Anxiety

August 26, 2013
Anxiety is particular among most mental disorders in that it exists both pathologically and colloquially: to be “anxious” can connote a psychological condition, but it can also refer to a more commonly emotional or situational state. Both definitions are dealt with in this broad history of anxiety. Rutgers sociology professor Horwitz largely shies away from modern tendencies toward biological explanation and treatment, instead covering the sociocultural aspects of anxiety’s past, present, and future. He begins in the classical period with Hippocrates and proceeds up to the present. Almost an entire chapter is devoted to the rise of Freud in the 20th century, when the modern definition of anxiety developed. In these respects, the book might not differ from histories of other illnesses. However, Horwitz’s priorities lay less in innovation than in clear, readable organization: each short chapter is punctuated with a concise summary; all of this is wrapped up with a timely conclusion, wherein Horwitz argues for the necessity of balancing neuroscientific advances with the disease’s complex history in creating diagnostic criteria for anxiety. What is fascinating about this book is less the facts it presents than its ambiguities: anxiety will always force us to question the lines between the normal and the disordered, nervousness and depression, fears and pathologies.

Starred review from September 15, 2013

For the anxious, life is a roller coaster they want to slow down. Sociologist and historian Horwitz (sociology, Rutgers Univ.; Creating Mental Illness) traces how anxiety has been understood and treated from the time of Hippocrates and Aristotle through Freud to neuroscience and pharmaceutics today. He guides readers through all aspects of this surprisingly large topic: fear, worry, dread; theories, treatments, and social consequences through history; religious, cultural, and scientific aspects of anxiety; and anxiety's various causes, from snakes and spiders to debt and war. Freud moved the concept of anxiety from the sphere of religion (as in the writing of St. Augustine) and philosophy (as in Soren Kierkegaard) to medicine. First claiming that repressed impulses were its cause, he later retracted, stating that it was in fact anxiety that caused repression. More recently, behaviorists have cured some types of the condition with desensitization rather than through analysis. Horwitz shows how pharmaceutical stocks go up as Americans, anxious not to be anxious, press their primary physicians for pills, while psychiatrists obsess about diagnostic terminology in part to suit the demands of insurance companies. VERDICT For observers of the human condition, this work is, despite some overwrought sentences, an enlightening tour of anxiety, set at a sensible pace, with an exceptional scholar and writer leading the way.--E. James Lieberman, George Washington Univ. Sch. of Medicine, Washington, DC

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