Chapter 7

SUMMARY AND SYNTHESIS OF THEORIES OF ANXIETY

I speak purposely of “hypotheses.” This [formulating of hypotheses on anxiety] is the most difficult task that has been set us, but the difficulty does not lie in the incompleteness of our observations, for it is actually the commonest and most familiar phenomena that present us with such riddles; nor does it lie in the remoteness of the speculations to which these phenomena give rise, for speculation hardly comes into the picture in this connection. No, it is genuinely a question of hypotheses; that is to say, of the introduction of the right abstract ideas, and of their application to the raw material of observation so as to bring order and lucidity into it.

—Sigmund Freud, “Anxiety,”
NEW INTRODUCTORY LECTURES

IN THIS CHAPTER OUR PURPOSE IS TO SYNTHESIZE THE theories and data on anxiety presented in the preceding chapters. In Freud’s words, our aim is to try, through “introduction of the right abstract ideas,” to bring some “order and lucidity” into the field. Our purpose is to construct a comprehensive theory of anxiety so far as this is possible and, where integration is impossible, to point out the crucial areas of difference among the various theories. My own viewpoint will be discernible both implicitly and explicitly in this synthesis.

THE NATURE OF ANXIETY

It is agreed by students of anxiety—Freud, Goldstein, Horney, to mention only three—that anxiety is a diffuse apprehension, and that the central difference between fear and anxiety is that fear is a reaction to a specific danger while anxiety is unspecific, “vague,” “objectless.” The special characteristics of anxiety are the feelings of uncertainty and helplessness in the face of the danger. The nature of anxiety can be understood when we ask what is threatened in the experience which produces anxiety.

Let us say that I am a college student walking to the dentist’s office to have a tooth pulled. On the way I meet a revered professor whose class I have been in this term and whom I have seen in his office. He does not speak to me nor nod nor give me any greeting whatever. After I pass him I feel a diffuse gnawing “in my breast.” Am I not worth noticing? Am I nobody—nothing? When the dentist picks up his pincers to pull my tooth, I feel a fear much more intense than the anxiety on the street. But the fear is forgotten as soon as I’m out of the dentist’s chair. The anxiety, with its gnawing, stays with me all day long and may even appear in my dreams that night.

The threat, thus, in anxiety is not necessarily more intense than fear. Rather, it attacks us on a deeper level. The threat must be to something in the “core” or “essence” of the personality. My self-esteem, my experience of myself as a person, my feeling of being of worth—all of these are imperfect descriptions of what is threatened.

I propose the following definition: Anxiety is the apprehension cued off by a threat to some value that the individual holds essential to his existence as a personality. The threat may be to physical life (the threat of death), or to psychological existence (the loss of freedom, meaninglessness). Or the threat may be to some other value which one identifies with one’s existence: (patriotism, the love of another person, “success,” etc.). Nancy, whom we will discuss below (p. 262), illustrates the identification of the love of another person with her existence when she said, speaking of her fiancé, “If anything went wrong with his love for me, I’d break down completely.” Her security as a self depended upon this other person’s love and acceptance of her.

The identification of a value with one’s existence as a personality is dramatized in the remark of Tom1 in his anxiety over whether he would be retained in his job or be forced to resort again to government relief: “If I couldn’t support my family, I’d as soon jump off the end of the dock.” He thus tells us that if he could not preserve the self-respecting position of being the responsible wage-earner, his whole life would have no meaning and he might as well not exist. This he would confirm by snuffing out his own life—committing suicide. The occasions of anxiety will vary with different people as widely as the values on which they depend vary. But what will always be true in anxiety is that the threat is to a value held by that particular individual to be essential to his existence and, consequently, to his security as a personality.

The terms “diffuse” and “vague,” so often used to describe anxiety, do not mean that anxiety is less painful than other affects. Indeed, other things being equal, anxiety may be more painful than fear. Nor do these terms refer merely to the generalized, “over-all” psychophysical quality of anxiety. Other emotions, like fear, anger, and hostility, also permeate the whole organism. Rather, the diffuse and undifferentiated quality of anxiety refers to the level in the personality on which the threat is experienced. An individual experiences various fears on the basis of a security pattern he has developed; but in anxiety it is this security pattern itself which is threatened. However uncomfortable a fear may be, it is experienced as a threat which can be located spatially and to which an adjustment can, at least in theory, be made. The relation of the organism to a given object is what is important, and if that object can be removed, either by reassurance or appropriate flight, the apprehension disappears. But since anxiety attacks the foundation (core, essence) of the personality, the individual cannot “stand outside” the threat, cannot objectify it. Thereby, one is powerless to take steps to confront it. One cannot fight what one does not know. In common parlance, one feels caught, or if the anxiety is severe, overwhelmed; one is afraid but uncertain of what one is afraid. The fact that anxiety is a threat to the essential, rather than to the peripheral, security of the person has led some authors like Freud and Sullivan, to describe it as a “cosmic” experience. It is “cosmic” in that it invades us totally, penetrating our whole subjective universe. We cannot stand outside it to objectify it. We cannot see it separately from ourselves, for the very perception with which we look will also be invaded by anxiety.

Harold Brown illustrates this when he states that he is “afraid of losing my mind”—a phrase often used by patients to describe this feared imminent “dissolution.” Brown also stated that he had no “clear or distinct feelings, even of sex,” and that the emotional vacuum was “excruciatingly uncomfortable.” (One wonders whether the great preoccupation with sex in this country and in the Western world nowadays is a grasping at the easiest way to get distinct feelings to shore the self up against the anxiety of disintegrating society.) It is very difficult to appreciate from the outside what a person in severe anxiety is experiencing. Brown rightly remarked about his friends “imploring a drowning man [me] to swim when they don’t know that under the water his hands and feet are tied.”

