One of the commonest symptoms of anxiety is the abnormal awareness of the action of our heart. Palpitation is a normal accompaniment of a response to danger. In this case the increased action of our heart serves to prepare us to meet the threat. However, as soon as the danger passes the action of our heart returns to normal and we cease to be aware of it. But when we suffer from anxiety, the unpleasant awareness of the action of our heart is often constantly with us.

Besides the persistence of the palpitation there is another factor. In our normal response to real danger our heart does in fact beat more strongly. But in the palpitation of anxiety there may be little actual overactivity of the heart, and the unpleasant awareness is due to our hypersensitivity to the normal beating of our heart rather than to overactivity of the organ.

The feeling of palpitation focuses our attention on our heart. We are all familiar with the dangers of heart attacks from coronary thrombosis. We soon come to feel that something is wrong with our heart. To reassure us our doctor takes an electrocardiogram and tells us that it shows our heart to be quite normal and that the palpitation is only due to our nervous condition. But we are not reassured. A lurking feeling remains that there is something wrong. In fact, it is hard to be reassured so long as our anxiety is still with. us.

A few years ago I saw an industrial tycoon, a man of strikingly pleasant personality and such exceptional ability that in a matter of a decade he had amassed a great fortune. But over the previous two and a half years he had suffered from pain over his heart and quite violent palpitation; and as a result was unable to enjoy the material success he had achieved.

In the manner of the real tycoon he was determined at all costs to get himself fixed up. He was not sure whether it was ten or twelve cardiologists that he had consulted in the various capital cities of Australia. He had gone to America to the most famous cardiological clinic in that country. He had been treated by a psychiatrist in America and by three psychiatrists in Australia.

“You can tell when there is something wrong with your heart, you can feel it,” he asserted.

There was obviously no point in having a head-on collision with such a man, so I merely said, “Anyway, you would be more comfortable if you were more relaxed.” And we went on from there.

One day about eighteenth months later I was driving home, when I caught sight of him in his car. In typical style he shouted, “Never better in my life.”

I must also tell you something of the other side. Last week I saw a healthy, athletic student who was becoming crippled by pain over his heart. Two leading cardiologists had assured him that his heart was perfectly normal. He was really brought to me against his wishes, by his father. He is convinced there is something wrong with his heart. He will not listen to me. He refuses to come back. Yet I am sure that if he would only do what I suggest he would soon be free of the pain.

Rejection by the patient like this does not happen often, but it is the most common cause of failure.


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