A philosophical cure for fear and anxiety


“Anxiety” said the philosopher Søren Kierkegaard, “is the dizziness of freedom.” What could he have meant by that?

Anxiety can be defined as “a state consisting of psychological and physical symptoms brought about by a sense of apprehension at a perceived threat.”

Fear is similar to anxiety, except that with fear, the threat is, or is perceived to be, more concrete, present, or imminent.

Fear and anxiety can, of course, be a normal response to life experiences, protective mechanisms that have evolved to prevent us from entering into potentially dangerous situations and to help us escape from them should they befall us regardless.

For example, anxiety can prevent us from coming into close contact with disease-carrying or poisonous animals, such as rats, snakes, and spiders, from engaging with a much stronger or angrier enemy, and even from declaring our undying love to someone who is unlikely to spare our feelings.

If we do find ourselves caught in a potentially dangerous situation, the fight-or-flight response triggered by fear can help us to mount an appropriate response by priming our body for action and increasing our performance and stamina.

In short, the purpose of fear and anxiety is to protect us from harm and, above all, to preserve us from death—whether literal or figurative, biological or psychosocial.

On the other hand, severe or inappropriate anxiety can be maladaptive, preventing us from doing the sorts of things that most people take for granted, such as leaving the house or even our bedroom. I once treated a patient with an anxiety disorder who, to avoid ever having to leave his bedroom, urinated into a bottle and defaecated into a plastic bag.

Such pathological anxiety is very common and often presents in one or more distinct patterns or syndromes, such as phobia, panic disorder, or post-traumatic stress disorder (PTSD).

As with the adaptive forms, these pathological forms of anxiety can be interpreted in terms of life and death. Common phobias such as arachnophobia (spiders), ophidiophobia (snakes), acrophobia (heights), achluophobia (darkness), and brontophobia (storms) are all for the sorts of dangers that commonly threatened our ancestors. Today, man-made hazards such as motor cars and electric cables are much more likely to strike us, but most phobias remain for natural dangers, presumably because man-made hazards are too recent to have imprinted themselves onto our genome.

Panic disorder involves recurrent panic attacks during which symptoms of anxiety are so severe that the person fears that he or she is suffocating, having a heart attack, or losing control. Very soon, the person develops a fear of the panic attacks themselves, which in turn sets off further panic attacks. A vicious cycle takes hold, with the panic attacks becoming ever more frequent and severe and even occurring “out of the blue.”

As with phobias, the ulterior fear in panic disorder is of death and dying, as it is also with PTSD, which is a reaction to a traumatic life event, such as a car crash or physical or sexual assault. Common symptoms of PTSD include anxiety, of course, but also numbing, detachment, flashbacks, nightmares, and loss of memory for the traumatic event.

The symptoms of PTSD vary significantly from one culture to another, so much so that PTSD is sometimes thought of as a “culture-bound syndrome.” Culture-bound syndromes are essentially culture-specific anxiety disorders, which, again, like all anxiety disorders, can easily be understood in terms of life and death.

Dhat, for example, seen in South Asian men, involves a sudden fear about the loss of semen in the urine, whitish discoloration of the urine, and sexual dysfunction, accompanied by feelings of weakness and exhaustion. Dhat may be rooted in the old Hindu belief that it takes 40 drops of blood to create a drop of bone marrow, and 40 drops of bone marrow to create a drop of semen, and thus that semen is a concentrated essence of life.

In addition to fear and anxiety and their pathological forms (such as phobias, panic disorder, etc.), there is a more abstract or philosophical form of anxiety that has been called “existential anxiety.” While fear and anxiety and their pathological forms are grounded in threats to life, existential anxiety is rooted in the brevity and apparent meaninglessness or absurdity of life, that is, in a kind of metaphorical death.

As I argue in my new book, Heaven and Hell: The Psychology of the Emotions, existential anxiety is so disturbing that most people avoid it at all costs, constructing a false reality out of goals, aspirations, habits, customs, values, culture, and religion in a bid to deceive themselves that their lives are special and meaningful and that death is distant or delusory.

Unfortunately, such self-deception comes at a heavy price. According to the philosopher Jean-Paul Sartre, people who refuse to face up to “non-being” are acting in “bad faith” and living out a life that is inauthentic and unfulfilling.

Facing up to non-being can bring insecurity, loneliness, responsibility, and, consequently, anxiety, but it can also bring a sense of calm, freedom, and even nobility. Far from being pathological, existential anxiety is a necessary transitional phase, a sign of health, strength, and courage, and a harbinger of bigger and better things to come.