NORMAL AND NEUROTIC ANXIETY

The phenomenological description of anxiety given in the above several pages is applicable to different kinds of anxiety, not only to neurotic anxiety. It can be applied, for example, to the reaction to the catastrophic condition seen in Goldstein’s brain injured patients. It is also applicable, making allowance for differences in the intensity of the reaction, to normal anxiety experienced by all kinds of people in all kinds of situations.

As an example of normal anxiety, let us consider an illustration which is pieced together from what persons who lived under totalitarian governments have reported to me. A prominent Socialist was living in Germany when Hitler came into power. Over a period of some months he knew that some of his colleagues were being imprisoned in concentration camps or taken off to other unknown fates. During this period he lived in the perpetual awareness that he himself was in danger, but he never could be certain if he would be apprehended, or, if he were, when the Gestapo would come, or, finally, what would happen to him if he were arrested. Throughout this period he experienced the diffuse, painful, and persistent feelings of uncertainty and helplessness which we have described above as characteristic of anxiety. And the threat confronting him was not merely that of possible death or the pain and humiliation of the concentration camp; it was a threat to the meaning of his existence as a person, since the freedom to work for his beliefs was a value which he identified with his existence. This man’s reactions to threat had all the essential characteristics of anxiety, yet it was proportionate to the actual threat and could not be termed neurotic.

Normal anxiety is that reaction which (1) is not disproportionate to the objective threat, (2) does not involve repression or other mechanisms of intrapsychic conflict, and, as a corollary to the second point, (3) does not require neurotic defense mechanisms for its management. It (4) can be confronted constructively on the level of conscious awareness or can be relieved if the objective situation is altered. The undifferentiated and diffuse reactions of the very young infant to threats— such as falling or not being fed—fall in the category of normal anxiety. These threats occur before the infant is mature enough for the intrapsychic processes of repression and conflict involved in neurotic anxiety. Also, so far as we know, the threats may be experienced by the infant in its state of relative helplessness as objectively real dangers to its existence.

Normal anxiety continues throughout life in the form of what Freud termed “objective anxiety.” The signs of the presence of such normal anxiety may be only a general restiveness, wariness, a glancing about alertly even though there is no stalking enemy outside. Howard Liddell has said (Chapters 3 and 4) that anxiety accompanies intellect like its shadow. Lawrence Kubie similarly makes anxiety the bridge between the early startle pattern and later rationality in human beings. Alfred Adler believed that civilization itself is a product of man’s capacity to be aware of his inadequacies, which is another expression of anxiety. I cite these ideas to demonstrate the importance of normal anxiety in everyday life.

The existence of normal anxiety in adults is frequently overlooked because the intensity of the experience is often so much less than that of neurotic anxiety. And, since one characteristic of normal anxiety is that it can be managed constructively, it does not show itself in “panic” or in other dramatic forms. But the quantity of reaction should not be confused with its quality. The intensity of the reaction is important as a distinction between neurotic and normal anxiety only when we are considering the question of whether the reaction is proportionate to the objective threat. Every individual experiences greater or lesser threats to his existence and to values he identifies with his existence in the course of his normal development as a human being. But the human being normally confronts these experiences constructively, uses them as “learning experiences” (in the broad and profound meaning of that term), and moves on in his development.

One common form of normal anxiety is that inhering in man’s contingency—i.e., the human being’s vulnerability to the powers of Nature, to sickness and fatigue, and to eventual death. This is termed Urangst² or Angst der Kreatur in German philosophical thought, and is referred to by contemporary students of anxiety such as Horney and Mowrer. This kind of anxiety is distinguished from neurotic anxiety in that Urangst does not imply the hostility of Nature. Furthermore, Urangst does not lead to defense mechanisms, except as human contingency becomes the symbol or focus for other conflicts and problems within the individual.

Practically speaking, it is often very difficult to distinguish the normal from the neurotic elements in anxiety connected with death, for example, or with other aspects of the contingency of the human situation. In most persons the two kinds of anxiety are intermingled. It is certainly true that much anxiety about death falls in the neurotic category—for example, the excessive concern with death in periods of adolescent melancholy. In our culture, whatever neurotic conflicts the individual has in adolescence, old age, or any other period of development may cluster around the symbols of human helplessness and powerlessness in the face of eventual death.3 Hence I do not wish to open the way for the rationalization of neurotic anxiety under the façade of normal anxiety about human contingency. As a practical measure in clinical work, it may be that, whenever concern about death arises, it is best to work first on the assumption that neurotic elements may be present and to endeavor to ferret them out. But scientific concern with neurotic elements in such anxiety should not be permitted to obscure the fact that death can be, and should be, admitted and confronted as an objective fact.

At points like this, the work of the poets and writers who, as Sophocles put it, seek to “see life steadily and see it whole,” may be a useful corrective to the constrictive tendencies in our scientific preoccupation with the neurotic forms of behavior. Death is a concern in poetry of all sorts, and one certainly would not presume to lump all the poets under the category of neurotics. A person of poetic imagination, for example, may contemplate the ocean from a rocky promontory and “consider the brief span of my life, swallowed up in the eternity before and behind it, the small space that I fill, or even see, engulfed in the infinite immensity of spaces which I know not, and which know not me,” and he may “wonder to see myself here rather than there . . . now rather than then” (Pascal). Such feelings are terror that he may drown, and retreats from the visual experience and the contemplation. Both are anxiety, but the former is normal and the latter neurotic. On the contrary, the poetic feelings of the immensity of time and space and the brevity of one individual’s existence (together, of course, with the realization that man is the mammal who can transcend this brevity in the respect that he knows it, as other animals do not, and that man is the mammal who can wonder)—these feelings can highlight the value and significance of the individual’s present experience and his creative possibilities, whether in the aesthetic, scientific, or any other realm.

