Colin Walker has a few things to say about anxiety, coming off of Stephen of Strandlines having a few things to say about anxiety, and I wanted to cite them both as sort of an introduction to a couple of things I wanted to say about mental health and normativity.
Anxiety is complex and unpicking all the reasons why a given scenario is anxiety inducing would take me all day. To try and explain it briefly, it’s about being observed, often from multiple directions, it requires a level of performance, it requires recalling information which can prove surprisingly elusive when your brain is taken up with processing anxiety, it’s looking for the exit, the need to escape, and it’s about the negative voice in your head telling you what a loser you are because you can’t even do the simplest of things without this whole thing going off in your head.
Anyone with any kind of anxiety is going to recognize that bit about being observed. It’s called the spotlight effect and it’s a hell of a thing.
It’s among the reasons why I’m usually sitting with my back to the wall at a coffeeshop if I’m there working on the laptop. There are times when I can work at the counter, but my psychological resources for the day have to be at a pretty good level. Open plan offices can be something of a nightmare if you’re subject to the spotlight effect. Even if in the moment you’ve a firm grasp that realistically no one cares what you’re doing, this kind of anxiety can grip you anyway.
(Not so incidentally, that bit about performance and recall will have any actually-autistic person vigorously nodding their head. If you’re autistic, and also almost certainly anxious, it’s not just about processing the anxiety stimulus itself but also all the other different kinds of stimuli coming at you at once.)
There are times when I feel anxious in an environment or situation that I would normally navigate perfectly fine and I can’t readily explain why. Maybe that sense of performance is what does it but something triggers me and it’s often impossible to say what.
I’ve written before that the only way I can describe it is a feeling of claustrophobia and the need to get out of the place or situation.
In my original autism diagnosis, after the autism itself was a line noting “anxiety features” that were “secondary to autism”, described as “social/performance distress”. This performance aspect is a real thing, to be sure. When you’re autistic (I can’t speak for non-autistic anxiety), it’s not just the social performance itself but the also masking that often comes along with it.
I’ve also often tried to describe various autistic and anxious experiences by invoking claustrophobia. It’s a good analogy (metaphor?) because it’s very difficult to explain to someone who doesn’t have to deal with various mental health challenges that these experiences legitimately can be called pain, but not the sorts of physical pain with which people would be familiar. There are physical sensations that come with, say, anxiety, but those sensations aren’t pain, per se, yet the mental experience very much wants to be described with words like “pain”.
Claustrophobia often can be a good stand-in if you’re trying to get someone to understand what it’s like for you.
A little further down, Walker mentions that during anxiety experiences, one might spot him “fiddling with the hem of my jacket or jumper, even a fold in my jeans”. He calls it a “distraction” more than a “comfort”, and wonders if it’s “some form of stimming”.
There’s no question: it’s a stim. I’d maybe challenge him a bit by asking if the distraction isn’t, in fact, something of a comfort. The thing about self-regulatory behavior (a good term for those who wince at “stim” basically being short for self-stimulation or self-stimulus) is that literally it is all about creating that “focus” Walker mentions. It’s meant to provide a kind of oasis of self-directed input.
In autistic anxiety, this can get wrapped up in the masking question. More overt stimming behavior might be more soothing, unless for you it just will summon more spotlight effect. It took me awhile, for example, to surrender to rocking in public, and it took clear self-knowledge that I was not going to make it through without the regulation of that more noticeable stim.
(It’s funny that Walker mentions “the sensation of having the material between my fingers” because when I was very, very young I had a blanket made, I think, from a bathrobe that had a long, dangling extra bit of silky hem hanging off. It was common for me to run its entire length between two fingers. Decades later, after my autism diagnosis, I identified this as my very first stim.)
Walker mentions that social performance does not always yield anxiety, and places the reason for this on matters of control. This is another thing that people who don’t have to deal with this don’t always seem to understand (or even be willing). Sometimes, yes, autistic or anxious people can do things that superficially seem to be their stressors. Almost always, it comes down to control and predictable structure. This is a thicket, because it always runs the risk of people nagging you that if you can do this why can’t do that. All this does is risk the person self-limiting the things they enjoy, which certainly isn’t going to make them “better”.
There’s a Romano Santos piece for Vice on whether or not a mental health diagnosis “makes your symptoms worse” that’s interesting so far as it goes but I wish it had gone further, or maybe deeper.
It’s possible that this is the case for certain people, he said, but it’s more likely that people become more aware of their symptoms and subsequently attribute those symptoms to their diagnosis.
“People can have any number of symptoms that have just become ‘normal’ for them and then they realize, ‘This is my ADHD, or anxiety, or depression, or trauma,’” said Puder.
For example, someone recently diagnosed with an anxiety disorder may notice when they become irritable, how their worrying impacts their sleep at night, or physical symptoms like heart palpitations and nausea. Those things probably didn’t get worse after the person learned they had an anxiety disorder, it’s just that now the person might be paying more attention and have something to pin those symptoms on.
Sure. The thing is, though, that, yes, you can get “worse” after a mental health diagnosis.
I’m speaking here from the standpoint of a midlife autism diagnosis but I guarantee you this applies to anyone who receives some sort of mental health diagnosis later in life and who up to that point unknowingly had been masking due to the innate peer pressures of social conformity.
It is a very common experience of late-diagnosed autistics to become “more autistic” after their diagnosis. Not because you’re actually “more autistic” but essentially because you become “less masked”. Diagnosis was permission for my brain to let loose. This meant two things: autistic behaviors came more freely, and suddenly I felt the now-conscious weight of decades of chronic stress (or trauma) from operating as an unknowing autistic in a world not built for me.
