The pattern continued for six months. For six months I experienced a brief weekly relief and a quick weekly relapse. For six months—about four years to the teenage consciousness—all the activities that had once come naturally to me were as labor-intensive as if I were doing them in pudding. I couldn’t study, I couldn’t think, I couldn’t socialize. Most troubling of all, I couldn’t laugh. The most hilariously acid joke or outrageous pratfall rang hollow and pathetic. It was as if the world had lost some of the supports holding it upright and now sagged like a circus tent coming down.
Then, at the start of my senior year, something bizarre happened: I recovered. I was making no new effort, had no new pharmacological help, experienced nothing resembling an emotional synthesis or catharsis. I was barely participating in therapy anymore; for the most part I just sat there with my fingers laced, politely playing out the clock. Nothing outward had changed. Yet I started to feel better—and quickly, too. All I needed to do to reclaim my former self, it came to seem, was nothing at all. Time would do the work all on its own.
This isn’t to say I became totally unaffected by what had happened. It remained naggingly clear that while everyone I knew was stepping up their efforts to remove each other’s clothing I had stopped my efforts completely. But since a reversion to not getting laid was merely a reversion to normalcy, I wasn’t much bothered. It still occurred to me that I might have contracted HIV, but as time passed and I didn’t break out in sarcomas my paranoia deflated and I began, incrementally, to unclench. Each morning I woke in my loft less tremulous with the sense that during the night I had dreamed of catastrophe, disasters tumbling one after another like in some frenetic horror movie. The icicle in my chest thawed, then melted, then disappeared.
People with chronic anxiety may recognize this episode of peace restored as a false détente, a psychic ceasefire that in retrospect gives off the same aura of accumulating violence as the years between the World Wars. Because what everyone with chronic anxiety eventually realizes is that time, on its own, means exactly nothing. Time is just a distraction to anxiety. Its power to comfort is tied directly to its ability to maintain consistency. So long as the days are the same, so long as the ride is generally smooth, you’ve got a halfway decent chance of remaining steady. If you are a desert hermit or a cloistered nun, this approach may hold anxiety at bay for a lifetime. If you are a regular person with regular human relationships, if you exist in the flux of mundane reality, you’re sleepwalking toward the edge of a cliff.
I can point with great precision to the moment I fell off that cliff. It was the day my parents dropped me off at college: Brandeis University, the only nonsectarian, Jewish-sponsored institution of higher learning in the country and therefore, presumably, one of the world’s anxiety epicenters. I was standing curbside in the wet New England heat, my stout brick dorm—my new home—at my back, and I was watching my parents climb into their car and drive off. As they turned the bend and disappeared, all at once the frost re-formed on my sternum. My mind befogged, my vision began to shimmer, my limbs began to tingle, and I was suddenly seized by the impulse—an impulse it took every bit of self-respect I could muster to stop myself from acting on—to go bolting down the road after them, an idiot dog chasing a car.
• • •
It was bedlam. The campus was bedlam. Everywhere I turned hordes of eighteen-year-olds scurried around as if they’d just thrown off the chains of some vicious bondage. They wore expressions wide with opportunity, of almost limitless choice, of restrictions lifted, slates cleaned, surveillance minimal. They were joyful and unhindered, electric, confident. They strutted and flexed and postured heroically in the vegetal summer air. My parents thought they were dropping me off at a respected liberal arts college, but where they had really dropped me off was Jewish Mardi Gras.
I shuffled up and down the brick footpaths feeling like a health inspector at an orgy. Dodging errant Frisbees and threatened introductions, I considered every scrap of information on college I had picked up over the years, every campus movie and novel, every off-color anecdote from an older cousin or brother, every damaging revelation about the student life of a politician, and I found, to my chagrin, that I could not come up with a single one that did not proclaim, loudly, that college was a place where a person was supposed to let go. Everyone wanted me to let go. My parents wanted me to let go, my friends wanted me to let go, Sandra wanted me to let go. Mahatma Gandhi, had he been available for questioning, would have wanted me to let go. More than anyone, the school’s administrators wanted me to let go. Why else would they have gone to such lengths to engineer this celebratory atmosphere—all those orientation games and trust exercises and mixers, all those quads primped and planted and manicured to within an inch of their lives—if not to make me feel at home and uninhibited? And why did I feel, in spite of their best efforts, as if I had been shipped off to a gulag?
