How do you notice the absence of something? When you’re repeatedly hit on the head with a hammer and it suddenly stops, will you experience pleasure?
The absence of pain is different from the presence of pleasure. Luvox didn’t
give me any pleasure. It didn’t change my personality or give me an “edge”
socially. It didn’t make me more charming or outgoing. It didn’t help me focus or concentrate better or do my work more effectively.
What it did was escort the sisters of seizure out of the room. Out of the house, really. After a few weeks of 150 milligrams a day, most of my
physiological reactions were gone — the air “hunger,” the weak spells, the
panic attacks, the obsessive thinking.
I dropped out of therapy soon after my symptoms disappeared. I walked out the way I walked in — without knowing what was wrong or what I needed to talk about. I had done with pills what I could not do with willpower, prayer, meditation, yoga or therapy.
As socially disapproved acts go, the decision to get on “mental medicine” is
on par with the decision to get divorced. Prescriptions and divorces are
granted freely, but there are widespread taboos against both. Divorcis and
patients get accused of not trying hard enough, of being quitters, of looking
for an easy way out. Both suffer for years before approaching the taboo’s
threshold, and cross it after realizing the only other option is to keep suffering.
Doctors grant prescriptions for the same reason judges grant divorces — to stop years of pain and suffering and allow the parties to build better lives.
Doctors and judges are the only ones to bear witness to the wrecked lives before them, but it is we who pass judgment. When a weight’s been lifted off you, people complain you look too thin.
Critics believe SSRIs cauterize the pain and suffering fundamental to
personal growth. They dismiss Zoloft (a widely prescribed antidepressant)
as “Soul-off.” It’s a question I wrestled with constantly. In the rush to
relieve the pain, did I leave myself behind?
And never mind ordinary people like me, what happens to the extraordinary
when we pump them full of neurotransmitter regulators? What if genius,
madness and greatness are the products of biochemical imbalances? If Holden Caulfield had been given Prozac, would he have lost the orneriness, the implacability, the pain that made him a beloved hero for challenging society’s hypocrisy?
While I am still no fan of SSRIs, my stridency against them diminished in
proportion to their effectiveness. The truth is, Holden Caulfield would have
been in no danger of becoming a castrated critic of society. Most antidepressants don’t change your personality. They don’t make you feel better about things that should upset you. They lift the disabling weight of a disorder so you can feel the pain, pleasure, sorrow or joy appropriate to
the situation. Antidepressants as a prophylactic to life is pure “weed
theory” — a theory growing through the cracks of inhospitable facts. There’s nothing to support it, but the theory grows anyway.
Most people on SSRIs are as caught up in their emotions as the rest of the
world. But now, instead of crying for no apparent reason, SSRI users cry when
they’re sad. Now, instead of their hearts racing without cause, their hearts pound away
when they’re in danger. Now, instead of repeating endlessly, SSRI users’ thoughts have a beginning, middle and end.
Luvox worked. And it worked without changing my personality. The real
issue with antidepressants isn’t that they’ll fundamentally change your
character. It’s that you have to sacrifice so much to be on them. Critics
of the pill-popping nation rarely acknowledge what it takes to stay on a
regimen of antidepressants. Even doctors frame the side effects as minor
inconveniences. Like sex. Or rather the lack of it. Now there’s a minor
inconvenience.
Sex on an SSRI is like copping a feel with an oven mitt. The drugs rob you
of the mood, then they rob you of the mode. You start off not wanting to and
you end up not being able to. And even when you are willing and able, it
still feels deadened, like there was a condom snapped tightly over your
brain stem, making sure pleasure didn’t leak out.
Involuntary teeth grinding is another common side effect. It wasn’t unusual
for me to literally bite myself awake. Examining the blisters on the inside
of my lower lip, my doctor could only shrug and say it was a small price to pay
for the peace I was getting in return.
Luvox also robbed me of the pleasure of getting drunk. High crime or
misdemeanor, the light buzz of a glass of cabernet turned into a vague,
distasteful fogginess.
Critics are right about one thing — getting on an antidepressant is easy.
What they don’t tell you is that staying on it isn’t. Nearly half of all
people taking SSRIs stop taking them within six months. This is a stunning
noncompliance rate. The easy way out is a lot harder than it looks. If the
pills are such an easy shortcut, why do people quit taking them?