For the philosopher and theologian Paul Tillich, refusing to face up to non-being leads not only to inauthenticity, as Sartre had said, but also to pathological (or neurotic) anxiety.

In The Courage to Be, Tillich writes:

He who does not succeed in taking his anxiety courageously upon himself can succeed in avoiding the extreme situation of despair by escaping into neurosis. He still affirms himself but on a limited scale. Neurosis is the way of avoiding nonbeing by avoiding being.

According to this striking outlook, pathological anxiety, although seemingly grounded in threats to life, in fact, arises from repressed existential anxiety, which itself arises from our uniquely human capacity for self-consciousness.

Facing up to non-being enables us to put our life into perspective, see it in its entirety, and thereby lend it a sense of direction and unity. If the ultimate source of anxiety is fear of the future, the future ends in death; and if the ultimate source of anxiety is uncertainty, death is the only certainty.

It is only by facing up to death, accepting its inevitability, and integrating it into a life that we can escape from the pettiness and paralysis of anxiety, and, in so doing, free ourselves to make, and get, the most out of our lives.

This esoteric understanding is what I have come to call “the philosophical cure for fear and anxiety.”

Le_Jardin_de_Nébamoun.jpgIneni, architect to Pharaoh Thutmose I (d. 1492 BCE), had his garden painted into his tomb, along with a list of all the trees within it—presumably, so that they might be accounted for in the afterlife.

Ineni’s garden included:

  • 170 date palm
  • 120 doum palm
  • 73 sycamore fig
  • 31 persea
  • 16 carob
  • 12 grape vine
  • 10 tamarisk
  • 8 willow
  • 5 fig
  • 5 pomegranate
  • 5 garland thorn
  • 2 moringa
  • 2 myrtle

A grand garden of this sort symbolized control and mastery over nature, a haven of peace and plenty, of order and beauty, by which to project the status, power, and temperament of its owner. Other, more famous, examples include the Hanging Gardens of Babylon, the Gardens of the Real Alcázar in Seville, and the Gardens of Versailles.

The garden could also have a religious or philosophical message or dimension. For example, the Old Testament’s four rivers of Eden are represented by four watercourses in Islamic paradise gardens, and four paths in Christian cloister gardens. The Zen garden, by hinting at hidden principles, serves as an aid to meditation about the true meaning of existence.

The Gardens at Versailles reflect a rationalist, Cartesian vision of God-given ideas and principles for the intellect to apprehend or recognize, whereas English landscape gardens are more in the empiricist mold, presenting nature as a stream of sensory experiences skirting across the blank slate of the mind.

In either case, the garden represents a taming of nature, from dark and deadly forest, or disease-infested swamp, to an extension of our living space: open and structured to still our minds, but retaining enough mystery to sustain our interest and even, perhaps, capture our imagination.

Individual plants too can have a meaning. English churchyards often feature yew trees, which are poisonous, dark, and evergreen, and symbolize both death and immortality. A yew tree is commonly found near the lychgate, where, prior to the advent of mortuaries, cadavers guarded by vigils awaited burial.

In the ancient world, the palm tree symbolized victory, peace, and bounty, while the cedar of Lebanon symbolized pride, majesty, and dignity. Both also stood for righteousness, as in Psalm 92:12: “the righteous shall flourish like the palm tree, grow tall like the cedar of Lebanon.” Today, Cedrus libani is the national emblem of Lebanon, and a symbol of the peaceful Cedar Revolution of 2005.

Trees can also be planted to mark an important occasion, which is why British royals are often asked to brandish a shovel. In a recent annual tradition, the Friends of my local park purchase a noteworthy tree and invite a dignitary such as the Lord Mayor to plant it.

Today, gardening is more popular than ever. According to the National Gardening Survey 2018, more American households (77%) are gardening than ever before. In the U.K. 87% of homes have access to a garden, and 27 million people report a personal interest or active engagement in gardening, even if it is only on a balcony.

Sporting replacements of the BBC’s flagship Gardeners’ World achieve only a third of presenter Monty Don’s usual viewing figures of almost three million—which, in the U.K. is many more people than go to church.

Community garden projects and ‘guerrilla gardening’ are on the rise, as are garden towns and villages. Two years ago, one of my neighbours organized for thousands of daffodils to be planted on a neglected and overlooked common, transforming it into a Wordsworthian idyll for the selfie generation. I wonder, do they know that ‘daffodil’ is Narcissus in Latin?