One answer is that I was supposed to feel this way—that it was inevitable and even normal and I was just misreading the signals. Over the years, my mother says, she has treated dozens of college freshmen, many of whom experienced their first jolt of true, consciousness-unmooring anxiety upon leaving home. It seems that college-matriculated eighteen-year-olds are something of a therapeutic cash cow. If my mother had told me this when I was eighteen, which she didn’t, I wouldn’t have believed her. The evidence of my pathological singularity was too prevalent and convincing. But now the college’s insistence on stuffing those first days with activity strikes me as proof positive that not only was I one of many trembling through all that manic, merciless gaiety, but that I was, in a very important sense, in the psychological majority. All around me anxiety was rampant and I didn’t have a clue.
For most American teens, college represents a first dose of bona fide, adult-level choice. It means a sudden widening of possibility, a chance to think, love, and live in pretty much any way that suits you at any moment, for pretty much any reason. The freedom afforded by college happens to be exciting and desirable; it gets the blood up. But what all those barbeques and mixers fail to convey—what they are in fact actively designed to ward away like a bad smell—is the converse truth that the freedom afforded by college is inevitably also unsettling and confusing and deeply anxiety-provoking. Freedom is anxiety’s petri dish. If routine blunts anxiety, freedom incubates it. Freedom says, “Here are the lives you can choose, the different, conflicting, mutually exclusive lives.” Freedom says, “Even if you don’t want to make choices you have to, and you can never, ever be sure you have chosen correctly.” Freedom says, “Even not to choose is to choose.” Freedom says, “So long as you are aware of your freedom, you are going to experience the discomfort that freedom brings.”
Freedom says, “You’re on your own. Deal with it.”
• • •
We’re not as accustomed to thinking of anxiety in terms of freedom as we once were. The idea of choice as something that’s prima facie unsettling to the human organism comes up often enough when we talk about the proliferation of lifestyle options—too many cable channels or brands of toothpaste or parenting techniques—but not nearly as much when we talk about the personal, private condition of anxiety. And yet for a very long time the idea that anxiety and freedom were linked was not only widely circulated but enormously influential.
The wellspring of this influence happens also to be the first book ever to treat the subject of anxiety head-on: Kierkegaard’s 1844 treatise The Concept of Anxiety. Kierkegaard was writing out of a complaint that might have been directed at the organizers of freshmen orientation weeks. His age, he wrote, “was a cowardly age,” in which “one does everything possible by way of diversions and . . . loud-voiced enterprises to keep lonely thoughts away, just as in the forests of America they keep away wild beasts by torches, by yells, by the sound of cymbals.” To Kierkegaard, anxiety was a universal and ineradicably human experience, and directly linked to our spiritual selves. The subtitle of The Concept of Anxiety is “A Simple Psychologically Orienting Deliberation on the Dogmatic Issue of Hereditary Sin.”
If you had to read that a few times to try and figure out what it means, try to read the book. Even Kierkegaard experts have trouble getting through it. Some scholars have argued that the whole thing is so confusing and opaque and generally out-of-whack that it must have been a hoax. I couldn’t get through the thing myself; it made me nervous. And yet it’s clear that Kierkegaard was writing out of intimate experience. His descriptions of anxiety are some of the most vivid we have:
And no Grand Inquisitor has in readiness such terrible tortures as has anxiety, and no spy knows how to attack more artfully the man he suspects, choosing the instant when he is weakest, nor knows how to lay traps where he will be caught and ensnared, as anxiety knows how, and no sharp-witted judge knows how to interrogate, to examine the accused, as anxiety does, which never lets him escape, neither by diversion nor by noise, neither at work nor at play, neither by day nor by night.