The high dropout rate speaks to fundamental questions about SSRIs: What are you willing to give up to have a “normal” life? Is it sex? Is it the
embarrassment of involuntary hand tremors? Is it a sound sleep? What
abnormality are you willing to take on for the hope of normality?
I lasted a little over a year on Luvox. I wanted out. Maybe I wanted sex
without the oven mitts, maybe I was tired of the sores in my mouth or maybe I was just in denial — it had been so long since I’d had an anxiety attack, maybe I thought I was “cured.” But mostly, I just couldn’t get past the fact I was on “mental medicine.”
My doctor tapered me off slowly, reducing the dosage by 25 milligrams every few weeks. I stepped up my meditations, prayers and yoga — I knew I couldn’t just get off the pills and hope for the best. I figured if I had a plan I’d be strong enough to manage without pills.
I was wrong. The sisters of seizure rose slowly, rubbing their eyes from the
long sleep. It wasn’t long before they brandished their pickaxes again.
Everything came back: the chest pains, the feelings of panic and dread, the
rapid breathing, the wrenching fear that I was going insane.
But the worst was my obsessive thinking about time. It gathered like a
squall. If I were balancing my checkbook, I’d stop in the middle to put
away some books, then I’d stop in the middle of that to write a letter, which
I’d interrupt to take on something else, all the while worried about what I
hadn’t completed. I was consumed with the idea that I was running out of
time. I would stand in the shower, angry I wasn’t soaping up fast enough.
My doctor wrote on his prescription pad and handed it to me. “I don’t want
to get back on Luvox,” I said, ignoring his hand. He pressed the slip of paper on me. “Call him,” he said. “He specializes in anxiety
disorders, he’s got an astonishing success rate and he does it without
medication.”
Ponce de Leon Avenue is one of Atlanta’s oddest streets. It’s two lanes of
decaying southern elegance and urban blight yielding to an in-town revival.
Well, at least the symbolism is right, I remember thinking as I pulled up to Dr. Crowe’s office.
I stepped into a room whispered in earth tones. Chris Crowe is a towering
man, 6-foot-4, with twinkling blue eyes. He mitigated the threat of his height with a calm, soothing voice. Soon after we met he made a remark I’d never heard before from a psychologist: “We should be done in 12-15 sessions.”
I immediately disliked him. I don’t trust people who promise profound
changes in a short time. But his steady, dignified and scientific view of
what I was going through won me over — that, and the fact that he described
every symptom I suffered better than I could.
Dr. Crowe is a cognitive-behavioral therapist. The term is an oxymoron,
juxtaposing two opposing views of psychology. Cognitive therapy was
developed by Aaron Beck in Philadelphia in the ’60s. Its basic premise
is that misguided thoughts cause pathological anxiety. Change the thoughts,
reduce the anxiety. Cognitive therapy broke from traditional psychotherapy
by ignoring emotions and traumatic childhoods. It only cared about thoughts and beliefs.
Behavioral therapy, on the other hand, sneered at every school of psychology. It didn’t care about thoughts, beliefs, insights or the unconscious. Founded by Russian physiologist Ivan Pavlov and American psychologist B.F. Skinner, behaviorism sees pathology as learned behavior. And, it posits, what is learned can be unlearned. A dog conditioned to salivate when a bell rings right before feeding can get unconditioned if the food no longer appears after the bell.
No one has to put the dog on the couch to identify underlying food issues.
It’s fairly remarkable that these two schools of thought, so radically
different from each other, have turned out to be so mutually dependent as a
treatment for anxiety disorder.
Though few studies have compared cognitive-behavioral therapy with medications, the existing data suggest parity. But medications are a hare to therapy’s turtle. They provide faster relief, but they’ll only get you to the finish line if you’re
willing to refill prescriptions for the rest of your life. Stop the prescriptions and you stop the relief. Therapy, on the other hand, seems to be effective for years after the last session.
No one knows what the noncompliance rate is for therapy relative to medication, but it’s probably high, if my experience is any gauge. There are no side effects to therapy — but what it lacks in unintended consequences it makes up for with intentional pain.
Behaviorism has a charming theory called “intentional exposure,” which is a
fancy way of saying that the way out of pain is to go through it, over and
over and over again, until it goes away on its own.
“You mean the way to stop my shallow breathing is to breath shallowly?” I
asked Dr. Crowe incredulously. I did not want a lesson in Zen koans. “Yes,”
he replied. “We’re going to mimic the shallow breathing in a controlled
setting.” He gave me two thin straws with instructions to pinch my nostrils
and breathe through the straws in my mouth.
