Monday, May 11, 2009

What Are The Chances?

(Happy 200th post to me...)

And so it stays just on the edge of vision,
A small unfocused blur, a standing chill
That slows each impulse down to indecision.
Most things may never happen: this one will
And realisation of it rages out
In furnace-fear when we are caught without
People or drink. Courage is no good:
It means not scaring others. Being brave
Lets no one off the grave.
Death is no different whined at than withstood.

From "Aubade," Philip Larkin

Last week saw an evening of violent storms and tornado warnings, greeting by my disaster-enthralled son with hopefulness and by my more knowing daughter with alarm. The tornadoes were many miles away, so there was no real need for concern at that point, but still she pleaded for reassurance: "Daddy, are you sure there won't be a tornado?" Well, no I couldn't be absolutely sure, but I tried to explain that some things in life are so rare that there's no point in worrying about them beyond taking common-sense precautions.

She wanted some examples. Well, having the house get nailed by a tornado may be comparable to a person getting struck by lightning. Really bad stuff, but extremely unlikely. What else, she wanted to know, and a couple of responses came to mind but were discarded. Maybe like getting eaten by a shark (no good--beach season coming up). Maybe like someone invading our home and killing us all ("So when did you start having problems sleeping?" her therapist asks 20 years from now). So I came up with: Like getting hit by a meteorite. This wasn't really accurate, as no human being in recorded history has been struck and killed by a meteorite, but it sounded sufficiently farfetched that she was reassured.

Anxiety disorders are basically the mind's inability to tolerate horrendous but rare outcomes. The daily stream of consciousness continually flows over and around appalling eventualities. This nagging cough could mean cancer. This plane could go down at any moment. My child could be snatched away from the bus stop by a passing pedophile. All of these are non-bizarre possibilities, but the non-anxiety-disordered mind, knowing that there is only so much apprehension to go around, is able to focus on more probable scenarios that can realistically be modified.

One component of cognitive-behavioral therapy for anxiety disorders entails pointing out statistical considerations. The cough is much more likely to be a lingering but benign virus. Air travel is far safer than ground travel. This is a safe neighborhood, and you can't watch your child every second of every day. The reason why anxiety disorders can be tough, and CBT can be limited, is that human beings are rational only to a point. After all, terrible things do happen, every day, even if the sensational media makes them seem far more common than they are.

The flip side of the anxious person's intolerance of uncertainty is a craving for control. The more control we have over our lives, the more we seem to demand. Many have complained of our hypervigilant contemporary culture, obsessed with food additives and helmets and whatnot when objectively most of us live safer and more secure lives than any in the past.

I am fond of biographies, and whenever I read about a life prior to this century I am always struck by how commonplace and open death used to be. Obviously this was particularly true of young children falling prey to infectious diseases, and in the past, once one made it past age 5 or so, one had a decent chance of a full lifespan. But nonetheless, otherwise healthy adults succumbing unexpectedly to various ailments was far more common throughout history than it is now. To be sure, automobile accidents negate some of this gap, as did AIDS before it became a somewhat treatable disease, but the gap remains. In first world countries the default assumption is now a life of eighty years at least, and any remote endangerment of this forecast, whether by swine flu or tainted peanut butter, provokes near-panic.

That stormy night I reflected briefly on what it would be like if, against all odds, an F-5 tornado devastated the neighborhood at 2:00 A.M. A thunderous roar vaguely perceived through the fog of sleep, then the house exploding around, then a split second of feeling thrown violently through the air, then a dreadful impact, then nothing--forever.

"Good night...Everything will be fine...I'll see you in the morning," In life one is walking parallel to an abyss--just don't look down, or at least not for more than a moment. What else is one to do?

Now Mondays are worth worrying about, rolling around as they do with high predictability. I suppose that recurrent Mondays, as the wag said about enduring old age, are preferable to the alternative.


Anonymous said...

The devastating consequences of a highly unlikely catastrophe are intensely more evocative and existence threatening than the near-benign aftermath of a statistically very probable event which produces no emotional response, only a mere shrug. Whether the benign event occurs or not is of no palpable consequence - so why bother agonising over irrelevancies? Whereas the disastrous event-albeit very remote-will be painful if it does happen, thus bears thinking about (but not necessarily agonising over and over and the point of obsession). SO the resultant anxiety produced by this event in the abstract is paradoxically a rational response - there IS something to be feared, should the unthinkable, but remotely possible occur.

If the anxious mind is stuck in a torturous groove, there's little statistics and probabilities can do to alleviate the dread. One can only substitute one fear for another. A bit like addiction.

Rationalities and irrationalities happily live side by side in the same brain, same thought, same reality. Awareness or ignorance - it matters not sometimes.

Distraction is the opiate of the anxious.

chris said...

Does the comment re:anxiety disorders apply to social anxiety? Rejection, making embarrasing statements, etc. are all common events of life. It seems just as much to be intolerance to normal pains as poor guessing about likelihood of things.

Novalis said...

It seems to me though that at the core of serious social anxiety is a dread of being rejected utterly, of being found to be socially beyond the pale.

While obviously is it difficult statistically to say what the risk of this is, it may be that in evolutionary history the costs of being a pariah--outside of the protection of the group--would have been so extreme that there may be a subtle genetic aversion to it, one that can become pathologically sensitized. Sheer speculation I know, but that's what I do here.

Anonymous said...

In 1952 my Father an artist and classical musician who played the violin in NYC has a massive stroke
and as back then there was nothing
anyone could do for a Cerabal Thrombosis (and the ensuing violence my Father showed as words did not come out as he intended) he was putinto one of the worst State mental hospitals for the rest of his life.
Due to laws the protecting kids from being in such hospitals in the pre Throrazine years,I only saw him
at his death bed.
It was as if I saw my Dad at Bergen-Belsen C.C.he was just skin
and bones amongst the hollowed eyes
we saw from those that survived the camps.
It was then that our family Dr.who
was a Jewish refuge from Hitler's German,gave me copies of the writing from another Physician who
held a mystical and artistic concept and creed about Physicians
and Medical care.
He was the editor of a long forgotten magazine "MD" his name
is (actually was) Dr.Felix Marti Albanez.
His blending of the arts and medicine and Philosophy continues
on this most appreciated blog.
As a teenager i becoming the family
breadwinner ,once my Father was put
away by disease,My good Physician
who introduced me to the writings
of Dr.Albanez ,saved my mental life.
To think of another Humanist Shrink
besides Dr.Michael Reaves in Oregon
is comforting.

By the way my wife is from Wilson NC , we watched that line of Tornados you spoke of elsewhere from mid town NYC where we live, on the live webcast from WRAL.

Speaking about events immediate!

Mike the Photog.