My Age of Anxiety: Fear, Hope, Dread, and the Search for Peace of Mind

  • Scott Stossel
Knopf: 2014. 9780307269874 | ISBN: 978-0-3072-6987-4

Scott Stossel is, in his own words, a “quivering, quaking, neurotic wreck”. He is frightened of flying, vomiting and cheese. He has thrown tennis matches from a winning position just to get off the exposed stage of the court, and struggles to control his bowels. For three decades he has been a regular in the offices and clinics of psychiatrists, psychologists and psychoanalysts, and a testing ground for whatever treatment, drug or quack therapy they thought might bring some relief.

Stossel offers an unsparing and unsentimental look at a subject that many keep hidden.

Stossel is also a married father of two and editor of The Atlantic magazine. His terrific book My Age of Anxiety is his attempt to reconcile those two worlds, and offers an unsparing and unsentimental look at a subject that many keep hidden: mental illness.

Stossel suffers from anxiety, a condition that he identifies early on as tricky to define. Is anxiety the list of symptoms offered by psychiatrists? The biological response to threat that we share with animals? The social consequence of the shared knowledge of our mortality? Or the chemical consequence of misfiring neurotransmitters and brain circuitry?

Books exploring personal experiences of mental illness tend to be either overwrought accounts of personal trauma that shed little light on the world beyond the author's nose, or the more detached observations of scientists and medics. It is rare to find works that bridge these objectives, which is one reason that the writer Andrew Solomon achieved such success with The Noonday Demon (Chatto & Windus, 2001), his personal and scientific account of depression. Stossel's book deserves a place on this higher shelf.

My Age of Anxiety covers all the academic ground one would expect. We get the biological idea that anxiety is an unsuited modern deployment of an atavistic fight-or-flight physiological response to threat, the psychological basis for conditioned responses — that anxiety is a learned, if inappropriate, fear — and the nascent attempts to link mind and body through brain scans and genetics. With help from some friendly neuroscientists, Stossel finds he has a variant of the SERT gene implicated in anxiety.

Stossel is also aware of current controversies in psychiatry. He gives fair voice, for example, to both sides in the debate over the usefulness of pharmaceuticals, talk therapies and the shift from viewing anxiety as a social and philosophical issue to a disorder of chemical and electrical signals.

And he shows his skills as a writer with colourful and moving accounts of traumatic personal episodes. As a child and adolescent he suffered extreme separation anxiety and, aged 13, would wake the neighbours and ask them to call the police when his parents were out. The treatments were often equally grisly. Given an emetic syrup to make him vomit as exposure therapy to rid him of his phobia, he endures only hours of severe nausea and painful retching.

Stossel addresses the heterogeneous ingredients of anxiety by trying to cover them all — as if a sense of completeness alone can bind them together. His policy of full disclosure may not always be to everyone's tastes: an anecdote of a blocked toilet and a meeting with John F. Kennedy Jr, for one, feels gratuitous. But the approach also offers useful reminders of the human cost of taking strong positions on the use of drugs and other areas of scientific and medical uncertainty. Poised between a psychiatrist who puts him on drugs and a therapist who urges him to abandon them, Stossel finds himself lying to the therapist to spare her feelings when he returns to the psychiatrist.

One of Stossel's motives is the hope that the book might bring him peace. Still, he writes, “If it's relief from nervous suffering that I crave, then burrowing into the history and science of anxiety, and into my own psyche, is perhaps not the best way to achieve it.”

We should all hope it works: the man is due a break.