Feeling good, or bad, in a cloud of anxiety

Psychologist Michael Kyrios has just seen his first patient with an anthrax phobia. “It’s someone who has obsessive-compulsive disorder and a lot of fears about contamination,” he says. “I was waiting for it.

“When AIDS became a big thing, a lot of people with obsessive-compulsive disorder would appear with AIDS-related phobias. They feared that they might catch it, or that they might be responsible for making someone else ill.”

The result in both cases is the same: patients obsess about safety with compulsive hand washing, repetitive checking or total avoidance of situations seen as risky. A Sydney GP reports that one patient blithely claimed she had no fear of anthrax because she was washing her hands 20 times a day. Australia is thousands of kilometres from the “Ground Zero” of the New York World Trade Centre attack, and all its anthrax scares have so far proved to be hoaxes. But the level of anxiety in the community has risen from the background hum of white noise to something louder and more insistent since September 11. We have been enveloped not in a cloud of bacteria but a cloud of emotion.

Doctors, psychologists and telephone counsellors say many people who were already struggling to cope have sought help because the news about terrorism pushed them into anxiety or depression. People are ringing Lifeline with sudden fears of tall buildings or enclosed spaces; Kids Helpline had a 400 per cent increase in calls following the twin towers attack; GPs report an average of five patients a day asking – mostly jokingly, they think
– about the risks of anthrax. Sales of emergency gear and gas masks have rocketed. Both the professionals and the retailers agree there have been twin peaks of the anxiety: the first few days after the towers crashed, followed by the days after Prime Minister John Howard’s announcement that Australia would send troops overseas for the war against terror.

But increased fearfulness is not the full story. There are at least two other elements in the nation’s emotional response to international terror, according to a wellbeing survey of 2000 Australians that asked them about their reactions to the September 11 terrorist attacks on New York and Washington. It found people were deeply saddened by the destruction and death, but that they had also become more satisfied with their own lives and with life in Australia generally.

Researcher Richard Eckersley helped produce Australian Unity’s National Wellbeing Index, released this week. He says disasters and the saturation media coverage given to them can lead to more psychological disturbance “but also to a national rallying and a greater sense of community and comradeship”.

He speculates that Australians feel better about themselves because the attacks have jolted people “out of the rut of everyday life – making them more aware of what they have and the preciousness of life”.

Ninety per cent of people surveyed said they had been saddened and 25per cent rated their sadness at 10 on a scale of one to 10: “That’s equivalent to the loss of a child or a partner, not usually something as general as this. It does suggest that quite a few people were very, very worried or distressed by what happened. And yet at the broad popular level, there has been this lift in satisfaction levels.”

The national wellbeing index rose 3.3 percentage points to 60.4 per cent and the personal wellbeing index rose 1.2 points to 74.7 per cent. The research echoes similar US findings: Americans are reporting higher rates of depression, insomnia and difficulty with concentration, along with higher satisfaction with their own lives and with their nation.

This is not as contradictory as it seems: “It makes sense in that people are responding to different questions. You can be saddened by the event, which is an emotional response, but still judge yourself to be slightly more satisfied with your own life, which is a cognitive evaluation.”

Dr Kyrios suggests Australians’ increased satisfaction might be a “post-hoc rationalisation”: “We need (to think) this in order to cope with that; we need to find meaning in order to cope with these horrible things happening around us.” It had been many years since the Me Generation questioned life: “This is something that wars tend to do, trigger a resurgence in the search for meaningful values.”

They also help detonate a resurgence of symptoms in people who have already suffered emotional trauma. Dr Bill Pring, psychiatry representative for the Australian Medical Association, says: “The terrorist event in the US has been a partial cause of a relapse or an actual episode of illness in some people.”
He says those at risk include people who have experienced warfare first-hand, such as soldiers and civilians who remember the World War II bombing of Europe, and anyone with lingering after-effects of peacetime traumas such as car accidents or domestic violence.

Many war veterans being treated for post-traumatic stress have become even more stressed, confirms psychologist David Forbes of the Australian Centre for Post-Traumatic Mental Health. “They’ve had more frequent nightmares and increased vigilance; they’re more conscious when they’re out of maintaining awareness about who is around them and what activities are happening around them, watching out for anyone that might look suspicious or have an intention to carry out harm. They wouldn’t want anyone standing behind them.”

Even children are not immune. The professional consensus is that children will take their cue from the responses of the adults around them. They did, says Kids Helpline’s Felicity Sloman. Callers in the week after the attack were worried because their parents had become so distressed – “If my parents need to be worried, then I need to be worried.” Calls are now back to normal levels, and anthrax is not a theme.

But most of the callers to Kids Helpline are teenagers. Primary school students are still anxious, according to Professor Erica Frydenberg, a psychologist in the faculty of education at Melbourne University. She says a class of teachers this week told her children are scared because they misunderstand. “They’re transferring the knowledge about what happened overseas to the possibility of it happening here. They think they are personally endangered.” Dr Kyrios adds: “Anything happening on TV could be happening outside as far as children are concerned.”

He says the ordinary person’s helplessness in the face of world events is freeing for some people; they just get on with their lives, realising there is little they can do. But others are comforted by taking action, however illogical, to protect against what they feel are their risk factors.

Alen Saynte is manager of Mitchell King disposals in Sydney, where gas mask sales have rocketed from two a month to 400. Customers have told him, “It’s OK for me, but my husband works in the city,” or “My husband works for an American company”.

The loss of trust in the environment makes people cling to the familiar. The tourism industry reports that more Victorians are booking holidays close to home. But the urge to circle the wagons has its downside. Ray Fritz, manager of Lifeline, says callers have been preoccupied not just with anxiety about the safety of themselves and their loved ones but with concerns about the future of community. The walls between in-groups and out-groups have been reinforced by fear.

“People who are on the edges of society – people who are homeless, who have some sort of disability or a mental illness or carers for those sorts of people – they’re expressing concerns that their links in the community are disappearing,” Mr Fritz says. “There seems to be a sense that people are caring less about those people who are on the edge and focusing more on the mainstream. One response of people who are fearful is to affiliate with those people they know best, so people who have trouble connecting anyway find it even more difficult.”

The political focus on “boats and borders” has made asylum seekers a clear “out” group, he says, and Lifeline workers have had to try to encourage some callers to be more tolerant. There has also been a rise in the number of employers requesting help with counselling staff who have been racially abused in the workplace, he says.

If politicians had wanted to link asylum seekers with terrorism, “(They) have succeeded. The issues are interlinked in people’s minds.”
Welcome to the not-so-brave new world.

First published in The Age.