Another common form of normal anxiety is that related to the fact that each human being develops as an individual in a social matrix, a world of other individuals. As seen most clearly in the development of the child, this growth in a context of social relationships involves a progressive breaking of dependent ties with parents, which in turn involves greater or lesser crises and clashes with parents. This source of anxiety has been discussed by Kierkegaard and Otto Rank, among others. Normal anxiety, Rank held, inheres in all experiences of “separation” throughout the individual’s life career, beginning with separation from the mother when the umbilical cord is cut, and ending with the separation from human existence in death. If these potentially anxiety-creating experiences are negotiated successfully, they lead not only to greater independence on the part of the child or adolescent but to the reestablishment of relations with parents and other persons on new and more mature levels. The anxiety in such cases should then be described as “normal” rather than “neurotic.”

It may be useful to note in greater detail why the subjective aspect is essential to the understanding of neurotic anxiety. If one were merely to phrase the problem of anxiety objectively—i.e., in terms of the relative capacity of the individual to cope adequately with threatening situations—it surely could justifiably be argued that there is no logical need to distinguish between neurotic and normal anxiety. All one could say is that anxious individuals are less able than other individuals to cope with threats. In the cases, for example, of feeble-minded persons, or of Goldstein’s brain-injured patients, one cannot term the frequent vulnerability to threats “neurotic.” To one of the compulsively orderly brain-injured patients, finding the objects in his closet in disarray might be an objective threat and plenty of cause for the profound anxiety which ensues, since because of his curtailed capacities he could not then orient himself to the objects. So far as we know, the threats which cue off the frequent and severe anxiety of Goldstein’s patients are for them objectively real threats. As we have indicated above, the same would be true for young infants and might very well be true in many cases for children or others who are in fact relatively weak and powerless.

Neurotic anxiety, on the other hand, is the reverse of our definition of normal. It is a reaction to threat which is (1) disproportionate to the objective danger, (2) involves repression (dissociation) and other forms of intrapsychic conflict, and as a corollary (3) is managed by means of various forms of retrenchment of activity and awareness, such as inhibitions, the development of symptoms, and the varied neurotic defense mechanisms.4 Generally, when the term “anxiety” is used in scientific literature, “neurotic anxiety” is meant.⁵ It will be noted that these characteristics are related to each other; the reaction is disproportionate to the objective danger because some intrapsychic conflict is involved. Thus the reaction is never disproportionate to the subjective threat. It will likewise be noted that each one of the above characteristics involves a subjective reference. Thus the definition of neurotic anxiety can be made only when the subjective approach to the problem—i.e., based on what is going on intrapsychically within the individual—is included.

It was largely through Freud’s genius that scientific attention was focused on the inner psychological patterns and conflicts which render the individual unable to cope with a relatively minor objective threat. Harold Brown hears of the slight accident his mother had to her arm; this sets in motion a train of associations which leads him to dream of being killed and to conflicts which are indeed catastrophic. Thus the problem of understanding neurotic anxiety boils down to the question of understanding the subjective inner psychological patterns which underlie that particular person’s excessive vulnerability to threats. The distinction made in Freud’s early writing—a viewpoint carried through his work with only slight modification—is that objective anxiety refers to “real,” external threats and neurotic anxiety is a fear of one’s own instinctual “impulse claims.” This distinction has the merit of underlining the subjective locale of neurotic anxiety. But it is not strictly accurate in the respect that an impulse arising within the individual constitutes a threat only if its expression would result in a “real” danger, such as punishment or disapproval by other persons. Though Freud modified his earlier view to some extent in this direction (Chapter 4 above), he did not fully carry through the implications of this insight to ask the question: What is involved in the relationship between the individual and other persons to bring it about that a given impulse, if expressed, should constitute a threat?⁶

Neurotic anxiety, therefore, is that which occurs when the incapacity for coping adequately with threats is not objective but subjective—i.e., is due not to objective weakness but to inner psychological patterns and conflicts which prevent the individual from using his powers.⁷ These conflicts generally have their genesis (as will be discussed more fully in succeeding sections) in the situation in early childhood, when the child was not able objectively to meet the problems of a threatening interpersonal situation. At the same time the child cannot consciously admit the source of the threat (as, for example, in the awareness “My parents don’t love me or want me”). Hence repression of the object of the anxiety is a central feature of his or her neurotic anxiety.

Though the repression generally begins in the child’s relations with his or her parents, it continues in the form of repression of similar threats as they occur throughout life. This could be illustrated in practically any clinical case: see especially the cases of Nancy, Frances, and Brown.⁸ Repression of fear of the threat results in the individual’s being unaware of the source of his apprehension; thus in neurotic anxiety there is a specific reason why the affect is “objectless,” in addition to the general source mentioned earlier of the objectless nature of all anxiety. The repression (dissociation, blocking off of awareness) which occurs in neurotic anxiety in itself renders the individual more vulnerable to threats and thus increases neurotic anxiety. First, repression sets up inner contradictions within the personality, thus making for a shaky psychological equilibrium, which is bound to be continually threatened in the course of everyday life. Second, because of the repression the individual is less able to distinguish and fight against real dangers as they occur. For example, the person who represses a good deal of aggression and hostility may at the same time assume a compliant and passive attitude toward others, which in turn increases the likelihood that he will be exploited by other people, which in turn gives him more aggression and hostility to repress. Finally, repression increases the individual’s feeling of helplessness in that it involves a curtailing of his own autonomy, an inner retrenchment and shelving of his own power.

ORIGINS OF ANXIETY

Normal anxiety is an expression of the capacity of the organism to react to threats; this capacity is innate and has its inherited neurophysiological system. Freud remarks that the “tendency toward objective anxiety” is inherent in the child; he believed that it is an expression of the self-preservation instinct and has an obvious biological utility. The particular forms this capacity to react to threats will assume in a given individual are conditioned by the nature of the threats (environment) and by how the individual has learned to deal with them (past and present experience.)

