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In the course of psychotherapeutic treatment anxiety is constantly present. In this constancy it differs from other neurotic symptoms, which appear and disappear in the varying expressions of the patients’ emotional conflicts. These conflicts take place between the unconscious or forgotten elements in character development; and between the unconscious and conscious elements. In the phenomenon of “transference” they also exist between patient and therapist. Whatever the changing forms of neurotic symptoms, anxiety is a continuous accompaniment. No psychotherapeutic interview is without this symptom, whether admitted by the patient or recognized in its unconscious manifestation by the therapist.
As a result, it is of essential importance that the therapist attempt to understand the nature of anxiety. How and when did it arise? What is its dynamic basis? What purpose, if any, did it originally serve, does it now serve? How can the patient be relieved of this burden?
It is with such questions in mind that the following suggestions are offered. They undoubtedly represent but a partial picture of the origin, significance and dispelling of this condition of suffering. As an outcome of observation during psychoanalytic practice, however, they invite discussion.
Anxiety is not an emotion in itself. We can speak of love, jealousy, fear or anger as emotions. We cannot so speak of anxiety. It is certain, however, that it has an emotional content; we feel anxious. But it is as an adverb to a verb: we may feel anxiously whether we love, are jealous, are fearful or are angry. It is a feeling tone, not in itself a feeling. It may accompany emotions of whatever kind; and it is a constant element in those who are its victims, no matter what emotion they are experiencing.
Anxiety is often confused with the emotion of fear and yet it is not synonymous. For fear is always justifiable and has an immediate factual causation. If we have abdominal pain we are afraid of ulcers or of an inflamed