The character Bob has some triggers or stressors that stimulate his anxiety response to external stimuli. Bob’s overriding sensitivity is to change. Within his room, he is safe and in control. The outside world is unpredictable, unreliable, harsh, judgmental, and to Bob, unforgiving. The outside world- others- are not to be trusted. When Bob meets Leo he meets a human force of stability, predictability, self-assuredness and confidence that Bob likely found calming and comforting. Leo has become Bob’s port in the ocean of life. Thus, when Leo goes on holiday this was an extreme stressor for Bob, as he had to endure the possibility that Leo would not come back. That Leo was leaving him because Bob is annoying and dependent.
To make his way to the bus, to fake his death and to problem-solve scenarios to be with Leo and his family, Bob overcomes his fears or at least uses humor and a sense of fun to re-channel the anxiety he has about life (” I feel good I feel great I feel wonderful”, Bob walking to Leo’s office). Though, it is clear that having a support network, such as that from a family and friends, is an important preventative to susceptibility to stressors (Bourne, 2005). Bob is alone in this world, his only reference point is himself and he has grown to trust only his own opinion. Others, including Leo, are to be ridiculed and so brought within Bob’s control. Other people stress him. He is unable to take on the responsibilities of an adult over the age of 35 years (work, contributing to society, developing social ties, perhaps have a family). This socio-cultural stressor is likely due to Western society in which Bob is embedded has no place for extreme psychological differences, or “deviant” behavior (Kalish, 2005). The only feasible way for Bob to live his life is to remain within his room, to use handkerchiefs when he must go out, take the stairs instead of an elevator with others or tie himself to the mainsail of a yacht when learning to sail. His alternatives are of course medication or residential care. From the movie it appears that Bob is seeking some form of psychiatric aid, which would likely include medication as well as psychotherapy.
A very personal stressor would be Bob’s effect on Leo, that he pushes away someone that he actually admires (as well as is annoyed by) and Leo’s derogatory words and actions would undermine Bob’s ability to internalize a positive self-concept (Eifert, & Heffner, 2003). Bob is his own worst enemy, as he hinders that which he longs for the most, true friendship, love and a sense of belonging. The negative comments and actions of Leo would serve to reinforce Bob’s idea of self as not worthy and not able to cope with life’s challenges. Hence, we would seek even more to bind his ties with Leo as feelings of abandonment and disorientation (he is also now in Hampshire, far from his comfort zone). That Leo is not aware of Bob’s anxiety is concerning from a professional stance, and with a client-therapist dyad, it is unethical and harmful to the patient/client.
Turning now to the physiological symptoms of Bob, as he appeared anxious and enacting behaviors to cope with anxiety it is contended here that Bob experienced panic attacks, generalized anxiety disorder and agoraphobia. Throughout the movie, Bob experiences emotions such as excitement and stress, anxiety and even fright. It is acceptable to assume that Bob experienced palpitations of the heart during these periods of heightened experience. Although Bob never mentioned a faster beating of his heart, there were times during excitement when his hand came up his best to cover his heart. Also during anxiety it is reasonable that Bob was sweating, as can be seen in scenes where his hair is wet or plastered against his face, and his armpits are stained with sweat. Although Bob never looks angry it is safe to assume that he had periods of fear and anxiousness, such as when Leo left on holiday, or when he was on the bus; “Hello, I’m Bob, will you knock me out”. His experiences of nervousness and stress trigger his brain to produce more hormones that stimulate sweating. For Bob to relax during these periods is important as this can mediate the hormones being released in the brain. Bob uses humor and other annoying behavior to cope with his anxiety. He creates habits and rituals that are grounded in humor and spontaneity to decrease his stress levels. However, overall, Bob does not appear to sweat more than most other people, and the literature shows that researchers are not entirely sure as to why stress triggers more sweating in some people as compared to others.
Bob’s times of feeling dread and apprehension were perhaps best shown when he wanted to sail. It was an activity he so wanted to do yet was letting his fears of the unknown and unpredictable and slight risk get in the way of what he wanted to do.
It also looked as though at times that Bob was shaky, his arms, legs and sometimes his entire body shaking and trembling. This is one of the few times when Bob appeared to have a really difficult time keeping his anxiety symptoms under control. The biochemical changes that must be taking place in his brain when Bob is experiencing fear and anxiety, take immediate effect on his nervous system, hence the palpitations, sweating, and trembling.
Biological changes across Bob’s body would have produced a dis-harmony in his body chemistry, which is believed to be responsible for the manifestation of symptoms of an anxiety disorder (Cannon, 1929). Bob is a perfect example of how the flood of hormones and neurotransmitters released throughout the body due to stress, and the subsequent t electro-chemical changes that take place, that a person’s thoughts and emotions can be affected. As the brain is plastic, the structural changes that take place can become deeply embedded, making anxiety responses more likely when Bob feels threatened. During one of his panic attacks on the bus Bob asks another passenger to knock him out, it may be that he felt in pain, given the palpitations he may have felt like he was having a heart attack, or just the feeling of an impending “doom” that sleep would take him away from until the feeling passed (Gross, 2002). Tidal waves of fear can feel like matters of life or death.
Ultimately, the symptoms of stress and anxiety in a person can be manifold, though for Bob they centered on sweating, trembling, and possible palpitations. The habits and rituals that Bob uses in his life, such as handkerchiefs, repeating phrases, making jokes, and clinging to Leo, are all ways for him to avoid feeling anxious and feels as though he has some control over his life. These activities and icons help Bob to relax, and so sweat less, have fewer palpitations, and be less likely to shake as well as using humor to avoid situations of responsibility (Plaiser, Bruijin, & Graff, 2006). Being relaxed would help Bob to focus on what he sees around him, what people are actually saying when they speak and so he would develop loving and sustainable relationships based on reciprocity. In turn, Bob would feel listened to and accepted, he would take “baby steps” to take on responsibility and so start to contribute to a social group.
Yoga, regular physical activity, fresh fruit and vegetables, plenty of fiber, a healthy dose of leisure time and the extension of personal networks to create supportive and adaptive social links, synergize to relax a person, decrease stress and the nervous system response.
References
Bourne, E. (2005) The Anxiety & Phobia Workbook. Boston: New Harbinger Publications.
Cannon, W. B. (1929). Bodily changes in pain, hunger, fear and rage. New York: Appleton.
Eifert, G. H., & Heffner, M. (2003). The effects of acceptance versus control contexts on avoidance of panic-related symptoms. Journal of Behavior Therapy and Experimental Psychiatry, 34, 293-312.
Gross, J. J. (2002). Emotion regulation: Affective, cognitive, and social consequences. Psychophysiology, 39, 281-291.
Kalish, J. (2005) Anxiety reduction through detachment: Subjective, physiological, and neural effects. Journal of Cognitive Neuroscience, 17(6), 874-883.
Plaiser, I, Bruijin, J., & Graff, S. (2006) The contribution of working conditions and social support to the onset of depressive and anxiety disorders among male and female employees. Social Science & Medicine, 64(2), 401-410.