“It used to be a piece of good advice to all young writers to avoid alliteration; and the advice was sound, in as much as it prevented daubing. None the less for that, was it abominable nonsense, and the mere raving of those blindest of the blind who will not see. The beauty of the contents of a phrase, or of a sentence, depends implicitly upon alliteration.”
—Robert Louis Stevenson, “On Some Technical Elements of Style in Literature” (1905)
When the first English poetry was given by the gift and grace of God it was imparted to an illiterate shepherd named Cædmon and the register that it was received and was alliterative. In the seventh century, the English, as they had yet to be called, may have had Christianity, but they did not yet have poetry. Pope Gregory I, having seen a group of them sold as slaves in the markets of Rome, had said “They are not Angles, but angels,” and yet these seraphim did not sing (yet). There among his sheep at the Abbey of Whitby in the rolling Northumbrian countryside, Cædmon served a clergy whose prayers were in a vernacular not their own, among a people of no letters. A lay brother, Cædmon feasted and drank with his fellow monks one evening when they all took to reciting verse from memory (as one does), playing their harps as King David had in the manner of the bards of the Britons, the scops of the Saxons, the Makers of song–for long before poetry was written it should be plucked and sung.
In his Ecclesiastical History of the English People, St. Bede described how the monks were “sometimes at entertainments” and that it was “agreed for the sake of mirth that all present should sing in their turn.” But in a scene whose face-burning embarrassment still resonates a millennium-and-a-half later, Bede explained that when Cædmon “saw the instrument come towards him, he rose up from the table and returned home.” Pity the simple monk whom Alasdair Gray in The Book of Prefaces described as a “local herdsman [who] wanted to be a poet though he had not composed anything.” An original composition would wait for that night. Cædmon went to sleep among his mute animals, but in the morning he arose with the fiery tongue of an angel. Bede records that in those nocturnal reveries “someone” came to Cædmon asking the herdsman to sing of “the beginning of created things.” Like his older contemporary, the prophet Muhammad, some angelic visitor had brought to Cædmon the exquisite perfection of words, and with a commission most appropriate–to create English verse on the topic of creation itself. When Cædmon awoke, he was possessed with the consonantal bursts of a hot, orange iron bar being hammered against a glowing, sparkly anvil; the sounds in his head were the characteristic alliteration of his native English.
That bright night in a dark age, what was delivered unto the shepherd were the first words of English poetry: “Nū scylun hergan hefaenrīcaes Uard, / metudæs maecti end his mōdgidanc, /uerc Uuldurfadur, suē hē uundra gihwaes, / ēci dryctin ōr āstelidæ / hē ǣrist scōp aelda barnum / heben til hrōfe, hāleg scepen,” and so on and so forth. The other monks brought Cædmon to the wise abbess St. Hilda, who declared this delivery a miracle (preserved only in 19 extant manuscripts). Gray described this genesis of English literature: A herdsman sang in a “Northumbrian dialect of Anglo-Saxon” to an amanuensis “who got learning from the Irish Scots,” his narrative being a “Jewish creation story transmitted to him through at least three other languages by a Graeco-Roman-Celtic-Christian church” with verse forms “learned from pagan German warrior chants.” The migrations of peoples and stories would, as with all languages, contribute to the individual aural soul of English, so that the result was an Anglo-Saxon literature that sounded like wind blowing in over the whale-road of the North Sea, reminding us that “Alliteration is part of the sound stratum of poetry. It predates rhyme and takes us back to the oldest English and Celtic poetries,” as Edward Hirsch writes in A Poet’s Glossary.
Read that bit of quoted verse from Cædmon aloud and it might not sound much like English to you, the modern translation roughly reading as “Now [we] must honor the guardian of heaven, / the might of the architect, and his purpose, / the work of the father of glory / as he, the eternal lord, established the beginning of wonders,” (and so on and so forth). But if you sound out what philologists call “Anglo-Saxon,” you’ll start to hear the characteristic rhythms of English–staccato firing of short, consonant rich words, and most of all the alliteration. Anglo-Saxon, if heard without concentration, can sound like someone speaking English in another room just beyond your hearing; it can sound like an upside-down version of what we speak every day; it can sound like what our language would be if imitated by a non-fluent speaker. Cædmon’s verse may have been gifted from angels, but the ingredients were his tongue’s phonemes, and unlike the Romance language’s rhyme-ready vowels, he had hard Germanic edges.
Such was the template set by Cædmon, for though “Old English meter is not fully understood,” as Derik Attridge explained in Poetic Rhythm: An Introduction, it does appear to “have been written according to complex rules.” Details of prosody are beyond my purview, but as a crackerjack explanation, what defines Anglo-Saxon meter is a heavy reliance on alliteration, whereby what connects the two halves of a line, separated by a caesura (the gap you see between words in the bit of Cædmon quoted above), is an alliterated meter stress. In Cædmon’s first line we have the alliteration of “hergan/hefaenrīcaes,” in the second line the alliterative triumvirate of “metudæs/maecti/mōdgidanc,” a pattern that continues throughout the rest of the hymn. A meter that David Crystal in The Stories of English described as “the most structurally distinctive verse form to have emerged in the history of English.”