After a few minutes, Dr. Crowe asked me to rank, on a scale of one to eight, how similar the breathing felt to the breathing in an actual anxiety attack.
“Eight,” I replied. “Excellent!” he said.
Excellent? This sucks, I thought to myself. And so our sessions would go.
I’d rank and he’d exult. “Eight.” “Excellent!” “Eight.” “Excellent!”
Homework is to behaviorists what multiplication tables are to taciturn
teachers — an indispensable way to torture students into a more evolved state. Suddenly, I was faced with more homework than I’d had since high school.
When I first came to Dr. Crowe I was thinking along the lines of
stopping, not increasing, the debilitating physical sensations I experienced.
Imploding myself through structured and repeated exposures to panic-like
physical sensations was not what I had in mind.
The success of a behavioral program depends on how much you’re willing to
inflict and withstand pain. Which explains the dropout rate. Scheduling
discomfort is one thing; keeping the appointment is another. I found myself
saying, “OK, it’s time to experience heavy pressure on my chest and the
feeling I’m going to pass out.” Most of the time I couldn’t bring myself to
do it.
There’s a sadistic streak running through behaviorism. If your hand hurts
because you stuck it in a meat grinder, behaviorists will tell you the pain
won’t go away until you stick your arm in all the way to your elbow.
The worst exercise, by far, was the “intentional worrying” Dr. Crowe
prescribed for my time obsession. It’s similar to “systematic
desensitization,” a technique developed by the famous psychologist Joseph
Wolpe to cure phobias. But instead of focusing on feared places (crowded
rooms) or animals (snakes), the “intentional worrying” desensitizes you to
the thoughts, feelings and physical sensations brought on by obsessive
thinking.
Instead of waiting for the next wave of obsessive thinking to
overpower me, Dr. Crowe instructed me to intentionally set it off. I’d speak
whatever thoughts and feelings I had out loud, putting myself into a state of panic, and then would endlessly repeat them until the level of obsessive thinking (and its attendant anxieties)
decreased to half its highest level. Sometimes it took up to 40 minutes — 40 minutes just to get the noise level in my head down by half.
I was demoralized by the exercises. They were hard, and there was little
progress to serve as reinforcement. In addition to the “intentional
exposure” exercises, I was supposed to be doing three to four “progressive muscle
relaxation” exercises every day (a combination of tensing and releasing
different body muscles and deep breathing), each lasting 10-15 minutes. The real stuff hurt bad enough; why was I trying to manufacture it? Luvox was so much easier.
I often did not do the homework, and in our sessions, Dr. Crowe had yet another issue to deal with — my sense of guilt and shame. How do you explain to yourself, let alone another person, that you didn’t have the discipline to do the work required to help yourself?
My symptoms got worse, but in a perverse way they helped me see that I might be on the right track. “The needle moved,” I thought to myself. “Maybe in the wrong direction, but it moved.” And maybe it’s true that the night is darkest right before the light.
My first real breakthrough was on the cognitive side. I stopped thinking I
was spiraling into insanity when I had an anxiety attack. Dr. Crowe didn’t
cheerlead me into thinking positively about the attacks. Instead, he gave
me a lesson in physiology. “It’s normal to have fairly wide variations in
body functions,” he instructed. “Throughout the day, blood pressure goes up
and down. So do sugar levels, muscle tension and heart rate. Most people
aren’t even aware of them, because they’re so subtle. But unlike most
people, the limbic part of your brain is on guard 24 hours a day, scanning
for the slightest variation in any of these functions. When it senses a
change it rings the danger alarm and makes your body react like you just
stepped between a grizzly and her cubs.”
According to Dr. Crowe, I was misinterpreting normal sensations as
pathological symptoms. When I finally got it — that I wasn’t going insane — I could almost hear the sound of understanding clicking into place. The realization didn’t stop the attacks from coming, but I learned to have a certain detachment from them. My anxiety attacks took on the cast of a burglar alarm going off in a deserted house. I could walk around the
property and see that nothing was wrong — except that the alarm kept going off by mistake.
I started doing the homework more and more. When I ranked the severity of breathing through the straws, they slowly dropped from eights to sevens,
sixes and fives. And just as slowly, my real breathing attacks receded like
the tide, lapping at less and less of the shore.
One day it occurred to me that I had gone several days without a bout of air
hunger or feeling like the strike of the clock would choke me. It had been
at least 15 years since I could say that.
