The Predisposition to Anxiety

The considerations which I present have to do chiefly with the predisposition to anxiety and its relation to increased narcissism, especially in severe neuroses. I present these considerations largely in the form of questions rather than conclusions. The stages by which I arrived at these questions I give here in order to present the background of this paper: (1) the analysis of particularly severe neuroses in adults, (2) the searching for supportive or related data in the medical, psychiatric and psychoanalytic clinical experience of myself and others, (3) a supplementary review of some experimental work and observations, (4) a review of Freud's later publications concerning anxiety, especially The Problem of Anxiety, (5) and finally, a return to my own case material which I reviewed in the light of my questioning. For the sake of consolidating this presentation, however, I shall now take this circle of search in a little different order. I shall reserve the presentation of the case material for a subsequent paper in which I hope to discuss also some special considerations of treatment. I have chosen this order because I believe that the clinical material in itself is inevitably so detailed as to be possibly confusing unless the reader is already aware of the underlying thesis. In my work, however, the clinical material came first and the thesis was the result of my observations. In this paper I shall first discuss Freud's later statements concerning anxiety; I shall then present factual observations

From the New York Hospital and Department of Psychiatry, Cornell University Medical College, New York.

Read before The New York Psychoanalytic Society on March 12, 1940.

Editor's Note: This article was originally published in The Psychoanalytic Quarterly, Volume 10, Number 1 , pp. 66-94. According to the Quarterly's style at the time of first publication, reference information appears in footnotes rather than in a reference list at the end of the article. The Quarterly th