Anxiety seems to be all-pervasive these days. For example, a recent study by the World Health Organization identifies that Ireland is among the top countries in the world for anxiety disorders. Why is this the case?

A good starting point in working this out begins with one’s perspective as to what anxiety is. The prevailing medical model takes the position that anxiety is a disorder in the mind, and that it can be classified in a number of different ways that are well-known in contemporary narrative – for example, we would all know about Obsessive Compulsive Disorder (OCD), phobias, Post Traumatic Stress Disorder (PTSD) etc. The neuroscientist will tell us that the manifestation of these disorders can be detected in the part of the brain called the amygdala, which is the part of us that deals with danger, fear and anxiety. There is a view of the world these days that all one has to do is to calm down the fluctuations of the fear reading in the amygdala in order to eliminate anxiety – the instant fix, if you will.

Yet another view of anxiety is one put forward almost 100 years ago by the great psychiatrist Sigmund Freud. He was of the view that there were two types of anxiety, the first of which many of us will know when a major known challenge comes to our door – the imminent threat of unemployment for example, or the fear that there won’t be enough money to pay the bills etc. But Freud also made reference to the anxiety, the source of which is unknown, which a client of mine referred to as the threat “that lurks around the corner”. This type of anxiety is the one that, as the great Greek philosopher Aristotle termed it 2,400 years ago, “in the absence of any external cause of terror, we find ourselves experiencing the feelings of terror”. And I believe that it is this latter form of anxiety which challenges us the most, and is certainly at the source of the problems of many people who visit me in my clinic.

What lies at the root of this form of anxiety? Some will explain it in terms of the pressures that people face these days in society, including factors such as wealth and income equality, the challenges post the economic crash since 2007 etc. My own take is that Irish people are faced with a question about the nature of our subjectivity and our being, when we cannot find a conclusive reason for why we don’t feel right, that something is missing in our lives. This is a place I found myself in twenty years ago and I have been attempting to make sense of it since.

What can we do in the face of this terror? I believe myself that there is great value in discussing the matter initially with the General Practitioner, if for no other reason that all possible organic reasons are checked out and discounted. But, in the situation where the source of the anxiety remains an unknown, where the terror and dread remains even after the best primary care is delivered, I can think of no better solution than an attentive form of listening such as is provided by a psychoanalytically informed practitioner. The perspective of such a practitioner is that the signal of danger indicated by anxiety is also an invitation to explore our desire, to consider the specialness and possibility about us that makes us different from anybody else. There is no instant fix in such a perspective, but there is the possibility of growth in this special type of dialogue. But, like the climber in the picture, it offers the possibility of going up rather than down, in a situation where staying where we are is not an option.