Most days I operate with a 90 percent reduction of symptoms, but sometimes I end up red-lining the anxiety meter without any provocation. One night last week I couldn’t sleep because I was taken over by an all-too-familiar set of sensations. Nothing important kept me up — not the worry of an important meeting or an urgent project — nothing but a racing heart, shallow breathing and a sense of dread. I realized the next morning that I hadn’t done my exercises for the past few days. I did most of them by the time the sun set.
The protocol for the treatment of anxiety disorders is proving a prophetic
observation by William James, the 19th century Harvard philosopher, on the
nature of emotions. In 1884 he ignited a debate that still rages in
psychology and the neurosciences, by posing a profound question: Upon
encountering a bear, does a person run because he is afraid, or is he afraid
because he sees himself running?
It’s a chicken-and-egg question. What comes first — the conscious awareness (thought) or the physiological reaction (emotion)? James scandalized his peers by siding with the latter. Today’s neuroscientists are throwing their hats in with James. It’s a well-known fact among neurobiologists that the brain processes sights and sounds in milliseconds while even the simplest thought can take several seconds to form.
Cognitive behaviorists like Dr. Crowe very much believe in James’ theory and have
developed a protocol around it. The treatment doesn’t target the bear or how you feel about the bear — it targets the running. By cognitive “restructuring” (correctly interpreting the difference between symptoms and sensations) and “extinguishing” behaviors (breathing through straws eventually stopped the shallow breathing by wearing out its effects),
cognitive-behavior therapy produces remarkable results.
Dr. Crowe told me he rarely sees his patients again once they’ve gone through the four-month program. I hesitate to say whether I’ll see him again. I’d like to pronounce myself cured, but I’m afraid to claim what may be asked back.
“Oh, no!” I whisper to myself. I see it coming and I don’t know what to do. I grip the steering wheel harder, my breath as uneven as my thinking.
My heart accelerates, my eyes dart. I pretend I’m not in danger, but my body betrays me. I’m trying to catch my breath, but the thing is, I’m not out of breath.
Stay calm, I think to myself; it isn’t real.
Or is it?
I’m not sure.
I step hard on the gas trying to get away from it, but it hits me anyway. I pull off the road the first chance I get. I know there’s no damage. There never is. I lean my head against the steering wheel at the hopelessness I’ve come to.
Anxiety attacks hit you like an oncoming car you can’t swerve away from; you’re nothing but pavement to them. Rapid breathing, heart palpitations, odd chest pains, crippling weak spells, obsessive thinking patterns — because
there’s nothing causing the symptoms, you’re convinced of a pending psychotic break. In fact, the fear of going insane is one of the most common symptoms of anxiety disorder.
Therapy helped, but it was a little like coming through surgery without truly recovering. Major life issues got resolved, but the anxieties kept
popping up anyway. People say if you get at the root of a psychological
problem, it’ll go away. They’re wrong. Thousands of dollars and reams of insurance forms later, I learned what every amateur gardener learns the first week on the job: Pulling weeds out by the root doesn’t get rid of them permanently.
I took up meditation. It worked in the dubious way low-fat cookies help
with sugar cravings. Sometimes you end up doing more damage than the damage you tried to avoid. Meditation or relaxation exercises would often be an open invitation to the family of dysfunction living inside me, my sisters of seizure. Often, I’d lie on my couch trying to relax, but would
literally seize up as the sisters climbed on me with little pickaxes. I’d
writhe and thrash, but it was no good; I couldn’t get them out of me. Sometimes flushing them out helped. They’d ride the tears all the way down, until all I could feel was their absence.
The sisters of seizure understood etiquette, sparing me the embarrassment of panic attacks, chest pains and weak spells when other people were around. I lived under the rule of a polite pathology.
In full roar, my obsessive thinking took me over completely. I didn’t so
much think during those times as I was
thought upon. The ending of any
relationship would bring the obsessive thinking to gale-force proportions. Gradually, my anxiety demons tired of my romantic failures and began to focus on something they could ride whether I was single, married or in between: time. I
became overwhelmed by my perceived lack of it. For years I thought I was just experiencing the normal time crunch of the overextended. But I never felt the corrosive obsession stronger than when I got laid off and had
nothing but time on my hands. I simply couldn’t derail my thoughts off the clock. Women hear biological clocks ticking; I heard psychological
timers going off every few minutes to warn me that I didn’t have time to do whatever I was doing.