Gardening is more and more recognized, and even prescribed, for its health benefits. These include: increased muscle strength and cardiovascular fitness; improved sleep and diet (if you grow your own produce); reduced stress, anxiety, and depression; a greater sense of community and belonging; and better self-esteem.

You don’t even have to get your hands dirty: some of these benefits accrue simply from visiting a garden, or even just looking over one—although it probably helps to notice and mentally engage with the greenery.

Researchers in Korea randomly assigned hospital patients recovering from thyroidectomy to rooms with plants and flowers, and rooms without, and found that the test group fared significantly better, asking for less pain relief and requiring less time in hospital. So yes, it makes sense to bring flowers, and, at home, to have indoor plants.

Even street trees greatly benefit our health. An American study looking at the city of Toronto found that, for cardio-metabolic conditions (heart disease, stroke, diabetes, obesity…), an increase of just 11 trees per city block compared to an increase in annual personal income of $20,000.

How might gardening help with mental health? To various degrees, we live inside the stories we tell ourselves. But gardening drags us out of our tortured heads and back into the natural world, which blunts the ideological and emotional extremes to which detached, abstract thought is prone.

In 1920, a mentally strained Ludwig Wittgenstein took up the post of assistant gardener at Klosterneuburg Abbey, explaining in a letter to a friend that he had been longing for “some kind of regularized work which, of all the things I can do in my present condition, is the most nearly bearable…”

Voltaire’s Candide (1759) is an attack on the highly abstracted, convoluted, and strained philosophy of Gottfried Wilhelm von Leibniz, and famously concludes with the phrase “we must cultivate our garden.”

In the Philosophy of Existence (1938), Karl Jaspers describes this disinterested process of looking outside oneself—or phenomenology, as it is sometimes called—as “a thinking that, in knowing, reminds me, awakens me, brings me to myself, transforms me.”

Just picture the gardener’s pure and simple delight at the first crocuses or tulips, a bird’s nest, a swarm of bees…

If gardening makes us feel better, it also makes us into better people. It is a moral education, a school of life, instilling virtues such as pragmatism, patience, perseverance, reliability, and humility, which then transfer out into other spheres.

In his treatise on agriculture (c. 160 BCE), Cato is quite clear that farmers make the bravest and strongest soldiers, and that, of all men, they are “the most highly respected, most stable, and least hated.”

In Plato’s Phaedrus (c. 370 BCE), Socrates compares the wise man to the good husbandman, who is careful to scatter the right seed in the right soil in the right season. Similarly, the good teacher is careful to sow the right words in the right soul at the right time. For Plato, the Divine Teacher, teaching is the gardening of the soul.

Building on these notions, Epicurus (d. 270 BCE) sought in his garden just outside Athens to return to an agricultural golden age of harmony, community, and self-sufficiency—to ground a flourishing life in the midst of a flourishing garden.

A garden is a microcosm of the outside world. Gardeners are acutely aware of the rhythms and cycles of nature: which flowers are in their prime, when to plant out the seedlings, when and how and how much it last rained. Just as music is time made audible, so the garden is “time made visible” [Clive James].

Winter is difficult, yes because it is dark and cold, but also because time is no longer structured by a succession of flowerings and fruitings. Time becomes amorphous, to be entertained and endured rather than savoured and celebrated like the season of magnolias, cherry blossom, rhubarb, plums, or chestnuts.

More than just keen observers of time, gardeners are real-life Time Lords, able to speed up time by working in the garden, and later to slow it right down by sitting back and surveying the fruits of their labour. Some gardeners are even able to step out of time altogether, working year round to create timeless moments of perfection.

But moments are all they will ever be. When you paint a picture or write a book, it is there for ever (and isn’t that just amazing?), but when you mow the lawn you have to do it all over again in just a few days’ time. The gardener is like Sisyphus, the mythological king made to repeat for all eternity the same meaningless task of pushing a boulder up a mountain, only to see it roll back down again.

In his essay of 1942, The Myth of Sisyphus, Albert Camus concludes: “The struggle to the top is itself enough to fill a man’s heart. One must imagine Sisyphus happy.”

Even in a state of utter hopelessness, Sisyphus can still be happy. Indeed, he is happy precisely because he is in a state of utter hopelessness, because in recognizing and accepting the hopelessness of his condition, he at the same time transcends it.

The oldest musical instruments to have been found, flutes made from bird bone and mammoth ivory, are more than 42,000 years old; and it has been argued that, by fostering social cohesion, music—from the Greek, ‘the art of the muses’— could have helped our species outcompete the Neanderthals. Remember that next time you stand to the national anthem.

