's fears; it may in fact mean having the courage to refuse the promptings of various people -- most of them well-intentioned and loving and concerned -- to face them.  Foresight, and calculated evasion in light of it, is a perfectly acceptable mechanism of emotional self-defense, as far as I'm concerned-- more than that, a necessary one. 

My other two survival strategies are simpler-- they involve other people, and humor. The blessings of other people when it comes to panic should be obvious. Other people have with them some cord that traces back to sanity-- and this is true not because they are all "normal" (unlike oneself, presumably) -- they certainly are not, if they know you, a reader of this blog. But human beings in groups are able to provide each other with that thing that is so intimate, and at once so dependent on one's relationship with others -- the self -- that can preserve them from madness.

It is because I am aware of how necessary the presence of other people is to keep the mind from steadily removing all its own structures of support, from deliberately destroying all its own means of self-sustenance, that I am quite convinced that subjecting people to solitary confinement in prison is an inhuman atrocity. The company of other people is one of the few things that can provide the mind with bread crumbs leading back to reality and selfhood. In their absence, there is no end to the violence the human brain can inflict on itself.

As for "humor," I use the word deliberately. As opposed to "laughter," that is. Laughter is manifestly not any kind of cure for any Serotonin-inhibited spiral. If one is in the midst of a deep depression or a sudden spike in panic, there are few things as disheartening to hear as "laughter" in a crowded room, especially in the various booming and tinkling manifestations in which it reaches one's ears in such places, apparently from people happier than oneself (though if they are really, who can say?) 

Humor is something very different. Humor is what Freud, as cited by Andre Breton, described as "elevating." It is a process of transmogrification-- an alchemy whereby we reach inside ourselves and turn those darkest thoughts and ugliest grey matters into a source of joy. It is the ultimate, the greatest declaration of the mind's sovereignty over itself-- of its capacity to mock in the face of its own tendency toward self-immolation. 

Humor is the second self within me who observes the whole onset and escalation of panic, and who is able to recognize within it an otherwise obscure fact -- the fact that what I am doing in these instances, and why, is actually kind of funny.