Many people today are experiencing anxiety over health-related issues. While some search for solace in bottles — whether of pills or alcohol — Harvard psychiatrist Dr. Kevin Majeres has some surprising advice. What is the attitude he thinks someone should have toward anxiety?
“Bring it on!”
The Minnesota native has found that anxiety, when feared, only increases. Conversely, anxiety, when accepted and used as energy in the pursuit of virtuous actions, is actually helpful.
Majeres completed his undergraduate studies at the University of Dallas and earned his M.D. at the University of Texas Southwestern. He is currently on the faculty of Harvard Medical School and conducts his private practice in Harvard Square.
Majeres has helped thousands of students and others to reframe their anxiety and use it to achieve lasting, meaningful success based on the loving service of others. He speaks in this interview of how to transform “the sufferings of Good Friday” into “the joy of new life on Easter Sunday.”
What exactly is anxiety?
Anxiety occurs when someone perceives a situation as a threat, but the situation does not require a fight-or-flight response. The perceived threat leads to a release of adrenaline, which would be helpful if the person needed to respond to the situation by fighting or fleeing. Since that response is not needed, the adrenaline release is like a car revving in neutral: It is all ready, but has nowhere to go. The unused adrenaline is experienced as anxiety.
Saints such as Francis de Sales, Alphonsus Liguori and Thérèse of Lisieux have written of how to deal with anxiety, although that specific word isn’t necessarily used in English translations. Have you found the saints to be helpful, from a psychological standpoint?
One of the greatest saints of the Church, Thomas Aquinas, started me on the path to psychiatry. I had always planned on becoming a physician, but then I picked up Aquinas’ Summa Theologiae in a public library in the 10th grade. I was fascinated by his description of human acts and his synthesis of faith and reason; I also did not know at the time that saints could be philosophers, and philosophers, saints! I read more in philosophy and theology, always going back to Aquinas.
I still retained my interest in medicine, and eventually I came to see psychiatry as the best way for me to serve others. In psychiatry I’ve been able to learn and teach so many things that help people to flourish, so I’m grateful that St. Thomas got me started in that direction.
St. Francis de Sales wrote in Introduction to the Devout Life that anxiety is the soul’s greatest enemy, sin only excepted, so we should calm and compose our minds before pursuing a course of action.
We certainly should not let anxiety determine our actions. However, what I’ve found is that we should also not think of anxiety as something that we need to get rid of before we can start living our ideals.
Paradoxically, we attain peace of mind when we not only tolerate anxiety, but wholeheartedly welcome it. This might sound odd at first. Anxiety is simply the feeling of adrenaline when we are facing a threat. But adrenaline is there to help us perform at our best — it’s the ultimate performance enhancer! The more we learn to welcome the boost that adrenaline provides, and put it to good use, the sooner we will be free of anxiety. This happens when we come to see that the threat is really an opportunity that can help us to learn and grow. We’ll be focusing on acting better, rather than feeling better.
So, yes, anxiety is a great enemy in the sense that, because of it, people might try to avoid whatever could seem threatening. Because of anxiety, people flee from challenges, yet challenges are the only way we grow. And for a Christian, the challenges we face each day can be seen as sharing in the cross — they are there to be embraced, wholeheartedly. If strong emotions are what challenge us, we can still embrace them. We do this by accepting that they are occurring, and then using the energy they give us to act according to our ideals.
That would relate to the second half of what St. Francis said about calmly pursuing a course of action — and to what he wrote in another place in the book about not becoming annoyed at being annoyed, or angry at being angry, etc.
Being anxious about being anxious would only make things worse, but accepting and using adrenaline for the pursuit of good ends makes things so much better. The key is that no matter what emotions may be triggered, we can always view them in a positive way: as an occasion for practicing patience with ourselves and charity with others.
Instead of pursuing freedom from discomfort, we pursue a virtuous course of action, and in the pursuit, we find a higher kind of freedom, that of always being able to act according to our faith and love. As a side benefit, we also find peace. But we cannot seek the feeling directly. We can learn instead to embrace these difficult emotions and act virtuously while they’re present.
As I said before, the energy of the difficult emotions increases our ability to grow in virtue. For example, it might be very challenging initially for someone to do a presentation in front of a group, but if that person nevertheless gives several presentations, his repeated actions profoundly train his brain — specifically his amygdala, whose job is to scan for present threats — to reinterpret giving presentations not as a threat but as an opportunity. After each decision to act contrary to his desires to flee, those feelings get weaker and weaker. Eventually he will experience a new sense of peace and confidence.
You’ve stated that inadvertent idolatry can be a contributing factor to anxiety — that someone may tenaciously hold on to a desired outcome that “must” occur, while other outcomes are seen as catastrophic.
Someone held back by anxiety could very well be idolizing his own bank account, his own health, or his own prestige at work. He is so terrified at even the remote possibility of giving certain things up, because he has made them into idols.
Venerable Fulton Sheen said in Finding True Happiness that, allowing for exceptions due to physiological problems, the better a person is morally, the better mental health he will experience. Have you found this to be the case?
If we let our negative emotions, such as fear, anger or cravings, determine our behavior, we could end up stuck in vicious cycles. We will have strengthened those emotions and the power they have over us. On the other hand, when we determine our behavior according to our ideals — such as love or patience — we end up creating virtuous cycles. When we’re stuck in vicious cycles, our world shrinks, and we get intensely focused on attaining relief from discomfort. That’s what leads to a worsening of our mental health.
The way we get trapped in vicious cycles can be summarized in three psychological concepts: negative processing bias, inward collapse of attention, and automation.
