NOTES

1. ANXIETY IN MID-TWENTIETH CENTURY

1. W. H. Auden, The age of anxiety (New York, 1947).

2. Ibid., p. 3.

3. Ibid., p. 45.

4. Ibid., p. 44.

5. Ibid., p. 42.

6. I was excited to find, during the first writing of this book, that Leonard Bernstein had composed a symphony, which had its premiere in 1949, entitled Age of anxiety. On the basis of his conviction that Auden’s poem truly presents the “state of the age” in general, as well as speaking for the particular individual members of that age like himself, Bernstein translated the poem into the symbols of instrumental music.

7. Quoted in the New York Times, December 21, 1947, Sec. 7, p. 2.

8. Max Brod, in Appendix to Kafka’s The castle (New York, 1930), p. 329.

9. Herman Hesse, Steppenwolf, trans. Basil Creighton (New York, 1947); originally published in German in 1927.

10. Ibid., p. 28. Emphasis mine.

11. R. S. Lynd and H. M. Lynd, Middletown (New York, 1929), and Middletown in transition (New York, 1937).

12. Middletown, p. 87.

13. Ibid., p. 493.

14. Middletown in transition, p. 315.

15. Ibid., p. 177.

16. This problem is discussed in some detail in Chapter 6, where we discuss the relation between cultural change and anxiety.

17. Middletown in transition, p. 315.

18. Robert Jay Lifton, Thought reform and the psychology of totalism (New York, 1961).

19. John S. Dunne, The way of all earth (New York, 1972).

20. Robert Jay Lifton, The life of the self (New York, 1976), p. 141.

21. Robert Jay Lifton, History and human survival (New York, 1961), p. 319.

22. Charles Ford. “The Pueblo incident: psychological response to severe stress,” in Irwin Sarason and Charles Spielberger (eds.), Stress and anxiety, II (New York, 1975), pp. 229–241.

23. Paul Tillich, The Protestant era (Chicago, 1947), p. 245.

24. The education of a correspondent (New York, 1946).

25. New York Times, February 1, 1948.

26. World communism today (New York, 1948).

27. To some extent, it might be said, dictatorships are born and come to power in periods of cultural anxiety; once in power, they live in anxiety—e.g., many of the acts of the dictating group are motivated by its own anxiety; and the dictatorship perpetuates its power by capitalizing upon and engendering anxiety in its own people as well as in its rival nations.

28. Several references to “fear of fear” preceding Roosevelt’s are cited by J. Donald Adams (New York Times Book Review, p. 2, Jan. 11, 1948): Emerson, quoting from Thoreau’s Journals, “Nothing is terrible except fear itself.” Carlyle, “We must get rid of fear; we cannot act at all till then.” Sir Francis Bacon, “Nothing is terrible except fear itself.” “We have nothing to fear but fear itself” has also been attributed to the Roman, Seneca. Such statements do not make sense on the level of fear. Strictly speaking, a fear does not prevent action; it prepares the organism for action. It is doubtful whether the phrase “fear itself” has logical meaning—one is afraid of something. “Fear itself” is more logically to be termed anxiety. Indeed, if the term “anxiety” is substituted, all the above quotations make better sense.

29. Modern man is obsolete (New York, 1945), p. 1. First printed as an editorial in The Saturday Review of Literature and then published in book form. Though Norman Cousins used the term “fear,” he is describing what I would call anxiety. “Fear of irrational death” is a good example of anxiety.

30. Arnold Toynbee, How to turn the tables on Russia, Woman’s Home Companion, August, 1949, 30 ff.

31. Reinhold Niebuhr, The nature and destiny of man (New York, 1941), p. 182.

32. Ibid.

33. R. R. Willoughby, Magic and cognate phenomena: an hypothesis, in Carl Murchinson (ed.), Handbook of social psychology (Worcester, Mass., 1935), p. 498.

34. Ibid., p. 500.

35. Statistics furnished by the Center for Policy Research, Columbia University.

36. Discussed in Chapter 4.

37. Sigmund Freud, Introductory lectures on psychoanalysis, trans. James Strachey (New York, 1966), p. 393.

38. Sigmund Freud, New introductory lectures in psychoanalysis (New York, 1974), p. 113.

2. PHILOSOPHICAL INTERPRETERS OF ANXIETY

1. This assumption, which is implicit in this chapter, is dealt with in some detail in Chapter 6.

2. Cf. Rollo May, Historical roots of modern anxiety theories, in Anxiety (New York, 1950).

3. Other aspects of the development of modern culture as it affects the problem of anxiety (e.g., the economic and sociological aspects) are referred to in Chapter 6. A summary of the cultural backgrounds of contemporaneous anxiety is given in Chapter 7 and may serve as a supplement to the discussion in this chapter.

4. Ernst Cassirer, An essay on man (New Haven, Conn., 1944), p. 16.

5. This point is discussed in Chapter 6.

6. The age of anxiety (New York, 1947), p. 8.

7. Cassirer, op. cit., p. 16.

8. The Protestant era (Chicago, 1948), p. 246.

9. Cassirer, p. 16.

10. His definition of emotions is a predecessor of the modern James-Lange theory: “By emotion I understand the modifications of the body by which the power of action in the body is increased or diminished, aided or restrained, and at the same time the ideas of these modifications.”—Origin and nature of the emotions, Spinoza’s ethics, Everyman edition (London, 1910), p. 84.

11. Spinoza’s ethics, The power of the intellect, p. 203. Spinoza saw the political aspect of “freedom from fear,” as mentioned in Chapter 1, p. 11.

12. Spinoza’s ethics, Origin and nature of the emotions, p. 131.

13. On the basis of this statement of Spinoza’s, one can contemplate with profit how greatly the historical situation in which one lives conditions one’s anxiety and fear. One could say that living without fear in the twentieth century—the day of atom bombs, totalitarianism, and traumatic social change—shows weakness of mind, or, more accurately, insensitivity, atrophy of mind.

14. Spinoza’s ethics, The strength of the emotions, p. 175.

15. The power of the intellect, in Spinoza’s ethics (London, 1910), p. 208.

16. Cf. Kurt Riezler, The social psychology of fear, Amer. J. Sociol., May, 1944, p. 489. For examples of such psychic conflicts underlying anxiety, see what I describe as the “rift between expectation and reality” which underlay some of the neurotic anxiety of the cases in Part II, page 335, below.

17. It is, however, to be borne in mind that Spinoza’s seventeenth-century cultural situation was not only different from the situation of the nineteenth and twentieth centuries, but also that his confidence in reason was different from the deteriorated forms of rationalism in the nineteenth century. These last involved a denial and repression of emotion. Also, since we are chiefly interested in Spinoza as a spokesman for the confidence in reason in the seventeenth century, it is important to emphasize that he was by no means merely a rationalist in the contemporary connotation of that term. His ethical and mystical interests gave a broad and profound context to his thought which was absent in the later and more limited forms of rationalism. For example, if we should follow out to the ultimate step his analysis of how to overcome fear (and anxiety, so far as anxiety appears as a problem), we should discover that each destructive affect must be overcome by a stronger, constructive one. We should also find that he defined the ultimate constructive affect in the curiously mystico-rationalistic phrase, the “intellectual love of God.” In other words, fear (and anxiety) can be overcome in the last analysis only by a religious attitude toward one’s life as a whole. It should also be mentioned, by the way, that one important consequence of the broad base of Spinoza’s thinking was that he was able to avoid the dichotomy between mind and body which characterized other philosophies of his day.

18. Pascal’s pensées, ed. and trans. G. B. Rawlings (Mt. Vernon, N.Y., 1946), pp. 36, 7.

19. Pascal’s thoughts, trans. Edward Craig (New York, 1825), p. 110.

20. Pascal’s pensées (Rawlings ed. and trans.), op. cit., p. 35.

21. It is interesting to note in connection with Pascal’s lament that the emotions were not reasonable, that it became Freud’s endeavor, more than three centuries later, to extend the domain of reason to include the emotions.

22. Rawlings (ed. and trans.), op. cit., p. 38.

23. Craig (trans.), op. cit., p. 84.

24. The question of why he was an exception, and why he experienced inner trauma and anxiety to a much greater degree than his contemporaries, would take us afield from this discussion. We might, however, mention Cassirer’s suggestion that Pascal’s view of man is really a carry-over from medievalism, and that despite Pascal’s scientific genius, he had not really absorbed the new view of man which had emerged at the Renaissance.

25. This term “technical reason” is Paul Tillich’s. It refers to the fact that in the nineteenth century reason, in practice, became increasingly applied to technical problems. The theoretical implications of this growing emphasis on the technical aspects of reason were not widely appreciated at the time.

26. An essay on man, op. cit., p. 21.

27. Ibid., p. 22.

28. Freud often wrote of his aim of making unconscious material conscious, and thus increasing the scope of reason. In his more theoretical writings (see Civilization and its discontents and The future of an illusion), he has a concept of reason and science which is inherited directly from the seventeenth and eighteenth centuries. But in actual practice his concept of reason, involving as it does a union of conscious experience with the vast store of unconscious tendencies within the individual, is a quite different thing from “reason” in traditional rationalism.

29. Paul Tillich, Existential philosophy, Journal of the History of Ideas, 1944, 5:1, 44–70. Since Tillich’s own thinking participates in the Existentialist tradition, his descriptions of the movement have special cogency and will be quoted frequently in this section.

30. The relationship of this form of thought to American pragmatism, as presented by William James, will be clear. Modern representatives of existentialism include Martin Heidegger, Karl Jaspers, Jean-Paul Sartre, and Gabriel Marcel.

31. Existential philosophy, op. cit., p. 66.

32. Ibid., p. 67.

33. Ibid., p. 54.

34. Walter Lowrie, A short life of Kierkegaard (Princeton, N. J., 1944), p. 172.

35. Ibid., p. 116.

36. The concept of dread, trans. Walter Lowrie (Princeton, N. J., 1944), p. 123.

37. Tillich, p. 67.

38. Werner Brock, Contemporary German philosophy (Cambridge, 1935), p. 75. For an appreciation of Kierkegaard by a twentieth-century psychologist, see O. H. Mowrer, Anxiety, in Learning theory and personality dynamics (1950). Mowrer believes that it was necessary for Freud to produce his work before the insights of Kierkegaard could be widely understood.

