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From her six years of experience in the British Emergency Medical Services during World War II, Elizabeth Zetzel (1949) has distilled observations pertaining to individual differences in the capacity to bear anxiety. Special characteristics of wartime experience focus attention on this variability. As the soldier responds to realistically appraised danger, it is necessary for him to function in a state of anxiety. He cannot afford to have his anxiety “blocked,” for it is vital to his survival that he be kept alert to threats in his life and ready for instant life-preserving action. He must not, however, become overwhelmed with his anxiety or it will interfere with his effectiveness. The function of the army psychiatrist is to improve or restore the overwhelmed soldier's ability to bear his emotional responses to the imminent danger situation in order to enable him to return to a life-threatening situation.
There is, in fact, an optimal level of anxiety for all activities, and, in some, the “fine tuning” that is necessary becomes especially conspicuóus. In psychoanalysis, for example, we are fundamentally committed to the evocation of affective responses. Once these emotions make their appearance, the patient must “handle” them. If the patient permits his emotions to build up to uncontrollable, threatening proportions, the analyst is confronted with a potential psychoanalytic emergency that may interrupt the therapeutic work (Peto, 1967). On the other hand, if the patient's fear of his emotions has led him to develop extensive disassociations of affect, or widespread affect inhibitions, psychoanalytic interpretation remains a mere cliché and its therapeutic potential is limited (Krystal, 1973).