Soon I was canceling dates, outings, sporting events and family get-togethers. Never mind my unemployment, I was out of time. Little by
little I left my house less and less. I got a lot done, but I couldn’t begin to tell you what. The sisters of seizure, tugging at my sleeves for most of my life, became increasingly convinced they owned the shirt.
I couldn’t sleep. I was in a stable relationship, in a satisfying job, making lots of money, but I couldn’t sleep. It made no sense. The calmer my circumstances became, the louder my anxiety attacks clanged. I fell into a pattern — one night I couldn’t sleep, the next night I slept 16 hours. Over and over the pattern repeated until, exhausted, I crawled to my family doctor. He gave me Halcyon, a sleeping pill. It worked, but within days I needed higher and higher doses. He switched me to Ambien. The third night on it I collapsed onto my bathroom floor, passed out for hours. I woke up, climbed into bed and slept it off. The next day my doctor dispensed with sleeping pills altogether and pressed a prescription for Klonipin into my hand. It’s the brand name for Clonazepam, a class of drugs called benzodiazepines, which slow down the nervous system. They’re used mainly to treat epileptic seizures, but doctors often prescribe them for anxiety.
Trying all these pills actually added to my anxiety. I hate pills; I grew up believing aspirin was a cheap way out of pain. But I was too far gone to stand on ceremony. Beliefs tend to fly out the window when a crisis walks in the door.
My doctor suggested I see a psychiatrist.
“For what?” I asked him. “If I knew
what was wrong, I’d already be seeing one.”
I’m no stranger to therapy, but
I’d always gone for a specific reason — relationship troubles or family issues. What was I going to say on the couch: Nothing’s wrong except I’m going out of my mind?
Besides, Klonipin worked. The problem with it, as singer Stevie Nicks found
out, is that it’s highly addictive. After splitting with Fleetwood Mac, Nicks developed such a hard-core dependency on Klonipin that she ended up in drug rehab for weeks. What my doctor couldn’t get me to do, the fear of being a pill-popper did. But before I could see a shrink I had to slip past
the barbarians at the gate. My HMO didn’t want a personal visit with a board-certified physician or a licensed therapist to determine what I needed. They wanted somebody I’d never met to figure it out over the phone.
When you’re being interrogated for needing care, your only hope is to sound
pitiful enough to deserve help. During the call I kept thinking, what if I
don’t sound as bad as I am? What if I don’t sound pathetic enough?
The phone attendant peppered me with a dozen highly personal questions,
click-clacking my answers into a computer. With every question, I felt I had
to “prove” my need for help. Finally, I blurted out “What makes you
qualified to determine whether I’m in enough pain to see a psychiatrist?
You’re 1,500 miles away, you can’t see how tired I am, the nervous tension or the circles under my eyes.”
It was like throwing bricks in the Grand Canyon. My objections got swallowed up in a cavernous hole without so much as a sound. She granted approval for a psychiatrist, but only for three sessions. As an afterthought, she mentioned there’s usually a four- to six-week wait for the psychiatrists in their panel.
I smashed four or five buttons on the phone, making her earphones pop. “I just spent the last 20 minutes telling you I’m in a crisis,” I seethed into the mouthpiece, “and you’re acting like I called with an inconvenient mosquito bite.”
I got in the next day, but with a psychologist instead. She diagnosed me
with generalized anxiety disorder — with a little obsessive-compulsive disorder (OCD) on the side.
Anxiety derives from the Latin word angere, which means to choke or strangle. In healthy people, the stress response (fight, flight or fright) is
provoked by genuine threats and is used to take appropriate action. But for
the 10 million Americans with generalized anxiety disorder, there is no
obvious stressor. They carry with them a more or less constant state of
tension and anxiety. Although sufferers recognize that their obsessive
thoughts and physiological responses are baseless, senseless and excessive,
they can’t stop them — no matter how hard they try.
Women have twice the risk for anxiety disorders than men do. The symptoms of anxiety disorders and heart failure are so similar doctors have
difficulty distinguishing between the two. For example, mitral valve
prolapse, a common heart problem, can have nearly identical symptoms as panic disorder. So can paroxysmal supraventricular tachycardia, a heart-rhythm disturbance. In fact, studies have shown that up to 60 percent of patients with chest pain who see their physician for heart problems are actually suffering from panic disorder.
