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Winnicott's paper “Fear of Breakdown” (1986) is, like much of his work, deceptively complex. His starting point is a particular symptom—the excessive fear of impending breakdown voiced by certain patients. But, in the course of delving to the roots of this fear, Winnicott touches upon several difficult and fundamental issues, such as the nature of the difference between neurosis and psychosis, and the origins of the ego. In addition, he outlines a sense of the word “unconscious” which is different to that usually implied by psychoanalytic use of the term.
In this paper I wish to concentrate on what Winnicott means by the term “primitive agony”, which he uses, in “Fear of Breakdown”, to describe an anxiety experienced by the ego at such an early stage that its fledgling defenses were unable to deal with it adequately. In order to discuss this idea I propose to examine, alongside it, a single chapter of Dostoevsky's The Brothers Karamazov (1977), which involves the appearance to Ivan Karamazov of a hallucinatory figure claiming to be the Devil. In this chapter Dostoevsky's writing powerfully conveys a sense of impending and painful madness as Ivan begins to lose his grip on his sense of reality. The text disturbs us—the readers—because we, as well as Ivan, are made to feel disconcerted, and are placed in a mad and painful position as spectators of the action. I shall argue that Dostoevsky achieves this by representing Ivan's lapse into and terror of psychosis in a way which closely corresponds with Winnicott's formulations.