This problem of the origin of anxiety raises the question of whether and to what extent anxiety and fears are learned. In past decades this question has been approached by means of debates on which fears are inherited and which are not. I believe that these debates were based on a confused statement of the problem and, therefore, have largely been beside the point. The accepting of a list of “inherited” fears, as did Stanley Hall, had both practical and theoretical weaknesses. The practical weakness was that assuming certain fears and foci of anxiety to be inherited implied that little or nothing could be done to correct or alleviate them. The theoretical weakness was that these so-called instinctual fears could be easily disproved, as in the case of the “innate fears” described by John B. Watson.

Given the fact that very few protective responses are present in the new-born infant, it does not follow that all later responses are due solely to learning.9 With respect to the problem of the “inheritance” of anxiety or fear, I submit that the only assumption necessary is that the human organism has the capacity to react to threats, a capacity which its ancestors possessed likewise.

But the question of which particular events will have threat value for an individual depends upon learning. These events are the “conditioned stimuli.” This is especially clear in the matter of fears: they are conditioned responses to particular events which the individual has learned are a threat to him. The same is true for particular foci of anxiety. In a personal communication to me, Hobart Mowrer had the following to say on the problem:

I would put it this way: we are so constructed that traumatic (painful) experiences produce the emergency reaction of Cannon. Objects and events associated with trauma take on threat value, i.e., become capable of producing the emergency reaction. When this reaction thus occurs, as a conditioned response, it is fear. The capacity to react to threats then means (a) the capacity to learn to do so, or (b) the actual end-results of learning.¹⁰

One general comment may be added. At the present time the different approaches to the problem of whether anxiety is learned not only involve the question of definition—i.e., whether the author is talking about normal or neurotic anxiety or fears—but also the protagonists have divergent emphases. The tendency is for learning psychologists, observing that each particular fear or focus of anxiety is demonstrably closely related to the given individual’s experience, to state simply that anxiety is learned. On the other hand, neurophysiologists such as Cannon, centering their attention on the given capacities of the organism, have tended to assume that anxiety is not learned. I believe that there does not need to be a conflict between these two emphases.

With regard to the specific sources of neurotic anxiety, Freud centers his attention chiefly on the birth trauma and on the fear of castration. In his early writings he treats the birth trauma as a literal source of anxiety, later anxiety being a “repetition” of affect which originally occurred with the birth trauma. It has been pointed out (Mowrer) that the “repetition of affect” is a dubious concept; a threat must continue to be present or the affect would not be present. Later, Freud tended to employ the birth experience more symbolically; it stood for “separation from the mother.” This is more understandable, for although there is no way of knowing on the basis of present data whether the difficulty of one’s birth predisposes to later anxiety, the symbol of early anxiety as dread of separation from the mother does have meaning. Rankians and some Freudians speak of birth as breaking one set of ties and moving into a new and strange situation, a symbol which is similar to Kierkegaard’s concept of anxiety as arising at every new possibility in one’s experience. In any case, if separation from the mother is seen as the origin of anxiety, the crucial question for understanding the development of patterns which underlie later anxiety is the meaning of this separation—i.e., what particular values are involved in the relation of the child to its mother which are threatened by the separation? In the case studies of unmarried mothers in this book, separation from their mothers in infancy and childhood meant something different to the middle-class young women than to the proletarians. To the former it meant a confusion of values, a double-bind, an inability to orient one’s self; to the latter, it meant simply going out on the street and making new friends.

With regard to castration, again Freud’s position is ambiguous. At times he treats castration as a literal source of anxiety (Hans is afraid the horse will bite his penis off). At other times he uses the term symbolically, castration standing for the loss of a prized object or value. There would not be radical disagreement with the contention that castration is often a symbol in our culture for the child’s being deprived of individual power at the hands of stronger adults, power here referring not only to sexual activity but to work or any sort of individual creative activity. If fear of the loss of the penis is seen as the origin of anxiety, the crucial question again is the meaning of this loss—i.e., what is the nature of the relation between the child and its parents that the child should feel threatened, and what particular values significant for the child are threatened?11

Since anxiety is a reaction to a threat to values held essential to the existence of the personality, and since the human organism owes its existence to its relation to certain significant persons in its infancy, the essential values are originally the security patterns existing between the infant and these significant persons. Hence there is considerable agreement that the relation between the child and its parents is crucial for the origins of anxiety (Sullivan, Horney etc.) In Sullivan’s concept of anxiety, the mother occupies the significant position. The mother is not only the source of the satisfaction of the infant’s physical needs; she is the source of its over-all emotional security as well. Whatever would endanger that relationship would be a threat to the infant’s total status in his interpersonal world. Hence Sullivan holds that anxiety has its origin in the infant’s apprehension of disapproval by its mother. This apprehension occurs via empathy between infant and mother long before the infant is sufficiently mature to be consciously aware of approval or disapproval. For Horney, basic anxiety has its origin in the child’s conflict between his dependency on his parents and his hostility toward them. Several writers hold that anxiety has its origin in the conflicts in the developing individuality of the child and the need to relate to other persons in its community (Fromm, Kierkegaard).

MATURATION OF THE CAPACITY FOR ANXIETY

In preceding chapters we have considered three types of response to danger which are exhibited by the developing human organism: first, the startle pattern, a pre-emotional, innate reflective reaction; second, anxiety, the undifferentiated emotional response; and third, fear, a differentiated emotional reaction. We noted that the infant very early exhibits the startle pattern—as early as the first month of life. We recall that emotions which can be called anxiety came only later: Gesell’s infant confined to the pen showed mild apprehension at five months, one sign of which was persistent head-turning. I earlier remarked that this head-turning seemed to me a significant picture of anxiety: the infant feels some threat is imminent but cannot know where it comes from nor how to relate himself to it spatially. Only several months later, as we also saw, the same infant in response to the same stimulus exhibited reactions marked by crying, which Gesell terms “fear.” This progression is maturation, a development from a less differentiated toward a more differentiated type of response.

In an earlier chapter I mentioned the “eighth month anxiety” described by René Spitz. The child’s maturation proceeds to the point where he can recognize his mother and the environment in which she fits. Thus he is thrown into anxiety when a stranger appears where the mother ought to be.