This could only have been written by someone who understood anxiety from the inside. It’s a sufferer’s account. Even Kierkegaard’s abstractions have the feel of lived truth. He saw that although anxiety is experienced as a kind of all-encompassing nausea—he compared it to the dizziness that afflicts a person when he peers down into an abyss—there is always something specific behind the feeling. That something specific is the popping up of an option—a crossroads. Before anxiety there is possibility. “Possibility means I can. In a logical system it is convenient enough to say that possibility passes over into actuality. In reality it is not so easy, and an intermediate determinant is necessary. This intermediate determinant is anxiety.” Whenever a person is faced in life with a choice, his whole being trembles with the dilemma of what to do. It trembles because, being human, he wants both things but can’t have both; because deciding always means being altered; and because alteration, however desirable, is always violent. Anxiety is the stage a person has to pass through on his way to creating himself.
You can probably see from this why The Concept of Anxiety has been called “the sourcebook of existential psychology.” That we’re all free to make ourselves and that freedom is uncomfortable is pretty much Existentialism 101. You can probably also see why Kierkegaard might appeal to a person whose anxiety began as the result of an unwise choice. But there’s something about Kierkegaard’s yoking of anxiety to freedom that’s hard to accept, even offensive. This is a corollary to his thesis; it follows directly from the definition of anxiety as a sort of byway between possibility and actuality, a necessary anguish one endures in order to grow or develop or improve. Because if that’s true then there are essentially two types of people, those who push through the anxiety and those who are beaten back by it. Everyone, in Kierkegaard’s estimation, feels anxiety; it’s part of the human condition. What separates the men from the boys is how you respond. Boys shut their eyes—they refuse to look into the abyss. The men look. They own up to ambiguity and conflict. They own up to reality. They are more tuned in to life as it actually is. A friend of mine who read a lot of Sartre used to say, “We all make decisions. Some of us more than others.” Kierkegaard said, “The greater the anxiety the greater the man.”
This is where Kierkegaard loses me. It’s flattering to think that there might be some immutable suffering-greatness nexus, but it contradicts my experience of just how anxiety operates day to day. It contradicts a facet of anxiety that I find to be absolutely essential. I’ll describe this by way of something I call the Roy Rogers Problem.
• • •
The Roy Rogers Problem refers to a meal I had seven years ago at the Roy Rogers franchise in the Grover Cleveland Service Area and park-and-ride, between exits 11 and 12 off the New Jersey Turnpike. I was on my way from Chicopee, Mass., to Trenton (long story) and had stopped to pee and buy washer fluid when, all of a sudden, I was struck by an urgent need for a roast beef sandwich. The problem—the philosophical crux of the matter—was what to put on the roast beef.
I’m talking here about your semi-liquid condiments. Some choices trigger one’s anxiety sense and others do not. After selecting and purchasing my foil-wrapped sandwich at the cafeteria-style counter, I headed to the fixin’s bar, where I decided that what my sandwich required produce-wise was a single slice of whitish-pink tomato and absolutely no lettuce. I had no difficulty with this decision; I didn’t even have to think about it. And yet the condiments caused me immediate trouble. I quickly ruled out mustard: I don’t like mustard on roast beef. And the mayonnaise on offer was sallow and crusty, as if it had been left out for days. This left me gazing through the cloudy, fingerprint-smudged sneeze guard at the dark condiments: barbeque sauce and ketchup.
Barbeque or ketchup. It’s a tough call under any circumstances. Ketchup is the conservative choice—unassuming, sturdy, the tried-and-true way to offset the saltiness of the meat. In presidential terms, ketchup is Eisenhowerian. But what I began to wonder, standing there at the fixin’s bar, was whether my life at that moment maybe called for something spicier, something as sweet and taste-bud-arousing as ketchup but with an edge. A sexy, bold condiment. A Kennedyesque condiment!
