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But none of these treatments have fundamentally reduced the underlying anxiety that seems woven into my soul and hardwired into my body and that at times makes my life a misery. As the years pass, the hope of being cured of my anxiety has faded into a resigned desire to come to terms with it, to find some redemptive quality or mitigating benefit to my being, too often, a quivering, quaking, neurotic wreck.
Many nights, I would begin the evening fueled by caffeine and nicotine, which I needed to propel me out of torpor and hopelessness - only to overshoot into quaking, quivering anxiety.
To some people, I may seem calm. But if you could peer beneath the surface, you would see that I'm like a duck
paddling, paddling, paddling.
As recently as 1979, neither panic attacks nor panic disorder officially existed.
During high school, I would purposely lose tennis and squash matches to escape the agony of anxiety that competitive situations would provoke in me.
It is an irony of medical history that even as Freud's later work would make him the progenitor of modern psychodynamic psychotherapy, which is generally premised on the idea that mental illness arises from unconscious psychological conflicts, his papers on cocaine make him one of the fathers of biological psychiatry, which is governed by the notion that mental distress is partly caused by a physical or chemical malfunction that can be treated with drugs.
I had no trouble with strangers finding out about my anxiety. It was my friends and colleagues I was concerned about.
For the social phobic, any kind of performance - musical, sporting, public speaking - can be terrifying because failure will reveal the weakness and inadequacy within. This in turn means constantly projecting an image that feels false - an image of confidence, competence, even perfection.
People who suffer from anxiety are very good at hiding it. That can often be a contributor to the anxiety because the gap between the internal perception and the external impression can feel so large.
I have, since the age of about 2, been a twitchy bundle of phobias, fears, and neuroses. And I have, since the age of 10, when I was first taken to a mental hospital for evaluation and then referred to a psychiatrist for treatment, tried in various ways to overcome my anxiety.
To say that my anxiety is reducible to the ions in my amygdala is as limiting as saying that my personality or my soul is reducible to the molecules that make up my brain cells or to the genes that underwrote them.
There's a vast encyclopedia of fears and phobias, and pretty much any object, experience, situation you can think of, there is someone who has a phobia of it.
All the textbooks talk about avoidance as a classic hallmark of anxiety disorder. So you need a therapist who is sympathetic and understanding but will also push you to do precisely the things that scare you.
The truth is that anxiety is at once a function of biology and philosophy, body and mind, instinct and reason, personality and culture.
It is a fact - I say this from experience - that being severely anxious is depressing. Anxiety can impede your relationships, impair your performance, constrict your life, and limit your possibilities.
There is an element in which anxiety co-represents with aspects of my personality I wouldn't want to give up. It allows you to have foresight. I may not be as empathetic. It's hard to figure out the difference between pathology and personality.
Barbra Streisand developed overwhelming performance anxiety at the height of her career; for 27 years she refused to perform for the general public, appearing live only in private clubs and at charity events, where she presumably believed the pressure on her was less intense.
I don't want to be in a position that could make me vomit, like air travel. I've purloined airsick bags and stuffed them everywhere, just in case I ever feel the need to throw up. I haven't vomited since 1977, but I think about it all the time. I recognize that it's irrational, but I'd rather jump out of a window than vomit.
Individuals who rate high on the so-called Anxiety Sensitivity Index, or ASI, have a high degree of what's known as interoceptive awareness, meaning they are highly attuned to the inner workings on their bodies, to the beepings and bleatings, the blips and burps, of their physiologies; they are more conscious of their heart rate, blood pressure, digestive burblings, and so forth than other people are.
To grapple with and understand anxiety is, in some sense, to grapple with and understand the human condition.
There are lots of things, including changing the kind of inner dialog, that can mitigate anxiety. And yes, there are people who have the glass half full and glass half empty, and I'm afraid the glass is going to break and I'll cut myself on the shards.
Hugh Grant, who several times has announced that he was thinking of retiring from acting, has said that he suffers from panic attacks when the cameras start rolling.
I've always been interested in intellectual history and in psychology, and anxiety is obviously something that's been a big part of my life.
Some social phobics find even positive attention to be aversive. Think of the young child who bursts into tears when guests sing "Happy Birthday" to her at a party - or of Elfriede Jelinek afraid to pick up her Nobel Prize. Social attention - even positive, supportive attention - activates the neurocircuitry of fear. This makes sense from an evolutionary perspective. Calling positive attention to yourself can incite jealousy or generate new rivalries.
Even though my mom herself was anxious, I think she didn't know how to deal with it in her kid, and my dad just had no conception of what this was about, and sort of didn't even want to acknowledge it.
Even as economic and political freedoms have advanced enormously and generated huge benefits for humanity, they've also created a great deal of anxiety because every time you have to make a choice, there's anxiety about making the wrong one.
for the existentialists, what generated anxiety was not the godlessness of the world, per se, but rather the freedom to choose between God and godlessness. Though freedom is something we actively seek, the freedom to choose generates anxiety. "When I behold my possibilities," Kierkegaard wrote, "I experience that dread which is the dizziness of freedom, and my choice is made in fear and trembling." Many people try to flee anxiety by fleeing choice. This helps explain the perverse-seeming appeal of authoritarian societies - the certainties of a rigid, choiceless society can be very reassuring - and why times of upheaval so often produce extremist leaders and movements: Hitler in Weimar Germany, Father Coughlin in Depression-era America, or Jean-Marie Le Pen in France and Vladimir Putin in Russia today. But running from anxiety, Kierkegaard believed, was a mistake because anxiety was a "school" that taught people to come to terms with the human condition.
I am living on the razor's edge between success and failure, adulation and humiliation - between justifying my existence and revealing my unworthiness to be alive.
The average high school kid today has the same level of anxiety as the average psychiatric patient in the 1950s.")
Paul Tillich, a theologian who grew up in Weimar Germany, similarly explained the rise of Nazism as a response to anxiety. "First of all a feeling of fear or, more exactly, of indefinite anxiety was prevailing," he writes of 1930s Germany. "Not only the economic and political, but also the cultural and religious, security seemed to be lost. There was nothing on which one could build; everything was without foundation. A catastrophic breakdown was expected every moment. Consequently, a longing for security was growing in everybody. A freedom that leads to fear and anxiety has lost its value; better authority with security than freedom with fear.