39. The concept of dread, op. cit. Walter Lowrie states that in English “we have no word which adequately translates Angst” (preface to above edition, p. ix). Hence, after much deliberation, Dr. Lowrie and the other early translators of Kierkegaard decided to use the term “dread” as a translation into English of Kierkegaard’s Angst. I certainly agree that the term “anxiety” in English is often used in superficial ways, for example, to mean “eagerness” (“I am anxious to do something”) or as a mild form of worry or has other connotations which do not at all do justice to the term Angst. But the German Angst is the word which Freud, Goldstein, and others use for “anxiety”; and it is the common denominator for the term “anxiety” as used in this book. The question is whether the psychological meaning of “anxiety” (in contrast to the literary meaning) is not very close—in fact much closer than the term “dread”—to what Kierkegaard meant by Angst. Professor Tillich, who was familiar with both the psychological meaning of Angst and Kierkegaard’s works, believed this to be true. I endeavor in this book to preserve both of these meanings, the superificial and the profound, by the two terms “normal anxiety” and “neurotic anxiety.” In any case, Professor Lowrie generously gave me permission to render the term “dread” as “anxiety” in the quotations from his translations of Kierkegaard, in order to conform with the usage of terms in this book.

After all these difficulties, I was delighted to discover that the most recent translation by Kierkegaard scholars restores “anxiety” to its rightful place. See The Concept of anxiety, ed. and trans. Howard v. Hong and Edna V. Hong (Northfield, Minn., 1976)

40. The concept of dread, p. 138.

41. Ibid., p. 99.

42. Kierkegaard goes on to insist that, for the realization of selfhood, one must always move ahead: “So it is too that in the eyes of the world it is dangerous to venture. And why? Because one may lose. But not to venture is shrewd. And yet, by not venturing, it is so dreadfully easy to lose that which it would be difficult to lose in even the most venturesome venture, and in any case never so easily, so completely as if it were nothing . . . one’s self. For if I have ventured amiss—very well, then life helps me by its punishment. But if I have not ventured at all—who then helps me? And, moreover, if by not venturing at all in the highest sense (and to venture in the highest sense is precisely to become conscious of oneself) I have gained all earthly advantages . . . and lose my self! What of that?” Kierkegaard, Sickness unto death, trans. Walter Lowrie (Princeton, N.J., 1941), p. 52. (Italics mine.)

43. The concept of dread, p. 44.

44. Ibid., p. 38.

45. Ibid., p. 92.

46. Ibid., p. 40.

47. Sickness unto death, op. cit., p. 43.

48. It should be clear that Kierkegaard, like the exponents of modern psychotherapy, is not speaking of what is sometimes called “unhealthy introspection.” Such introspection arises not from too much self-awareness (which is a contradiction in terms in Kierkegaard’s view) but rather from conditions of blocked self-awareness.

49. In philosophical terms, this is the problem of man’s “essence” as over against his “existence.”

50. The concept of dread, op. cit., p. 47.

51. Ibid., p. 65.

52. The concept of dread, p. 92.

53. Ibid., p. xii, quoted from his Journal (III A 233; Dru No. 402).

54. It is interesting that Otto Rank also holds that the healthy individual is the one who can create despite the inner conflict (between “life will” and “death will,” in his terms), whereas the neurotic is the one who cannot manage this conflict except by retrenching and sacrificing his creativity.

55. In contemporary psychopathology it is held that there is always anxiety where there is guilt feeling (fear of punishment) but that the reverse is not necessarily true. It will be seen, however, that Kierkegaard is speaking of a different level—i.e., the relation of guilt feeing to creativity.

56. The process of creativity has not been adequately explored in contemporary psychology. The testimony of the artists would support Kierkegaard at this point: Degas says, “A picture must be painted with the same feeling as that with which a criminal commits his crime,” and Thomas Mann speaks of the “precious and guilty secret” which the artist keeps. One can find more insight into this phenomenon in mythology; in the myth of Prometheus, creativity is pictured as a defiance of the gods. One could ask psychologically whether individuation, and the creativity involved, means a progressive breaking from, and defiance of, the mother; or in Freudian terms, whether creativity is a progressive dethroning of the father.

57. The concept of dread, op. cit., p. 96.

58. Ibid., p. 65.

59. This will be discussed frequently in subsequent chapters. For example, see particularly the cases of Phyllis and Frances in Chapter 9; see also Chapter 10.

60. The concept of dread, op. cit., p. 110.

61. Ibid. Compare Ibsen’s description of inmates of a lunatic asylum: “Each shuts himself in a cask of self, the cask stopped with a bung of self and seasoned in a well of self.” Peer Gynt.

62. The concept of dread.

63. Ibid., p. 114 n.

64. Ibid., p. 109.

65. Ibid., p. 124.

66. Ibid.

67. Ibid., p. 129.

68. Ibid., p. 107.

69. Ibid., p. 139.

70. Ibid., p. 139.

71. Ibid., p. 144.

72. Ibid., p. 141. (Italics mine.)

73. Ibid., p. 140.

74. Ibid., p. 142.

3. ANXIETY INTERPRETED BIOLOGICALLY

1. The only names of unifiers that come to mind are Hans Selye and Ludwig von Bertalanffy. But important as their contributions are, the former is in the field of experimental medicine and surgery, and the latter in theoretical biology. We are still left without our unifying of the heterogeneous researches on anxiety. Stress is similar to anxiety but, as I will indicate later, is not to be identified with it.

2. Eugene E. Levitt, Commentary on the psychiatric breakthrough, in Charles Spielberger (ed.), Anxiety: current trends in theory and research, I (New York, 1972), p. 233.

3. Harry Stack Sullivan, Conceptions of modern psychiatry (Washington, D.C., 1947), p. 4.

4. Aaron Beck, Cognition, anxiety, and psychophysiological disorders, in Charles Spielberger (ed.), Anxiety: current trends in theory and research, II (New York, 1972), p. 349.

5. John W. Mason, Emotion as reflected in patterns of endocrine integration, in L. Levi (ed.), Emotions—their parameters and measurement (New York, 1975).

6. C. Landis and W. A. Hunt, The startle pattern (New York, 1939).

7. Landis and Hunt, op. cit., p. 23.

8. Ibid., p. 21.

9. Ibid., p. 153.

10. Ibid.

11. Ibid., p. 136.

12. Ibid., p. 141. Note that this is the startle pattern, meaning it is the response of the total organism. This may explain why in the literature of the last two decades, the researchers, increasingly interested in isolating discrete elements in neurology and physiology, should have neglected the startle pattern.

13. L. S. Kubie, The ontogeny of anxiety. Psychoanal. Rev. 1941, 28:1, 78–85. The startle pattern is applied in different ways. See Stress and Behavior, by Seymour Levine, Scientific American, January, 1971, 224:1, 26–31.

14. Kurt Goldstein, The organism: a holistic approach to biology (New York, 1939), and Human nature in the light of psychopathology (Cambridge, 1938).

15. A distinction must be made between “biological,” referring to the organism as an acting and reacting totality, and “psychological” referring to one level in that totality. It is true, as some writers have held, that a study of brain-injured patients does not yield data on the specifically psychological aspect of neurotic anxiety, since these patients are neurologically impaired to begin with. For example, Mowrer (1950) holds that the anxiety of Goldstein’s patients is more akin to Urangst (basic, normal anxiety) than to neurotic anxiety. Indeed, it is doubtful whether the term “neurotic anxiety” has any meaning when applied to these patients. This distinction, however, does not contradict my statement that Goldstein’s findings are of great value in providing a biological base for the understanding of anxiety. It is my judgment (as will be indicated in detail later) that the understanding of anxiety on the psychological level is not inconsistent with, but complementary to, Goldstein’s findings on the biological level.

16. Though he rejects the concept of “drives,” Goldstein holds that one can speak of the “needs” of the organism in its trend to actualize itself.

17. R. R. Grinker and S. P. Spiegel, Men under stress (Philadelphia, 1945). The frequent studies, incidentally, of anxiety in soldiers in this book is by no means an overfondness for things military. It is because soldiers, like unmarried mothers, will stay put in their group long enough to be studied. They also, again like the unmarried mothers, are in a purportedly anxiety-creating situation.

18. Bourne, Rose, and Mason, Urinary 17-OHCS levels, Arc. Gen. Psych., July, 1967, 17, 104–110.

19. Of course a “pseudo-object” is often found for the anxiety. This is the function of phobias and superstitions. As is well known, anxiety is often displaced on any acceptable object; there is generally relief from the pain of anxiety if the sufferer can attach it to some thing. The presence of pseudo-objects in anxiety ought not to be confused with the real sources of the anxiety.

20. The organism, op. cit., p. 292.

21. Ibid., pp. 293, 297.

22. Ibid., p. 295.

23. Ibid.

24. Readers who wish a clinical illustration of these points are referred to the case of Brown in Chapter 8, especially to the discussion on page 233.

25. Of course, Goldstein does not intend, in this discussion of the objectless nature of anxiety, to divorce the organism from its objective environment. The individual is always faced with an objective environment, and it is only in seeing the organism-in-environment—that is, the organism reacting to tasks which it cannot solve, that we are able to understand the onset of anxiety.

26. Op. cit., p. 295.

27. Ibid., p. 296.

28. See P. M. Symonds, The dynamics of human adjustment (New York, 1946), p. 155.

29. The organism, op. cit., p. 297.

30. Gray, reviewing the origin of fears, formulated a fourfold classification of innately fear-producing stimuli: “intensity, novelty, special evolutionary dangers (from generations of experiences with predators) and stimuli arising from social interaction.” The first two principles all diminish rapidly with age. The latter seem subject to maturation; they tend to become stronger over time. J. Gray, The psychology of fear and stress (London, 1971).

