Wellcome Book Prize Shortlist: My Age of Anxiety

Posted on 28th April 2015 by Scott Stossel
With the winner announced tomorrow, we continue our look at the shortlist for this year's Wellcome Book Prize.

The Wellcome Book Prize is awarded to a book that engages and explores with some aspect of medicine, health or illness. This can cover a number of genres of writing from crime and romance to popular science, sci fi and history. Through this, the Wellcome Book Prize aims to encourage debate around these topics through these books.

In My Age of Anxiety, Scott Stossel draws on his own long-standing battle with anxiety and presents an astonishing history of the efforts to understand the condition from medical, cultural, philosophical and experiential perspectives. Read an extract below.


And no Grand Inquisitor has in readiness such terrible tortures as has anxiety, and no spy knows how to attack more artfully the man he suspects, choosing the instant when he is weakest, nor knows how to lay traps where he will be caught and ensnared, as anxiety knows how, and no sharpwitted judge knows how to interrogate, to exam- ine the accused as anxiety does, which never lets him escape, neither by diversion nor by noise, neither at work nor at play, neither by day nor by night.

—Søren Kierkegaard, The Concept of Anxiety (1844)

There is no question that the problem of anxiety is a nodal point at which the most various and important questions converge, a riddle whose solution would be bound to throw a flood of light on our whole mental existence.

—Sigmund  Freud, Introductory Lectures on Psycho-Analysis (1933)

I have an unfortunate tendency to falter at crucial moments. For instance, standing at the altar in a church in Vermont, waiting for my wife-to-be to come down the aisle to marry me, I start to feel horribly ill. Not just vaguely queasy, but severely nauseated and shaky—and, most of all, sweaty. The church is hot that day—it’s early July—and many people are perspiring in their summer suits and sundresses. But not like I am. As the processional plays, sweat begins to bead on my forehead and above my upper lip. In wedding photos, you can see me standing tensely at the altar, a grim half smile on my face, as I watch my fiancée come down the aisle on the arm of her father: in the photos, Susanna is glowing; I am glistening. By the time she joins me in the front of the church, rivulets of sweat are running into my eyes and dripping down my collar. We turn to face the minister. Behind him are the friends we have asked to give readings, and I see them looking at me with manifest concern. What’s wrong with him? I imagine they are thinking. Is he going to pass out? Merely imagining these thoughts makes me sweat even more. My best man, standing a few feet behind me, taps me on the shoulder and hands me a tissue to mop my brow. My friend Cathy, sitting many rows back in the church, will tell me later that she had a strong urge to bring me a glass of water; it looked, she said, as if I had just run a marathon.

The wedding readers’ facial expressions have gone from register- ing mild concern to what appears to me to be unconcealed horror: Is he going to die? I’m beginning to wonder that myself. For I have started to shake. I don’t mean slight trembling, the sort of subtle tremor that would be evident only if I were holding a piece of paper—I feel like I’m on the verge of convulsing. I am concentrating on keeping my legs from flying out from under me like an epileptic’s and am hoping that my pants are baggy enough to keep the trembling from being too visible. I’m now leaning on my almost wife—there is no hiding the trembling from her—and she is doing her best to hold me up.

The minister is droning on; I have no idea what he’s saying. (I am not, as they say, present in the moment.) I’m praying for him to hurry up so I can escape this torment. He pauses and looks down at my betrothed and me. Seeing me—the sheen of flop sweat, the panic in my eyes—he is alarmed. “Are you okay?” he mouths silently. Helplessly, I nod that I am. (Because what would he do if I said that I wasn’t? Clear the church? The mortification would be unbearable.)

As the minister resumes his sermon, here are three things I am actively fighting: the shaking of my limbs; the urge to vomit; and unconsciousness. And this is what I am thinking: Get me out of here. Why? Because there are nearly three hundred people—friends and family and colleagues—watching us get married, and I am about to collapse. I have lost control of my body. This is supposed to be one of the happiest, most significant moments of my life, and I am miserable. I worry I will not survive.

As I sweat and swoon and shake, struggling to carry out the wed- ding ritual (saying “I do,” putting the rings on, kissing the bride), I am worrying wretchedly about what everyone (my wife’s parents, her friends, my colleagues) must be thinking as they look at me: Is he having second thoughts about getting married? Is this evidence of his essential weakness? His cowardice? His spousal unsuitability? Any doubt that any friend of my wife’s had, I fear, is being confirmed. I knew it, I imagine those friends thinking. This proves he’s not worthy of marrying her. I look as though I’ve taken a shower with my clothes on. My sweat glands—my physical frailty, my weak moral fiber—have been revealed to the world. The unworthiness of my very existence has been exposed.

Mercifully, the ceremony ends. Drenched in sweat, I walk down the aisle, clinging gratefully to my new wife, and when we get outside the church, the acute physical symptoms recede. I’m not going to have convulsions. I’m not going to pass out. But as I stand in the reception line, and then drink and dance at the reception, I’m pantomiming happiness. I’m smiling for the camera, shaking hands—and wanting to die. And why not? I have failed at one of the most elemental of male jobs: getting married. How have I managed to cock this up, too? For the next seventy-two hours, I endure a brutal, self-lacerating despair.


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