I am not a California native. I spent the first 35 years of my life mostly on the east coast. I like to say that you've become a naturalized Californian when you stop worrying about earthquakes and start worrying about fire.
I probably fear fire most of all. Fear of fire is not a free-floating irrational fear that you can (and should) condition away. Fire is a real threat. It can kill you in the most horribly painful way imaginable. You can't intellectually eliminate that fear, nor do you want to. If you blunt it with alcohol or tranquilizers, you'll decrease your chances of survival. We fear fire because hundreds of thousands of years of human evolution bred out those who didn't fear it. You need some fear of fire to survive. The question is, how much.
I don't know if my fear of fire is worse than anyone else's. I don't remember any specific incident in my childhood that would have imprinted it in me, such as being burned on the stove or by a fireplace or accidentally starting a fire. Or maybe this is the imprinting experience. This has been an extreme situation even for adults. I wonder what the PTSD (post-traumatic stress disorder) situation is going to be like around here when this is all over.
Fire is alive, yet it is soulless. Fire is unthinking, uncaring, and completely arbitrary. It is utterly relentless. You deal with it on its terms, not yours. It's a primal force. You can completely understand the physics and the chemical reactions, but that doesn't mean you can always control it. You can only try.
All hazards are much like cliffs. Fall off one and you die. I place a lot of value on my upper brain, and I use it as much as I can to stay away from cliff edges. But if I go over the edge, my upper brain can no longer help me. And the worst part is that you don't always know where the cliff edge is.
Looking at what I wrote above last week, I can see that I was under a lot of acute stress. Fear is a natural human reaction to something like this, but Kimberly and I managed to redirect most of it toward something constructive. We collected as much irreplaceable stuff as we could, leaving the stuff that could be replaced with money. And we did things to try to reduce our anxiety level, like avoiding the TV news and getting our factual information (maps, weather, evac orders, etc) from the web. Now that it's all over, we're slowly unpacking, returning everything to its original locations. The acute stress is gone, but our nerves are still recovering. Although this will take a little more time, I don't think I'll have PTSD (post traumatic stress disorder). In fact, I wonder if I'll follow through on the resolutions I made last week to make our house more fire-resistant and to set up regular off-site backups of all my computer data.
There's a huge difference between acute and chronic fear. Acute fear, like acute pain, is adaptive. As long as it's not so severe (as with panic) to be disabling, and that can be difficult, acute fear can help you survive. That's why we evolved to have it. But chronic fear is like chronic pain. Both are maladaptive. Both can ruin your life.
I know someone who suffers from severe chronic fears of health risks that by any rational, objective standard are extremely small or nonexistent. I will call this person X to protect his/her identity. I do not pretend to be a psychiatrist, nor do I play one on TV, but just as I don't have to be a cardiologist to suggest that someone with sudden chest pains and shortness of breath should to go to the emergency room, I can suggest to X that he/she probably has a serious case of obsessive-compulsive disorder (OCD) and should seek evaluation and treatment from someone who is a mental health professional.
Chronic anxieties, fears and obsessions are ruining X's life, but X refuses to get help. X has a never-ending list of excuses: he/she can't afford medical care; has sick pets to take care of; can't deal with the traffic to the doctor's office; has a business to run; has a vehicle that isn't reliable; has problems entirely due to slow business and insufficient income, not a mental illness; doesn't want to take mind-altering medications; would "outsmart" any mental health professional and render him/her ineffectual; has mental health problems too severe to fix, and so on and on and on. Not a single excuse is valid. Some are even contradictory (e.g., X's mental health problems are too severe to fix, yet X's problems all stem from insufficient income). X is a highly intelligent and talented professional, and I'm convinced that X's productivity and income would skyrocket if he/she got healthy. This would eliminate X's money problems and one of the excuses, yet X still refuses to get treatment. This has gone on for years with no signs of abating.
Maybe this comes from the continuing stigma of mental illness. It has abated somewhat in recent years, especially as so many people have discovered the benefits of antidepressants, but it's still strong. Maybe it comes from the feeling that in a physical illness, something is wrong with some part of your body, but in a mental illness, there's something wrong with you. You don't like admitting that your brain -- what defines you -- could actually be broken, and so you don't work to get it fixed, or at least running better.
There's also a widespread perception of psychiatrists as adversaries, and not just by the Scientology nuts. Psychiatrists want to "get the better" of you. Psychiatrists secretly analyze and judge you, and screw with your mind, and trick you into doing things, and if they decide you're crazy they can lock you away and you'll never be able to prove that you aren't crazy. People only go to psychiatrists when they're ordered to do so as punishment from a court. And so on. Yes, there have been historical abuses of psychiatry. Yes, there have been a few incompetent psychiatrists, and a few who betrayed or exploited their patients. Unfortunately, this is also true of every other branch of medicine. But psychiatrists are MDs (medical doctors), and like all MDs they've taken the Hippocratic Oath.
This is an even bigger tragedy today because the options to treat OCD, just like the options for depression, have never been more numerous and effective. In fact, many SSRIs (e.g., Prozac) are as effective on OCD as on depression. They're reasonably safe as well as effective. I've experienced both depression and the effectiveness of an SSRI. Nothing happens for a few weeks, and then, wham, within just a day or two, it was like a light switch. But X has never personally experienced it. X has had problems for so long that X can't even remember a time when he/she didn't. This creates a "potential hill" that seems insurmountable, so the situation remains at an impasse. If anybody has any ideas, please let me know.
Phil Karn, 30 Oct 2007