The vast majority of Anglo-Saxon’s “structurally distinctive verse,” as with all literatures, is lost to us. By necessity, oral literature disappears, as ephemeral as breath in the cold. Words are subject to decay; poetry to entropy. Only about 400 manuscripts of Anglo-Saxon survive, less than the average number of books in a professor’s office in Cambridge, or Berkeley, or Ann Arbor. Of those, slightly fewer than 200 are considered “major,” and there are but four major manuscripts of specifically poetry. The earliest of these, the Junius manuscript, is that which contains Cædmon’s hymn; the latest of these, the Nowell Codex, contains among other things the only extant Anglo-Saxon epic, that which we call Beowulf. Such is undoubtedly an insignificant percentage of what was once written, of what was once sung to the accompaniment of a lute. Much was lost in the 16th century when Henry VIII decided to dissolve the monasteries, so that most alliterative verse was either turned to ash, or stripped into the bindings of other books, occasionally discovered by judicious bibliographers. Almost all Anglo-Saxon literature, from poetry to prose, hagiography to history, bible translation to travelogue, could be consumed by the committed reader in a few months as they’re squirreled away in a Northumbrian farm house.
Anglo-Saxon has a distinctive literary register that revels in riddles, in ironic understatement, in the creative metaphorical neologisms called “kennings,” and of course in alliteration. This is the literature of the anonymous poem “The Seafarer,” a fatalistic elegy of a mere 124 lines about the life of a sailor, whose opening was rendered by the 20th-century modernist poet Ezra Pound as “May I for my own self song’s truth reckon, /Journey’s jargon, how I in harsh days / Hardship endured oft.” Pound was not only bewitched by alliteration’s alluring galumph, but the meter of “The Seafarer” propels the action of the poem forward, the cadence of natural English speech tamed by the defamiliarization of enjambment and stress, rendering it simultaneously ordinary and odd (as the best poetry must). Anglo-Saxon is a verse, for which the Irish poet and translator of Beowulf Seamus Heaney remarks, where even when the language is elevated it’s also “always, paradoxically, buoyantly down to earth.” Read aloud “The Wanderer,” which sits alongside “The Seafarer” in the compendium known as the Exeter Book, where the anonymous scop sings of “The thriving of the treeland, the town’s briskness, / a lightness over the leas, life gathering, / everything urges the eagerly mooded / man to venture on the voyage he thinks of, / the faring over flood, the far bourn.” Prosody is an art of physical feeling before it ever is one of semantic comprehension–poems exist in the mouth, not in the mind. Note the mouth-feel of “The Wanderer’s” aural sense, the way in which reading it aloud literally feels good. Poetry is a science of placing tongue against teeth and pallet, it is not philosophy. This is what Heaney described as “the element of sensation while the mind’s lookout sways metrically and farsightedly,” and as English is an alliterative tongue it’s that alliteration which gives us sensation. A natural way of speaking, for as Heaney wrote “Part of me… had been writing Anglo-Saxon from the start.”
The cumulative effect of this meter is as if a type of sonic galloping, the clip-clop of horses across the frozen winter ground of a Northumbrian countryside. Such was the sound imparted to Cædmon by his unseen angel, and these were the rules drawn from the natural ferment and rich, black soil of the English language itself, where alliteration grows from our consonant top-heavy tongue. Other Germanic languages based their prosody on alliteration for the simple reason that, in the Icelandic of the Poetic Eddas or the German of Muspilli, the sounds of the words themselves make it far easier to alliterate than to rhyme, as in Italian or French. The Roland Greene and Stephen Cushman-edited Princeton Handbook of Poetic Terms explains that among the “four most significant devices of phonic echo in poetry”—rhyme, assonance, consonance, and alliteration—it was the last which most fully defined Anglo-Saxon prosody, grown from the raw sonic materials of the language itself. To adopt a line from Charles Churchill’s 1763 The Prophecy of Famine, Cædmon may have “prayed / For apt alliteration’s artful aid,” but the angel only got his attention–the sounds were already in the monk’s speech.
Every language has a certain aural spirit to it, a type of auditory fingerprint which is related to those phonemes, those sounds, which constitute the melody and rhythm of any tongue. Romance languages with their languid syllables, words ending with the open-mouthed expression of the sprawled vowel; the spittle-flecked plosives of the Slavic tongues, or the phlegmy gutturals of the Germanic, and despite their consonants the gentle lilt of the Gaelic languages. Sound can be separate from meaning as something that can be felt in the body without the need to comprehend it in the mind.