31. Ibid., p. 300.

32. Ibid., p. 303.

33. Ibid., p. 306.

34. Kurt Goldstein, Human nature in the light of psychopathology, p.113.

35. Ibid., p. 115.

36. Ibid., p. 117.

37. Goldstein offers a challenging corrective to much of the discussion in this field: “There are no ‘specific’ neurophysiological bases for anxiety or fear,” he stated in conversation with me; “If the organism reacts at all, the whole organism reacts.” This does not imply, of course, that it is not useful to study sympathetic activity—for example, as one important aspect of the neurophysiology of anxiety and fear—but it does imply that such a study must be subsumed under a more comprehensive view of the organism as a reacting totality. Nor does Goldstein’s view imply that some reactions of the organism are not more specific than others. For example, fear is a more specific reaction, neurophysiologically as well as psychologically, than anxiety, so the practice of describing the neurophysiology of fear solely in terms of sympathetic activity is less fallacious than the same procedure with anxiety. As we shall later demonstrate, one distinction between fear and anxiety is that anxiety strikes at more fundamental, and hence, more engrossing, “strata” in the organism. Furthermore, the reader should perhaps be warned that while much of great value is known about the neurophysiological reactions of the organism under threat (which knowledge we shall endeavor to review in the remainder of this chapter), there is a great deal about the neurophysiology of anxiety which we do not know.

38. This is one distinction between the autonomic system and the other nervous system in the organism, the central (cerebral-spinal) system which is more directly under conscious control.

Recently there have been studies demonstrating that conscious control of the autonomic nervous system is more possible than we had thought. This has been shown by Neil Miller at Rockefeller University and also by the experiments in biofeedback by Barbara Brown. I do not believe, however, that any of these invalidate the basic description we are here making.

39. See Walter B. Cannon, Bodily changes in pain, hunger, fear and rage, 2nd ed. (New York, 1927), and The wisdom of the body (New York, 1932).

40. The wisdom of the body, op. cit.

41. Grinker and Spiegel, op. cit., p. 144.

42. Cannon, Wisdom of the body, op. cit., p. 254.

43. Ibid., p. 253. A later criticism made of Cannon’s work is that emotional processes are the function of the entire autonomic nervous system, with the sympathetic and parasympathetic functioning reciprocally and simultaneously in producing what we call emotions. Also Cannon’s work is deficient in understanding the role of hormones which was not possible in his day. Other than these additions, Cannon’s work is still considered the classic in the field. Paul Thomas Young, Emotion, in International encyclopedia of social sciences, V (New York, 1968), pp. 35–41.

44. R. R. Willoughby, Magic and cognate phenomena: an hypothesis, in Carl Murchison (ed.), Handbook of social psychology (Worcester, Mass., 1935), p. 466.

45. Walter B. Cannon, “Voodoo” death, Amer. Anthrop., 1942, 44:2, 169–181.

46. E. Tregear, in J. Anthrop. Inst., 1890, 19, 100, quoted by Cannon, in “Voodoo” death, 170.

47. Ibid., p. 176.

48. A. G. Leonard, The Lower Niger and its tribes (London, 1906), pp. 257 ff.

49. Ibid., p. 178.

50. George Engel, Psychological development in health and disease (Philadelphia, 1962), pp. 290, 392–393.

51. Ibid., p. 179.

52. Ibid., p. 180.

53. Engel, op. cit., p. 383, and Aaron Beck, op. cit., pp. 343–354.

54. Leon J. Saul, Physiological effects of emotional tension, in J. McV. Hunt (ed.), Personality and the behavior disorders (New York, 1944), Vol. I, pp. 269–305.

55. J. J. Groen and J. Bastiaans, Psychosocial stress, interhuman communication, and psychosomatic diseases, in Charles Spielberger and Irwin Sarason (ed.), Stress and anxiety (New York, 1975), Vol. I, p. 47.

56. Engel, op. cit., p. 391.

57. Dunbar, Emotions and bodily changes, p. 63.

58. Saul, op. cit., p. 274. This pattern is mentioned to emphasize the interrelation of many anxiety states with dependence on the mother.

59. For another example, see case of Brown, Chapter 8, below, esp. page 241.

60. Saul, op. cit., pp. 281–84.

61. Ibid., p. 294.

62. Ibid., p. 292.

63. Bela Mittelmann, H. G. Wolff, and M. P. Scharf, Experimental studies on patients with gastritis, duodenitis and peptic ulcer, Psychosom. Med., 1942, 4:1, 58. (Quotes are printed by permission of the authors and of Paul B. Hoeber, Inc., Medical Book Department of Harper & Brothers. Copyright, 1942, by Paul B. Hoeber, Inc.)

64. From Human gastric function by Stewart Wolf and H. G. Wolff. Copyright 1943, 1947, by Oxford University Press, Inc. (Quotes are printed by permission of Oxford University Press.)

65. Ibid., p. 112.

66. Ibid., p. 120.

67. Ibid., pp. 118–19.

68. Ibid., p. 92.

69. Mittelman, Wolff, and Scharf, op. cit., p. 16.

70. Engel presents an interesting case of an infant, who, like Tom, had a gastric fistula. When “Monica was outgoing and relating to persons either affectionately or aggressively, her stomach secreted actively.” In other words, Monica was similar to Tom without Tom’s neurotic tendencies.

71. Op. cit., p. 176.

72. Op. cit., p. 54 (italics mine).

73. Ibid., p. 240.

74. See Jerome Hartz, Tuberculosis and personality conflicts, Psychosom. Med., 1944, 6:1, 17-22. I suggest that the progression may be roughly as follows: When the organism is in a catastrophic situation, the endeavor to solve the conflict takes place first on the conscious level; then on the specifically psychosomatic level; and if neither of these is effective, the conflict may involve a disease such as tuberculosis representing a more complete involvement of the organism.

75. Op. cit., p. 140.

76. We have indicated above the questionable nature of this assumption.

77. J. C. Yaskins, The psychobiology of anxiety—a clinical study, Psycoanal. Rev., 1936, 23, 3 and 4, and 1937, 24, 81–93.

78. Needless to say, we are speaking of the anxiety related to the patient’s behavior patterns, not the specific anxiety related to the fact that he has a disease (which may obviously be present during the disease). Many observers have spoken of the “substitution function” of the disease for anxiety. Draper (see Saul, op. cit.) mentions also that a neurosis may function as a substitute for organic symptoms.

79. Quoted by Dunbar, Emotions and bodily changes, p. 80.

80. This observation, of course, is directed only against oversimplified applications of Cannon’s findings, not against Cannon’s classical work itself.

4. ANXIETY INTERPRETED PSYCHOLOGICALLY

1. Howard Liddell, The role of vigilance in the development of animal neurosis, paper read at the symposium on anxiety of the Amer. Psychopath. Ass., New York, June, 1949. (Published in Hoch and Zubin [eds.], Anxiety [New York, 1950], pp. 183–197.)

2. We shall see later, in our discussion of anxiety and the impoverished personality, that a person’s blocking off his or her anxiety also blocks off creativity. This leaves the personality impoverished. But the converse of this is not necessarily true—that the more anxiety one experiences, the more creative he or she is (cf. Chapter 11).

3. The reasoning which leads Liddell to this conclusion is very similar to that of Sullivan, and it also has much in common with the viewpoints of Freud and of Mowrer on the social origins of anxiety.

4. John B. Watson, Behaviorism (New York, 1924).

5. This and following excerpts from Child psychology (rev. ed., New York, 1940), p. 254, by A. T. Jersild are reprinted by permission of Prentice-Hall, Inc. Copyright, 1933, 1940, by Prentice-Hall, Inc.

6. A. T. Jersild and F. B. Holmes, Children’s fears (Child Development Monograph No. 20, Bureau of Publications, Teachers College, Columbia University, New York, 1935), p. 5. By permission of Teachers College. Copyright, 1935, by Teachers College, Columbia University.

7. See Jersild, Child psychology, op. cit., p. 255. Quotations are from A. L. Gesell, The individual in infancy, in Carl Murchison, ed., The foundations of experimental psychology (Worcester, Mass., 1929).

8. Jersild, op. cit., p. 255.

9. Cf. George Engel, Psychological development in health and disease (Philadelphia, 1962), p. 50, quoting René Spitz, Anxiety: its phenomenology in the first year of life.

10. Jersild, op. cit., p. 256. Whether these reactions—for example, those connected with competition—which Jersild describes as “fears” are really fears or anxiety is a question which can be answered only on the basis of the actual situation. Clinical studies indicate that intrapsychic conflicts may be projected on the environment and give rise to anxiety; one common example of this is the anxiety underlying phobias. This likewise presupposes not only some level of maturation but also intricate conditioning and experiential processes.

11. Based upon interviews with 398 children aged five to twelve years. See A. T. Jersild, F. V. Markey, and S. L. Jersild, Children’s fears, dreams, wishes, daydreams, pleasant and unpleasant memories (Child Development Monograph No. 12; New York: Teachers College, Columbia University, 1933).

12. Jersild and Holmes, Children’s fears, op. cit., p. 328.

13. Ibid., p. 308.

14. See page 126–27.

15. Jersild continues: “For example, a child’s apparent fear of being abandoned, exhibited whenever his mother leaves the house on a brief errand, may be associated with other symptoms of distress that first appeared when a new baby came into the household. This particular expression of fear may abate in response to parental efforts to help the child overcome it, only to be followed by other expressions of fear—such as fear of sleeping alone in a dark room—if the underlying uncertainties still persist.” Child psychology, op. cit., p. 274.

As an actual case I cite the following: A boy of three was sent to his grandparents farm for the period during which his mother gave birth to twins. On his mother’s arrival with the new babies, the boy began to exhibit a strong “fear” of the tractor on the farm. It was noted by the parents that this “fear” took the form of the boy’s running to his parents ostensibly for their protection from the tractor. On the assumption that the underlying cause of the boy’s “fear” was feelings of isolation and rejection related to the previous separation from the parents and the advent of the two babies, the parents ignored the item of the tractor as such and devoted their efforts to helping the boy overcome his feelings of isolation. The fear of the tractor shortly vanished. If it had been assumed that the exhibited fear was related specifically to the threat of the tractor, I do not deny that the child could have been conditioned, in the usual meaning of this term, out of the fear of the tractor. But if, as hypothesized by the parents, this fear were really a focus for anxiety which actually had quite different roots, the “fear” would simply have shifted to a new object.