Anxiety disorders frequently co-exist with OCD. According to the journal Biotech Business, “People with Obsessive-Compulsive Disorder experience unwanted, recurring and disturbing thoughts they are powerless to suppress. This causes overwhelming anxiety, prompting them to perform repetitive, ritualized, compulsive behavior to alleviate the anxiety.”
I had OCD Lite. I was powerless to suppress the unwanted, recurring thoughts of time running out on me but it never expressed itself in something visible, like constantly washing my hands or repeatedly checking to see if the door was locked. I belonged to the half of OCD sufferers who have obsessive thoughts without the ritualistic behavior. I had the wattage, but not the plumage.
There is a growing belief among scientists that anxiety disorders emerge from neurobiological substances that trip the body’s fire alarm even when there isn’t any smoke in the vicinity. Neurotransmitters like norepinephrine, serotonin and dopamine help you prepare for danger by putting your body on red alert. If you’re walking down a dark, deserted street and hear footsteps behind you, these neurotransmitters are going to jolt your heart, lungs and muscles into a state of anxiety.
But what if you’re not in a dark, deserted alley with approaching footsteps
behind you? What if you’re on the way to the beach with your body blaring a five-alarm bell that won’t shut off? Scientists believe that people with
panic and anxiety disorders don’t need to be in danger to feel all the physiological responses to it. Somewhere along the line, their bodies got stuck on red alert. Researchers believe that anxiety disorders aren’t a sign of weak-kneed hypochondria, but of neurochemical excess or deficit.
They believe it. I didn’t say I did.
So when the therapist and my family doctor urged me to go on an
anti-depressant, I refused. I ricocheted between anger, shame and pity at
the suggestion of it. I saw it as a total loss of control, an abdication of
personal will and direction. The next time a tough life choice came up, how
could I be sure it was me making the decision? Would I forfeit my life’s
important decisions to a pill?
I was drowning in shame. What kind of man needs medication to cope with
everyday life? I asked myself. Had my life gotten that out of control?
My therapist seemed bewildered by the extent of my shame. “Why,” she asked intently, “do you think it’s strong to suffer and weak to fight?”
“Because,” I shot back, “pills are for other people.”
She folded her hands in her lap, staring at me. “If somebody on the street
threatened your life, would you consider it weak to defend yourself?”
- – - – - – - – - – - – - – - – - – - – -
Luvox (fluvoxamine maleate) is one of the newer selective serotonin
reuptake inhibitors (SSRIs). It’s the first medicine approved by the FDA for the
treatment of OCD, and was actually developed for children and adolescents
who were driving their parents crazy with their rituals. Some kids, fearing
“contamination,” insist their parents wash their laundry over and over, or
check their homework repeatedly or scream at their siblings for “infecting”
their room by walking into it.
Luvox was found to be so effective in treating OCD in children that it was just a
hop, skip and a jump to prescribe it to adults. It’s now the most popular
medication for all OCD sufferers. It also showed great promise for
eliminating anxiety and panic attacks.
My legs dangled over the examination table as I waited for my family doctor
to write the prescription. I had nothing but contempt for people who used
pills as shortcuts. I saw them as the able-bodied collecting welfare;
people who were capable but unwilling to do the heavy lifting life demands.
And now I was one of those contemptible people. I was an utter
failure in my own eyes. I had fought and lost and I had no more fight in me, and for that I would never forgive myself. This is a mental cane I’ll be walking around with, I thought to myself. The only thing missing is a Boy Scout to help me across the street.
All my life, the only pill I allowed myself to take was aspirin. Now I
was about to become the poster child for selective serotonin reuptake
inhibitors. Nothing knocks you off your ideological high horse faster than
an experience that rears up at your beliefs. As my doctor wrote the prescription, I
felt the sting of hypocrisy rising inside me. I brushed a tear away as I
accepted the slip of paper, vowing that no one would know.
“What was he thinking?”
It’s a question echoing through responses to the Kennedy tragedy, as people weigh the risk he took in flying at night. But the question is better asked of someone else, according to scientists who study the psychology of risk-taking — someone like Michael Ballacchino.
Ballacchino lay down on his Honda Magna V-45 750 motorcycle at 130 mph, hanging on like laundry on a gusty day. “It was a real rush,” he deadpanned. He stopped at 130 mph because “the motorcycle started screaming.” And, well, it’s not like he has a death wish.