It is clear that the factor of maturation must be taken into account in understanding the child’s protective reactions. Freud noted this when he remarked that the capacity for anxiety is not at its maximum at birth, but emerges and develops in the maturing infant to a high point which he believed occurred in early childhood. Goldstein holds that anxiety may be observable in the new-born infant in some situations, but that the capacity to respond with specific fears is a later development. Agreeing, therefore, that maturation must be taken into account, we proceed to the more controversial problem—and the problem which has very important implications for anxiety theory—of whether anxiety or fear appears first.

It is widely agreed that the infant may exhibit anxiety responses in its very early days. Lauretta Bender remarks that clear anxiety responses can be observed as early as the eighth or ninth day of the infant’s life. But whereas responses which can be called fear are described in infants in later months, I have never come across descriptions of behavior in these first weeks of the infant’s life which could be termed fear. Or when very early responses are called fear—as by Watson in his theory of the “two original fears”—it seems clear that what is being described is the diffuse, undifferentiated apprehension properly to be termed anxiety. To me it seems a curious phenomenon that many writers in the field of anxiety and fear speak of the “early fears” of the infant but no one, as indicated above, identifies these so-called early fears. For example, Symonds speaks of anxiety as growing out of “primitive fear states” and as a corollary he employs fear as the more inclusive, generic term and anxiety as the derived emotion.12 But the apprehensive behavior Symonds describes in the very young infant seems certainly to be anxiety—as he, in fact, terms it. He actually describes no reactions which he calls fears in these earliest experiences of the infant. It seems to me that there is a general uncriticized assumption in much psychological literature that somehow fears must be the first to emerge and anxiety must be a later development. Perhaps that assumption is due partially to the fact that the study of anxiety has chiefly dealt with neurotic anxiety—which is certainly a complex affect and does not appear before the development of the capacity for self-awareness and other complicated psychological processes in the child. Perhaps, also, the uncriticized tendency to employ fear as the generic term is partially a product of the tendency in our culture (discussed in Chapters 2 and 4) to be preoccupied with the specific items of behavior which traditionally have fitted the methods of the dominant form of thought in our period, mathematical rationalism.

My knowledge and experience of anxiety and fear leads me to summarize their origin in the following way. After the first reflexive protective reactions, there emerge the diffuse, undifferentiated emotional responses to threat—namely, anxiety; and last to emerge in maturation are the differentiated emotional responses to specific, localized dangers—namely, fears. This order is also discernible in an adult’s reaction to a danger stimulus—let us say to the sudden blast of a gunshot. First, the adult responds with startle. Second, as he becomes aware of the threat but is unable to localize the source of the shooting or to tell whether it is aimed at him, he is in the state of anxiety. Third, as he is able to spot the source of the gunshot and to take steps to get out of the way, he is in the state of fear.

ANXIETY AND FEAR

Until recent years the distinction between fears and anxiety has been frequently overlooked in psychological studies, or the two affects have been lumped together on the assumption that they have the same neurophysiological base. But this failure to make a differentiation confuses the understanding of both fears and anxiety. The reactions of an organism in times of fear and of anxiety may be radically different, due to the fact that these reactions occur on different psychological levels of the personality.

This difference may be clearly seen in the psychosomatic studies of gastrointestinal activities in states of fear and anxiety. When Tom, the person with the fistula into his stomach (as discussed in Chapter 3), was confronted with a specific danger—e.g., that the irate doctor would discover the mistake he had made—Tom’s gastric activity was suspended and his psychological and physiological state was that of the familiar pattern of mobilization for flight. Clearly, this was fear. But when Tom had lain awake at night distressed about how long his employment at the hospital would last, his neurophysiological reactions were the exact opposite: gastric activity was accelerated and sympathetic (“flight”) activity was at a minimum. This was anxiety. The difference in these two reactions may be described as follows: in the fear Tom knew what he was afraid of, and a specific adaptation in one direction was possible—namely, flight. In the anxiety, though the tension was occasioned by an apparently specific danger, the threat cued off in Tom an internal conflict on whether he could be a self-supporting man or would have to return to government relief. Detection by the doctor in the instance of fear would have been uncomfortable but not catastrophic. But the threat in the second instance was to values Tom held essential to his existence as a self-respecting personality. The point emphasized here is not only that the reactions in fear and in anxiety may be quite different, but that fear and anxiety represent threats to different levels in the personality.

It is now possible to solve the problem of the relation between anxiety and fears. The capacity of the organism to react to threats to its existence and to its values is, in its general and original form, anxiety. Later, as the organism becomes mature enough neurologically and psychologically to differentiate specific objects of danger, the protective reactions can likewise become specific; such differentiated reactions to specific dangers are fears. Thus anxiety is the basic, underlying reaction—the generic term; and fear is the expression of the same capacity in its specific, objectivated form. This relation between anxiety and fear holds for the neurotic as well as for the normal forms of these effects. A neurotic fear is a specific, differentiated, objectivated expression of underlying neurotic anxiety. In other words, neurotic fears bear the same relation to neurotic anxiety as normal fears do to normal anxiety. I believe anxiety is “primal” rather than “derived.” If one is to speak of either emotion as derived, it is fear that is derived rather than anxiety. In any case, the customary procedure of subsuming the study of anxiety under the study of fear, or trying to make anxiety intelligible through a study of fear, is, I am convinced, illogical. The understanding of fears hinges upon the understanding of the prior problem of anxiety.

If, however, one cannot cope with dangers in their specific forms, one will be threatened on the deeper level which we call the “core” or “essence” of personality. Using a military analogy, battles on various segments of the front lines represent specific threats; so long as the battle can be fought out on the periphery, so long as the dangers can be warded off in the area of the outer fortifications, the vital areas are not threatened. But when the enemy breaks through into the capital of the country, when the inner lines of communication are broken and the battle is no longer localized; when, that is, the enemy attacks from all directions and the defending soldiers do not know which way to march or where to take a stand, we have the threat of being overwhelmed, with its corollaries, panic and frantic behavior. The latter is analogous to a threat to the basic values, the “inner citadel” of the personality; and in individual psychological terms it is the threat responded to as anxiety.

