The Business of Treating Anxiety

When Freud invented talk therapy over a century ago, he emphasized the importance of anxiety. For the great Viennese neurologist, depression was someone of an afterthought, a secondary manifestation.

Of course, we have come a long way from Freud. The advent of cognitive therapy, specifically designed to treat depression, along with the arrival of different medications for the condition, made depression the primary modern emotional affliction.

Anyway, anxiety began to recede into reduced significance, until more recently, when, as the Wall Street Journal reported yesterday, the mental health business discovered a lucrative source of fees. (via Maggie's Farm)

The Journal called anxiety a new industry, and you conclude, without reading too far in the article, that the mental health profession does not know what to do about anxiety. There are so many different treatments that you imagine therapists throwing everything they have against the wall, tio see what sticks.

A multitude of treatments abounds, from the strictly medical to the newest in New Agey panaceas:

A search for “anxiety relief” on Google pulls up links for supplements in the form of pills, patches, gummies and mouth sprays. There are vibrating devices that hang around your neck and “tone your vagus nerve,” weighted stuffed animals, bead-filled stress balls and coloring books that claim to bring calm. Ads for online talk therapy apps pop up on social-media sites.

On reading such a comprehensive list, one can only conclude that something is missing. As it happens, among the oldest and more widespread treatments for anxiety is yoga. Stretching and breathing exercises are notably effective in taming anxiety. The article says nothing about yoga.

And, of course, the article has nothing to say about a more radical form of anxiety, the kind that produces phobias.

Meanwhile, back with Freud, his initial theory of anxiety honed in on guilt. Guilt is obviously a form of anxiety, the kind you feel when you anticipate being punished for a crime or a sin. In Freudian theory, as in Christian theology, we are all miserable sinners and we fear the wages of our sin.

Thus, anxiety as guilt; or guilt as anxiety.

In that context, we can ask how religions have taught people to deal with anxiety. Surely, it must begin with confession, the basis for psychoanalytic therapy. And then, after confessing your sins you are allowed to erase them by doing penance. 

Obviously, if the sinner does not punish himself, God will punish him. Thus, penance has been a cure for a certain type of anxiety, the kind that Freud placed at the center of his new religion.

Penance is a form of self-punishment, designed to have the penitent sinner pay a price for his dereliction. Think of the flagellants who roamed from village to village during the Middle Ages, punishing themselves in order to ward off God’s punishment-- the bubonic plague.

Or think of religions where people atone for their sins by fasting for a day.

Naturally, the psycho professions have nothing to do or to say about sin and penance. They have ignored religion, even though Freudian theory is merely a recycled religion, one that is dressed up with the vestments of science.

So, in a time when we have learned to separate science from religion, we have turned the treatment of anxiety into a business. This suggests that we have yet to find a more effective means of treating it, whether through therapy or through medication.

But, we need to keep therapists in business, and we need to address a problem that seems disproportionately to befall the irreligious,  so we soldier on.

As for cause, if anxiety does not derive from our sinful propensities and proclivities, its current manifestation and ubiquity must derive from another source.

Let us note that people feel more anxiety and more threatened when they feel alone and vulnerable, separated from groups. Radical individualism makes us anxious. As Aristotle so sagely put it, in his Politics, a human individual detached from social groups cannot long survive.

So, another aspect of anxiety, one that people today are increasingly aware of, is the simple fact that people do not feel connected. They do not feel like they belong. They feel detached and thus vulnerable.

In that case, the cure for anxiety is socialization, getting along with other people, developing constructive social ties. Again, the Journal article ignores this rather obvious solution to a problem.

Note well, however much of a sinner you are, dealing with anxiety through religious sacraments affirms your membership in a community. I will pass on whether or not God is going to forgive you, but regardless of whether he does, your membership in a religion will serve you well.