Dorothy Rowe - Beyond Fear

Edith was a very good woman who had devoted her life to others. She often acted as chauffeur for one of my clients, and while this client was talking to me Edith would visit some of the elderly patients in the hospital. One day she phoned me and asked whether, when she came the next day, she could have a quick word with me. I agreed, and so the next day she came into my room, apologizing for taking up my time and sitting nervously on the edge of her chair. What she wanted to know was whether she was going mad. The evidence that she might be was that she would often wake at 2 a.m. and lie worrying. The fear that pervaded her being manifested itself as the fear that no one would look after her when she was old. What if she became senile and incontinent, like the old women she visited on the psychiatric ward? She had done enough nursing to know that I could not truthfully say that her old age would not bring indignities and inadequacies, but there is one truth I could tell her.

Waking in the early hours of the morning in a sweat of terror is an extremely common experience. All across the country people are experiencing that terrible loneliness of being. They have woken suddenly to the greatest uncertainty a human being can know. There is no shape or structure to hold them. They are falling, dissolving; totally, paralysingly helpless without hope of recovery or of rescue. Sickening, powerful forces clutch at their hearts and stomachs. They gasp for breath as wave after wave of terror sweeps over them.

We all knew such terror when, as small children, we found ourselves in a situation which filled us with pain and helpless rage. We screamed in fear and in the hope that our good parents would rescue and comfort us. Now grown up, we know the extent of our loneliness and helplessness. Some of us wake, like Edith, completely alone. Some of us have another form sharing our bed, but it is effectively insensate, a log refusing to acknowledge our misery. Others of us, more fortunate, share our bed with a kindly person who switches on the light, makes us a cup of tea, and holds us close. Such love can make our terror recede like the tide, but, like the tide, it can return, and there is no good parent there to pick us up and cuddle us and assure us that the world is a safe place and there is no reason to be afraid. We are grown up now, and, try as we might to deny it, we know the loneliness of being. We long for good parents who will rescue and love us, but we know that there are no good parents and, while we might believe in God the Father, in these times of terror He is far away.

For some people the waves of terror and the sense of annihilation last for many minutes. Some people move very quickly to turn the terror into all kinds of manageable worries - manageable not because the worries are about problems which can be solved but because they turn a nameless terror into a named anxiety. Thoughts like ‘Who will look after me when I get old?’, ‘I can’t manage the tasks I have to do at work today’, ‘The lump on my groin is certain to be cancer’, ‘If my daughter goes to that school she’ll get mixed up in drugs’, ‘I won’t be able to meet this month’s bills’, ‘I should have done more for my parents before they died’ are indeed terrible, but they give a sense of structure and have a common, everyday meaning. With these common, everyday meanings we can pretend that the terror we felt did not happen, and that we belong to the everyday world.

However, not everyone can do this. For some people, lying there in the dark, the terror goes on and on. When Edith described to me how this happened to her she said, ‘It gets so bad I think I shall run outside the house in my nightie and stand in the middle of the road so I’ll get run over and that’ll stop it.’

‘Not in your street at 2 a.m. you won’t,’ I said, knowing how empty her town was at night. I went on to tell her that the terror she felt is called ‘existential angst’. She laughed at this ridiculously pretentious name. ‘I’ll remember that next time,’ she said, ‘I’ll lie there and think, “I’m experiencing existential angst.’“

I do hope she does, and finds her laughter in the midst of her terror. It would be so monstrously unfair if Edith followed the path of a woman whose inquest was reported in the paper recently. She was an elderly patient, not long discharged from a psychiatric hospital. A nurse told the coroner that she had looked in the patient’s room at midnight and seen her sound asleep. When she returned at 6 a.m. she found her floating in the bath. The coroner returned an open verdict. There was no mention of the terror which the poor woman could bring to an end only by filling the bath with water and, all alone, immersing herself in it. When fear is terrible, all we can do is run away.

Fear has a vital life-saving function. It is the means by which our body mobilizes itself to move swiftly and efficiently to protective action. When we interpret the situation we are in as dangerous, adrenaline, which is produced by the adrenal glands just above the kidneys, as well as at the ends of the neurones in the brain, is pumped into our system, thus causing our heart rate, blood pressure and blood sugar level to increase, and so preparing the body to fight or flee. If we act physically, by striking out at the source of the danger or by taking to our heels and running away, then we make use of our body’s preparations. But if we neither fight back nor run away we are left with the effects of these preparations and they can be most unpleasant.

Our heart beats fast and we feel shaky, sweaty and tingly. Some people experience severe headaches, some feel nauseous, some feel dizzy and close to fainting. Some people do faint. When these reactions occur in company, where we need to be calm and collected, we can feel very ashamed of ourselves. When they occur and we do not know why, we can feel frightened and so start on the sickening cycle of fearing fear itself.

Faced with an external danger, such as a man carrying a gun, or an oncoming monstrous tsunami, we can stand and fight or flee. However, sometimes the people around us will not let us do either. Children who are frightened of their parents or teachers may be prevented from either fighting to protect themselves or running away. Lacking the means to support themselves or their children, women may be unable to flee from husbands who frighten them. Needing to support their families, men may be unable to fight or flee from employers who frighten and mistreat them.

Thus it is very easy to find ourselves in a situation where we wish to fight or to flee but feel that we can do neither. Such a conflict leaves our mind in a turmoil and our body reacting appropriately to our reading of the situation (danger) and inappropriately to our reaction to our reading of the situation (neither fighting nor fleeing).

If we can make such a conflict explicit, by thinking about it very clearly and honestly and by discussing it with understanding friends and counsellors, then we can often find a way to solve the conflict or to live with it more easily. But if we dare not make the conflict explicit to others or even to ourselves, then we cannot resolve it and our misery goes on.

Shirley came to see me because she was nervous. She had given up driving because she was frightened she would have an accident and hurt someone.

‘I’m not worried about hurting myself. It’s other people that I worry about.’

She felt nervous when she had to go into a room where there were other people.

‘I worry that they’ll all look at me. Yet I like going out and having a social life. It’s just I sort of feel ashamed. I don’t know why. I do go out, like we go out for a drink, and I find my hands shaking.’