I deliberated for a long time. I scrutinized the tubs of sauce with their white nasal spouts as if I were consulting the oracle at Delphi. A dense knot of glassy-eyed commuters began to build behind me. Eerily, no one said a word. You would expect the patrons of a North Jersey rest stop not to have much tolerance for extended condiment deliberations. But that just shows how insidious our stereotypes can be. It was like they understood and respected the quandary in which I found myself. Like they’d been in the same position themselves. But there they were, breathing. I registered their presence. I felt a mounting pressure to act one way or the other. Barbeque or ketchup. Ketchup or barbeque. When you get down to it the difference is negligible. Both are genealogically related to the tomato. Both contain satisfyingly high levels of corn syrup. Even the difference in their appearance is subtle, the matter of a few shades. And so I got the idea—a flash of insight, really—that what I’d do was choose not to choose. I would apply a dollop of ketchup to one half of the sandwich and a dollop of barbeque sauce to the other and if they happened to mingle when I reapplied the top portion of my bun . . . so be it!
Then, just as I was about to execute my plan, someone to my right cleared his or her throat and abruptly, driven by a mechanism external to the deliberations I’d been making, I reached out and plunged a haphazard squiggle of ketchup onto my sandwich, then skittered away like a crab. That I’d done this, that I’d acted against my own rationally thought-out wishes, was, once I’d found a table and settled in front of my tray, a source of more dread and anguish than maybe I can convince you is true. But it is. In that inconsequential moment, sitting in front of a four-dollar lunch, I was almost as anxious as I’ve been at any other moment in my life.
And what nags me about this is that the source of my anxiety was exactly what Kierkegaard says the source of anxiety is, and what he praised in direct proportion to the volume any person possesses: possibility. The awareness that life is a series of choices any one of which could be either aggrandizing or disastrous. That this happens to be true I have no trouble signing on to. Anyone who has lived past the age of ten knows that even piddling actions can wind up having big consequences, and that even when you are super-conscious of your behaviors you can’t know how things are going to turn out in the short- or the long-run. That’s the drama of it all. On the one hand, your very existence means you can and will change things in your life and others. On the other hand, you aren’t God, so everything is always going to be drenched in uncertainty and doubt.
The problem I have with all of this, the Roy Rogers Problem—or, if you prefer, the Vinaigrette–Bleu Cheese Dilemma, or the Häagen-Dazs–Ben & Jerry’s Conundrum—is with the part that connects living-in-doubt to truth, and so to greatness. Because if you are one of those people who registers the drama of human agency every time he goes to the fixin’s bar, then there is going to come a point at which an admirable receptivity to anxiety crosses over into self-involvement of the nastiest, most radical sort. There is going to come a point at which you are so alert to your freedom and the responsibilities thereof that you lose the ability to distinguish between those choices that are vital to human existence and those in which the likelihood that they will mean anything to anyone is so infinitesimal, so statistically remote, that even to consider the possibility is going to be a total waste of your time. And when that happens, when you reach that point, then whatever greatness you can lay claim to because of the atypical sensitivity of your consciousness will start to eat away at itself. Because greatness, with all due respect to Kierkegaard, isn’t just a matter of having a sensitive consciousness. It’s a matter of having a lot of consciousness so that you can turn that consciousness back on itself. It’s a matter of using your consciousness to dull the parts that are distracting and harmful and build up the parts that are effectual and courageous.
Kierkegaard was right: To be human is to be anxious. But that’s just the starting point. The next and most important step is learning how to discipline your anxiety without smothering it completely. Without, in fact, wanting to smother it.
• • •
There are two types of anxiety sufferers: stiflers and chaotics.
Stiflers are those who work on the principle that if they hold as still, silent, and clenched as possible they will be able to cut the anxiety off from its energy sources, the way you cinch off the valve on a radiator. It isn’t hard to spot a stifler. They tend to look haunted and sleepless, like combat veterans, and they are more likely to chain smoke and pour themselves a drink within five minutes of getting home from work.
Chaotics, by contrast, work on no principle whatsoever. Although chaotics are sometimes stiflers when alone, around people, and especially in tense interpersonal situations, they are brought into a state of such high psychological pressure that all the valves pop open of their own accord, everything is released in a geyser of physicality and verbiage, and what you get is a kind of shimmery, barely stable equilibrium between internal and external states, like in those rudimentary cartoons where the outlines of the characters continuously squiggle and undulate. Sometimes the behavior of chaotics is interpreted by laymen as emotional honesty, but it’s almost always involuntary. Chaotics are merely stiflers with weak grips.
