Coward

Why We Get Anxious & What We Can Do About It

Tim Clare

• Publisher: Canongate Books
• Year: 2022
• ISBN:
  9781838853112
• Topic: Personal Development
• Subtopic: Self Improvement

After a decade of living with panic attacks and anxiety, Tim Clare made a promise to himself – he would try everything he could to get better, every method and medicine.His year of treatments took him from anti-depressants to hypnosis, running to extreme diets, ice baths to faecal transplants. At the end of it he discovers what helps him (and what doesn't), and what might help others. Most of all, he comes to rethink anxiety and encourages all of us to do the same.

I.

TAIL

How I became anxious

Some years ago I grew a tail. It was about a sixth of my body length, a mix of cartilage and bone.

‘Coward’ comes from the Old French coart, meaning ‘one with a tail’. It may have been intended to evoke a dog with its tail between its legs in the instinctive gesture of submission. In old descriptions of heraldry, a ‘lion coward’ is a coat of arms depicting a lion with its tail between its legs.

There are fewer than sixty cases of humans born with tails in medical literature. Some estimates put the number as low as twenty. The difference is accounted for by a distinction between a ‘true tail’, which contains muscle, can grow as long as 18cm and can move, and a ‘pseudotail’, a growth that superficially resembles a tail, but turns out to be a projecting bone, a tumour, or, in one macabre case, ‘a thin, elongated parasitic fetus’.¹

A human with a tail feels like a contradiction in terms. Perhaps we find such births unsettling because we think of evolution as an event in our distant past, not a journey that continues. Labels like ‘human’ and ‘animal’ imply a comforting permanence.

My tail lasted about four weeks before being reabsorbed into my body. As did yours. We all grow a tail inside the womb. It peaks around week five then retreats inside us. Its column of vertebrae becomes the main supporting structure for our developing skeleton. Our tail becomes our spine.

We never lost our tail. It hides within us.

—

When I first held my daughter, Suki, seconds after her birth, my sleep-deprived brain refused to process her as real. My wife’s labour had lasted three days and nights. It had been so gruelling that, at points, we genuinely forgot a child was on the way.

The thing gazing up at me seemed like a sophisticated movie prop. Her hair was red with blood. We stared at each other, stunned.

I never felt I deserved to be a father, nor that I would be any good at it. All the same, I had longed for it. I had held my wife’s hand in the hospital when, over a year earlier, the nurses told us she had miscarried. When they showed us the scan, with the empty space where a foetus ought to have been, I pawed at the air between me and the screen, as if I could reach inside the image and fix it.

I have heard people say that mentally ill people who have children are selfish. Perhaps I am.

Over the past fifteen years I have been diagnosed variously with generalised anxiety disorder, panic disorder, acute anxiety, panic attacks and depression. I’ve been called anxious, uptight, stressed, paranoid, hysterical and unhinged. A worrier. A pessimist. A neurotic.

All with some justification, I might add. I am not easy to be around. Most of my life has been shaped by fear – anticipating it, reducing it, blocking it out. But none of those labels ever quite felt like they fitted.

—

In English, we have many words to describe someone who is habitually afraid. We might call a person ‘shy’, which in some circles is almost complimentary, a near-synonym for ‘modest’. If we think their fear serves a purpose we might call them ‘concerned’ or ‘vigilant’. Drop their status a few notches and we have ‘cautious’, ‘wary’. Drop it further and we hit ostensibly neutral terms: ‘anxious’, ‘worried’, ‘fearful’, ‘nervous’. Want to imply a minor, vaguely comic failure of character? Call them ‘jumpy’, ‘paranoid’, ‘panicked’. Our most critical terms make anxiety their whole identity. We might dub someone a ‘wimp’, or transform them into a ‘baby’, ‘chicken’, or ‘pussy’. (The fearful undergo similar mutations in German: from the evocative Angsthase or ‘fear-hare’, and Weichei, a ‘soft egg’, to the chimeric Duckmäuser, literally ‘duck mouse’, a moral hypocrite too scared to voice their true opinion.)

At the bottom of the heap is ‘coward’ – a word which carries such odium that at many points in history being labelled one has been grounds for execution.

Most of our words for bravery are somatic – located within the body. We say someone has ‘guts’, ‘heart’, ‘spine’, ‘balls’, ‘nerve’ or, if we wish they were a bit less liberated, ‘cheek’. To call someone a coward is to point out our shameful ancestral stowaway and imply it still controls them. Humanity’s dirty little secret.

