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This paper, translated here for the first time in English, was originally published in the Internationale Zeitschrift für Psychoanalyse, Vol. XXIII, 1937, pp. 339–359.
Fenichel reviews the theory of the origin of anxiety in infancy: id impulses, unable to utilize satisfying pathways of discharge, pour over into the vegetative nervous system where they are experienced as anxiety. Later anxiety is utilized by the ego as a signal to indicate that a situation is, in its judgment, dangerous. Usually, however, what was meant to be a mere danger signal, mobilizes great quantities of dammed up libido—libido which has been prevented from finding adequate discharge pathways—and then the infantile 'discharge in spite of everything' reënsues and a situation 'analogous to trauma' is recreated resulting in an 'anxiety attack'.
Fenichel then discusses at length the origins of the trauma: ultimately the fear of loss of love, fear of punishment and fear of the 'collapse of the ego' should the excitation reach the point of orgasm. The last fear is due in most instances to excessive sexual excitation in childhood—typically in primal scenes—during which the ego is flooded by id impulses and since, just as in the case of prohibitions, adequate discharge is impossible, a vegetative discharge ensues which is experienced as anxiety.
Thus it is the impossibility of satisfaction due to the recollection of such traumata which causes a constant damming up of libido. Mobilization of this libido creates a situation 'analogous to trauma' and anxiety attack takes the place of an orgasm. Aggression is inextricably bound up with sexual excitement and is (mis-) handled in the same manner: instead of a healthy discharge of anger, an anxiety attack.
Persons suffering from this conflict repetitively recreate anxiety situations, both in the hope of gaining complete satisfaction and in the hope of obtaining ego mastery over the excitement. These repetitions bring about a relative—though never economi