In his masterpiece Gödel, Escher, Bach: An Eternal Golden Braid, the logician Douglas Hofstadter provides examples of individual languages’ aural spirit. Hofstadter examines several different “translations” of the Victorian author Lewis Carrol’s celebrated nonsense lyric “Jabberwocky” from Through the Looking-Glass and What Alice Found There. That strange and delightful poem, as you will probably recall, encapsulates the aural spirit of English rather well. Carrol famously declared “Twas brillig, and the slithy toves / Did gyre and gimble in the wabe; / All mimsy were the borogoves, / And the mome raths outgrabe.” Other than some articles and conjunctions, the poem is almost entirely nonsense. Yet in its hodge-podge of invented nouns, verbs, and adjectives, most readers can imagine a fairly visceral scene, but this picture is generated not from actual semantic meaning, but rather from the strange wisdom of English’s particular aural soul. From “Jabberwocky” we get a sense of its preponderance of consonants and its relatively short words, a language that sounds like chewing a tough slab of air-dried meat. As Hofstadter explains, this poses a difficulty in “translating,” because the aural sense of English has to be converted into that of another language. Despite that difficulty, there have been several successful attempts, each of which enact the auditory anatomy of a particular tongue.
Frank L. Warrin’s French translation of Carrol’s poem begins, “Il brilgue: les tôves lubricilleux / Se gyrent en vrillant dans le guave”; Adolfo de Alba’s Spanish starts, “Era la asarvesperia y los flexilimosos toves / giroscopiaban taledrando en el vade”; and my personal favorite, the German of Robert Scott’s first stanza, reads as “Es brillig war. Die schlichte Toven / Wirrten und wimmelten in Waben; / Und aller-mümsige Burggoven / Die mohmen Räth’ ausgraben.” What all translations accomplish is a sense of the sounds of a language, the aural soul that I speak of. You need not be fluent to identify a language’s aural soul; unfamiliarity with the actual literal meanings of a language might arguably make it easier for a listener to detect those distinct features that define a dialect. Listen to a YouTube video of the prodigious, late comedic genius Sid Caesar, a master of “double-talk,” who while working in his father’s Yonkers restaurant overheard speakers of “Italian, Russian, Polish, Hungarian, French, Spanish, Lithuanian, and even Bulgarian” and subsequently learned that he could adeptly parrot the cadence and aural sense of those and other languages.
In his memoir Caesar’s Hours: My Life in Comedy, with Love and Laughter, the performer observes that “Every language has its own song and rhythm.” If you’re fluent in fake French or suspect Spanish, you may naturally inquire as to what fake English sounds like. When I lived in Scotland I had a French room-mate whom I posed that query too, and after much needling (and a few drinks) he recited a sentence of perfect counterfeit English. Guttural as German, but with far shorter words; it was a type of rapid-fire clanging-and-clinking with words shooting out with a “ping” as if lug-nuts from a malfunctioning robot. If you want a more charitable interpretation of what American English sounds like, listen to Italian pop star Adriano Celentano’s magnificently funky fake-English song “Prisencolinensinainciusol,” where with all the guttural urgency THAT our language requires, he sings out “Uis de seim cius nau op de seim/Ol uoit men in de colobos dai/Not s de seim laikiu de promisdin/Iu nau in trabol lovgiai ciu gen.”
If every language has this sonic sense, then poetry is the ultimate manifestation of a tongue’s unique genius; a language’s consciousness made manifest and self-aware, bottled and preserved into the artifact of verse. Language lives not in the mind, but rather in the larynx, the soft pallet, the mouth, and the tongue, and its progeny are the soft serpentine sibilant, the moist plosive, the chest gutturals’ heart-burn. A language’s poetry will reflect the natural sounds that have developed for its speakers, as can be witnessed in the meandering inter-locking softness of Italian ottava rima or the percussive trochaic tetrameter of Finland’s The Kalevala. For Romance languages, rhyme is relatively easy–all of those vowels at the ends of words. That Anglo-Saxon meter should be so heavily alliterative, along with its consonant-heavy West Germanic cousins like Frisian, also makes sense. Why then is rhyme historically the currency of English language poetry after the Anglo-Saxon era? After all, one couldn’t imagine a philistine’s declaration of “This can’t be poetry; it doesn’t alliterate.”
The reasons are both complex and contested, though the hypothesis is that following the Norman invasion (1066 and all that) Romance poetic styles were imposed on the Germanic speaking peoples (as indeed they’d once imposed their language on the Celts). In A Poet’s Guide to Poetry by Mary Kinzie, she writes that “In the history of English poetry, rhyme takes over when alliteration leaves off.” A century-and-a-half of free verse, and almost five centuries of blank verse, and so enshrined is rhyme that your average reader still assumes that it’s definitional to what poetry is. But alliteration, despite its integral role in the birth of our prosody, and its continual presence (often accidental) in our everyday speech, is relegated to the role of adult child from a first marriage whose invitation to Thanksgiving dinner has been lost in the mail. There is an important historical exception to this, during the High Middle Ages, when the Germanic throatiness of old English was rounded out by the softness of Norman French and some poets chose to once again write their verse in the characteristic alliterative meter of their ancestors. Or maybe that’s what happened, it’s entirely possible that English poets never chose to abandon alliteration, and the so-called alliterative revival with poems like the anonymous Pearl Poet’s Sir Gawain and the Green Knight and William Langland’s Piers Plowman are just that which survives, giving the illusion that something has returned which never actually left.