Hey you. Your tail is showing.

—

I wasn’t always a coward.

My mum tells me that as a young child I was ‘fearless’, running off down the beach towards the ocean without looking back, toppling into the duck pond (I remember being underwater, the greeny-brown murk, the peace), shouting out in class and performing to an audience whenever I had the chance.

The change was gradual. Increased self-awareness, social intelligence and inhibition are, after all, natural and healthy parts of our development, as are the acquisition and generalisation of fears.² You burn your hand on a hot stove, you learn to be wary of touching any stove. You gauge the mood in the room before launching into that fifth rendition of ‘Frère Jacques’.

When I was seven, my granddad died while we were on holiday together. One moment he was alive, the next my little brother ran in, wide-eyed, announcing: ‘Pop’s gone to Heaven!’ My mum and nan were crying. A policeman came. I remember Nan with her head in her hands, saying, ‘It’s just a shell, it’s just a shell’; Pigeon Street on the TV; standing in the corner of the kitchen, a box of Sugar Puffs at my head height; Dad drawing a multicoloured potato for my brother while Mum wept in the next room; the alien weirdness of a world where someone could be deleted, and what seemed like minutes later we were doing colouring-in and pointedly not mentioning it. We drove home that night.

I was relieved when I learned I was not invited to the funeral. Over the months that followed, I glimpsed the adults in my life naked with grief – the shock and raw boredom of death’s aftermath. I learned never to speak of what had happened, or my feelings. I was spared the pain – and the catharsis – of saying goodbye. As far as I was concerned, Pop had been buried alive.

—

My first memory of deep, grinding worry comes from when I was fourteen, when the bullying started.

I had been to the dentist to get my braces checked. Walking home afterwards, I decided to pop into the local electronics shop to buy a birthday present for my brother. It was the closest thing our small town had to a record store. They had the entire Top 50 chart as CD singles. I loved music and would listen to hours of radio and albums every night. I was flicking through the charts when two boys from two years below came in and, after looking around for a bit, started teasing me.

I ignored them. I got teased a lot: about my weight, my glasses, my hair, my braces – nerd insignia that TV, movies and comics said meant you deserved abuse. I was kind of numb to it. It wasn’t nice but it rarely felt personal. ‘They’re trying to get a reaction,’ I was always told. ‘Don’t let them see they’re getting to you and they’ll leave you alone.’

Bullying moved like a storm front. Most of the time, all you had to do was hunker down, and it passed.

Eventually the boys wandered out. As they left, one of them glanced back through the window. Maybe I’d finally had enough, or maybe, with glass between us, I felt a rush of bravado. As he looked at me, I pulled a face.

They turned around and came back in. Standing either side of me, they started shouting, ‘Pull us a face!’ They called me ‘Henry’. They kept shouting the name, over and over. They called to the shop assistant to say, ‘Hello, Henry’ to me, which he did, rolling his eyes as if reluctantly humouring them, but complying all the same. I stood there, staring down at the CDs in their clear plastic jewel cases, in silence, my cheeks burning, my hands shaking.

Don’t let them see they’re getting to you.

It can’t have lasted longer than five minutes, but it felt like hours.

Finally, they left.

It might not sound like the most traumatic experience, but to give you a sense of how excruciating recounting this incident is for me (I’ve never written it down, never told it in detail to anyone, even my wife) it took me days to write those few short paragraphs. I procrastinated. I ran miles. My sleep was patchy. In the middle of mundane tasks I found myself bursting into tears. When I finished, I came down with a heavy cold.

It’s to do with what came afterwards. Every time those boys saw me at school, they would shout the name – even now, I instinctively call it ‘the name’ rather than exposing myself to the chest pains that come on when I type ‘Henry’ – circling me, yelling ‘Pull us a face!’, laughing. They snatched my pencil case and wouldn’t give it back until I’d pulled a face. They hung around the entrance to school at the start and end of the day. I lived literally next door to my secondary school, so I ended up climbing through the hedge each morning rather than face them. They knew where I lived. My house got egged. We got prank calls where the person on the other end mocked my grandfather’s voice (he had survived a tracheotomy and spoke in croaks). Once, when I didn’t have any lessons in the morning, I woke up to find one of them in my house, climbing the stairs.

This was every day for an entire school year. My friends didn’t do anything to help. Sometimes they joined in. I was scared to tell my parents – who assumed the egging was random pranksters – or teachers in case it made things worse. More than that, I felt ashamed. I still do. It was my fault. They had latched on to something defective and ugly in me. I felt helpless and humiliated and worthless. At night, I would lie on my bed and stare at the ceiling, my stomach churning, my head and hands clammy.