16. Jersild, Child psychology, op. cit., p. 270.

17. Jersild and Holmes, op. cit., p. 305. Several studies indicate that a common, if not the chief, fear of school children is that they might fail in school. Studies also show this fear of failure to be very much out of proportion to the actual experience or reasonable probability of failure on the part of the student.

18. See the following chapter on Freud, Sullivan, et al.

19. The phenomenon of phobias presents in extreme form a demonstration of the above hypothesis. Phobias appear as specific, but are found on deeper analysis to be concentrations of anxiety at one point in the environment in order to avoid anxiety at other points. See Freud’s analysis of Hans, the five-year-old boy whose phobia of horses, Freud indicates, was a displacement of anxiety arising out of his relations with his father and mother.

20. Hans Selye, The stress of life (New York, 1956), pp. 55–56. Also cf. p. 311.

21. Selye, op. cit., p. vii.

22. Ibid., p. 66. Gregory Bateson questions the use of the term “energy” both in biology and psychology. He writes: “It would have been more fruitful to think of lack of energy as preventive of behavior, since in the end a starving man will cease to behave. But even this will not do: an amoeba, deprived of food, becomes for a time more active. Its energy expenditure is an inverse function of energy input.” Gregory Bateson, Steps to an ecology of mind (New York, 1972), p. xxii.

23. Charles Spielberger, Anxiety: current trends in theory and research (New York, 1972), II, p. 345.

24. Peter Bourne, Robert Rose, and John Mason, Urinary 17-OHCS levels, Archives of General Psychiatry, July, 1967, 17, p. 109.

25. Hans Selye, Stress and distress (Toronto, 1974).

26. M. K. Opler, Culture, psychiatry and human values (Thomas, 1956), p. 67.

27. I am especially indebted at this point to my research associate, Dr. Joanne Cooper.

28. Spielberger (ed.), Anxiety: current trends in theory and research, Vol. I and II. Irwin Sarason and Charles Spielberger (eds.), Stress and anxiety (New York, 1966), Vols. I–IV. Charles Spielberger, Anxiety and behavior (New York, 1966).

29. Richard Lazarus and James Averill, Emotion and cognition: With special reference to anxiety, in Spielberger (ed.), Anxiety: current trends in theory and research, Vol. II, pp. 241–283.

30. Seymour Epstein, The nature of anxiety with emphasis upon its relationship to expectancy, in Spielberger (ed.), Anxiety: current trends in theory and research, Vol. II, ch. 8.

31. See my distinction between stress and anxiety earlier in this chapter.

32. Walter D. Fenz, Strategies for coping with stress, in Sarason and Spielberger (eds.), Stress and anxiety, Vol. II, pp. 305–335.

33. Seymour Epstein, Anxiety arousal and the self-concept, in Spielberger and Sarason (eds.), Stress and anxiety, Vol. III, pp. 185–225.

34. Op. cit.

35. Epstein, op. cit., p. 223.

36. Charles Spielberger, Current trends in research and theory on anxiety, in Spielberger (ed.), Anxiety: current trends in theory and research, Vol. I, p. 10.

37. Norman Endler, A person-situation-interaction model for anxiety. In Sarason and Spielberger (eds.), Stress and anxiety, Vol. I, pp. 145–162.

38. H. D. Kimmel, Conditioned fear and anxiety, in Spielberger and Sarason (eds.), Stress and anxiety, Vol. I, pp. 189–210.

39. Yona Teichman, The stress of coping with the unknown regarding a significant family member, in Spielberger and Sarason (eds.), Stress and anxiety, Vol. II, pp. 243–254.

40. See my earlier discussion of Robert Jay Lifton’s Protean man in Chapter 1.

41. Charles Ford, The Pueblo incident: Psychological response to severe stress, in Spielberger and Sarason (eds.), Stress and anxiety, Vol. II, pp. 229–240.

42. Richard Lynn, National differences in anxiety, in Spielberger and Sarason (eds.), Stress and anxiety, Vol. II, pp. 257–272.

43. D. B. Coates, S. Moyer, L. Kendall, and M. G. Howart, Life event changes and mental health, in Sarason and Spielberger (eds.), Stress and anxiety, Vol. III, pp. 225–250.

44. O. H. Mowrer, A stimulus-response analysis of anxiety and its role as a reinforcing agent, Psychol. Rev., 1939, 46:6, 553–65.

45. Ibid., p. 555.

46. Anxiety-reduction and learning, J. exp. Psychol. 1940, 27:5, 497–516.

47. Cf. N. E. Miller and John Dollard, Social learning and imitation (New Haven, Conn., 1941).

48. Cf. O. H. Mowrer, Preparatory set (expectancy)—some methods of measurement (Psychol. Monogr., 1940), No. 233, pp. 39, 40.

49. I would call the reactions of Mowrer’s animals in this experiment fear, and Mowrer himself, from his later perspective, would likewise term the reactions fear.

50. Cf. O. H. Mowrer, Freud’s theories of anxiety: a reconciliation. Unpublished lecture given at Yale Institute of Human Relations, 1939.

51. O. H. Mowrer, A. D. Ullman, Time as a determinant in integrative learning, Psychol. Rev., 1945, 52:2 61–90.

52. Elsewhere (page 97 and Chapter 6), I discuss these two qualities of the human being as (1) man is the mammal who lives by symbols and (2) man is the historical mammal in that we possess the capacity for self-awareness of our history. We are, therefore, not just the product of history (as all animals are), but in varying degrees, depending upon our self-awareness of history, we can exercise selectivity toward our history, can adapt ourselves to portions of it and correct other portions. Within limits we can mold history and in other ways use it in our development in self-chosen directions. Cassirer also makes these two qualities distinctive for human beings; cf. An essay on man (New Haven, Conn., 1944).

53. O. H. Mowrer, op. cit.

54. In the light of this distinction, we raise a question in regard to the implications of the concept of anxiety as a drive. That anxiety does operate as a drive, a ”secondary” drive, as is emphasized by learning theorists (Miller and Dollard, Symonds, etc.) is indisputable. And its reduction, like the reduction of other drives, is rewarding and reinforces learning. But strictly speaking, behavior which occurs chiefly and directly to lessen the drive of anxiety is adjustive, not integrative. To me, it falls in the same category as the learning of neurotic symptoms. This is Goldstein’s point when he holds that all activity which is a direct product of the individual’s anxiety (i.e., when the motivation is the reduction of anxiety as a drive) is marked by a stress on partial aspects of action, compulsiveness, and lack of freedom. And, “as long as these activities are not spontaneous, are not outlets of the free personality, but are merely the sequelae of anxiety, they have only a pseudo-value for the personality.” (See Chapter 3 above.)

55. Mowrer, op. cit.

56. Mowrer, op. cit.

57. Ibid.

58. Ibid.

59. Ibid.

60. Ibid.

61. Ibid.

62. O. H. Mowrer, Anxiety, chapter in Learning theory and personality dynamics (1950).

63. Søren Kierkegaard, The concept of dread, trans. Walter Lourie (Princeton, N.J, 1944), p. 38.

64. In the previous chapter we discussed the ingenious psychosomatic studies which used physiological, neurological, psychological, and case-history approaches, combining clinical and experimental procedures. The book-length study of Tom likewise falls into this multidimensional category. I would add at this point only that these studies have their great value for the understanding of anxiety because the investigators were able to (1) inquire into subjective as well as objective factors; (2) study each individual as a unit in his life situation; and (3) pursue the study of each over a period of time.

65. These terms are placed in quotation marks because, in the final analysis, I do not believe that genuine autonomy is possible without corresponding responsibility.

5. ANXIETY INTERPRETED BY THE PSYCHOTHERAPISTS

1. Cf. Thomas Mann, Freud, Goethe, Wagner (New York, 1937).

2. The problem of anxiety, trans. H. A. Bunker (New York, 1936), p. 111.

3. New introductory lectures in psychoanalysis (New York, 1965), p. 81.

4. Introductory Lecture on Psychoanalysis, p. 395. Beyond this brief distinction, Freud does not—either in the chapter on anxiety in the Introductory lectures or in his later Problem of anxiety—throw much illumination on the problem of fear as such. He treats Stanley Hall’s list of allegedly innate fears—fear of darkness, fear of bodies of water, of thunder, etc.—as phobias, which are by definition expressions of neurotic anxiety. In a summary of Freud’s views in W. Healy, A. F. Bronner, and A. M. Bowers, The structure and meaning of psychoanalysis (New York, 1930), p. 366, a distinction between real fear and neurotic fear is made which is parallel to Freud’s distinction between real and neurotic anxiety. Real fear, it is stated, is the reaction to an objective danger, whereas neurotic fear is the “fear of an impulse claim.” Freud is interpreted as holding that “three practically universal childhood fears”—fear of being alone, fear of darkness, and the fear of strangers—arise out of the “unconscious Ego’s fear of loss of the protecting object, namely, the mother” Ibid. This is synonymous with his definition of the source of anxiety in similar situations. Apparently the terms “fear” and “anxiety” are here used interchangeably, the former being the term for the emergence of anxiety in specific form.

5. Ibid., p. 394.

6. Ibid., p. 395.

7. Ibid., pp. 401–2.

8. The problem of anxiety, pp. 51–52.

9. Introductory lectures, pp. 403–4.

10. Ibid., p. 409.

11. Ibid., p. 407. Cf. René Spitz, Chapter 4, p. 95.

12. Ibid., p. 410.

13. New introductory lectures, p. 85.

14. The problem of anxiety, p. 80.

15. New introductory lectures, p. 86.

16. The problem of anxiety, p. 22.

17. New introductory lectures, p. 86. If Hans were merely afraid of his father’s punishment (as an external danger), Freud would not call his anxiety neurotic. There are several cases later in this book where the person—Louise, Bessie, et al.—is able to judge the parent’s action for what it really is. Such a situation leads to objective anxiety, in Freud’s terms, not neurotic anxiety. The neurotic element enters because of the ego’s perception of the danger inherent in the internal instinctual promptings (Hans’s hostility toward his father, for example). Now it is well known that inner promptings in the individual’s experience can come easily to stand for external, objective dangers. If hostility toward the parent is met by retaliation, the child will soon be conditioned to experience anxiety whenever the hostile promptings arise intrapsychically.