When I went off to college, I wanted very much to be a stifler. Partly this was because of pride. To go crying to your mother right after you’ve had sex for the first time is sufficiently humiliating that it fosters a need to maintain composure at similar points in the future. Partly, however, it was because going off to college isn’t just a journey into dread-inducing freedom. It is also a journey into a sudden, stultifying constriction of one’s personal space—which is to say, the opposite of freedom. This is what makes college so precarious a transition for your less robust types. It’s an anxiety double whammy: In the existential sense, college radically expands life’s possibilities; but in the nitty-gritty, flesh-and-bone sense, college throws you into cramped living quarters with people you have never met and share no genetic affiliation with but whom you have no choice not only to endure but also to shower with, brush your teeth alongside, and defecate three feet away from. After close to two decades of cohabiting exclusively with parents and siblings, this shift can cause a fair amount of psychological friction. This is particularly true because in freshman dormitories it is something of an imperative to present yourself as poised and confident even if you are in fact bilious, angst-ridden, and actively decompensating. In this way, the dorms are not unlike army barracks, right down to the bunk beds, the thin mattresses, and the young men weeping quietly into their pillows.
It became clear very early on that, in these conditions, I didn’t have what it takes to be a stifler. I tried. How I tried! In those first weeks away my circumoral muscles got a serious workout, what with me grinning anytime anyone so much as breathed in my direction. The grin was a reflex, like a startled cat extending its claws. I didn’t realize how disturbing it must have come off to my new classmates until late one night I tried it out in the mirror. I looked like Charles Manson at a parole hearing. My other efforts presumably didn’t come off much better. There was, for example, my voice. I did my best to pitch it somewhere short of screamingly hysterical but I could never pull it off. The problem was that the thicket of muscles that connect the head to the shoulders were, in my case, perpetually clenched—a condition that, had I weighed more than 120 pounds at the time, might have made me look like a villain on the pro wrestling circuit, playing to the crowd. Instead I looked and sounded like an enormously ugly girl at a Justin Bieber concert.
Then there was the coughing. I coughed a lot. It was a mid-level cough, volume-wise, halfway between a throat-clear and a deep-phlegm extraction, and I peppered my conversation with it liberally. I did this in order to quell the sensation that I was about to projectile weep onto whomever I was talking to. This sensation welled up in me especially when I had to talk to professors, and it was deeply unsettling, because I took it for granted that in calculating final grades a professor could only be swayed negatively by the fact that he’d been wept on. The coughing helped.
But not for long. By the end of my fourth week at school round-the-clock anxiety and the addled half-sleep that comes with it had eaten so thoroughly into my defenses that only the most violent fits were able to keep the tears at bay. There was simply nowhere to escape to. At home when I was anxious I could count on two places in which I was free to freak out as extravagantly as I wanted: my bedroom and the bathroom. Even in high school the bathroom was usually available for a quick nervous breakdown, because by then improved security had driven the smokers outside, across the property line. In the dormitory bathroom, I discovered, it was almost impossible to find the solitude a real anxiety attack demands.
Three times, out of a sort of neurotic muscle memory, I hurried down the hallway from my room to find a stall in which I could take my head in my hands and let loose with whatever high-order grunting or moaning might, when the paroxysm had run its course, result in an hour or two of calm. The first time I found a barrel-chested sophomore in lacrosse shorts vomiting energetically into (or mostly into) the middle of a long line of sinks. When he noticed me standing there (the cough) he stared at me briefly with wet deer eyes and said, by way of explanation, “Tequila.” The second time the bathroom was being used for the same purpose, but now by a long-haired freshman who was naked save for a pair of tight turquoise underwear. The third time the sophomore was back, although this time he didn’t notice me because he was unconscious. From the looks of it he had passed out in medias vomitus, slumped in a position that one would think it would be impossible to remain unconscious in no matter one’s blood-alcohol level: his knees on the tile, his arms dangling at his side, and his chin resting on the lip of the sink. I took one look and hurried back to bed.
