Freud - Complete Works (696 page)

Inhibitions, Symptoms And Anxiety

4283

   On a previous occasion I have
stated that phobias have the character of a projection in that they
replace an internal, instinctual danger by an external, perceptual
one. The advantage of this is that the subject can protect himself
against an external danger by fleeing from it and avoiding the
perception of it, whereas it is useless to flee from dangers that
arise from within. This statement of mine was not incorrect, but it
did not go below the surface of things. For an instinctual demand
is, after all, not dangerous in itself; it only becomes so inasmuch
as it entails a real external danger, the danger of castration.
Thus what happens in a phobia in the last resort is merely that one
external danger is replaced by another. The view that in a phobia
the ego is able to escape anxiety by means of avoidance or of
inhibitory symptoms fits in very well with the theory that that
anxiety is only an affective signal and that no alteration has
taken place in the economic situation.

   The anxiety felt in animal
phobias is, therefore, an affective reaction on the part of the ego
to danger; and the danger which is being signalled in this way is
the danger of castration. This anxiety differs in no respect from
the realistic anxiety which the ego normally feels in situations of
danger, except that its content remains unconscious and only
becomes conscious in the form of a distortion.

   The same will prove true, I
think, of the phobias of adults, although the material which their
neuroses work over is much more abundant and there are some
additional factors in the formation of the symptoms. Fundamentally
the position is identical. The agoraphobic patient imposes a
restriction on his ego so as to escape a certain instinctual danger
- namely, the danger of giving way to his erotic desires. For if he
did so the danger of being castrated, or some similar danger, would
once more be conjured up as it was in his childhood. I may cite as
an instance the case of a young man who became agoraphobic because
he was afraid of yielding to the solicitations of prostitutes and
of contracting a syphilitic infection from them as a
punishment.

Inhibitions, Symptoms And Anxiety

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   I am well aware that a number of
cases exhibit a more complicated structure and that many other
repressed instinctual impulses can enter into a phobia. But they
are only tributary streams which have for the most part joined the
main current of the neurosis at a later stage. The symptomatology
of agoraphobia is complicated by the fact that the ego does not
confine itself to making a renunciation. In order to rob the
situation of danger it does more: it usually effects a temporal
regression to infancy (in extreme cases, to a time when the subject
was in his mother’s womb and protected against the dangers
which threaten him in the present). Such a regression now becomes a
condition whose fulfilment exempts the ego from making its
renunciation. For instance, an agoraphobic patient may be able to
walk in the street provided he is accompanied, like a small child,
by someone he knows and trusts; or, for the same reason, he may be
able to go out alone provided he remains within a certain distance
of his own house and does not go to places which are not familiar
to him or where people do not know him. What these stipulations are
will depend in each case on the infantile factors which dominate
him through his neurosis. The phobia of being alone is unambiguous
in its meaning, irrespective of any infantile regression: it is,
ultimately, an endeavour to avoid the temptation to indulge in
solitary masturbation. Infantile regression can, of course, only
take place when the subject is no longer a child.

Inhibitions, Symptoms And Anxiety

4285

   A phobia generally sets in after
a first anxiety attack has been experienced in specific
circumstances, such as in the street or in a train or in solitude.
Thereafter the anxiety is held in ban by the phobia, but it
re-emerges whenever the protective condition cannot be fulfilled.
The mechanism of phobia does good service as a means of defence and
tends to be very stable. A continuation of the defensive struggle,
in the shape of a struggle against the symptom, occurs frequently
but not invariably.

   What we have learnt about anxiety
in phobias is applicable to obsessional neuroses as well. In this
respect it is not difficult for us to put obsessional neuroses on
all fours with phobias. In the former, the mainspring of all later
symptom-formation is clearly the ego’s fear of its super-ego.
The danger-situation from which the ego must get away is the
hostility of the super-ego. There is no trace of projection here;
the danger is completely internalized. But if we ask ourselves what
it is that the ego fears from the super-ego, we cannot but think
that the punishment threatened by the latter must be an extension
of the punishment of castration. Just as the father has become
depersonalized in the shape of the super-ego, so has the fear of
castration at his hands become transformed into an undefined social
or moral anxiety. But this anxiety is concealed. The ego escapes it
by obediently carrying out the commands, precautions and penances
that have been enjoined on it. If it is impeded in doing so, it is
at once overtaken by an extremely distressing feeling of discomfort
which may be regarded as an equivalent of anxiety and which the
patients themselves liken to anxiety.

   The conclusion we have come to,
then, is this. Anxiety is a reaction to a situation of danger. It
is obviated by the ego’s doing something to avoid that
situation or to withdraw from it. It might be said that symptoms
are created so as to avoid the generating of anxiety. But this does
not go deep enough. It would be truer to say that symptoms are
created so as to avoid a
danger-situation
whose presence has
been signalled by the generation of anxiety. In the cases that we
have discussed, the danger concerned was the danger of castration
or of something traceable back to castration.