In All the Fun’s in How you Say a Thing: An Explanation of Meter and Versification, Timothy Steele writes that some regard the alliterative revival as a “conscious protest against the emerging accentual-syllabic tradition and as a nationalistic effort to turn English verse back to its German origins.” Whether that’s the case is an issue for medievalists to debate. What is true is that the Middle English poetry of this period represents a vernacular renaissance of the 13th and 14th centuries when much English poetry read as, well, English. Again, with a sense of mouth feel, read aloud Simon Armitage’s translation of Sir Gawain and the Green Knight when the titular emerald man picks up his just severed head and says, “you must solemnly swear/that you’ll seek me yourself; that you’ll search me out/to the ends of the earth to earn the same blow/as you’ll dole out today in this decorous hall.” That “s,” and “e,” and “d” – there’s a pleasure in reading alliteration that can avoid the artifice of rhyme, with its straitjacket alterity. Armitage explains that “alliteration is the warp and weft of the poem, without which it is just so many fine threads” (that line itself replicating Anglo-Saxon meter, albeit in prose). For the translator, alliteration exists as “percussive patterning” which is there to “reinforce their meaning and to countersink them within the memory,” what Crystal calls “phonological mnemonics.”
But if the alliterative poetry of the High Middle Ages signaled not a rupture but an occluded continuity, then it is true that by the arrival of the Renaissance, rhyme would permanently supplant it as the prosodic element du jour. Adoption of continental models of verse are in large part due to the coming influence of Renaissance humanism, yet the 14th-century also saw the political turmoil of the Peasant’s Rebellion, when an English-speaking rabble organized against the French-speaking aristocracy, motivated by a proto-Protestant religious movement called Lollardy and celebrated in a flowering of vernacular spiritual writing, which contributed to the Church’s eventual fear of bible translation. As the rebellion would be violently put down in 1381, there was a general distrust among the ruling classes of scripture rendered into an English tongue–could a similar distrust of alliteration, too common and simple, have shifted poetry away from it for good? Melvyn Bragg writes in The Adventures of English: The Biography of a Language that poets like Langland (himself possibly a Lollard) rendered their verse “more believable for being so plainly painted,” a poetry “meant to sound like the language of the people.” This was precisely what was to be avoided, and so perhaps alliteration migrated from the rarefied realms of poetry back to simple speech, eventually reserved mostly for instances in which, as Bragg writes, there is a need to “Grab the listener’s or reader’s attention…such as in news headlines and advertising slogans.”
Madison Avenue understands alliteration’s deep wisdom, such that “Guinness is good for you” (possibly true) and “Greyhound going great” (undoubtedly not true).” While at home in advertising, Attridge explained that alliteration is a “rare visitor to the literary realm,” with Hirsch adding that it now exists as a “subterranean stream in English-language poetry.” Subterranean streams can still have a mighty roar however, as alliteration’s preponderance in the popular realm of slogans and lyrics can attest to. Alliteration exists because alliteration works, and while it’s been largely supplanted by rhyme for several hundred years it remains in the wheelhouse of some of our most canonical poets. The 19th-century British poet Gerard Manley Hopkins largely derived his “sprung rhythm” from Anglo-Saxon meter, where he lets the Sybil’s leaves declare “let them be left, wildness and wet; Love live the weeds and the wilderness yet,” calling forth all the forward momentum of “The Wanderer.”
For exhibition of alliteration’s sheer magnificent potential, examine W.H. Auden’s under-read 1947 masterpiece The Age of Anxiety, which demonstrates our indigenous trope’s full power, especially in a contemporary context, and not just as a fantasy novel affectation for when an author needs characters to sound like stock Saxons. Across six subsections spread amongst 138 pages, four war-time characters in a Manhattan bar reflect on modernity’s traumas in a series of individual inner alliterative monologues. Alliteration is perfectly attuned to this setting, which Auden later described as “an unprejudiced space where nothing particular ever happens,” because alliteration simultaneously announced itself as common (i.e. “This is what English speakers sound like”) while also clearly poetic (“But we don’t normally alliterate as regularly as that”). Take the passage in which one of the characters, now drunk in a stream of consciousness reverie (for that’s what good Guinness does for you…), examines his own face across from himself in the barroom mirror (as one does). Auden writes:
How glad and good when you go to bed,
Do you feel, my friend? What flavor has
That liquor you lift with your left hand;
Is it cold by contrast, cool as this
For a soiled soul; does yourself like mine
Taste of untruth? Tell me, what are you
Hiding in your heart, some angel face,
Some shadowy she who shares in my absence,
Enjoys my jokes? I’m jealous, surely,
Nicer myself (though not as honest),
The marked man of romantic thrillers
Whose brow bears the brand of winter
No priest can explain, the poet disguised,
Thinking over things in thieves’ kitchens.