18. Percival M. Symonds, The dynamics of human adjustment (New York, 1946).

19. Introductory lectures, p. 406.

20. The problem of anxiety, p. 98.

21. Introductory lectures, p. 408.

22. The problem of anxiety.

23. Ibid., p. 75.

24. Ibid., pp. 99–100.

25. Ibid., p. 105.

26. Ibid., p. 123.

27. Since castration and other aspects of the Oedipus situation are so important in Freudian discussions of anxiety, another question may be raised: Does not neurotic anxiety arise around castration or the Oedipus situation only when there are prior disturbances in the relationship between parents and child? To illustrate in the case of Hans, are not the boy’s jealousy and consequent hatred of his father themselves the product of anxiety? Apparently Hans had exclusive needs for his mother, needs which her loving the father would threaten. Are not such needs (which may fairly be termed excessive) in themselves an outgrowth of anxiety? It may well be true that the conflict and anxiety leading to the particular phobic construction which Freud analyzes are specifically related to ambivalence and hostility toward the father. But I submit that this hostility and ambivalence would not have developed except that Hans was already in a disturbed relationship with his mother and father which produced anxiety and led to exclusive demands for his mother. One can understandably hold that every child experiences clashes with its parents in its development of individuality and autonomy (vide Kierkegaard, Goldstein, et al.), but in the normal child (defined as the child in a relationship to its parents which is not characterized by pronounced anxiety) such clashes do not produce neurotic defenses and symptoms. I here suggest that Oedipus situations and castration fears do not emerge as problems—i.e., do not become the foci of neurotic anxiety—unless prior anxieties already exist in the family constellation.

28. For discussion of the possible relation between birth and anxiety, see Symonds, op. cit.

29. Cf. D. M. Levy: “[The] most potent of all influences on social behavior is derived from the primary social experience with the mother.” Maternal overprotection, Psychiatry, 1, 561 ff. Grinker and Spiegel, whose viewpoint represents a development of Freudianism, point out in their study of anxiety in combat airmen that fear or anxiety will not develop unless the value or object that is threatened in combat is “something that is loved, highly prized, and held very dear.” This may be a person (one’s self or a loved one) or a value like an abstract idea. Men under stress (Philadelphia, 1946), p. 120. I suggest, in line with Freud’s discussion above, that the primal form of the prized person is the mother and that the capacity to prize other persons and values is a development from this first prototype.

30. The problem of anxiety, p. 100.

31. I agree with those critics of the Freudian libido theory who hold that the theory is a carry-over from nineteenth-century physiochemical forms of thought.

32. The problem of anxiety, p. 86. This is the point I make with respect to the function of symptoms (see Chapters 3 and 8).

33. Ibid., p. 152.

34. Ibid., p. 112. In some interpretations of Freudian theory the first emphasis of Freud is still made. Cf. Healy, Bronner, and Browers: “Symptom-formation . . . is now regarded as a defense against or a flight from anxiety” (The structure and meaning of psychoanalysis, p. 411). I advanced the view in Chapter 3 above, that the symptom is a protection not from anxiety but from the anxiety-creating situation.

35. The confusing implications of Freud’s topology are seen in his tendencies to think of the ego and the id as literally geographical regions in the personality. In his last writing, Outline of psychoanalysis (New York, 1969), he refers to his “topographical” viewpoint, speaks of the ego as “developed out of the cortical layer of the id” (p. 55), and uses such phrases as “mental regions” (p. 2) and “the outermost cortex of the ego” (p. 18). The tendency to locate the “ego function” geographically reminds me of the endeavors of Descartes and others of the seventeenth century to locate man’s “soul” in the pineal gland at the base of the brain! Again, we can do no better than to quote Freud against himself; the essential thing is to grasp psychological facts psychologically.

36. The concept of the “separation of the individual from the whole” has a long history in human thought, running back to Anaximander in the preclassical period in ancient Greece. It would be agreed that it is a fruitful concept psychologically as well as philosophically, and that Rank has much empirical, experiential data on which to base his psychology.

37. The trauma of birth (English trans.; New York, 1929). (Original publication in German, 1924.)

38. Otto Rank, Will Therapy; an analysis of the therapeutic process in terms of relationship (authorized trans. from the German; New York, 1936), p. 168.

39. Ibid., p. xii.

40. Ibid., pp. 172–73.

41. Ibid., p. 175.

42. Cf Kierkegaard in Chapter 2.

43. Will therapy, p. 175. Apparently Rank means it is not possible to overcome all anxiety therapeutically; he indicates clearly that neurotic anxiety may be overcome. As regards normal anxiety, he would hold that it may be surmounted in the sense that the healthy individual moves ahead despite anxiety. By creativity one surmounts normal anxiety and overcomes neurotic anxiety.

44. Pearce Bailey, Theory and therapy: an introduction to the psychology of Dr. Otto Rank (Paris, 1935). Needless to say, Rank’s use of the term “collective values” antedated the appearance in Europe of fascism, a neurotic form of collectivism.

45. Adler here implies a negative view of culture (i.e., civilization is developed because it compensates for weakness), which is not consistent with his general positive valuation of social experience. The above view is similar to the Freudian concept that civilization is a product of man’s anxiety (or, more accurately, that anxiety leads human beings to sublimate their natural impulses into cultural pursuits). This general viewpoint is a half-truth and has the implication that all constructive activity is a defense against anxiety. It lacks a comprehension of the fact that the human being may act on the basis of positive, spontaneous powers and curiosity or, as Goldstein puts it, on the basis of the “joy of actualizing one’s own capacities.”

46. W. Beran Wolfe, Introduction to Alfred Adler, The pattern of life (New York, 1930).

47. Alfred Adler, The neurotic constitution (New York, 1926), p. xvi.

48. Alfred Adler, Problems of neurosis (New York, 1930), p. 73.

49. Alfred Adler, Understanding human nature (New York, 1927).

50. See discussion of this problem in Chapter 8.

51. See case of Brown, Chapter 8.

52. Understanding human nature, op. cit., p. 238.

53. Carl G. Jung, Collected papers on analytical psychology (London, 1920).

54. Carl G. Jung, Psychology and religion (New Haven, Conn., 1938), pp. 14–15.

55. Ibid., p. 18.

56. Ibid., p. 18.

57. Psychology and religion, chap. 1. (Italics mine).

58. A viewpoint of Erich Fromm, as phrased by Karen Horney, New ways in psychoanalysis (New York, 1939), p. 78.

59. Horney’s contention is that Freud’s instinct theories, and the libido theory which is derivative from them, are based on the assumption that “psychic forces are chemical-physiological in origin.” (Ibid., p. 47). She holds that psychology for Freud seems to be the science of how an individual uses or misuses libidinal forces. Horney does not deny that the outright frustration of a sheer biological need—such as that for food—would menace life and, therefore, be a source of anxiety. But beyond such fairly rare cases, it is to be recognized that biological needs assume a wide divergency of forms in different cultures, depending upon the patterns in the culture; and the point at which a threat to a biological need arouses anxiety depends in the great majority of cases on the psychological patterns of that culture. This is clearly indicated in a study of what sorts of sexual frustration arouse anxiety in different cultures. Horney believes that Freud’s nineteenth-century biological presuppositions prevented him from seeing the psychological context of such problems (she refers to “biological” in the sense of chemical-physical mechanisms, rather than to Goldstein’s use of “biological” in the sense of the organism responding as an entirety to its environmental situation).

60. Karen Horney, Our inner conflicts (New York, 1945), pp. 12–13.

61. New ways in psychoanalysis (New York, 1939), p. 76.

62. Cf. Goldstein, Kierkegaard, et al.

63. The neurotic personality of our time (New York, 1937), p. 89.

64. Ibid., p. 199.

65. one is reminded of W. Stekel’s central idea that all anxiety is psychic conflict. Conditions of neurotic anxiety and their treatment. However, in his epigrammatic statements, some of which show penetrating insight, Stekel did not work out systematically the nature of the psychic conflict as Horney has done.

66. The neurotic personality of our time, op. cit., p. 62. Horney feels it is entirely understandable that Freud in his Victorian culture considered that the expression of various sexual inclinations on the part, let us say, of the upper middle-class girl would incur real dangers in terms of social ostracism. But she warns against taking Freud’s culturally conditioned data as the basis for a generalization about personality. Except in unusual cases, her experience has been that anxiety which on superficial observation is related to sexual impulses often turns out to have its source in hostile or counter-hostile feelings about the sexual partner. This is plausible in the light of the consideration that sex is a very ready focus for dependent and symbiotic tendencies and that such tendencies are generally found in exaggerated form in anxious persons.

67. It is not to be implied that all hostility leads to anxiety conscious hostility does not necessarily produce anxiety, but may be a constructive function, resulting in actions which decrease the threat. Horney is speaking specifically of repressed hostility. Apart from the hostile content of repressions, one could remark that any repression sets the intrapsychic stage for anxiety in that the nature of repression itself involves some surrender of the autonomous power of the individual (some curtailment of the “ego,” as it would be stated in Freudian topology). The repression, of course, does not result in itself in conscious anxiety—indeed, its immediate purpose is precisely the opposite—but it represents a retrenchment of autonomy on the part of the individual and thereby accentuates his situation of weakness.

68. A criticism frequently made against Horney is that her emphasis on how the patient’s conflicts are manifested in his present relationships (an emphasis developed partly in reaction against what she felt to be Freud’s too exclusive emphasis on past origins) has led her and members of her school to neglect the origins of psychological conflict in early childhood. In my judgment, this criticism is justified.

69. From Harry Stack Sullivan, Conceptions of modern psychiatry, copyright 1940, 1945, 1947, 1953 by William Alanson White Psychiatric Foundation (New York: W. W. Norton & Company, Inc., 1953).

70. “Power motive” is to be sharply distinguished from “power drive,” the latter being a neurotic phenomenon which may be motivated by the accumulated frustration of normal needs for achievement. Sullivan’s concept of the expansion of the organism in terms of ability and achievement is parallel to Goldstein’s concept of self-actualization. Goldstein’s interest is more biological, whereas Sullivan’s persistent emphasis is that this expansion occurs and has its meaning almost wholly in interpersonal relationships.