ANXIETY AND CONFLICT

Neurotic anxiety always involves inner conflict. There is often a reciprocal relation between the two: a state of persistent unresolved conflict may lead eventually to the person’s repressing one side of the conflict, which then produces neurotic anxiety. And anxiety, in turn, brings in its train feelings of helplessness, impotence, and a paralysis of action which tend to cause or increase psychological conflict. The descriptions of this state of conflict range from Stekel’s summary statement, “anxiety is psychic conflict,” to the systematic endeavors of Freud, Kierkegaard, Horney, et al., to discover the nature of this conflict.

The view that the conflict underlying anxiety is between instinctual needs within the individual and social prohibitions stems from Freud. His topological description is that the ego is caught between id (instinctual urges chiefly of a libidinous character) on one hand and superego (cultural requirements) on the other. Though Freud modified his first theory that anxiety was simply converted repressed libido to the theory that the ego perceives the danger situation and then represses the libido, the content of the conflict and concomitant anxiety still cannot be gratified. The threat which cues off anxiety is seen in Freud as the threat of frustration of libido or, what amounts to the same thing, the threat of punishment if the libido is gratified.

This question of whether frustration of libido per se causes conflict and concomitant anxiety has been asked by numerous students of anxiety after Freud (Horney, Sullivan, Mowrer, etc.). The consensus of these investigators is that frustration itself does not cause conflict. The relevant question is, rather: What essential value is threatened by the frustration? This may be illustrated in the area of sex. Some persons have a great deal of sexual expression (i.e., suffer no frustration) and still have much anxiety. Other persons bear considerable sexual privation and are not prey to excessive anxiety. Still others, significantly, are thrown into conflict and anxiety when their sexual desires are frustrated by one possible partner but not when the same desires are frustrated by another person. Thus something more than the need for mere sexual gratification is occurring.

The problem is not the frustration in itself, but whether the frustration threatens some mode of interpersonal relationship which the individual holds vital to his security and self-esteem. In our culture sexual activity is generally identified by the individual with his sense of power, esteem, and prestige; in such an individual the threat of sexual frustration is very likely to cause conflict and anxiety. Our disagreement is not with Freud’s phenomenological description of the frequent relation between sexual repression and anxiety in his Victorian culture. It is due to the fact that sexual prohibitions are very frequently the modus in our culture of authoritative constraint of the child by his parents and later by society. These constraints result in a suppression of the child’s development and expansion. Sexual impulses will then involve a conflict with these authorities (usually parents) and will arouse the prospect of punishment by and alienation from the authorities. This conflict will certainly in many cases produce anxiety. But that does not mean that the libidinal frustration itself causes the conflict and anxiety. The threat of frustration of a biological urge does not cause conflict and anxiety unless that urge is identified with some value essential to the existence of the personality. When Sullivan states that the activities directed toward the pursuit of security are ordinarily more important to the human being than those directed toward physical satisfactions like hunger and sex, he does not mean to discount the biological aspect of behavior. He means, rather, to indicate that the physical needs are subsumed under the more comprehensive need of the organism to maintain and extend its total security and power.

Is there any common denominator of these conflicts? I believe that the common denominator can be found in the dialectical relation of the individual and his community.13 On one hand the human being develops as an individual; the fact of individuality is a given datum in the respect that each person is unique and to an extent discrete from other individuals. Actions, no matter how much conditioned by social factors, are still actions by an individual. At the point in development at which self-awareness emerges, there also emerges a measure of freedom and responsibility in each individual action. But, on the other hand, this individual develops at every moment as a member of a social nexus upon which he is dependent not only for the early meeting of his biological needs but also for his emotional security. It is only in interaction with other individuals in a social nexus that the development of a “self” and the development of personality are understandable.

The infant’s and child’s existence consists of a progressive differentiation of himself from his parents. When he is viewed from the individual aspect of the dialectical relationship, his growth consists of decreasing dependence on parents and increasing reliance upon and use of his own powers. When he is viewed from the social aspect, the child’s growth consists of his progressive relating to the parent on new levels. Blockage of development at either pole in this dialectic engenders psychological conflict, the end result of which is anxiety. Where there is “freedom from” without corresponding interrelationship, there is the anxiety of the defiant and isolated individual. Where there is dependence without freedom, there is the anxiety of the clinging person who cannot live outside a symbiosis. When one lacks the capacity to act on the basis of one’s own powers, he or she sets him- or herself up to be threatened by every new situation which requires autonomous action.

In this discussion it is not meant to imply that the conflict is between the individual and society, either in the Freudian negative usage of the term “society” or in the opposite Alderian positive sense. The point, rather, is that a failure of development at either pole in the dialectical relationship of individual-in-community results in a conflict which affects both poles. For example, if a person avoids autonomous individual decisions, he retrenches to a shut-in condition (Kierkegaard) and his possibilities of communicating with others is sacrificed along with his autonomy as an individual. The shut-in condition is a result of the endeavor to avoid conflict, but it actually results later in greater conflict—i.e., neurotic conflict and neurotic anxiety.

ANXIETY AND HOSTILITY

Anxiety and hostility are interrelated; one usually generates the other. First, anxiety gives rise to hostility. This can be understood in its simplest form in the fact that anxiety, with its concomitant feelings of helplessness, isolation, and conflict, is an exceedingly painful experience. One tends to be angry and resentful toward those responsible for placing him in such a situation of pain. Clinical experience yields many examples like the following: A dependent person, finding himself in a situation of responsibility with which he feels he cannot cope, reacts with hostility both toward those who have placed him in the situation and toward those (usually parents) who caused him to be unable to cope with it. Or he feels hostility toward his therapist, whom he believes should bail him out, as Brown did toward me (below, page 240).