• • •
All of my weep-sorties to the bathroom happened in the morning, at anxiety’s worst, and what the sight of my debauched hallmates suggested to me was not the simple, obvious fact that college students sometimes drink to excess and that drinking to excess isn’t terribly good for the body. What it suggested, rather, was that drinking to excess was the comparatively smart way to go. We were similar, lacrosse-shorts and turquoise-underpants and I. We all felt the urge to expel the poisons within us. We had all rushed to the bathroom. What divided us was what preceded that urge. They had presumably felt pleasure before their collapses. Their nausea followed joy, and so had a sort of built-in redemption. My nausea followed nausea, and so was redeemed by nothing. I’d botched the equation. It was supposed to go PLEASURE→NAUSEA→DISCHARGE. Mine went NAUSEA→DISCHARGE→NAUSEA. What I saw when I looked at lacrosse-shorts and turquoise-underpants wasn’t just a couple of puke-stained underclassmen but young men whose presence was explicitly intended to make it clear to me that my emotional life was untenable and self-destructive. They may have looked like schmucks, huddled there sickly, but the message they delivered was that I was the schmuck, for I didn’t even know to have a little fun before the pain. And who doesn’t know that?
My roommates delivered much the same indictment. Tom and Sanjay, of central Massachusetts and New Delhi, respectively, were not the sort to chase the pleasures of the flesh. In those first weeks, the majority were rushing into a haze of keg beer and bong hits and chopped-up Ritalin tablets. Not Tom and Sanjay. Would that they had, so that I could have been left alone with my anxiety rather than having to endure their unnerving equanimity hour after hour. They were geniuses of equanimity, those two. Tom, I could at least rationalize, had training in this respect. Tow-headed and rangy, he was a boarding-school veteran, and had the boarding-school veteran’s nonchalance down pat. On move-in day he ambled into our room carrying an economy-sized bar of Toblerone, took a look around at the drab bureaus and the barren bunk beds and nodded dispassionately, as if he were thinking, “I’ve seen better, but it’ll have to do.” Me he regarded with a more quizzical air. He must have encountered that look in the eyes of classmates before—that first-day terror—but his attitude still suggested, in those first weeks, that it was his peculiar fate to have to live for nine months in close quarters with a Woody Allen protagonist.
Sanjay regarded me with the same wary skepticism. This really hurt, because of all people Sanjay should have been my comrade in dread and homesickness. Six thousand miles from home, unaccustomed to the strange ways of the American teenager, mandated at pain of disinheritance to achieve his way into a top medical school, Sanjay should have been paralyzed by anxiety. We should have been up on our bunks trading pills like they were baseball cards. Instead Sanjay eyed me suspiciously, as if he were afraid I might walk across the room and collapse into his arms. Sanjay’s presence exuded the worst message of all. To me his poise said, “I’ve got it way worse than you and I’m managing fine.”
Or perhaps he didn’t see a thing, for one night on his way back from brushing his teeth he stooped to pluck a small white something off the carpet. “What is this?” he asked no one in particular.
It was one of my Xanax tablets. My mother had sent me to school with a small supply. It must have fallen out of the container as I fumbled with the cap one dreadful night.
“I don’t know,” I said.
“It’s a pill of some sort, I believe.”
“Yes,” I said. “It’s a pill of some sort.”
He paused to think for a second. “Is it your pill, Dan?”
“No,” I said. “Not mine. I don’t take pills.”
He examined it, turning it over in his palm. “I wonder how it got here.” Then: “Are you certain it isn’t yours?”
“Let me take a look.”
He handed it over, and I made a good show of scrutinizing the pill for signs of ownership.
“Oh,” I said. “Oh, right. Yes, it is mine. I totally forgot. It’s mine.”
“But you said—”
“I completely forgot. It’s mine. Thanks.”
“What is it?”
“It’s a . . . vitamin. It’s one of my vitamins.”
“A vitamin? What is it for?”
“My heart,” I said, and climbed into bed.