Or does he? According to classic psychoanalytic theory, Ballacchino wants his disk re-formatted and is simply trying to figure out whether he wants it
done on a Mac or a PC. The concept of Thanatos, the instinct toward death and self-destruction, is a famous Freudian concept; the psychoanalyst believed that Eros, the life instinct, must be opposed and balanced by the death instinct. To Freud, the healthy person looks for ways to reduce stress and tension. Imagine what he would have thought of today’s adventure-seekers.
In psychoanalytic circles, Ballacchino’s 90-foot jump from a cliff jutting
over Georgia’s Lake Altoona classifies him as dysfunctional. His father would get the same label,
for giving him helpful tips. But psychologist Frank Farley, a University of Wisconsin psychologist and past president of the
American Psychological Association, disagrees.
He would likely consider Ballacchino a classic example of what he calls “Type T” personality (as in thrill-seeker).
Farley has built a personality model for people whose idea of a good time is probably your idea of a heart attack. His research showed that thrill-seekers crave novelty,
excitement and adventure on a constant basis. They live for the surge of
vitality that comes from letting go of life’s handrails. Some Type T’s
express this in an intellectual way — and some, like Ballacchino, do it by
jumping off the roof of their house, confident that the mattress below will
break their fall.
According to Farley, the same inner force that propelled Evel Knievel to want to jump
the Grand Canyon propelled the Rev. Martin Luther King Jr. to jump-start the Montgomery bus boycott. For Type T’s, the quest for adventure can span many arenas; it isn’t just the physical rush, but also the intellectual and sometimes moral highs that risk-takers crave. Farley categorized Albert Einstein as a “Type T Mental” because ideas, not stunts, were his stimulating jolt of choice. Why jump out of an airplane when you can jump out of the space-time continuum?
Jake Rothschild is the perfect Type T contradiction — a thrill-seeker scared to death of roller coasters. Rothschild is afraid of falling out of bed, let
alone out of a plane. Yet he lives every bit as much on the edge as
free-falling skydivers. An entrepreneur most of his adult life, Rothschild
has lost businesses, contemplated personal bankruptcies and faced imminent foreclosures, all for the thin stream of oxygen called self-employment. Yet he lives for the promised sniff. The surge he gets from beating the odds and creating a business is indistinguishable from the surge a daredevil gets when he goes over the falls in a barrel. His current business — J.D. Rothschild & Co., a gourmet food producer — is a perfect example. Though it’s been met with astonishingly good reviews in the food press, the company has had at least three near-death experiences in securing capital. “I’m falling,” said Rothschild, echoing countless skydivers, “and I’m counting on that parachute to open when I need it.”
Many psychologists see the intoxication with stimulation as a biological throwback that preserved the species. An entire family could die if they all crowded into a cave without someone first checking for grizzlies. Throughout history, there was always an idiot in the family who volunteered.
The “need for speed” has forged the American character in such a way that Farley believes we are, in essence, a Type T nation. In fact, any country built by emigration — like the United States, Canada or Australia — will have Type T
platelets coursing through its national arteries. What could be more daring than to leave friends and family for parts unknown? America, rooted in rebellion and revolution, stretched by fearless frontiersmen and capitalized by
high-flying industrialists, is a thrill-seeking missile compared to other
countries. Today, our very affluence and stability give rise to the inner wild
child. The more unstable the culture, the less Type T personalities it tends
to have, according to many psychologists. You don’t see too many Kosovars
bungee-jumping off bombed-out river bridges.
But a funny thing happened on the way to our recklessness. For all our
Type T behavior, we live in a wuss culture. You can’t swing a helmeted cat
without hitting a mandated safety precaution, a risk-reducing law or a
stimulant-choking health trend. In fact, if you’re middle class in America, it’s hard to find real danger. Our hamburgers
are cooked to 165 degrees, our kitchens are Lysoled, our floors Pine-Soled
and our souls handcuffed to the television. We’re insured, benefited and
parachuted. We’ve got 911, 501 blues and 401(k)s. We’ve got disability,
dental and dismemberment. You can’t slip on a sidewalk without being served a subpoena.
As the natural excitement and stimulation of life gags on America’s
preventive chokehold, we’ve come up with more things to throw ourselves off of — like radio antennas and bridges. There is a huge paradox to a
frontier-busting culture now disinfecting itself from the slightest odor of danger. And to each paradox, a mutation must come. Ours is called extreme sports. BASE jumping (the acronym stands for Buildings, Antennas, Spans and Earth) is one of the hottest extreme sports in the country. Think skyscrapers, parachutes and
pavement and you get the general idea. As champion BASE jumper Frank Gambalie told U.S. News & World Report, “There aren’t many injuries in BASE
jumping. You either live or you die.”