Negative processing bias comes from complaining about or dreading the challenges we face. Our brains respond to our repeated acts of complaining by getting skilled at seeing the negative side of things, until they see neutral or even positive things in a negative light. That sets the stage for the inward collapse of attention, which leaves us stuck in our heads, worrying and ruminating. The needs of others are overlooked, and all of life becomes a matter of what is useful to me in the short term. This leads to automation, or reflexive behaviors in which we act on our fear, anger or cravings — isolating ourselves, criticizing others, procrastinating, bingeing and so forth. Energy that could have been directed to forming good habits is spent forming bad ones.
What should someone do if those three negative concepts have characterized his experience of the most recent of the coronaviruses?
In health matters, like any other aspect of life, we need a clear vision of the threats and opportunities we are facing. However, this can be difficult because of distorted or sensationalistic reporting and because the great fear of physical suffering and death can turn a normal concern into an obsession.
The question can be asked, “What are the risk factors in my specific situation — which may be very different from the risk factors of other people — and what can I do to minimize the risk of contracting the virus?” That can graduate into another question that addresses not just preventive measures, but proactive ones: “What can I do to thrive in this challenge, in the unique opportunities it is giving me?”
The first question is like asking what I can do to avoid losing a game, while the second one is like asking what I can do to win a game. The second one leads more easily to concern for others, a selflessness that helps us in our own lives.
In these times specifically, calling friends to encourage them and offering to get groceries for neighbors are two virtuous options. While in the store, even simple acts can go a long way, such as respecting distance, bearing patiently with the slow pace of some shoppers, and taking the time to smile at the clerks, who have tough jobs right now.
Could you address accepting the possibility of suffering and the certainty of dying — whether that be from COVID-19, diabetes, heart attack, stroke, cancer, car accident, etc. — in light of divine Providence?
We are told to take up our cross daily if we want to be disciples of Jesus. The cross comes to us in the challenges we face each day. They are there to be embraced lovingly — and then they give us life. The acceptance of suffering makes the suffering bearable, while fleeing from it makes it worse. It’s counterintuitive, but the more we run from suffering, the faster it follows us, while the more we welcome suffering, the more it brings out the best in us.
When we welcome crosses in life as they’ve been given to us by our loving Father, we cannot only maintain calm in light of challenges, but we can even start to see them as good for us. We can be grateful for them.
Right now, the great majority of people are not afflicted with coronavirus, and even the great majority of the people who are afflicted with it will survive. Not to mention, these highly unusual times afford us opportunities to help people who are in distress and to reassess why we do certain things in the first place. We can come out of this situation as much better people.
St. Alphonsus Liguori wrote similar things in Uniformity with God’s Will — that all that happens, happens by the will of God.
Yes, and what is God’s will? Our sanctification. It’s not merely a matter of reluctant resignation or sterile stoicism, but filial, affectionate acceptance of the means given to us to get to heaven. Love makes all burdens light.
Love, or the theological virtue of charity, contains all the other virtues and colors everything we do. If we truly love, then we can’t go wrong. That is, if we put God above all else and love our neighbor for God’s sake, we’re on the road to heaven. We even enjoy some of heaven on earth.
With charity we also have faith, which lets us see every challenge as coming from our Father God, and hope, which allows our minds to rest in his presence. Charity also infuses into us the cardinal virtues of prudence, justice, fortitude and temperance. Each virtue contributes to the good of others and to our own good.
It sounds like the thinking of neurologist Dr. Vince Fortanasce and psychologist Margaret Laracy, which is about solutions addressing the whole person, rather than quick fixes often based on chemistry alone.
Drugs can have many adverse side effects, including, quite ironically, symptoms that one is trying to alleviate in the first place. For many conditions, including anxiety, depression and addiction, people tend to respond better to a cognitive-behavioral approach than a pharmaceutical one. In most cases, cognitive-behavioral therapy is a well-rounded approach with long-lasting benefits for the whole person.
In helping someone to look at life with new eyes, the brain itself functions better. When someone goes through the process of reframing, he is not only thinking in different ways, but actually shaping how his brain functions through the formation of new neurological pathways. Virtuous living brings out the best in us, even on a physiological level.
And anxiety disorders can be overcome.
I would even say that the major cause of anxiety disorders is seeing anxiety as a disorder. Merely experiencing a feeling of apprehension is a normal part of life, but this feeling only becomes a problem when it is seen as one. The initial adrenaline rush is interpreted negatively, fear builds on fear, and then there is, in fact, disorder.
The better route is to reframe the anxiety itself, seeing it not as a disorder, but as an ally. The thing that is triggering our anxiety is actually an opportunity to practice living a virtue, with our adrenaline giving us the boost we need to rise to the occasion by loving and serving others.
Do you have some thoughts for those troubled or even overwhelmed by life while trying to satisfy many demands at once?
Multitasking is like taking your IQ and dividing it among the number of tasks you are simultaneously engaged in. With each added task, less intelligence is available. The better way is unitasking, or focusing all of one’s attention on one thing at a time. If someone is fully present to something, he will do it much better than if side shows vie for his attention.
Focusing on quality rather than quantity will enable someone to do his best work. After he is done with one thing, he can move on to another, and each one will be done better than if he tried to do them all at once.
Each hour of work gives us an opportunity to reframe challenges, recollect our attention into the present moment, and challenge ourselves to grow. I refer anyone interested in transforming their approach to work to my website OptimalWork.com and direct them especially to an upcoming e-book that will be made available in the next few weeks. It’s called The Golden Hour: How to Prepare Your Mind for Work, co-authored with Sharif Younes and Rashad Badr.
Any final thoughts?
Virtuous action, rooted in love, brings enduring happiness. Virtue can involve short-term discomfort, and even pain, but for those who embrace the sufferings of Good Friday, there is the joy of new life on Easter Sunday.
Register correspondent Trent Beattie writes from Seattle.