Inhibitions, Symptoms And Anxiety

4286

   If anxiety is a reaction of the
ego to danger, we shall be tempted to regard the traumatic
neuroses, which so often follow upon a narrow escape from death, as
a direct result of a fear of death (or fear
for
life) and to
dismiss from our minds the question of castration and the dependent
relationships of the ego. Most of those who observed the traumatic
neuroses that occurred during the last war took this line, and
triumphantly announced that proof was now forthcoming that a threat
to the instinct of self-preservation could by itself produce a
neurosis without any admixture of sexual factors and without
requiring any of the complicated hypotheses of psycho-analysis. It
is in fact greatly to be regretted that not a single analysis of a
traumatic neurosis of any value is extant. And it is to be
regretted, not because such an analysis would contradict the
aetiological importance of sexuality - for any such contradiction
has long since been disposed of by the introduction of the concept
of narcissism, which brings the libidinal cathexis of the ego into
line with the cathexes of objects and emphasizes the libidinal
character of the instinct of self-preservation - but because, in
the absence of any analyses of this kind, we have lost a most
precious opportunity of drawing decisive conclusions about the
relations between anxiety and the formation of symptoms. In view of
all that we know about the structure of the comparatively simple
neuroses of everyday life, it would seem highly improbable that a
neurosis could come into being merely because of the objective
presence of danger, without any participation of the deeper levels
of the mental apparatus. But the unconscious seems to contain
nothing that could give any content to our concept of the
annihilation of life. Castration can be pictured on the basis of
the daily experience of the faeces being separated from the body or
on the basis of losing the mother’s breast at weaning. But
nothing resembling death can ever have been experienced; or if it
has, as in fainting, it has left no observable traces behind. I am
therefore inclined to adhere to the view that the fear of death
should be regarded as analogous to the fear of castration and that
the situation to which the ego is reacting is one of being
abandoned by the protecting super-ego - the powers of destiny - so
that it has no longer any safeguard against all the dangers that
surround it. In addition, it must be remembered that in the
experiences which lead to a traumatic neurosis the protective
shield against external stimuli is broken through and excessive
amounts of excitation impinge upon the mental apparatus; so that we
have here a second possibility - that anxiety is not only being
signalled as an affect but is also being freshly created out of the
economic conditions of the situation.

Inhibitions, Symptoms And Anxiety

4287

   The statement I have just made,
to the effect that the ego has been prepared to expect castration
by having undergone constantly repeated object-losses, places the
question of anxiety in a new light. We have hitherto regarded it as
an affective signal of danger; but now, since the danger is so
often one of castration, it appears to us as a reaction to a loss,
a separation. Even though a number of considerations immediately
arise which make against this view, we cannot but be struck by one
very remarkable correlation. The first experience of anxiety which
an individual goes through (in the case of human beings, at all
events) is birth, and, objectively speaking, birth is a separation
from the mother. It could be compared to a castration of the mother
(by equating the child with a penis). Now it would be very
satisfactory if anxiety, as a symbol of a separation, were to be
repeated on every subsequent occasion on which a separation took
place. But unfortunately we are prevented from making use of this
correlation by the fact that birth is not experienced subjectively
as a separation from the mother, since the foetus, being a
completely narcissistic creature, is totally unaware of her
existence as an object. Another adverse argument is that we know
what the affective reactions to a separation are: they are pain and
mourning, not anxiety. Incidentally, it may be remembered that in
discussing the question of mourning we also failed to discover why
it should be such a painful thing.

Inhibitions, Symptoms And Anxiety

4288

VIII

   The time has come to pause and
consider. What we clearly want is to find something that will tell
us what anxiety really is, some criterion that will enable us to
distinguish true statements about it from false ones. But this is
not easy to get. Anxiety is not so simple a matter. Up till now we
have arrived at nothing but contradictory views about it, none of
which can, to the unprejudiced eye, be given preference over the
others. I therefore propose to adopt a different procedure. I
propose to assemble, quite impartially, all the facts that we know
about anxiety without expecting to arrive at a fresh synthesis.

   Anxiety, then, is in the first
place something that is felt. We call it an affective state,
although we are also ignorant of what an affect is. As a feeling,
anxiety has a very marked character of unpleasure. But that is not
the whole of its quality. Not every unpleasure can be called
anxiety, for there are other feelings, such as tension, pain or
mourning, which have the character of unpleasure. Thus anxiety must
have other distinctive features besides this quality of unpleasure.
Can we succeed in understanding the differences between these
various unpleasurable affects?

   We can at any rate note one or
two things about the feeling of anxiety. Its unpleasurable
character seems to have a note of its own - something not very
obvious, whose presence is difficult to prove yet which is in all
likelihood there. But besides having this special feature which is
difficult to isolate, we notice that anxiety is accompanied by
fairly definite physical sensations which can be referred to
particular organs of the body. As we are not concerned here with
the physiology of anxiety, we shall content ourselves with
mentioning a few representatives of these sensations. The clearest
and most frequent ones are those connected with the respiratory
organs and with the heart. They provide evidence that motor
innervations - that is, processes of discharge - play a part in the
general phenomenon of anxiety.

Inhibitions, Symptoms And Anxiety

4289

   Analysis of anxiety-states
therefore reveals the existence of (1) a specific character of
unpleasure, (2) acts of discharge and (3) perceptions of those
acts. The two last points indicate at once a difference between
states of anxiety and other similar states, like those of mourning
and pain. The latter do not have any motor manifestation; or if
they have, the manifestation is not an integral part of the whole
state but is distinct from it as being a result of it or a reaction
to it. Anxiety, then, is a special state of unpleasure with acts of
discharge along particular paths. In accordance with our general
views we should be inclined to think that anxiety is based upon an
increase of excitation which on the one hand produces the character
of unpleasure and on the other finds relief through the acts of
discharge already mentioned. But a purely physiological account of
this sort will scarcely satisfy us. We are tempted to assume the
presence of a historical factor which binds the sensations of
anxiety and its innervations firmly together. We assume, in other
words, that an anxiety-state is the reproduction of some experience
which contained the necessary conditions for such an increase of
excitation and a discharge along particular paths, and that from
this circumstance the unpleasure of anxiety receives its specific
character. In man, birth provides a prototypic experience of this
kind, and we are therefore inclined to regard anxiety-states as a
reproduction of the trauma of birth.