Josh Krulewitz, communications manager for ESPN, says the network carries “a couple hundred hours” of extreme sports. Presumably, the corporate sponsor is Xanax. The signature competition for the genre is the X Games: “Nielsen clocked 19 million viewers over the course of the week-long event,” Krulewitz crowed. The games took place in San Francisco last month, with 268,000 people in attendance.
Competition included “street luge” — a race involving eight-foot wheeled aluminum caskets roaring down hills at 60 mph with racers lying down, inches off the pavement — and history was made in the skateboarding competition, when Tony Hawk landed the first “900″ in the
sport. (He flew off the 12-foot “vert ramp,” leveled off at a cruising altitude of about 13 feet, rotated two and a half times in the air and, like triple-axle Olympic ice skaters, landed without falling. Or breaking
anything.)
If Farley and company explain thrill-seeking as the cognitive nuts and behavioral bolts of personality theories, Marvin Zuckerman sees it as a
genetic predisposition handed down like hazardous heirlooms. Zuckerman, a
professor of psychology at the University of Delaware, is a pioneer in the
genetic wing of arousal studies. A couple of decades ago, he ignited the
debate with a groundbreaking study of twins. His biometric analysis of what
he dubbed “sensation-seeking” in fraternal and identical twins revealed that
the nagging thirst for excitement may be inherited. “The heritable property of variances attributed to genetics was 60 percent,” Zuckerman said from his
university office, “even among twins raised in different families.”
Considering that heritability factors in other areas of human studies average
around 40 percent, Zuckerman believes he showed a “strong indication that
sensation-seeking is inherited.”
The discovery of the dopamine-4 receptor by an Israeli scientist in 1997
supports Zuckerman’s early findings. For the first time, a gene was associated with a personality trait. While no scientist worth his white coat
attributes traits to a single gene, the discovery of the “novelty-seeking”
gene added another layer of dots and dashes to the developing picture of human behavior.
Come on, you might think. Driving drunk on a wet bridge is genetic? Playing football on an icy ski slope is a deficit of neurotransmitters? Piloting an airplane over fog and water with a bum leg results from serotonin regulators on the blink? Well, not exactly.
Zuckerman developed a four-part sensation-seeking scale measuring the
propensity for “thrill and adventure seeking.” In his book “Behavioral
Expression and Biosocial Bases of Sensation Seeking” (Cambridge University
Press, 1994), Zuckerman defined the “High Sensation Seeker” as “seeking
novel, intense or complex sensations and experiences and willing to take
risks to get them.”
Through blood-chemistry analysis, Zuckerman found that such High Sensation Seekers have lower levels of monoamine oxidase, an enzyme that breaks down neurotransmitters like dopamine, serotonin and norepinephrine. “MAO is a protective enzyme,” said Zuckerman. “It regulates chemicals associated with arousal and pleasure like a thermostat regulating the temperature in a room.”
And for High Sensation Seekers, the room feels like a meat locker. Everyday life leaves them cold; predictability leaves them frozen. So they fire up
the heater with stunts, leaving themselves with a racing heart and us with an open mouth.
The role of MAO is far from clear. The only thing scientists agree on is that it plays a central role in regulating the pleasure principle. Still,
some patterns emerge: Low MAO levels seem to produce thrill-seekers, partyers, pioneers, social activists, policemen, emergency workers — people and activities that smack of risk. High MAO levels on the other hand, are associated with depression and bipolar disorders.
But there’s a dark side to all this sensation-seeking (as if there were a light side to death and dismemberment). High Sensation Seekers don’t always manifest as Michael Ballacchinos, jumping over their Alfa Romeos on skates. They’re often drug addicts, sex addicts, alcoholics or criminals who live under the doctrine of impulse. For every Ballacchino there’s a Belushi.
For every daredevil there’s a Dillinger. The Force may be with you, but it’s
just as likely to land you in jail as in the history books — if you believe the growing number of scientists who believe sensation-seeking may be a critical factor in crime.
The mechanism behind the high-throttle stakes for the next high may still be a mystery, but our underlying admiration for it is not. “If you’re not living on the edge,” said a poster at the X Games, “you’re taking up too much room.” We’re a country invented by sensation-seekers, and we’ve got a reputation to live up to. Broken limbs and watery graves notwithstanding, as long as we have the breath to exercise one last piece of bad judgment, we will do so.
