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Most emotional tensions have a large component of hostility—in fact, of both parts of the fight-flight reaction—and seek expression in all the ways that hostility and flight do.
At one end of the scale there is direct acting out of the hostility, to others, or to self. For example, the student who shot and killed another student who had teased him, and the coed who threw herself in front of a train.
There is also the less direct acting out of the neurotic, psychotic and psychopathic personalities.
There are those in whom the hostility is acted out relatively little but experienced, rather, in psychotic and neurotic symptoms. The student just mentioned who shot another was found to have had two psychotic episodes previously; the hostility in these episodes disrupted his mental apparatus but spared a victim.
At the other end of the scale are psychosomatic symptoms, in which the hostility causes tensions that are so strongly repressed they produce minimal psychological symptoms, but disturb the physiology. Sometimes, hostility may be sublimated to socially useful ends. Tensions may also be dissipated in useless activities, harmful or harmless, such as smoking or drinking; they may seek outlets in pursuits which in moderation are beneficial, such as exercise, sex, reading, studying, playing a musical instrument; or they may be sublimated into high forms of creativity, including art and science. Like everything else in the mental and emotional life, beneficial or harmful, everything is mostly quantitative, a matter of degree.