Granted the interrelation between hostility and anxiety, which affect is generally basic? There is ground for believing that, even though hostility may be the specific affect present in many situations, anxiety is often present below the hostility. This is especially observable in cases that show repressed hostility. Tom, we recall, “had a fear of his mother like a fear of the Lord,” and since one does not talk back to the Lord one fears so much, we can conclude that whatever hostility he had would be repressed. In some of the psychosomatic studies of patients with hypertension (a somatic symptom generally associated with repressed hostility) it has been found that the reason the patients repressed their hostility in the first place was that they were anxious and dependent. The rationale of such patterns can be broadened to cover many situations in which repressed hostility and anxiety are interrelated: The hostility would not have to be repressed in the first place except that the individual is anxious and fears counter-hostility or alienation. I do not mean to subsume all hostility under the problem of anxiety; it is certainly true that normal hostility may arise whenever an individual’s activity is constrained. We are speaking here specifically of repressed hostility.

CULTURE AND COMMUNITY

I have discussed in the last chapter the genetic background of a pattern which is the occasion for much anxiety in contemporaneous culture—namely, individual competitive ambition. It remains to summarize the status of the personality in our society with respect to this pattern and then to consider particularly the quantity of contemporaneous anxiety in relation to the historical stage of development of modern culture.

To recapitulate briefly, social prestige goals are dominant in our culture, social prestige being defined as success, this success in turn being defined chiefly in economic terms. The acquisition of wealth is accepted as proof and symbol of individual power. Since success is measured against the status of others, the striving for success is essentially competitive: one is successful if one excels and triumphs over others. The goal of competitive success not only arose by virtue of an emphasis on individual power set over against the community in the Renaissance, but as this goal persists it tends always to increase the juxtaposition of the individual and the community. Being the dominant cultural value, competitive success is likewise the dominant criterion of self-valuation; it is accepted as the means of validating the self in one’s own eyes as well as in the eyes of others. Whatever threatens this goal is, therefore, the occasion for profound anxiety for the individual in our culture because the threat is to values held essential to one’s existence as a personality—i.e., essential to one’s worth and prestige as a personality.

The dominant goal of competitive success, though defined chiefly in economic terms, carries over to become the individual’s goal in his personal relationships as well. Horney has excellently described this phenomenon in our culture:

It must be emphasized that competitiveness, and the potential hostility that accompanies it, pervades all human relationships. Competitiveness is one of the predominant factors in social relationships. It pervades the relationships between men and men, between women and women, and whether the point of competition be popularity, competence, attractiveness, or any other social value, it greatly impairs the possibilities of reliable friendship. It also as already indicated disturbs the relations between men and women, not only in the choice of the partner but in the entire struggle with him for superiority. It pervades school life. And perhaps most important of all, it pervades the family situation, so that as a rule the child is inoculated with this germ from the very beginning.14

Thus love, for example, instead of being a constructive means of overcoming individual isolation, is often a means of self- aggrandizement. One uses love for competitive purposes in the rivalry over winning a socially desirable and enviable mate; it is a proof of one’s social competence; the mate is viewed as an acquisition in much the same way as one would view winning profits on the stock market. Another common example is valuing one’s children because they win prizes in college or in other ways add to the competitive status of the family name. In our culture love is frequently sought as a means of allaying anxiety, but when it occurs in a competitive, depersonalized framework, it increases feelings of isolation and hostility and thereby increases anxiety.

Anxiety arises as a result of the individualistic competitive pattern here discussed not simply when the individual finds his possibilities for success threatened but in many more subtle ways. Anxiety arises out of the interpersonal isolation and alienation from others that inheres in a pattern in which self-validation depends on triumphing over others. This anxiety was already discernible in many of the powerful and successful individuals of the Renaissance (we noted it in Michelangelo). Anxiety likewise arises out of the intrasocial hostility produced by competitive individualism. Finally, anxiety arises out of the self-alienation resulting from viewing one’s self as an object of the market, or making one’s feeling of self-strength dependent on extrinsic wealth rather than intrinsic capacity and productivity. We are a “community . . . who has to obey his buyer,” in Auden’s terms. These attitudes not only distort one’s relation to one’s self, but to the extent that they make one’s criterion of self-worth contingent upon a kind of success which can be threatened every day by one’s neighbors’ counter-success, they augment one’s feeling of vulnerability, helplessness, and powerlessness.

We now turn to the problem of the relation between the quantity of anxiety experienced by contemporaneous individuals and the present state of our culture. The conviction that Western civilization in the twentieth century is permeated by considerable quantities of anxiety (or anxiety-like states) has been expressed in different ways by Tawney, Tillich, Mumford, Fromm, Horney, Mannheim, Cassirer, Riezler, and others. Each presents the evidence and the explanation for the situation from the particular viewpoint of his or her own explorations. The common agreement is that underlying this anxiety are profound cultural changes, which are described in varying terms like “the crisis in man’s view of himself,” or the “disintegration” of traditional cultural forms, and so forth.

In the second half of the nineteenth and the early twentieth centuries, the belief in pre-existent harmony—that which, in one way or another, had held people in some kind of community despite their competition against each other—had also disintegrated. Penetrating thinkers, like Karl Marx, realized that individual competitive ambition does not result automatically in the advance of social well-being. On the contrary, it was then producing feelings of powerlessness and isolation and increasing “dehumanization” (Marx), estrangement of people from each other (Paul Tillich), and increasing self-estrangement. The ideals and social “faith” which had dispelled anxiety now no longer did so; they only worked to allay anxiety in those willing to cling to the illusion which their old “faith” had become.15

Hence the cultural disunity which is described by almost every explorer of the contemporary scene. Mannheim, from the sociological viewpoint, spoke of the “phase of disintegration” through which Western society is passing. Cassirer, from the philosophical viewpoint, derived the disunity from the “loss of conceptual unity.” And Riezler, from the viewpoint of social psychology, derives the disunity from the “lack of a universe of discourse” in our culture.