In the Bible, David played on his harp to make King Saul feel better: ‘And it came to pass, when the evil spirit from God was upon Saul, that David took an harp, and played with his hand: so Saul was refreshed, and was well, and the evil spirit departed from him’ (1 Samuel 16:23 KJV).

The oral works ascribed to Homer would not have survived if they had not been set to music and sung. By his song, the lyric poet Thaletas brought civic harmony to Sparta, and is even credited with ending the plague in that city. The Pythagoreans recited poetry, sang hymns to Apollo (the god of music), and played on the lyre to cure illnesses of body and soul. In the Republic, Plato says that the education of the guardians should consist of gymnastic for the body and music for the soul, and that, once set, the curriculum should not be changed: ‘…when modes of music change, of the State always change with them.’ Aristotle concludes the Politics with, of all things, a discussion of music:

Since then music is a pleasure, and virtue consists in rejoicing and loving and hating aright, there is clearly nothing which we are so much concerned to acquire and to cultivate as the power of forming right judgments, and of taking delight in good dispositions and noble actions. Rhythm and melody supply imitations of anger and gentleness, and also of courage and temperance, and of all the qualities contrary to these, and of the other qualities of character, which hardly fall short of the actual affections…

In the 10th century, the Islamic thinker Al-Farabi wrote a treatise, Meanings of the Intellect, in which he discussed music therapy. Modern music therapy took form in the aftermath of World War II, when staff in veteran hospitals noticed that music could benefit their patients in ways that standard treatments could not, and started hiring musicians. In 1959, American composer and pianist Paul Nordoff and British special education teacher Clive Robbins developed a form of collaborative music-making to engage vulnerable and isolated children, helping them to develop in the cognitive, behavioural, and social domains. Today, Nordoff Robbins is the largest music therapy charity in the U.K.

Modern music therapy aims, by the use of music, to improve health or functional outcomes. It typically involves regular meetings with a qualified music therapist and various combinations of music-related activities. In ‘active therapy’ the individual and therapist make music using an instrument or the voice; in ‘passive therapy’ the individual listens to music in a reflective mode. You don’t have to be musical to take part. And, of course, you don’t have to take part to engage with music.

Does music therapy work? And if so, how? There is mounting evidence that music boosts levels of dopamine, a feel-good chemical messenger in the brain. Dopamine is linked to motivation and reward, and released in response to activities such eating and making love. Many people use music to power through a workout. Beyond distracting from discomfort, music triggers the release of opioid hormones that relieve physical and psychological pain. Forget the workout, just dance to the music. Dancing is the best exercise because it involves movement in all directions and engages the mind on multiple levels. Music also boosts the immune system, notably by increasing antibodies and decreasing stress hormones, which can depress the immune system. Techno and heavy metal aside, music lowers heart rate and blood pressure, and even reduces recovery time following a heart episode or surgery.

From the psychological perspective, music therapy alleviates symptoms of anxiety and depression and improves social and occupational functioning. Aside from the biological benefits such as increased dopamine and decreased stress hormones, music can help us to recognize, express, and process complex or painful emotions. It elevates these emotions and gives them a sense of beauty and meaning. We hear a human voice and feel understood. As Taylor Swift put it, “People haven’t always been there for me but music always has.”

I don’t think that music has to sound uplifting to be uplifting, so long as it helps us to work with our feelings. In the Poetics, Aristotle compared the purifying or cleansing effects of tragedy on the mind of the spectator to the effect of a cathartic on the body, and called this purging of the emotions catharsis.

The benefit of music extends beyond depression and anxiety to psychosis, autism, and dementia. In dementia, music can help with cognitive deficits, agitation, and social functioning. It helps to encode memories, and can in turn evoke vivid memories. In acquired brain injury, it can assist with the recovery of motor skills, and, through song, lend a voice to people who have lost the faculty of speech. At the other end of life, music played during pregnancy has been linked, in the newborn, to better motor and cognitive skills, faster development of language, and so on.

I remember as a teenager, lying in the blackness of the night and listening to Beethoven on my portable CD player. It completely transformed the makeup of my mind.

10 songs for the blues

  1. The Verve, Bittersweet Symphony
  2. Soul Asylum, Runaway Train
  3. Disturbed, The Sound of Silence
  4. Abba, Chiquitita 
  5. Rolling Stones, Paint it Black
  6. Royksopp, I Had This Thing
  7. Eurythmics, Here Comes the Rain Again
  8. Beethoven, Violin Concerto
  9. Bruce Springsteen, Human Touch
  10. The Verve, Lucky Man

If a song has been helpful to you, please share it in the comments section.