For years, I relived the incident, wishing I hadn’t provoked them, wishing I hadn’t left the house at all.

Wishing I’d had the sense to be a coward.

—

Self-blame seems perverse to those who haven’t found themselves on the receiving end of something horrible and apparently random. But many of us would rather blame victims – including ourselves – than believe the world is unfair and out of our control.

In 1966 psychologist Melvin J. Lerner conducted a follow-up³ to Stanley Milgram’s famous experiments on obedience.⁴ Students observed another student receiving electric shocks for making mistakes on a learning task. They were told they were taking part in research for the military about performing well under pressure. Their job was to watch the other participant for emotional cues. They were also asked to rate the participant’s ‘likeability’. They answered questions like: ‘How easily would this person fit in with your friends?’

In reality, the other participant was an actor and the electric shocks were fake. Lerner found that when participants believed they were powerless to intervene in the fake student’s suffering, they responded by rejecting and devaluing her. Lerner came to explain this through his ‘Just-World Hypothesis’.⁵ It’s frightening to admit parts of life are out of our control, so, Lerner argued, we find ways to blame victims for their misfortune. ‘Most people cannot afford,’ he said, ‘for the sake of their own sanity, to believe in a world governed by a schedule of random reinforcements.’

When Pop died, I acquired a dark secret. I had not wanted to go on holiday. Through some eerie, sympathetic magic, I had caused his heart attack.

When I was being bullied, I knew it was because of my own stupidity.

But there was an upside. If I had caused these bad things, it stood to reason I could stop them. If I could fix myself, I could make myself safe.

—

Cowardice is one explanation for why humans have survived so long. How we’ve morphed and bulked out and elaborated ourselves from protozoa, to fish flop-wheezing onto land, to tool-using chimps, to sad bipeds with Fitbits and sarcasm. Evolution rewards survival over satisfaction. It may be deeply pleasurable to notice how light bends when it strikes the dew drops beading on a waxy leaf, to appreciate the sweetness of dark berries plucked from the bush, but if you want to pass on your genes to the next generation it’s preferable to spot the wolf approaching through the undergrowth, or the looming cliff edge.

Fear wants to keep us safe. Better stressed than dead.

—

Suki had a tricky start to life. She got an infection and had to return to hospital. The doctors weren’t sure if she had meningitis.

Gazing down at Suki, a cannula in her wrist, her tiny chubby toes scrunched above the heart monitor strapped to her ankle, I feared for her. I loved her more than I knew how to deal with. I felt powerless. My wife was surviving on minutes of sleep, staying in the hospital for endless rounds of feeding, tests and medication. I was ragged and frightened. I have never felt more like a little boy dressed up as a man.

—

When Suki was about eight month...

Table of contents

• How to Read This Book
• 1. Tail: How I became anxious
• 2. Shift Happens: The moment I realised I couldn’t go on like this
• 3. The Exercist: Exercise; the fight, flight or freeze response; and neurotransmitters
• 4. Eat Shit and Diet: The gut–brain connection, microbiota and inflammation
• 5. Terrifying Abnormal Dreams: Antidepressants, tranquillisers, side effects and withdrawal symptoms
• 6. Modern Life Is Rubbish: The anxiety of modern life and the history of stress
• 7. This Is Fine: Social media and our addiction to doomscrolling
• 8. The Anxiety Gene: The genetic roots of anxiety
• 9. And It Feels Like Home: Childhood trauma, brain development and the power of nostalgia
• 10. Piece of Mind: The neuroscience of anxiety
• 11. Brain Storm: Stimulating parts of the brain with electricity and magnets, and taming our ‘threat circuit’
• 12. Paranoid Android: What robots and AI are teaching us about anxiety
• 13. Safety: How we perpetuate our fear, and the extreme exposure therapies that conquer it
• 14. Psychedelics: LSD, magic mushrooms, MDMA, and the growth of psychedelic therapy
• 15. The Water Cure: Cold-water immersion and wild swimming
• 16. Breathing: Pulmonary biology and the science of panic attacks
• 17. Hypnosis: Hypnotherapy and placebos
• 18. Religion: Seeking certainty in gods, scriptures and meditation
• 19. In These Uncertain Times: Anxiety disorders and global catastrophe
• 20. The Magic of Uncertainty: The power of stories, and learning to be comfortable when life is out of our control
• Appendix
• Acknowledgements
• Notes