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Dr. Alexander essentially makes two points: (a) anxiety associated with accomplishment may have roots other than the castration anxiety suggested by Freud; it also may be separation anxiety: (b) the threat is separation from fantasied omnipotence and total union with mother. The patient clings to an infantile ego ideal or its surrogate in the external world.
Dr. Alexander's patient reminded me of a very similar one who upon being offered an exciting academic opportunity turned it down with scorn and returned to his various nursing activities—sleeping, drinking and playing around with great ideas. His rationalization was that he “could not tolerate the idea of becoming a lesser light in the span of history.” A more likely cause was that any challenge in reality was threatening to his fantasies of omnipotence and aroused anxiety which he could not endure.
The importance of the problem to which Alexander addresses himself goes far beyond “those wrecked by success” (to use Freud's term) or those who avoid success. There is always some resistance to change even in the face of chronic misery and even with high probability of self-realization and pleasure. No one ever experiences a change which is really significant for him without some associated anxiety. Certainly every analyst is familiar with resistances to change, even when it is ardently desired. We have a tendency to remain in ruts partly because it is so painful when we try to get out of them.
Alexander makes a significant contribution when he asks if the avoidance of success or gratification has roots other than castration anxiety. I agree also that separation anxiety often is a paramount factor. One need only think of the frequent patient who clings to the therapist, no matter what the cost, rather than endure the ordeals and uncertainties of separation.
I propose still another factor. Any significant change inevitably puts a strain on the psychic apparatus. It disrupts whatever balance has been developed between ego