Lately I have been talking a lot with friends/family and mental health professionals about my on-going, free-floating feelings of fear. I haven’t arrived at any ultimate helpful conclusions, let alone a “fix”. Nonetheless, I thought I’d share some thoughts, whether stolen from others or arrived at on my own.
1) I don’t really know whether it’s helpful or appropriate to describe what happens to me with the word ‘fear’. When I’m being cautious about phrasing, I’ll talk about “the feeling-as-of-fear”.
On the one hand, as I explained in a recent blog post, the sensation isn’t “about” anything – not even an unreal thing like a ghost or Brian Mulroney’s return to power – whereas regular fears have what philosophers call “intensional objects”. Heck, it doesn’t even seem to be a response to external events: it seems to be internally caused. (The other day, for instance, I was reheating some Ethiopian food in the microwave. I put the plate in, I closed the microwave’s door, and I started to enter in the number of minutes and seconds. Whoosh! A terrible rush of fear-sensation. Does my reaction really merit the term ‘fear’?) Also, my wife Anita has suggested that if I can conceptualize the event as just “unpleasantness”, rather than as genuine fear, it may stop me from fretting about it so much – about how irrational it is, about how hard it is to get rid of, etc.
On the other hand, I was explaining to my friend Ann, who was one of my first philosophy teachers at Glendon College, the ways in which what happens isn’t like fear. She astutely pointed out, however, that it’s not merely a nasty feeling/sensation either. Many of the behavioral dispositions and physiological changes triggered by genuine, full-blown fear come along with it. My heart races. My chest and muscles tighten. I try to identify the cause, so as to escape from it.
Maybe I should call it ‘quasi-fear’?
2) As I was explaining to my friend Lindi how the fear-episodes seem to come out of nowhere, she made a helpful observation. She said it sounds like the onset of a hot flash. Not being a menopausal woman, I haven’t myself experienced hot flashes, but from her description of how they occur it seems an apt analogy. Both come unbidden and unwelcome, unpredictably and pretty much out of nowhere. Both seem to be caused by an internal rush of hormones, not by any external circumstance.
3) Several folks have found the following analogy helpful when understanding my fear-like symptoms. Everyone knows how it feels to awaken from a nightmare, realize that the whole thing was an illusion and that there’s no real danger, and yet continue to feel afraid for a minute or so. The sensations and physiological changes don’t disappear immediately post-awakening. Well, imagine having that “hangover from a nightmare” showing up just any old time throughout the day, and lasting between 30 minutes and an hour. Something like that is what I experience multiple times a day. It’s very unpleasant. And it’s very puzzling.
4) The best advice I’ve received is to follow Buddhist practice and just let the fear-sensation be there. Don’t exacerbate the situation by questioning the fear, trying to get rid of it, etc. The thing is, that advice is really, really hard to follow, and for good reason. As my friend Chris stressed to me, evolution made fear feel very unpleasant in order to i) rapidly draw your full attention and thereby ii) get you to recognize and evade the urgent danger. It’s just like physical pain in that respect: it’s supposed to feel awful and be hard to ignore. So, yes, I really do try to “radically accept” the quasi-fear; but I often can’t succeed. And that I can’t is built into the very purpose of fear.
5) My psychiatrist Dr. D regularly reminds me that there are plenty of fear-inducing things going on in my life right now, including especially CANCER. She once asked me, insightfully: “What would you think of a person with a diagnosis of inoperable cancer who didn’t feel the least bit afraid?” The answer is: such a person would be bizarre.
And so, sometimes when the fear-sensation hits, I say to myself that it makes sense, it’s to be expected – rather than telling myself that there’s no danger, that it’s a malfunction in my brain, that it’s a harmless albeit nasty feeling, etc. I’m not wholly convinced, however, that the (seeming) fear really is related to my cancer diagnosis. First, I have suffered from this for at least half a dozen years; hence the onset was long, long before I knew about the tumour. Second, mysteriously enough, the symptom went into remission starting around September, right when I learned about my illness! It popped up occasionally during the winter, including on Christmas day. But it didn’t restart in earnest until my regular cancer treatments halted.
In sum: granted, I do have a reason to feel afraid (viz., malignant cancer); but I’m not sure that it is the reason why I randomly get scared. (Recalling the example above, what does reheating leftover Ethiopian lentils and injera have to do with a tumour in my esophagus?)
6) The only patterns that I’ve noticed are… Though I don’t wake up in the morning feeling afraid, the fear often comes on while I’m preparing breakfast. It doesn’t even wait until I sit down to work. Moreover, if I lay down to meditate and calm myself, and I happen to fall asleep, I wake up more scared than ever. So, there seems to be some sort of connection to awakening.
7) Finally, a word on drugs for the fear-sensations. Benzodiazepines, the medication of choice for anxiety, don’t make it go away. However, if I take a clonazepam at the onset, as the fear begins to grow, it seems to keep things from worsening. I guess that’s good news.
Even better, I discovered through sheer serendipity a drug that is super effective against the fear. I was having a minor surgical procedure, related to my chemotheraphy; I was getting really afraid as the surgeon began to cut; and so, a nurse injected me with a sedative. The fear utterly evaporated in about 30 seconds! I can hardly describe the relief.
Great news, except… the drug she used was fentanyl! I googled to see whether one could be treated for severe anxiety with that drug, or one of its close cousins, its scary name notwithstanding. Unfortunately, as I experienced for myself post-surgery, the drug wears off quite rapidly. Worse, when it’s out of one’s system, the fear comes back even worse than before. Only a higher dose will fix the latter. As the nurse said to me: used in a clinical setting, for the right reasons, fentanyl is a great medication, but…