The disunity, or contradiction, from the psychological side can be seen by anyone who looks seriously at contemporaneous culture. Horney phrases the contradiction as between.

the alleged freedom of the individual and all his factual limitations. The individual is told by society that he is free, independent, can decide his life according to his own free will; “the great game of life” is open to him, and he can get what he wants if he is efficient and energetic. In actual fact, for the majority of people all these possibilities are limited. . . . The result for the individual is a wavering between a feeling of boundless power in determining his own fate and a feeling of entire helplessness.¹⁶

There is the contradiction between the accepted theory that each individual is free to gain economic success by his own efforts and merit and the actuality that he is to a great extent dependent upon suprapersonal technical forces (e.g., the market) over which he has little or no control. Kardiner noted that the people in Plainville “subscribe in the main to the American credo of vertical mobility and believe that a man can become anything he wants to. Actually, opportunities are very limited for them . . . even if they go away.”17

Another contradiction is between the accepted individualistic rationalism (“each individual can decide on the basis of the facts”) and the actuality that most decisions of the individual are based on motivations quite beyond conscious rational appraisal of the situation. The psychological helplessness arising out of this contradiction often leads the individual to cling to the illusion of rational power under the “anonymous authorities of public opinion,” “science,” and so forth. Kurt Riezler wrote:

To the rational man of the industrial age everything has a “natural cause”; no demons interfere. Yet in times of crisis, he too can be gripped by indefinite fear. . . . Rational man is the heir of a long period of relative security in which he accumulated a great many matters of course to be taken for granted. This dubious training may be partly responsible for his vulnerability. His scheme of order is rational only in theory.¹⁸

The illusion of rationality temporarily allays anxiety by suppressing the contradictions. This has special point for the problem of anxiety since the confronting of anxiety is often avoided because of its “irrational” nature. We shall observe this in the case of Helen (p. 251 ff.), who tried to suppress the fact that she was pregnant and used all kinds of “scientific” data in the service of her illusion. The tendency throughout our culture is to “rationalize” anxiety into specific fears, which the individual may then believe he confronts in a rational way. But this involves a suppression of the real source of the anxiety. And, in most people, the illusion sooner or later breaks down.

Contradictions and inconsistencies in a culture, of course, make the member of the society more vulnerable to anxiety because they increase the number of situations in which he is unable to decide on any approved course of action. We recall the Lynds’s statement that the individual in Middletown is frequently “caught in a chaos of conflicting patterns, none of them wholly condemned, but no one of them clearly approved and free from confusion.” Now when the individual’s values and goals are threatened, he cannot orient himself by reference to consistent systems of value within his culture. The threat the individual experiences is, therefore, not just to his possibility of attaining his goal, but almost any threat may likewise raise doubts as to whether the goal is worth attaining—i.e., the threat becomes a threat to the goal itself. The reader will recall that I pointed out that fear changes into the more profound and pervasive state of anxiety when the threat ceases to be peripheral but becomes a threat to the standard of value itself. This is what leads to the feeling of the “dissolution of the self.” I believe this is what is going on in our society. Thus what might objectively appear to be only a minor threat to an individual’s values may in our culture throw the individual into panic and profound disorientation.

In a similar vein, Mannheim holds that “it is important to remember that our society is faced, not with brief unrest, but with a radical change of structure.”19 In periods of unemployment, for example, anxiety arises not simply because of the temporary threat to subsistence:

For man, however, the catastrophe [of unemployment] lies not merely in the disappearance of external opportunities for work but also in the fact that his elaborate emotional system, intricately connected as it is with the smooth working of social institutions, now loses its object-fixation. The petty aims towards which almost all his strivings are directed suddenly disappear, and, not merely does he now lack a place to work, a daily task, and an opportunity for using the integrated labor attitudes formed through long training, but his habitual desires and impulses remain ungratified. Even if the immediate needs of life are satisfied, by means of unemployment relief, the whole life-organization and the family hopes and expectations are annihilated.20

Then Mannheim proceeds to the point which seems to me of crucial significance:

The panic reaches its height when the individual comes to realize that his insecurity is not simply a personal one, but is common to masses of his fellows, and it becomes clear to him that there is no longer any social authority to set unquestioned standards and determine his behavior. Herein lies the difference between individual unemployment and general insecurity. If in normal times an individual loses his job, he may indeed despair, but his reactions are more or less prescribed and he follows a general pattern in his distress.²¹

In other words, in individual unemployment the person can still believe in the validity of the cultural values and goals, despite the fact that his achieving the goals himself is at the time threatened. But in mass unemployment and insecurity the individual cannot even believe in the values and goals basic to his culture.

I here propose that the quantity of anxiety prevalent in the present period arises from the fact that the values and standards underlying modern culture are themselves threatened.²² The distinction, like Mannheim’s, is between a peripheral threat—i.e., a threat which members of the society can meet on the basis of the assumptions of their culture—and a threat on a deeper level—namely, a threat to the underlying assumptions, the “charter”²³ of the culture itself. We recall Tawney’s argument that the previous revolutions in the modern period occurred on the accepted cultural assumption of the sovereignty of individual rights; the revolutions sought and obtained a broadening of the base of individual rights. But this underlying assumption of the culture was itself unquestioned and unthreatened. I believe the situation now is different. The threats involved in the present social changes are not threats which can be met on the basis of the assumptions of the culture but rather are threats to those underlying assumptions themselves.

Only thus can we understand the profound anxiety which occurs in many an individual in our society at the prospect of some minor economic change, an anxiety entirely out of proportion to the actual threat. The threat is experienced not as a threat to subsistence, nor even chiefly to the prestige of the individual concerned, but is rather a threat to basic assumptions which have been identified with the existence of the culture, and which the individual, as a participant in the culture, has identified with his own existence.