That thrum supplied by alliterative meter, so much sharper and more angular than rhyme’s pleasing congruencies or assonance’s soft rounding, feels like nothing so much as the rushing blood in the temples of that drunk staring at his own disheveled reflection. Savor the slink of that “shadowy she who shares” or the pagan totemism of the “marked man” and the colloquialism of that which is “Hiding in your heart.” The Age of Anxiety perfectly synthesizes a type of vernacular bar-room speech that nonetheless is clearly poetry in the circumscribed constrictions of its language. In choosing our rhetorical tropes certain metaphysical implications necessarily announce themselves. Were The Age of Anxiety rhymed or in free verse it would be a very different poem, in this case a less successful one (despite our collective ignorance about Auden’s elegy). At one point, one of the characters imagines the future, imagines us, and she predicts that the future will be “Odourless ages, an ordered world/Of planned pleasures and passport-control, /Sentry-go sedatives, soft drinks and/Managed money, a moral planet/Tamed by terror.” This is, first of all, an obviously accurate prediction of life in 2019. It’s also one all the more terrifying in the familiar wax and wane of alliteration, for it calls forth the beating heart of English itself, and while not sounding like that stock medieval herdsman it still harkens back towards the primordial hymns of our tongue, of Cædmon strumming his lute while he pops antidepressants and checks Facebook for the 500th time that day.
Such experiments as The Age of Anxiety have been at best understood as literary affectations, or at worst declarations of nativist Anglophilia (as with Pound). Kinzie complains that alliteration draws “attention away from what words mean to hint at what are often the…irrational similarities in their sounds,” though I’d argue that that describes all rhetorical devices, from metaphor to metonymy, catachresis to chiasmus. She writes that alliteration appears “towards the self-conscious end of the continuum of diction,” but it’s precisely self-awareness of medium that makes language poetry. Hirsch writes that “Alliteration can reinforce preexisting meanings…and establish effective new ones,” which Kinzie interprets as mere “fondness for gnomic utterance.” But that’s the prodigious brilliance of alliteration–its uniquely English oracular quality. As with all verse, it’s these “gnomic utterances” that are birthed from the pregnant potential of our particular words, and alliteration’s naturalism is what makes it so apt for this purpose in our language. Prosody at its most affecting incongruously marries the realism of speech with the defamiliarization that announces poetry as being artifice, and that’s why alliteration is among the most haunting of our aural ghosts. Poetry is of the throat before it is of the brain, and alliteration is the common well-spring of English, sounding neither as contrived nor as straight-jacketed as rhyme. As such, why not embrace alliterative meter as more than just gimmick; why not draw attention to that aural quality of our language that is our common ownership? Our tongues already talk in alliteration, so let us once again proclaim our poems in alliteration, let us declare our dreams in it.
Meet Scott Hanford Stossel, an accomplished man in his mid-40s with two young kids, a solid marriage, and a job as editor of a prestigious magazine. A graduate of Harvard, Stossel is popular among his friends and admired by colleagues. At the same time, and to a pathological degree, he is a man riddled with angst. And, for him, it has ever been thus.
Since he was two, Stossel recalls being a “twitchy bundle of phobias, fears, and neuroses.” He was a head-banging, tantrum-throwing toddler. On school days, his parents pried him, screaming bloody hell, out of the car and into the classroom. At age 10 he met the psychiatrist who would treat him for the next 25 years. Seventh grade brought a full-on melt down necessitating Thorazine. Over the years, he’s endured a Job-like onslaught of phobias including fears of vomiting and fainting, of flying, of heights, of germs, and, curiously, cheese.
Life for Scott Stossel has been a gauntlet of morbid what-ifs: what if I pass out, lose control of my bowels, bolt from the podium in the midst of a speech?
To keep such mayhem at bay, he’s medicated himself with bourbon, scotch, gin, and vodka. By prescription, he has taken Klonopin, Xanax, Ativan, Imipramine, Wellbutrin, Nardil, Thorazine, Zoloft, Effexor, Paxil, and Propranolol, among others. “A living repository of all the pharmacological trends in anxiety treatment of the last half century,” is how the author describes himself.
Then, of course, there were therapies. He’s undergone psychodynamic psychotherapy, cognitive behavioral therapy, rational emotive therapy, exposure therapy, hypnosis, meditation, biofeedback, role-playing, eye movement desensitization and reprocessing, acupuncture, yoga, and meditation. One doctor tried, a la Clockwork Orange, to help him conquer his terror of vomiting by administering a nausea-inducing drug.