71. Sullivan, p. 14.

72. Patrick Mullahy, A theory of interpersonal relations and the evolution of personality, in Sullivan, op. cit., p. 121 (a review of Sullivan’s theories).

73. The term “disapproval” may not have a strong enough connotation to suggest the degree of threat involved or the degree of discomfort the infant experiences when this threat cues of anxiety. Certainly “disapproval” does not refer to reproof, a great deal of which, it is known, can be assimilated by the infant if the mother-child relationship is fundamentally secure.

74. Op. cit., p. 34.

75. Ibid., p. 20.

76. Ibid., p. 46.

77. Ibid., p. 22.

78. Ibid., p. 46.

6. ANXIETY INTERPRETED CULTURALLY

1. A. I. Hallowell, The social function of anxiety in a primitive society, Amer. Sociol. Rev., 1941, 6:6, 869–81.

2. Seymour Sarason, Kenneth Davidson, Frederick Lighthall, Richard Waite, and Britton Ruebush, Anxiety in elementary school children (New York, 1960).

3. The psychological frontiers of society (New York, 1945), p. 99.

4. Quoted in Gardner Murphy, Historical introduction to modern psychology (New York, 1932), p. 446.

5. Society as the patient, Amer. J. Social., 1936, 42, 335.

6. Karl Mannheim, Man and society in an age of reconstruction (New York, 1941).

7. Fromm, op. cit., p. 14.

8. Our concern with the Renaissance, the beginning of the modern period and thus the time when many of the cultural patterns which underlie contemporaneous anxiety received their formative influences, corresponds roughly to the emphasis in individual psychotherapy upon the period of early childhood, when the patterns which underlie the individual adult’s anxiety were formed.

9. Jakob Burckhardt, Civilization of the Renaissance in Italy, trans. S. G. C. Middlemore (New York, 1935).

10. Johan Huizinga, The waning of the Middle Ages (New York, 1924), p. 40.

11. Ibid.

12. Karl Mannheim, Man and society in an age of reconstruction (New York, 1941), p. 117.

13. In this chapter we refer to the work of artists on the presupposition that the artist expresses the underlying assumptions and meaning of his culture and that artistic symbols are often not only less distorted than the expressions in word symbols but also can communicate the meaning of the cultural period more directly.

14. Quoted in Burckhardt, op. cit., p. 146.

15. John Addington Symonds, The Italian Renaissance (New York, 1935), p. 60.

16. Burckhardt, op. cit.

17. Symonds, op. cit., p. 87.

18. Burckhardt, op. cit., p. 150.

19. Symonds, op. cit., p. 352.

20. Romain Rolland, Michelangelo, trans. F. Street (New York, 1915), p. 161.

21. Symonds, op. cit., p. 775.

22. Fromm, op. cit., p. 48.

23. Fromm points out that “if one’s relations to others and to one’s self do not offer full security, then fame is one means to silence one’s doubts.”

24. Ibid., p. 48.

25. Kardiner, op. cit., p. 445.

26. R. H. Tawney, The acquisitive society (New York, 1920), p. 47.

27. Ibid., p. 47.

28. Ibid., p. 49. From a historical perspective, it becomes clear that Freud was accepting the common prejudice of our culture since the Renaissance, that the triumphant individual who was able to achieve his own ends of gratification, to a large extent despite society, was the healthy personality. This is the psychological form of what Tawney, speaking from the economic viewpoint, has called the apotheosis of the individual’s self-interest and “natural instinct” for aggrandizement which has characterized industrialism in the past several centuries. This is one example of how the ideals in practice by our modern culture run counter to our long-time ethical traditions.

29. R. S. Lynd and H. M. Lynd, Middletown (New York, 1929), p. 87.

30. Op. cit., p. 72.

31. This is very important in understanding the totalitarian developments in our own day.

32. Ibid., pp. 72 ff.

33. Ibid., pp. 81–82.

34. Fromm, op. cit.

35. Ibid., p. 240.

36. Ibid., p. 29.

37. Ibid., p. 63.

38. Ibid., p. 62.

39. See Horney, Chapter 4.

40. I have described this same need for frantic activity among Vietnam soldiers in combat in Chapter 11.

41. Fromm, op. cit., p. 94.

42. W. H. Auden, The age of anxiety (New York, 1947), p. 42.

43. Erich Fromm, Man for himself: an inquiry into the psychology of ethics (New York, 1947), p. 72.

44. Fromm, Escape from freedom, p. 185.

45. Ibid., p. 186.

46. Ibid., p. 105.

47. Ibid., p. 152.

48. Escape from freedom, p. 217.

49. Cf. Kurt Goldstein, Chapter 3 above. Also cf. Kurt Riezler, The social psychology of fear, Amer. J. Sociol., 1944, 49, 489.

50. Abram Kardiner, The psychological frontiers of society (New York, 1945).

51. Ibid., pp. 411–412.

52. Ibid., p. 376.

7. SUMMARY AND SYNTHESIS OF THEORIES OF ANXIETY

1. See Chapter 3, page 78.

2. The literal translation of Urangst into English is “original anxiety.”

3. I suggest that the reason death, whenever it is discussed in our culture, may be a symbol for neurotic anxiety is that the normal recognition of death as an objective fact is so widely repressed. In our culture one is supposed to ignore the fact that he will sometime die, as though the less said about it the better and as though the experience of living is somehow enhanced if one can remain oblivious to the fact of death. Actually, the exact opposite occurs: the experience of living tends to become vacuous and to lose its zest and savor if the fact of death is ignored. Fortunately, this repression of the fact of death is now being changed to a greater openness on the topic.

4. It tends to paralyze the person, and thus does not make for constructive and creative activity.

5. This ambiguity is one of the reasons it is important to make a clear distinction between the two kinds of anxiety.

6. Cf. next section.

7. In dealing with persons in situations with which their age and objective capacities fit them to cope adequately, a handy distinction between normal and neurotic anxiety is ex post facto—i.e., how the anxiety is used—normal anxiety being that which is used for a constructive solution to the problem which causes the anxiety, and neurotic anxiety being that which results in defense from and avoidance of the problem.

8. Chapters 8 and 9, and the discussion on p. 331.

9. Cf. Jersild in Chapter 4, note 6.

10. Quoted by permission.

11. The term “castration” is often used by present Freudian analysts as equivalent to punishment. This generalized meaning of the term has the merit of placing the emphasis on the relationship between the child and his parents, but it still leaves open the question of what values are threatened by the punishment.

12. Dynamics of human adjustment (New York, 1946).

13. I am using “dialectical” as meaning a relationship in which each pole reciprocally influences and conditions the other pole. A influences B and B, in turn, influences A; each becomes a different entity by knowing the other. The term “community” is used rather than “society” because it implies a positive quality of relatedness, achieved by the individual by means of his own self-awareness.

14. Karen Horney, The neurotic personality of our time (New York, 1937), p. 284.

15. The term “dispelled” is used here in connection with an attitude which realistically obviates anxiety, and “allay” for an attitude which permits the avoidance of anxiety without solving the problem underlying the anxiety. The same attitude may dispel anxiety at one period but become a means of allaying (avoiding) anxiety at another. For example, the assumption that individualistic economic striving furthers community well-being was realistically true, and did dispel anxiety during the expanding stages of capitalism. In recent economic developments the assumption is considerably less efficacious, but it still persists as a means of allaying anxiety.

16. Neurotic personality of our time, p. 289 (italics mine).

17. Kardiner, op. cit., p. 264.

18. Kurt Riezler, Social psychology of fear, Amer. J. Socio., 1944, 44, 496.

19. Karl Mannheim, Man and society in an age of reconstruction (New York, 1941), p. 6. Mannheim sees the “phase of disintegration” through which Western society is now passing as consisting of a conflict between traditional principles of “laissez-faire” and “planless regulation” (totalitarianism). Laissez faire, as an economic and social principle, was serviceable during the major part of the modern period. When, due to various developments in the late industrial age, the principles of laissez faire were no longer serviceable, some form of regulation was bound to appear. The “morbid” forms of regulation which did appear are, in his terms, “dictatorship, conformity and barbarism.” Mannheim is convinced that the endeavor to return to laissez-faire principles is neither a possible nor a constructive solution, nor obviously is acquiescence to planless regulation. His recommendation is democracy based upon economic planning. In many respects the analysis in my study parallels Mannheim’s analysis, his term “laissez-faire” being related to the term “competitive individualism” as used here.

20. Ibid., p. 128.

21. Ibid., p. 130 (italics mine).

22. See Rollo May, Historical roots of modern anxiety theories, paper delivered at symposium on “Anxiety” of the Amer. Psychopath. Ass., June 3, 1949 (rpt. In Anxiety [New York 1964]).

23. The term is B. Malinowski’s, used in a lecture.

8. CASE STUDIES DEMONSTRATING ANXIETY

1. Mardi Horowitz, Stress response syndromes (New York: Jason Aronson, 1976).

2. I use the term in this way. It includes Jung, Adler, Rank, Sullivan, and all the psychotherapists, as well as many others. There is historical justification for the assumption that practically all methods which get at unconscious motivations, such as the Rorschach, stem from the great impetus given by Freud and his successors.

3. If we speak in diagnostic terms, this case might be described as severe anxiety neurosis or as schizophrenia. If the latter term is used, it should be made clear that it refers not to a distorting of reality, but to the fact that the person is so radically incapacitated by his anxiety that he cannot take care of himself in the real world. In such conditions, the diagnosis of severe anxiety neurosis may be interchangeable with a diagnosis of schizophrenia. In any case, we are concerned here primarily with the psychological dynamics rather than the diagnostic label.

4. The concept of dread, p. xii.

5. For those familiar with the Rorschach projective test, we append these technical details: total responses, 18: 1 M, 2 FM, 1 k, 6 F, 3 Fc, 3 FC (of which 2 were F/C), 2 CF; 13 responses (76%) were W, 5 responses (28%) D.

