Quotes from Scott Stossel

If we expect to suffer, we are anxious," Darwin wrote in The Expression of the Emotions in Man and Animals. "If we have no hope of relief, we despair.")

Those who are unable to experience anxiety are, generally speaking, more deeply pathological—and more dangerous to society—than those who experience it acutely or irrationally; they're sociopaths.)

My anxiety is a reminder that I am governed by my physiology—that what happens in the body may do more to determine what happens in the mind than the other way around.

Dr. W. believes, as Freud did, that anxiety could be an adaptation meant to shield the psyche from some other source of sadness or pain. I ask him why, if that's the case, the anxiety often feels much more intense than the sadness.

bitter fights over revisions for the DSM-V—which have included public denunciations of it by the chairmen of the task forces that produced the DSM-III and DSM-IV, respectively—suggest that psychiatric diagnosis may be more a matter of politics and marketing than either art or science. c

A report published by Britain's Mental Health Foundation in 2009 concluded that a "culture of fear"—marked by a shaky economy and hyperbolic threat-mongering by politicians and the media—had produced "record levels of anxiety" in Great Britain.

Today, evolutionary psychologists say Watson misinterpreted his Little Albert experiment: the real reason Albert developed such a profound phobia of rats was not because behavioral conditioning is so intrinsically potent but because the human brain has a natural—and evolutionarily adaptive—predisposition to fear small furry things on the basis of the diseases they carry. (I explore this at greater length in chapter 9.)

The very best meditators seem even to be able to suppress their startle response, a rudimentary physiological reaction to loud noises or other sudden stimuli that is mediated through the amygdala. (The strength of one's startle response—whether measured in infancy or adulthood—has been shown to be highly correlated with the propensity to develop anxiety disorders and depression.)

According to the National Institute of Mental Health, some forty million Americans, nearly one in seven of us, are suffering from some kind of anxiety disorder at any given time, accounting for 31 percent of the expenditures on mental health care in the United States.

Other recent research suggests that James and Lange were right in observing that physiological processes in the body are crucial to driving emotions and determining their intensity. For instance, a growing number of studies show that facial expressions can produce—rather than just reflect—the emotions associated with them. Smile and you will be happy; tremble, as James said, and you will be afraid.

Studies of the DSM-II found that when two psychiatrists consulted the same patient, they gave the same DSM diagnosis only between 32 and 42 percent of the time.

I smile gently while churning inside and thinking about what I've learned is a signature characteristic of the phobic personality: "the need and ability"—as described in the self-help book Your Phobia—"to present a relatively placid, untroubled appearance to others, while suffering extreme distress on the inside."c

Fear arises from a weakness of mind and therefore does not appertain to the use of reason. —BARUCH SPINOZA (CIRCA 1670)

The result of a physiological fear response that has no legitimate object, or that is disproportionate to the size of the threat, can be pathological anxiety—an evolutionary impulse gone awry.

Barbra Streisand developed overwhelming performance anxiety at the height of her career; for 27 years she refused to perform for the general public, appearing live only in private clubs and at charity events, where she presumably believed the pressure on her was less intense.

To grapple with and understand anxiety is, in some sense, to grapple with and understand the human condition.

Even as economic and political freedoms have advanced enormously and generated huge benefits for humanity, they've also created a great deal of anxiety because every time you have to make a choice, there's anxiety about making the wrong one.

Carly Simon abandoned the stage for seven years after collapsing from nerves before a concert in Pittsburgh in 1981. When she resumed performing, she would sometimes ask members of her band to spank her before she went onstage, to distract her from her anxiety.

One challenge is trying to extend access to more poorly served communities in rural areas and in the inner city. Sometimes you have kids who are suffering from trauma and post-traumatic stress disorder, and they have no way of getting access to the remedies that are available to them.

There's a book that's critical to understanding anxiety, a 17th-century book, 'The Anatomy of Melancholy,' by Robert Burton. I wanted to write something like that.

There are lots of things, including changing the kind of inner dialog, that can mitigate anxiety. And yes, there are people who have the glass half full and glass half empty, and I'm afraid the glass is going to break and I'll cut myself on the shards.

The fear of vomiting, which for me is one of the most original and most acute of my fears, is actually fairly common. Emetophobia, it's called, and by some estimates, it's the fifth most common specific phobia.

To say that my anxiety is reducible to the ions in my amygdala is as limiting as saying that my personality or my soul is reducible to the molecules that make up my brain cells or to the genes that underwrote them.

All the textbooks talk about avoidance as a classic hallmark of anxiety disorder. So you need a therapist who is sympathetic and understanding but will also push you to do precisely the things that scare you.