In On the Genealogy of Morality, Nietzsche (2006) imagines a future figure who might liberate humanity from dominant moral constraints. Today, we feel the reverberations of this vision as various figures step into that role, many, troublingly, aligned with fascist and capitalist values. But what of the left, of Marxist or revolutionary traditions? And where does psychoanalysis position itself amid the anxiety and uncertainty of our current moment? Can potential allies be committed to building coalitions across difference, answering Audre Lorde's (1984) call for a ‘coalition within the house of difference’? This resonates with Hancock (2016) and Bohrer's vision of ‘group unity without group uniformity’ (Bohrer 2019, p. 255) and Elizabeth Cole's (2008) emphasis on organising around shared interests rather than shared identity. As Lorde (1984) writes, recognizing that ‘our wars are the same’ allows for a collective future that honours individual difference. The group becomes a mirror of the diversity within each of us. To imagine psychoanalysis as a ‘community yet to come’, as Nancy (1991) and Derrida (1994) suggest, we must engage with South American feminists and psychoanalysts like Carolina Besoain, Ana Minozzo (2023), and their comrades.
Ana C. Minozzo's Anxiety as Vibration offers a radical rethinking of anxiety through the lenses of psychoanalysis, philosophy, art theory, and medical humanities and community-building praxis. Challenging the medicalisation of anxiety, Minozzo critiques traditional psychiatric frameworks and proposes a ‘creative clinic’ (p. 2) that moves beyond Oedipal structures, centring affect, embodiment, and co-poiesis, the collaborative process of meaning-making.
Let's begin with a brief summary of the book, before interrogating some of the concepts in more depth, and concluding with a possibility that arises from the work of anxiety. In looking at the historical production of anxiety as a diagnostic category, Minozzo shows how anxiety was sidelined
and then reintroduced in a biomedicalised form alongside depression. Minozzo critiques how pharmaceutical and psychiatric institutions commodify anxiety, turning it into something to be managed rather than explored. She draws on Deleuze's notion of ‘dividualization’ to argue that contemporary psychiatry fragments and alienates the subject from their own experience.
While noting its limitations, Minozzo argues that psychoanalysis still offers vital insights into the unconscious and affect. She calls for reorienting the field towards inclusivity, creativity, and an embrace of multiplicity and uncertainty. Minozzo traces Freud's evolving views on anxiety – from repression to ego threat – highlighting inconsistencies and the limits of the Oedipal framework. Through Freud's letters and case studies, she uncovers alternative readings that open anxiety to more dynamic interpretations, ones in which anxiety is ‘ “naturalised” rather than “pathologised”, appearing as a dynamic relation to the body, the unconscious and stimuli’ (p. 91). Examining Lacan's theory of anxiety as emerging in relation to the Real, she critiques its phallocentrism. Drawing on Deleuze and Guattari, she reframes anxiety as vibrational – an affective rupture with transformative potential.
She proposes a ‘vibrational clinic’ that replaces interpretation with embodied, collective, and experimental practice. Inspired by feminist psychoanalysis, Lygia Clark, and South American feminists, she reframes anxiety as a generative ‘full-void’ and a force of becoming. Rejecting patriarchal and individualizing models, she envisions psychoanalysis as a communal, political, and accessible practice rooted in care and activism. Engaging with Deleuze and Guattari's affect theory, Minozzo reimagines anxiety as a generative force, with the emphasize on fluidity, relationality, and transformation beyond pathology. In the conclusion she calls for a reimagined psychoanalysis rooted in co-poiesis and creative engagement. Rather than eliminating anxiety, she sees it as a catalyst for new ways of being and relating.
While for some the book may appear too polemic, and for others not polemic enough, its critique is sharp and cutting. In particular, the chapter on the production of anxiety exposes how psychiatric systems manufacture
and monetise anxiety, stripping it of its social and political dimensions. This insight echoes Antze and Lambek's (1996) observation that trauma narratives serve to construct atomised identities. In this model, the modern subject becomes defined by bodily memory – we can include anxiety – as something owned and treated. Therapeutic authority reinforces this, rendering anxiety the property of biomedicine, managed through bodily techniques like medication, and overseen by experts who probe for psychic wounds through interrogation, confession, and physical examination.
