ANXIETY IN THE MIND: APPREHENSION
We experience anxiety in pure form as apprehension. This is a particular form of nervous tension. There is the feeling of fear, but it is an objectless fear, and at the same time as we experience it we are aware that there is nothing that should make us afraid. When we feel real fear, we can always attach our emotion to some outside object, and say that we are afraid of this or that. But because of the objectless quality of anxiety, apprehension is extremely disturbing. We simply do not know of what we are afraid. We feel that something is going to happen, but we do not know what. Something bad is about to befall us, but we cannot imagine what it might be. If the anxiety is severe, this irrational element may evoke feelings of approaching insanity, and the disquiet of our mind is still further increased.
A patient of mine, a forty-six-year-old school teacher, showed:
Signs of this kind of severe apprehension. In spite of quite a massive physique, he had always been rather tense and jittery. Twelve months previously he had suffered a severe allergic reaction to one of the antibiotic drugs, and since then he had been in a terrible state.
He described his anxiety condition in these terms: “Get vague heart attacks.” “All kind of fears.” “Heart thumps and bangs.” “Keep sweating.” “Get very het-up.” “Attacks come on with physical effort such as moving the TV set.” “It started with pain in legs and arms.” “I walk down the street and become stricken with fear and have to return.” “Keep waiting for something to happen.” “Don’t want my wife to leave me even for a short time.” “In bed the sheet touched my throat and I thought I was strangling.”
In reading this, please remember that these excerpts from my case histories nearly all concern patients who have been referred to me by other doctors because of the severity of their nervous symptoms. This is intended to help patients like this, but it is also intended to help the great host of others who suffer only in mild degree, and who in ordinary circumstances would never seek the help of a psychiatrist or even the local doctor. Consequently, these notes about various patients whom I have seen will serve to illustrate the point I am trying to make. But although they may refer to conditions which you yourself have, in all probability in your case it is in much milder form.
In less severe form, apprehension may show itself as a vague uneasiness. The feeling is difficult to describe. We lose our natural calm and repose. We are uneasy. We try to pass it off, and say to ourselves that we are all right; but we know that we are not quite right, and the strange feeling of disquiet remains, and persistently disturbs us at our work, at home, and even in our sleep.
A fifty-year-old woman, whom I had known for most of my life as a robust extrovert, consulted me professionally. She said that she had felt depressed and frightened. She could not get going with her former zest. Her most disturbing symptom was a difficulty in breathing which was associated with a feeling of panic, so that she would catch her breath and could not properly relax.
She very quickly lost her symptoms with the relaxing exercises.
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