So Stossel enlisted his talent as a writer. “Maybe by tunneling into my anxiety for this book I can also tunnel out the other side,” he hopes. Did he make it? Not quite, “My anxiety remains as unhealed wound.” But while My Age of Anxiety has apparently fallen short of its intended therapeutic goals, it is — for the rest of us — a meticulously researched cultural and scientific biography of a mental affliction featuring the author as one very, very hard case.
Illness memoirs satisfy two human imperatives. The first is voyeurism. Sick-lit, as it’s been called, incites a kind of literary rubber-necking. We’re drawn to tales of once-behaved cells ravaging organs, of accidents that crumple the bones, of strokes that lead us to mistake our spouses for headgear. In most of these stories, the author emerges scarred but wiser. Illness narratives also foster readers’ identification with the afflicted. This can be invaluable to people suffering from the same condition. They want to know they are not alone. They want to prepare for the worst, to cope in better ways, to learn more about their illness.
The illness memoir thrives on gory detail. My Age of Anxiety is no exception; Stossel even frets that he’s gone overboard. “I worry that the book, with its revelations of anxiety and struggle, will be a litany of Too Much Information, a violation of basic standards of decorum and restraint.” That’s understandable, but such intimacies are needed; they nourish the reader’s empathy for the sufferer. And when the malady happens to be unbounded anxiety — a syndrome of outsize reactions to threats that aren’t really there — we can learn a lot about the author: his vulnerabilities, the kinds of certainties he craves, and the morbid reaches of his imagination.
On the lighter side, anxiety can be funny. It is the stuff of frantic shtick, stand-up comedy, and Woody Allen. Depression, by contrast, makes darkness visible. It thrives on isolation and rumination; its muse is Ingmar Bergman. As for psychosis, it’s just too alien to be amusing.
Here is Andrew Solomon in Noonday Demon, his memoir cum biography of depression:
Depression is the flaw in love. To be creatures who love, we must be creatures who can despair at what we lose, and depression is the mechanism of that despair.
Here is William Styron, author of Darkness Visible, his memoir of depression:
My brain had begun to endure its familiar siege: panic and dislocation, and a sense that my thought processes were being engulfed by a toxic and unnameable tide that obliterated any enjoyable response to the living world.
Here is Stossel:
As is so often the case with irritable bowel syndrome, it was at precisely the moment I passed beyond Easily Accessible Bathroom Range that my clogged plumbing came unglued. Sprinting back to the house where I was staying, I was several times convinced that I would not make it and –teeth gritted, sweating voluminously — was reduced to evaluating various bushes and storage sheds along the way for their potential as ersatz outhouses. Imagining what might ensue if a Secret Service agent were to happen upon me crouched in the shrubbery lent a kind of panicked, otherworldly strength to my efforts at self-possession.
A Secret Service agent? Evidence of paranoia? No. This incident, it turns out, took place on the Hyannisport property of the Kennedy family. Over a decade ago, Stossel had spent time with the Kennedys as he researched a biography of Sargent Shriver. The episode continues, bordering on slapstick. When Stossel reached the bathroom, he “flung” himself onto the toilet (“my relief was extravagant,” he writes, “almost metaphysical”). Then all hell breaks loose. The toilet malfunctions, spewing sewage about the room and on his clothes. Our humble narrator strips, and, as he sprints to his room clad only in a bathroom towel tied at the waist, encounters JFK Jr. in the hallway. The latter is unfazed.
Stossel portrays his own ordeals with good humor, but he treats his family soberly. A. Chester Hanford, dean of students at Harvard College from 1927 to 1947 was always “nervous,” says Stossel, his great-grandson. The future dean told his young wife that he half-hoped to be drafted for combat during WWI as “dodging bullets on a battlefield would certainly be less wrenching than having to lecture undergraduates.” (Notably, as Stossel points out, anxious people are much better at handing fear — real threats — than they are at managing imaginary dangers; in fact, they often do a better of it than normal folks.)
When Dean Hanford turned 50, he cracked. The deaths of colleagues in World War II and the demise of his best friend weighed on him. Flagellated by self-doubt, given to fits of uncontrollable weeping, and, finally, suicidal, he entered McLean Hospital in Belmont, Mass. Until his death almost 30 years later Hanford would undergo many hospitalizations. Other relatives bore the curse. Stossel’s mother, the granddaughter of the dean, was perpetually high strung; his sister has been treated with a range of anti-anxiety medications.
“Does my heredity doom me to a similar downhill spiral [as my great-grandfather] if I am subjected to too much stress?” Stossel wonders. And does it endanger his children? “For Maren and Nathaniel — May You Be Spared,” he writes in the dedication. Already, however, there are signs. His small son has serious separation-anxiety. His eight-year old daughter, like her father and grandmother before her, is saddled with an obsessive fear of vomiting. “Have I — despite my decades of therapy, my hard-won personal and scholarly knowledge of anxiety, my wife’s and my informed efforts at inoculating our children against it — bequeathed to Maren my disorder, as my mother bequeathed it to me?” the author asks. The answer resides in the nature of anxiety itself.