Minozzo's turning to feminists is key: it enables her to create a more fluid conception of anxiety. Considering the work of Rosi Braidotti (2011), she draws upon the concept of nomadic subjectivity, which is relational and fluid, in constant motion, shaped by affective encounters and not confined to any universal, but which invites difference. This takes us beyond binaries, an affirmative and creative act. Suely Rolnik's (2021) concept of ‘pimping of Life’ (p. 220) is another key idea. It is a call to ‘come to the support of life’, in my terms, which is to say push back in the face of capitalism and colonial structures that extract, regulate, and commodify vitality. As with Fanon (2018), there is a call to overcome alienation, but for Rolnik it is by means of working with affect, sensation, and collective processes rather than reinforcing individualist and capitalist models of selfhood, sometimes a by-product of how analysis gets framed by certain discursive practices.
The challenge is to create a new species of life, as Fanon (2024) puts it at the end of The Wretched of the Earth. For Minozzo this call is for co-poiesis (from poiesis, meaning ‘creation’ or ‘bringing forth‘), collaborative, dynamic processes of creation and becoming, as opposed to some individual self-development model. Again, the emphasis is on relationality, affect, sensation and fluid non-hierarchical transformation. This aligns with theories of listening with the skin (Connor, 2004), embodied psychoanalysis, affect theory, and discussions of non-verbal, atmospheric and pre-discursive forms of attunement.
It is illuminating to read Minozzo alongside Chris Mawson's Psychoanalysis and Anxiety: From Knowing to Being (2020). Drawing on Bion's later work, Mawson frames anxiety not merely as a
symptom but as a threshold for transformation – an opening from ‘K’ (knowledge) to ‘O’ (being or ultimate truth) (Mawson, 2020, p. 12). This movement involves a surrender of certainty and invites closer contact with the unknown dimensions of the self. As Bion suggests, transformation in analysis arises not through interpretation alone, but through reverie – an open, receptive state in which the analyst metabolises affect and bears anxiety alongside the patient (Bion, 1962; Mawson, 2020, pp. 54–56).
Mawson emphasises that anxiety is not just something to be explained but something to be endured and experienced. Drawing on Heidegger's existential ontology – particularly the concept of the unheimlich (uncanny) – he foregrounds how anxiety reveals the subject's estrangement from themselves and from the world (Heidegger, 1962; Mawson, 2020, p. 85). He enriches this reading with Brecht's Verfremdungseffekt (alienation effect), advocating for a clinical approach that ‘makes the familiar strange’ and allows for the ‘inclusion of the third’ (Mawson, 2020, p. 179) – a space beyond the binary of analyst and patient where new meanings may emerge.
Clinically, Mawson argues for a stance of ‘being over knowing’. Rather than interpreting from a position of detached expertise, the analyst must be impacted by the patient's experience and remain present to both ontic (everyday) and ontological (existential) anxieties (Mawson, 2020, p. 137). As Frieda Fromm-Reichmann observed, ‘the patient needs an experience, not an explanation’ (Fromm-Reichmann, 1950, p. 42). Taking the patient's suffering seriously means resisting premature interpretation and staying with what is strange, disorienting, and not-yet-symbolised.
While both Minozzo and Mawson recognise the transformative potential of anxiety, their approaches differ significantly. Minozzo's work expands the understanding of anxiety into a collective realm, while Mawson focuses more on the therapeutic encounter and the shift from intellectual to embodied understanding of anxiety within the clinical space. Both highlight the relational aspects of anxiety, but Minozzo integrates a broader socio-political context, while Mawson focuses on the clinical and individual dimensions.
Minozzo also emphasises the importance of being with this unbearable state of being, the crossing through one's anxiety that is so central to Lacan's presentation (Minozzo, 2024, p. 142). She observes that for Lacan, anxiety is not an emotion but an affect, which enables a close relationship to what a subject is, their being, in Mawson's Heideggerian terms. At the same time there is subtle and important difference. Minozzo, following Lacan, observes that affect is not repressed, it drifts, floats, dislocated, entwined with the Real. Anxiety, for Lacan, is a question of desire, one in which there is the marriage of libido to the death drive, his re-framing of Inhibitions, Symptoms and Anxiety. Life, says Richard Klein (2000), following Lacan, does not want to be cured.
Minozzo's reading underscores that anxiety, rather than a disorder to be managed, is a force of becoming – demanding not mastery but presence (p. 158). Melanie Klein's observation that psychic growth emerges at the threshold of anxiety – visible in moments of hesitation, disruption, or destruction during a child's play – highlights a site of transformative potential (Klein, 1955). This is especially true when such moments are held within reverie, a state of open, receptive attention in the analyst, where the child's anxiety can be contained, metabolised, and symbolised (Bion, 1962).