6. If I do not say much about Harold’s relation to his father, it is because I must select, and the mother relation seems to me crucial in the case. I do not mean to imply, however, that the father’s problems, his psychosis and eventual suicide, were not exceedingly important influences on the young man. Brown’s relation to his father, from childhood on, was characterized by (1) identification with his father, (2) belief that his father was excessively strong, (3) subsequent feelings of being pushed down by the father, and finally (4) being convinced by his father’s suicide that “my father, whom I thought was so strong, turned out to be so weak—so how can there be any hope for me?” Thus his relation to his father exacerbated his own profound dilemma of weakness.

7. Anxiety has a way of seemingly operating under self-generated power. I say “seemingly” because the occasion of the anxiety must have some element in it which pertains to the conflict that is its cause; only we cannot at the moment see this connection. It is the nature of anxiety to keep this connection hidden. In therapy, the client cannot permit himself to see the connection until he is ready to give up the neurotic element in the anxiety; and often, when he can permit himself to see the connection between the anxiety and his fundamental conflict, there is a dramatic, sudden easing of tension.

8. Physical examinations of Brown had always been negative. A special neurological conference was held concerning this symptom of dizziness, the conclusion of which was that it was in all probability a psychogenic symptom of anxiety. The dizziness almost always occurred in the context of an anxiety situation, such as on his assumption of some responsibility he dreaded. The similarity of the phrase “being struck in the back of the neck” with the anxiety dream of being killed (in which his assailant also struck him in the back) is obvious. The neurologist remarked, incidentally, to me that the therapy was doing well if it kept Brown out of a mental hospital.

9. The fear that he had cancer was associated with a dream of being a patient in a hospital with nurses taking care of him. This suggests one of the functions, or purposes, of the symptom.

10. The scoring on the second Rorschach: there were 50 responses; W percentage was reduced to 44 (almost normal); D was 40 per cent, and d, Dd, and S together were 16 per cent. The number of M had risen to 6 and FC to 4, which indicates much more use of intratensive productivity and also more effective extratensive productivity. There were 3 original responses on the second record, compared to no originality at all and much banality of response on the first.

11. The meaning of cancer as symbolic, and the importance of symbols in general for revealing unconscious material, emerges at this point. After all, Brown’s relation to his mother was a form of “psychic cancer.”

12. There is a sad addendum to the case of Brown. He got along well for a number of years. Then I received a phone call from him in another part of the country saying that he had gone into an anxiety spell so severe that he could not stand it; would I meet him at the train station and help him get into a mental hospital? This I did. He was transferred to another hospital and, unbeknown to me, was given a lobotomy. I had lunch with him several years later. He was then a Coca-cola salesman and seemed relatively contented.

Practically speaking, if drugs had been available when he was in the hospital, this would have been one time they would have been useful to tide him over that episode. There can be endless arguments about what should have been done, most of them meaningless because they are “oblique”—that is, they argue from our present knowledge and armamentarium back to the past of thirty years’ ago when such methods of treatment were not available. I am personally against lobotomies on principle; but whether it is better to suffer the reduction of one’s potentialities by half and live with some contentment is a question I will not try to answer here.

1. Walnut House is a fictitious name employed for the customary purposes of anonymity. These young women were between the ages of fourteen and the mid-twenties. Most of them chose Walnut House more or less voluntarily, though some were sent by social-work agencies. None were in therapy, though a psychiatrist connected with the courts of New York was in legal charge although she was not there often. The psychologist sometimes referred to is myself. The staff consisted of three full-time social workers and several nurses.

2. Pregnancy outside of marriage is surely less anxiety-creating in our present period, chiefly due to the change in social attitudes toward the situation. I am not suggesting that the experience itself, apart from the social status, carries less anxiety. For a more thorough discussion of anxiety and other emotions in abortion, see Magda Denes, In necessity and sorrow (New York, 1976).

3. The work of Kierkegaard yields pertinent and profound insights which are applicable to many kinds of people in many situations. Yet Kierkegaard gained his insights chiefly by the intensive study of one person—namely, himself. The same is true of Freud’s early theories on dreams, which have been very widely accepted and have proven applicable to many different kinds of persons; Freud arrived at these theories chiefly through a study of his own dreams.

4. Every young woman was interviewed on entering Walnut House by the head social worker, and the young woman then became the case of one of the other social workers, who held conferences with her regularly during her stay (lasting on the average between three and four months) at the house.

5. Copies of these check-lists are given in the Appendix. One purpose in using the second Rorschach and the third check-list was to discover if there were changes in the foci of anxiety after birth. To this end, the items in the third check-list are almost identical, except for rewording, with the items in the second check-list. In some cases it was not possible to administer the second Rorschach because some women did not return to Walnut House after the birth of their babies. Similarly it was not possible to administer the third check-list to the majority of them. Hence we have only limited data on the changes in foci of anxiety after the birth. Where the tests were given after parturition, the chief use of the results has been to show the shifts in that particular person’s attitudes and anxiety.

6. The rating is from 1 to 5, 1 equaling the optimum, or lowest, degree of anxiety. “Depth” refers to how penetrating and profound the anxiety is; this is intensity in its qualitative sense. “Width” refers to whether the anxiety is generalized or limited to special areas; this is intensity in the sense of the quantity of symptoms. “Handling” refers to the degree of efficient effort of the subject in managing her anxiety.

7. The items in these check-lists were classified independently by three persons: Dr. P. M. Symonds, a social worker at Walnut House, and myself.

8. The ratings for anxiety in the Rorschach are given separately in the discussion of the Rorschach in each case, and a summary rating of the anxiety of each individual against the others in the Rorschach is also given. In the latter, the rating for depth and width of anxiety are combined; the handling is omitted, since it refers to something different from quantity or kind of anxiety. Though the Rorschach ranking often agrees, or closely agrees, with my over-all anxiety ranking for the woman, the two are not to be confused.

9. See G. Allport, The use of personal documents in psychological science (New York, 1942).

10. Total responses, 46: 10 M, 7 FM, 1 m, 2 k, 1 K (with three additionals), 4 FK (with four additionals), 8 F, 4 Fc, 4 FC, 5 CF; popular responses 7, originals 15: W% 66, D% 34; intelligence estimate on basis of Rorschach: potentiality 130 (or higher), efficiency 120. This intelligence estimate accords with the reports received of two intelligence tests she had taken in school and college.

11. These methods of coping are often effective when a person is up against it. They are, for example, tried and true methods in the army, as we have seen in previous chapters.

12. As a matter of actual fact, Helen’s labor turned out to be not at all what she had dreaded. After parturition she remarked to the psychologist, “If your wife tells you women suffer in childbirth, just tell her it ain’t so.” It is impossible, of course, to reason from the fact that her fear actually turned out to be unrealistic to a conclusion that therefore the fear was neurotic. But nevertheless the relief Helen expressed after parturition seemed to be more similar to the “what-was-I-afraid-of?” feeling of people after a neurotic fear has been dispersed than the relief after escaping a real threat: “It was dangerous, but I was fortunate.”

13. Though the second Rorschach shows less anxiety than the first, there is still a substantial amount of anxiety present. I believe that Helen would have a moderate to moderately high degree of anxiety in any situation in which her subjective conflicts, such as we have been discussing, are cued off.

14. It is perhaps needless to emphasize that we are not referring to a genuinely scientific and rational attitude toward anxiety and guilt feelings; we are rather speaking of intellectualizing as a defense, an attitude of rationalization rather than a rational attitude.

15. Total responses, 41: 6 M, 3 FM, 1 K, 22 F, 7 Fc, 1 C’, 1 CF; popular responses, 5; originals, 8; W% 10, D% 41, d% 24 1/2; Dd% 24 1/2; (H plus A): (Hd plus Ad) is 12:13.;) percentage of responses in wholly colored cards, 29; intelligence estimate from Rorschach: efficiency 115, potentiality 125.

16. This was not only evidenced in her attitudes toward her mother, but also in her present situation: she stated that whenever she now felt worried, she put the worry out of her mind by thinking about her fiancé and “what a nice future we will have.”

17. Compare, in this respect, with the case of Phyllis, who, at the price of impoverishment of personality, was able actually to escape anxiety by avoiding emotional involvement with other persons.

18. Total responses, 13: 6 M, 2 FM (5 additional m), 2 F, 1 Fc, 2 CF; popular responses 3, originals 7; W% 62, D% 30; Dd% 8. Intelligence estimate; potentiality 120, efficiency 110.

19. Total responses, 22: 1 K, 11 F, 4 Fc, 1 c, 3 FC, 2 CF; W% 45, D% 55; popular responses 2, originals 4. Intelligence estimate from Rorschach: potentiality 100, efficiency 100.

20. The quantity of anxiety on the childhood list seems partly to be a function of Louise’s conscientiousness and her considerable desire to please the psychologist, in whose study she wished to cooperate. (See subsequent discussion of her being a deferential, compliant personality with people she considered her “superiors.”) The “present anxiety” check-list, filled out in the presence of a social worker, seems to be a fairer indication of her quantity of anxiety.

21. Total responses, 20: 1 M, 5 FM, 3 FK, 7 F, 2 Fc, 2 FC, popular responses 4, originals 2; W% 50, D% 40; S% 10; percentage of responses in last three cards, 25. Intelligence estimate: potentiality 115, efficiency 100. (This accords with an I.Q. of 101, from the report of psychometric tests given Bessie at the Children’s Court during her stay at Walnut House.)

22. It will be noted several times in these cases that the quantity of items checked on these lists seemed to be partly a function of the conforming, compliant tendencies of the girl in question (i.e., her being influenced by the belief that checking a large number would please me, the psychologist). The fact that Bessie did not check many items is support of this hypothesis in the respect that she was not a conforming type but was relatively self-assertive and was not noticeably influenced by the need to please other people.

23. It turned out not to be necessary that she go to court in the father’s trial, and she carried through the second instance successfully when the social worker and foster mother went with her.

24. Response to Card I: W-F-A-P; to Card II: W-M-H-P; to Card VIII: D→W-FM-A-P. In the testing-the-limits phase, she revealed she could use the color and also could employ the details of the blots without difficulty. This phase of the test corroborated the above hypothesis that the disturbance was not psychotic or due to organic deterioration but rather to severe psychological conflict. Dolores had a slight handicap in the use of the English language, but it was clear that this did not materially contribute to her block on the Rorschach, since the responses she did give, as well as her answers to the tester, were made entirely intelligibly.

