At different times we all experience nervous tension of some degree, and we are all familiar with the more obvious signs of anxiety. However, there is a multitude of ways in which anxiety may manifest itself, and some of these are of such a nature that they often mislead both patient and doctor into the belief that the trouble is due to some organic cause rather than to the disordered function of our mind.
I have seen quite a number of patients who had suffered from long-standing anxiety and nervous tension, and who had become so accustomed to their tensed-up state that they had grown to accept it as normal. Each of these consulted me on account of some bodily symptom, and when I commented on their general state of tension, they denied that they felt tense; and it was only after treatment that they realized that an easier and more relaxed way of life was possible for them. Strangely enough, one of these patients is a well-known surgeon.
The surgeon was referred to me by another doctor in the hope that I might be able to help him with a long-standing difficulty with his speech. I could see that he was a tense person, but when I asked him about it, he strongly denied that he was in any way tense, and added that everyone who knew him regarded him as particularly relaxed. His wife was with him at the time, so I asked her to lift up my arm and let it go suddenly. It flopped down with its dead weight on to the arm of my chair. I then asked her to do the same thing with the patient. When she let his arm go it remained stuck up in the air for a moment, held there by the tension in the patient’s muscles. Try as he might, he could not let his arm fall naturally and relaxed.
One day after two or three sessions of the relaxing exercises, he smiled, and said, “I never really knew that I was tense like that.”
Although it has not been completely cured, his speech is much improved, and he has achieved an ease in his ordinary way of life which he had not thought possible.
The signs of anxiety are elusive and may well escape even the physician who does not specialize in this aspect of medicine.