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"MY HEART KEEPS POUNDING AND POUNDING and I can't settle down …": a twenty-two-year-old young woman as she began to cry. Another woman, a thirty-year-old mother of a four-year-old child, abruptly sat up on the couch, saying, "I can't take any more; I've got to go." As she ran from the office, she acknowledged she was frightened, slammed shut the bathroom door, and "cried hysterically" in the dark. A man in his early forties started the hour with a sad look, saying, "I feel bad in my body too much—it's like getting an anxious feeling in the pit of my stomach when I try to avoid giving my ticket to the conductor."
In the quiet seclusion of the analytic office, all these people were suffering anxiety; they were afraid of something. I presume no one would take exception to the comment "[they] were suffering anxiety; they were afraid of something," yet this statement contains the source of unclarity, inconsistency, and confusion. A conscientious scan of the literature of fear and anxiety discloses no clear differentiation—the discussions are usually diligent, often profound and provocative, but nevertheless inconclusive (e.g. Freud 1936), (Goldstein 1963), (Arieti 1970), Sullivan 1953, (Horney 1937), (May 1977).1 Anxiety, as I view it, is fear that comes from danger to, or disruption of, the subjective sense one has while functioning, the familiar sense of me.
Goldstein (1963) describes anxiety as a sense of dissolution of the self. "The patient experiences the dissolution of the existence of his personality, as anxiety." It involves fear of a major disorganization of a usually voluntarily controlled vital functioning and anticipation of the psychic experience accompanying that disorganization—jointly,