Anxiety is the descendant of fear, our most primitive emotion. The arousal system instantly mobilizes organisms to defend against threat and, like any biological system, it can go awry. In so-called generalized anxiety disorder, a person exists in a chronic state of vigilance, ready to flee if need be. (Or, in the words of Freud, “Atrophied remnants of innate preparedness [as is] so well-developed in other animals.”) Individuals who suffer panic attacks feel as if they are suffocating. Presumably, specific neural mechanisms are hypersensitive and triggered by elevated but otherwise benign concentrations of carbon dioxide in the bloodstream (from situations such as rapid breathing or discomfort at being in a crowd) as pending asphyxiation.
Stossel suffered not only from these conditions but also from social phobia wherein a person is fearful of interacting with strangers lest he be rejected or humiliated by them. Some evolutionary theorists trace this glitch to the demands of hierarchical societies. That is, one had better be attuned to what others think of them or risk upsetting the social order of the tribe. As for the author, he suspects that that his social phobia has caused him to be a nice person. “[I]t may be that my anxiety lends me an inhibition and a social sensitivity that makes me more attuned to other people.”
Stossel’s own therapist dismissed the natural-functions-gone-wild hypothesis of clinical anxiety and put his money on existential crises as its engine. We grow old and die; lose loved ones; risk failure and humiliation; search unrequitedly for love and meaning. Anxiety is the shield we use to ward off the sadness and pain these inevitabilities bring, he tells Stossel. If he is right, the question then becomes why only some of us come undone in the face of these looming prospects.
For answers, Stossel is partial to the laboratory. He likes neuroscientists’ explanations of anxiety as excessive “neuronal firing rates in the amygdala and locus coeruleus.” The psychopharmacologists’ view of anxiety as the “inhibition of the glutamate system,” and geneticists’ errant “single-nucleotide polymorphisms” rightly strike him as “scientific and more convincing” than his therapist’s existential account. But they also raised questions:
Can my anxiety really be boiled down to how effectively gated my chloride ion channels are or to the speed of neuronal firing in my amygdala? Well, yes, at some level it can. Rates of neuronal firing in the amygdala correlate quite directly with the felt experience of anxiety. But 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.
“Shouldn’t this be liberating?” Stossel asks. “If being anxious is genetically encoded, a medical disease, and not a failure of character or will, how can we be blamed, shamed, or stigmatized for it? Eventually, he snapped out of this reductionistic reverie, reminding himself that “The same building blocks of nucleotides, genes, neurons, and neurotransmitters that make up my anxiety also make up my personality.” And his was a personality that accepted challenges, honored commitments, and excelled academically and professionally.
Finally, anxious habits can be learned. Here, the author’s mother taught a master class. This proper Mayflower descendant was chronically terrified of vomiting. Through her own doom-mongering and over-protectiveness, she inspired the author to spin out worst-case scenarios. Perhaps this is why Stossel holds such great store by the great Stoic Epictetus, who observed that “People are not disturbed by things but by the view they take of them.” From a young age, his mother taught him to take the dimmest possible one.
Though he treats her sympathetically — like his great grandfather, she is a tormented soul — he credits her with reducing him and his sister to “states of neurotic dependency.” His physician father, a depressive drinker, contributed the author’s boyhood shame (“You twerp, you pathetic little twerp”). Said a therapist from his adolescent days whom Stossel tracked down, “Your parents — an anxious, overprotective mother and emotionally absent father– were a classically anxiety-producing combination.”
“Thus me,” Stossel pronounces, “a mixture of Jewish and WASP pathology — a neurotic and histrionic Jew suppressed inside a neurotic and repressed WASP. No wonder I am anxious: I’m like Woody Allen trapped in John Calvin.”
So, what is anxiety? Stossel’s answer risks sounding evasive, but in the context of his rich book, is true and inevitable. It “is at once a function of biology and philosophy, body and mind, instinct and reason, personality and culture,” he concludes. “In computer terms, it’s both a hardware problem (I’m wired badly) and a software problem (I run faulty logic programs that make me think anxious thoughts).”
In 2004, the World Health Organization conducted a mental health survey of 18 countries including the U.S., China, the Netherlands, and Italy. It found anxiety disorders to be the most common form of mental condition on earth. According to a 2009 report called “In the Face of Fear,” England’s Mental Health Foundation, anxiety has been detected at “record levels.” Does this mean that we really do live in an age of anxiety.
