About life, the wisest men of all ages have come to the same conclusion: it is no good. Always and everywhere one has heard the same sound from their mouths — a sound full of doubt, full of melancholy, full of weariness of life, full of resistance to life. Even Socrates said, as he died: “To live — that means to be sick a long time: I owe Asclepius the Savior a rooster.” Even Socrates was tired of life. What does that prove? What does it demonstrate? At one time, one would have said (and it has been said loud enough by our pessimists): “At least something must be true here! The consensus of the sages must show us the truth.” Shall we still talk like that today? May we? “At least something must be sick here,” we retort. These wisest men of all ages — they should first be scrutinized closely. Were they all perhaps shaky on their legs? tottery? decadent? late? Could it be that wisdom appears on earth as a raven, attracted by a little whiff of carrion?
– Twilight of the Idols
Nietzsche condemned ‘life-denying’ attitudes born out of a weak will, such as those of Socrates, often employing the metaphors of health and sickness. Nowadays the medical profession is diagnosing ‘personality diseases’ and realising his words in a more literal sense. A weak will, unable to overcome the challenges, trials and setbacks of existence, really is a disease. From Psychology Today:
Wayne Katon, whose research focuses on depression, anxiety and somatoform disorders, makes the case that stress and anxiety play a primary role. In his view, personality doesn’t just create a hospitable environment—it’s an integral part of the diseases. He believes that the initial injury or illness is almost irrelevant. What really matters is the interpretation and emotional reaction. Patients develop what he calls “catastrophic cognitions”: beliefs that if they start to get back to their activity, they will damage themselves further.
According to Katon’s clinical observations, patients with chronic fatigue or fibromyalgia tend to be highly driven overachievers unaccustomed to feeling any loss of control. When injured or sickened, those who decide that the pain or illness has overwhelmingly and permanently damaged their bodies come to feel victimized and unable to cope. Learned helplessness sets in, and patients can find themselves perpetually depressed and inactive. “They have trouble getting back to that old lifestyle, and what sets in is depression,” Katon suggests. “In our modern society, for people who have driven themselves, fatigue becomes a palatable way out of a difficult existence.” Although Katon is well regarded in the field, this perspective is still widely debated, at conferences, in medical journals and even by peers at his own medical center.
However, some patients do describe their experience in similar terms. “Stress seems to be the killer,” Howard admits. “That’s what I think happened with me. I was a superachiever and a perfectionist. I was going to make it, no matter what. I didn’t anticipate the consequences.”
Fear of further damage and disability may keep patients from trying to get back to an active life. “Whatever caused this impairment is probably not what’s keeping it going,” Katon says. “What’s keeping it going to a large extent are the misbeliefs about getting back to an active lifestyle.”
Indeed, Hillenbrand had come to anticipate disaster when she tried returning to a normal life. “I had learned to expect complete collapses each time I overextended myself,” she recalls. “As I began to slide into exhaustion, I would anticipate how I would soon be unable to sit up and speak, and I would become very frightened. The anxiety I experienced as I slid into collapse would feed my exhaustion, and I would become still weaker.”