25. It would have been desirable to take a Rorschach directly after the “confession,” but this was not possible. We assume it is amply demonstrated in her behavior, however, that the radical change occurred at the time of her telling the truth about her pregnancy.

26. Total responses, 15: 2 M, 4 FM, 8 F, 1 FC; A% 60; popular responses 4, no originals; W% 33, D% 60, d% 7; total time 14', as compared to 35' on first Rorschach. Intelligence could not be estimated on the first record; on this one it is: potentiality 110, efficiency 90 to 100. (Her intelligence tests in the New York schools—fifth grade—indicated an I.Q. of 80, but this was considered unreliable because of her language handicap.)

27. It is significant that her first two check-lists, taken when she was in her period of paralyzing conflict, show a fairly high degree of response (i.e., a large number of items checked), whereas in the same period she refused to respond to the Rorschach. The plausible explanation seems to be that one knows what one is saying on the check-lists; there is no danger of unwittingly revealing her secret. Hence the check-lists would not be a threat to Dolores.

28. This rating of moderately low anxiety, based on the second Rorschach and her behavior after the relief of the conflict, is taken as our base in comparing Dolores with the other girls in the concluding chapter.

29. Total responses, 39: 2 M, 1 FM, 2 K, 18 F, 13 Fc, 1 c, 1 FC, 1 CF; total percentage in F area 80; W% 15, D% 59, d% 5, Dd% 21; (H plus A): (Hd plus Ad) equals 9: 14; popular responses 5, originals 3. Intelligence estimate: efficiency 110, potentiality 115.

30. My feeling in working on these notes was one of wanting to explode.

31. Total responses, 37: 2 M, 4 FM, 1 k, 4 K, 21 F, 3 Fc, 1 c, 1 CF; percentage in F area, 65; popular responses 6, originals 7; percentage of responses in Cards VIII, IX, and X, 51; only one H response in entire record; succession rigid; W% 16, D% 68, d% 8, dd% 8. Intelligence estimate: efficiency 110, potentiality 125.

32. Though the crucial element in Charlotte’s Rorschach was the rationally distorted responses, we are including the numerical scoring because that has been our form of presentation with the other cases. Total responses, 36: 9 M, 4 FM, 4 FK, 9 F, 3 Fc, 4 FC, 3 CF; average time per response, 1'45"; popular responses 8, originals 7; W% 44, D% 42, d% 3, Dd % 11.

33. We are, of course, speaking here only of the forms of psychosis which are psychogenic—i.e., have their origin in subjective, psychological conflict rather than organic deterioration. The general statement that these psychotic states are characterized by a lack of anxiety is not contradicted by the fact that anxiety is present in some forms of paranoia; the latter is a different configuration within the general pattern.

34. Total responses, 22: 1 M, 6 FM, 1 K, 3 FK, 5 F, 1 Fc, 1FC, 4 CF; popular responses 6, originals 4; W% 50, D% 50. Intelligence estimate: potentiality 120, efficiency 110.

35. The fact that the W% on the Rorschach was not high is a corroborating datum for the statement that her ambition was not aggressively competitive.

36. Total responses, 40: 1 M, 6 FM, 1 FK, 14 F, 10 Fc, 2 FC' 6 FC; W% 20, D% 70, Dd% 5, S% 5; popular responses 5, originals 15. Intelligence estimate: potentiality 110, efficiency 110.

37. Total responses, 12: 1 M, 5 F, 2 Fc, 2 FC, 1 CF, 1 C; popular responses 4, no originals: W% 67, D% 33. Intelligence estimate: potentiality 100, efficiency 100 (or less).

38. I am assuming the internalized expectations of Ada and her mother’s authoritative rules and standards are very much the same thing.

39. Total responses, 23: 3 M, 6 FM, 5 F, 6 Fc, 3 FC; A% 70; popular responses 6, originals 6; W% 39, D% 61; average reaction time, 2', 17"; percentage of responses in last three cards, 48. Intelligence estimate: potentiality 125, efficiency 110.

10. GLEANINGS FROM THE CASE STUDIES

1. Cases of Brown, Helen, Nancy, Ada, Agnes, Hester, Frances, Irene, and, most dramatically, Dolores.

2. Though the case of Brown is not in this series of unmarried mothers, it is illuminating to note that he exhibited the same conscious incapacity to see his mother as the tyrannical person she was, but interpreted her dominating acts as “loving” behavior. The conflict this involves is seen clearly in the respect that his dreams revealed that on a deeper level he actually was aware of her as dominating and tyrannical.

3. This is the ground for assuming a causal relationship between the rejection by parents, which generally occurs significantly in the early years, with present predisposition to neurotic anxiety. The a priori rationale behind such an assumption of causality has been given in previous chapters (along with the clinical data supporting the assumption) in the discussion of the viewpoints of Sullivan, Horney, Fromm, and, in fact, practically every psychoanalytic writer from Freud onward. All the above reasoning presupposes a continuity in individual character structure.

4. Curiously, this insight in 1950 is a prediction of the double-bind, formulated chiefly by Gregory Bateson later in the middle 1950’s. I have talked this over with Bateson since that time. He compared the situation with Darwin and Wallace—Darwin (Bateson) saw the breadth of the application of the new idea, and Wallace (me) did not. It is certainly true that I was not aware of the universal application of the concept at that time. It is also true that certain seminal ideas are “in the air” at certain times, as expressions of the “collective unconscious” of the age. They come out in a number of different thinkers more or less simultaneously. I suppose the “genius” is the one who recognizes the significance of the fish he has caught.

5. Cf. Kardiner’s point that the stage is set for the development of neurotic anxiety in Western man’s psychological growth pattern by, among other things, the inconsistency in the parental training of the children (Chapter 7 above).

6. If the rejection is complete—if, that is, the child in its infant months has no experience of relatedness, even of a hostile nature, with parents or parent surrogates—the result is the psychopathic personality. This type is also characterized by a lack of neurotic anxiety. The reader may remember that we had to rule out this possibility with Louise and Bessie. For an excellent discussion of this point, see Lauretta Bender, Anxiety in disturbed children, paper delivered at the American Psychopathological Association symposium on anxiety, June 4, 1949, published in the proceedings of that symposium, Paul Hoch and Joseph Zubin, Anxiety (New York, 1950).

7. These findings are contained in a summary of an unpublished paper, Some conditions of love in childhood, by Anna Hartoch Schachtel, March, 1943.

8. Donald W. MacKinnon, A topical analysis of anxiety, Character & Pers., 1944, 12:3, 163–76.

11. METHODS OF DEALING WITH ANXIETY

1. Blaise Pascal, Pensées (italics mine).

2. Bourne, Rosen, and Mason, Urinary 17-OHC Levels, reprinted from the Archives of General Psychiatry, August 1967, 17, 104–10.

3. Ibid., 138.

4. Ibid., 137.

5. Henrik Ibsen, Peer Gynt, trans. Michael Meyer (Garden City, N.Y., 1963), p. 16.

6. Ibid., p. 34.

7. See his Character analysis: principles and technique for psychoanalysis in practice and training, trans. T. P. Wolfe (New York, 1945).

8. Jerome Kagan, Psychosocial development of the child. In Frank Falkner, Human development (Philadelphia, 1966).

9. Irving Janis of Yale, in his study of persons in a hospital about to go into operation, found that those who had “no anxiety” and those who had excessive anxiety both fared poorly. Those who fared best were the ones who had a moderate amount of anxiety and performed what Janis calls their “work of worrying” adequately. (Cf. Psychological stress [New York, 1974].)

10. R. R. Grinker and S. P. Spiegel, Men under stress (Philadelphia, 1945).

11. Op. cit., p. 126.

12. Erich Fromm, Man for himself, an inquiry into the psychology of ethics (New York, 1947).

13. Both Freud’s critical attitude toward religious formulations and his own passionate devotion to science as the means of attaining human happiness are given in his two books: The future of an illusion (London and New York, 1961) and Civilization and its discontents (London and New York, 1961).

12. ANXIETY AND THE DEVELOPMENT OF THE SELF

1. E. Paul Torrance, Comparative studies of the stress-seeking in the imaginative stories of preadolescents in twelve different subcultures, in Samuel Klausner (ed.), Why man takes chances: studies in stress seeking (New York, 1968).

2. These two rankings were done by Dr. Bruno Klopfer, a Rorschach expert. The intelligence potentiality is based upon the Rorschach and is to be distinguished from efficiency of intelligence. It is very doubtful whether results from tests which measure efficiency of intelligence would be useful in the present problem.

3. “I might be anxious” is simply a less intense form of “I am anxious.”

4. In the case discussion of Sarah it was pointed out that, for her, extramarital pregnancy was not so much of an anxiety-creating situation as it was for the white women. Hence it is doubtful whether much weight should be given to her as the exception in these comparisons.

5. See p. 52.

6. As a demonstration of the relation of anxiety to intelligence, Amen and Renison’s study of children’s fears concluded that the more intelligent child can recall frightening experiences vividly and project them into the future as potential sources of threat. E. N. Amen and N. Renison, A study of the relationship between play patterns and anxiety in children, Gen. Psychol. Mon., 1954, 50, 3–41.

7. Kristen Kjerulff and Nancy Wiggins, Graduate students style for coping with stressful situations, J. of Ed. Psych., 1976, 68 (3), 247–254.

8. John Simpowski, The relationship of stress and creativity to cognitive performance. Diss. Abs. Int., 1973, 34 (5–A), 2399.

9. J. P. Denny, Effects of anxiety and intelligence on concept formation. Journ. of Exp. Psych., 1966, 72, 596–602.

10. From Brain-Mind Bulletin, January 3, 1977, 2 (4).

11. W. D. Fenz and S. Epstein, Gradients of physiological arousal in parachutists as a function of an approaching jump, Psychosom. Medicine, 1967, 29, 33–51.

12. See Liddell, p. 52.

13. Søren, Kierkegaard, Sickness unto Death, trans. Walter Lowrie (Princeton, N.J., 1941), p. 52.