Medicine

The spice of life

John Linklater

General practitioners note that a steadily increasing proportion of patients today present with illdefined, diffuse complaints of which anxiety and depression, either overt or dressed up and disguised, are representative and predominant. Neurotic illness is already responsible for 40 per cent of the workload, and many practitioners attempt to relate this widespread manifestation of unhappiness, to &etiological factors in society.

Yet, according to political pundits, we should be growing more contented. The Government regularly announces new egali tarian and anti-discriminatory regulations or legislation for improving the quality of life. Never has the security of tenure in employment been greater than it is today. Never has the average man enjoyed a less arduous working week.

We thus observe a paradoxically high and increasing level of neurotic discontent in the face of overwhelming, ever-growing, compulsory benevolence and welfare. Progressively fewer people seem able simply to enjoy being alive.

Those of us who have had the good fortune as I had in German occupied France and Italy to be energetically engaged in primitive survival, will bear me out that life, the sheer fact of remaining alive, was never so enjoyable as in those days. No food has ever tasted so good as food eaten ravenously, with no clear idea of when, or where or how the next meal would be obtained.

• Survival is the essence of it. Man is descended from ancestors of whom all survived a hostile environment at least long enough to breed. Survival is an intrinsic part of our nature, and we have a splendid neuro-hormonal mechanism for dealing adequately with real stress. This is the fight or flight response that sustains our efforts when facing starvation or hunting, or being hunted.

Those of our ancestors who most enjoyed their hard life, tended to survive the best. In the course of evolution, therefore, most of us have come to enjoy the piquancy of stress situations. This is why the joy of living comes from within. It is governed prin cipally by sense of purpose and clarity of aim, and, above all, by accepting a challenge and acquit ting ourselves well. Man is most happy when struggling successfully.

This concept has often been expressed in divers diverse ways.

Lorenzo de Medici, for example, epitomised the ebullient, energetic and expectant joy of the Renais sance by his belief that man could accomplish whatsoever he set out to achieve. He saw the colour of life as a reflection of the difference 'between individuals, each striving and struggling wholeheartedly to express himself in action, through his art, and sport, and fighting, and trading, and love of God.

The external stimuli, on the other hand, needed to ensure a high performance in life, are also well understood. They are the ancient stimuli that made us what we are, today. First, there has to be a real reward. Then, there has to be a real interest, in the sense that the task must be relevant. Last, there has to be a real fear of failure.

The Welfare State, however, irrevocably hooked to Freudian determinism, pays little heed to

evolutionary selection. It postulates, as in the Parable of the

Mad Gardener, that all men have equal rights, irrespective of the manner in which they carry out their duties and fulfil their obligations. It also postulates that, if forced into situations of equal opportunity, all men become equal, and therefore happy. It seeks, in fact, to reverse the physiological and mental attributes common to mankind.

By placing modern, domesticat ed man in an increasingly structured, non-competitive, cushioned, equal, all-found and all-decided environment, the Welfare State deprives him of a sufficient or frequent use for his stress mechanism: which mechanism then proves to be as bad a master as it is a good servant.

When we spend long aimless hours, absorbed and hypnotised by colour telly, when wall-to-wall carpeting, and fridge, and washing machines have all been installed, when we face neither danger nor disaster, and when we do not even take part in a symbolic hazard such as an exhausting or dangerous sport, then our latent, pent-up stress mechanism intrudes itself upon us by spontaneous, inappropriate and uncontrollable reaction.

Adrenalin and nonadrenalin circulate to excess. We thus feel a

sense of free-floating anxiety, and become restless and tense. Our grey matter, which has ultimate control over perception by means of cortical, efferent, nerve fibres, re-interprets our environment in a way that justifies and rationalises our anxiety. Trivia loom large. We worry about them. Little aches and pains bear ominous portent.

We worry about our health, and vainly seek relief by consuming palliative tablets that our general

practitioner prescribes, because he cannot treat the cause of our ills.

Our performance decreases. We are spoiling for a fight and show it by bad temper or even by irra tional outbreaks of violence. We have become neurotic through misuse.

The Government has removed both the carrot andthestick.lt has likewise weakened our sense ot purpose by denigrating national. racial, and religious ideals, and by substituting the unrealistic and unsatisfactory ideals of happy mediocrity and freedom from fear and worry. Left unsatisfied, without a clear sense of purpose. our paradoxical anxiety increases.

We lap our endless saucers of free, and equal milk, and ruefully reflect that in accepting these free goodies, we have lost the very spice of life.