And if so, why? After all, ours is an age of unprecedented material prosperity and well-being in the industrialized West. Life expectancies are, for the most part, long and growing. On the other hand, progress, itself, may be the culprit. For all their glories, growth of the market economy, increases in geographic and class mobility, the spread of democratic values and freedoms, carry their own perils — namely, panoply of choices. Within bounds, we are relatively free to choose where we live, whom we marry, and what we aim to be.
Finally, we are now quicker to pathologize the vagaries of everyday life. And, in trigger-happy hands, the official psychiatric manual can be a set of diagnoses in search of patients.
It’s hard to know. “There is no magical anxiety meter that can transcend the cultural particularities of place and time to objectively measure levels of anxiety,” the author wisely observes. What we do know is that some relatively fixed proportion of humanity has always been more anxious than others. Authoritative voices, observers and sufferers both, attest to this. Hippocrates (anxiety as “worries exaggerated in fancy”), Robert Burton, author of the magisterial The Anatomy of Melancholy in 1621, Charles Darwin (for years was too agoraphobic to leave the house), Søren Kierkegaard (he dubbed anxiety the “terrible torture” of Grand Inquisitor), Thomas Jefferson (posthumously diagnosed as a social phobic), Sigmund Freud (observer), Virginia Woolf (sufferer), William James (observer and sufferer), Mahatma Gandhi (public speaking), Barbra Streisand (crippling stage fright), and, last but not least, Donny Osmond, spokesperson for the Anxiety and Depression Association of America.
A different conception of anxiety — more a cultural affliction than a clinical scourge — was forged in the post WWII period. In his 1947 epic book-length poem called The Age of Anxiety, W.H. Auden described man as “unattached as tumbleweeds,” on a quest to find substance and identity in an increasingly industrialized world. The poem inspired Leonard Bernstein to write a symphony and Jerome Robbins to produce a ballet. A year later, historian Arthur M. Schlesinger Jr. proclaimed Western man looks “upon our epoch as a time of troubles, an age of anxiety…our familiar ideas and institutions vanish as we reach for them, like shadows in the falling dusk.”
This existential angst, some historians suggests, embodied a consciousness that led to America’s tranquilizer culture. In 1955, Carter Products began marketing Miltown for nerves, tension, and, insomnia, but the company was pessimistic that psychiatrists would prescribe it. Freud was ascendant in American psychiatry at the time and theory dictated that treating specific symptoms was of little clinical value. Be it depression, anxiety, or psychosis — all clinical presentations were taken to be interchangeable markers of deeper psychodynamic misfortunes. Still, Miltown was somewhat safer than barbiturates (e.g., Seconal, Nembutal, and Amytal) currently in use. The latter were highly addictive, produced brutal withdrawal syndrome, and were lethal if a person accidentally took just one too many.
To the manufacturer’s great surprise, Miltown became the best-selling drug ever marketed in the country. It was the first lifestyle drug for the stressed-out, can-do corporate man and his put-upon spouse as well as for celebrities. The comedian Milton Berle, for example, introduced himself as “Miltown Berle.”
Researchers were excited too. Miltown (along with Thorazine, a novel anti-psychotic introduced in the U.S. in the mid-’50s) contributed to a wholesale transformation of the way we think about mental illness. It meant that mental illness was brought on by deranged brain biology, not by Oedipal dramas, and thus corrected with medicine.
Soon, though, there was trouble in paradise. By the late 1950s, Miltown, too, revealed itself to be habit-forming. As sales began to fall off, Valium-type drugs, a class of tranquilizer called benzodiazepines, rushed in to fill the vacuum. But, as before, chemical infatuation gave rise to disenchantment. In the mid seventies the FDA had amassed reports of benzodiazepine dependence and withdrawal. Prozac, too, once kicked off a revolution. But within a few years of its release in 1988, Prozac (which also gained FDA approval to treat panic disorder) lost its luster.
Now, the golden age of psychopharmaceuticals is drawing to a close. Most of the major drug firms have curtailed or shuttered their drug discovery labs. The pipeline to the FDA is running dry. Despite this depressing picture, psychiatrists are optimistic that new approaches will eventually prove fruitful — the question is how soon.
In the meantime, current medications — which continue to be prescribed in record volumes — are often extremely helpful. Psychological and behavioral therapies are indispensible too. Some patients do very well and even the author found some relief, but not nearly enough.
And what of the writing cure? “[I]n finishing this book, albeit a book that dwells at great length on my helplessness and inefficacy, maybe I am demonstrating a form of efficacy, perseverance, productivity — and yes, resilience,” Stossel writes. Indeed, he’s done all those things and more. He’s produced an excellent synthesis of reportage, research, and personal revelation. We are the beneficiaries of his self-imposed therapy. But the patient-author still ails, not being able, he says, to “escape my anxiety or be cured of it.”
Yet with a condition so encompassing and of such long standing, could he ever strip the “real” him from his disease? From the beginning, fear and Stossel were born twins. One wonders if he would ache for that phantom creature if, somehow, it were excised.