This paper proposes that some practices and trends in mental health care may be considered as defensive responses to collective anxiety and fear. On a larger scale similar dynamics occur around fear of terrorism. Collectively and individually we are pulled by the defensive forces and dynamics associated with anxiety. This can in part explain the polarization that occurs around issues of definition and response to mental illness. Fear and anxiety push services towards simplistic viewpoints and futile practices. The capacity to view things from the perspective of others, embracing explanatory and therapeutic pluralism and adopting a humble attitude, may be helpful in enabling anxiety to be channelled productively.