So, while it’s true that diagnosis yields “relief” and a “way to accurately categorize what you are experiencing”, it’s also true that for people whose mental health conditions were hidden even from themselves due to masking, diagnosis can “make your symptoms worse”.
The irony here is that many of what we pathologize as symptoms in fact are adaptations to mitigate the impact of the actual underlying concern. Stimming is a good example here, in that (in autistics, anyway) this sort of behavior too often is targeted for “correction” because it’s seen as disruptive. Absent stimming behavior that becomes outright harmful, all this “correction” does is limit a person’s ability to self-regulate in stressful environment.
When we get “worse” after a diagnosis, sometimes what’s actually happening is our brains have been set free to make use of the tools it has developed to help us keep going.
Austin Kleon has a post which posits in its title that “normal is what you can successfully ignore”, an idea I want to interrogate a bit.
The matter at hand actually is the changing built environment in and around Austin, and along the way he quotes from a Jon Mooallem piece for The New York Times about the Covid era (which I haven’t yet read in full), drawing special attention to this bit, which I’ve slightly condensed.
In 1903, the German sociologist Georg Simmel took a long, hard look at life in big cities and concluded — I’m paraphrasing — that normal life is basically a continuous bombardment of irreconcilable psychic noise. […] We enter each moment expecting that it will resemble the last one, and if we find that continuity between past and present disrupted, it pays to perk up. […] But a city never stops throwing new stimuli at us, engaging our impulse to notice and differentiate. In a city, there’s simply too much newness for a human being to perceive without breaking. The psyche therefore “creates a protective organ for itself against the profound disruption,” Simmel wrote — a dispassionate crust he called “the blasé attitude.” […] One way to describe normal life would be as an arrangement of circumstances that can be successfully ignored.
As an autistic and anxious person, this entire thing sort of lit up my brain.
First, I just want to say that “an arrangement of circumstances that can be successfully ignored” is just about the perfect way to describe how normative people view normality. This precisely is how normative social defaults are treated: ignorable, and so any deviation not only becomes noticeable but likely deemed deviant.
Second, I need to say that most likely this is not at all how an autistic or anxious person encounters the world around them. Any given day is a fight against “too much newness for a human being to perceive without breaking”. That “continuous bombardment of irreconcilable psychic noise”? We can’t place that behind a “blasé attitude”. We, somehow, have to confront and deal with it, or else avoid it.
Our lives often are spent trying to mitigate the weight of what other people simply get to ignore.
The normative fact of that bombardment (I feel) is why the autistic brain developed the adaptation I’ve come to call robust defaults: by imposing predictable structure onto as much as we can, we conserve our resources for the times when, if needs must, we expose ourselves to the bombardment.
(To pull on the thread again: the closest we get to being able to ignore the bombardment is through self-regulatory behavior—which those embedded in normativity then call deviance.)
For me, when Strandlines says that “at the end of the day anxiety is just that – internal” and that "those external factors I described above are not really the problem”, I respectfully disagree. While it’s true, of course, that there’s an extent to which “brain is gonna brain”, the normative world is not built to make it any easier on such a brain. The externalities aren’t irrelevant; it’s just that they are so much more difficult to control absent a mass movement to build solidarity and capacity.
Some of the ways I’ve made living in the city tolerable from a perspective of peace: observe the seasons (yes, we have seasons here, you just have to pay attention), help Meg in the garden, bike around with my friends, watch the owls, establish dumb rituals with the kids, etc. The sociologists in the piece call these strategies, meant to bring about some kind of normalcy, “repertoires of repair.”
“Repertoires of repair” maybe is as good a poetic description of strategies like the robust defaults of the autistic or anxious brain as anything else I’ve come across. It’s worth looking at the Mooallem.
I recognized this listening to Hagen and Milstein lay out more of their initial arguments and observations. The focus of their first paper was on people’s attempts to break out of their ontological insecurity via “agentic enactment” (making a change to your environment) and “epistemic grounding” (collecting or avoiding new knowledge). They called these strategies for making the world more intelligible and manageable “repertoires of repair.” I was surprised how precisely their ideas, unwrapped from this academic language, mapped onto the shambles of real, human experience.
Agentic enactment and epistemic grounding are two tried and true strategies for neurodivergent minds to navigate the bombardment. The first can be viewed as exerting control (which for us often means structure), while the second can be read both as “special interests” and the “focus oasis” of self-regulatory behavior. Strategies, not pathologies, against the bombardment.
Suddenly, I was alive to a reassuring power of sociology, which Hagen would later describe to me like this: “Sociology makes you aware, in a systematic way, of the power of the society we’re embedded in, rather than seeing the world as an archipelago of individuals, the way economists and U.S. culture generally want to make you see things.”
This gets at what I meant when I respectfully disagreed with Strandlines when he said that anxiety is internal. Our minds are not purely internal, no matter how much the experience of consciousness is locked inside. Our minds are embedded in a world of physical and mental structures built for normative brains. There’s no question that there are elements of being autistic (or anxious) that are my brain making things harder for me. There’s also no question, though, that there are elements of normativity that make things harder for my brain.
When we view normativity as “an arrangement of circumstances that can be successfully ignored”—when we take normal for granted as normal—we stigmatize divergence when maybe what requires a bit of the stink of stigma is normalcy itself.