While Minozzo does not explicitly align herself with Kleinian theory, and would likely resist the association, her emphasis on the creative potential of anxiety – and on affect being held in a shared space, what she terms co-poiesis – resonates with Klein's ideas of containment and transformation. Both perspectives recognise anxiety not as a symptom to eliminate, but as a generative force when received within a relational matrix that allows for its elaboration and movement.
Minozzo, though working through a Deleuzian and Lacanian-inflected lens, echoes this notion of transformation through contact with anxiety. In her reading of Clark's therapeutic practice, we encounter the theatre of the Kleinian body – vomiting, swallowing (p. 12) – that invite participants into a co-created space of affective intensity and transformation. Clark's phantasmatics of the body stage an encounter with anxiety as something to be lived through and reconfigured, not
cured or resolved. Anxiety discloses the raw immediacy of our existence, our longing to be, and the groundlessness of that being. It is in relation to others that we find the capacity to stay with this exposure, to bear the weight of what is, and who we are.
Minozzo introduces the concept of ‘vibration’ to describe the encounter with excessive affect that eludes full representation. Vibrations, a term that is referenced 176 times, speaks of a remainder that cannot be represented that leads us to a point of excess. This intensive moment crosses the body in the form of symptoms or affects. Minozzo draws upon feminism, as well the works of Deleuze and Guattari, Lacan, and Freud, to emphasize the transformative potential inherent in these intense experiences.
Minozzo highlights Lacan's central claim that anxiety is defined not by the absence but by the unsettling presence of the object. Contrary to theories that tie anxiety to loss or lack, Lacan insists that anxiety arises precisely when the structural gap that supports the subject's sense of self collapses. As he famously puts it, ‘anxiety isn't about the loss of the object, but its presence’ (Lacan, 2014, p. 53). The phrase ‘anxiety is not without an object’ thus signals an encounter with an object that is intolerably present – a disruption that overwhelms the subject. Richard Klein (1996) interprets this as a ‘lack of a lack,‘ a pure presence that forecloses the space of desire.
It would have been interesting to hear what she makes of the images Lacan uses to depict anxiety. What's striking in Lacan's Seminar on Anxiety is the profusion of vivid, often unsettling imagery that unfolds alongside, and at times in tension with, the discourse of the master. These images form a visual counter-current to his spoken word, offering another register through which anxiety speaks. Lacan revisits the sphinx and evokes scenes of passage to the act; he conjures Maupassant's Horla, the elusive agalma, a persistent bloodstain, and the movements of an insect tracing the Moebius strip. He turns to kleptomania, masochism, and objects like the Shofar, eggs, and the fragmented body in bits – eyes torn from sockets, breasts severed, eyes on a plate. Myths and fables populate the seminar: Don Juan, the Bodhisattva, the golden calf destroyed, the wizard of the
grotto, the three brothers. There is the praying mantis locked in mutual gaze, the blind man's vacant eye, the sun's fire, a lip encasing biting teeth, and pegs no longer fitting into their holes. God appears not as soul but as jouissance – alongside Juliette, amidst the horrors of 120 Days of Sodom – and even the unspeakable: the eating of one's own dead child. These images do not merely illustrate; they pulse and disrupt, forming a visceral topology of anxiety, where meaning drifts and affect gathers force.
Perhaps the most striking image Lacan offers is his elaboration on Isakower's depiction of the Palaemon – a sea creature that achieves balance by plugging itself with grains of sand. These grains are not produced internally but incorporated from the outside, stabilising the organism through foreign material. Lacan uses this image to illustrate the superego as an intrusive, omnipresent force – often experienced as an embodiment of the death drive, generating anxiety and unconscious guilt. Like the Palaemon, the subject incorporates something alien: the voice. This voice is not assimilated but incorporated, functioning to contour the void within the subject. Hence, Lacan notes (2014, pp. 8–9), our own voice often sounds strange to us – unfamiliar, dislocated, reverberating from somewhere outside ourselves, echoing into the Real.
In summary, anxiety can be understood as a mood – an affective state, like being submerged in a pool of water. For some, this feels like drowning, being lost at sea, or caught in a whirlwind of thoughts; for others, it may feel like an oceanic rebirth. Acute anxiety, however, is terror – urgent and transformative. It reshapes one's surroundings, brings a sense of looming catastrophe, and creates a suffocating space that exiles the person from their life, from others, and even from themselves. The world collapses inwards, becoming enclosed, with no room to move – no room to think. One is split off from oneself, dislocated, unmoored. Thoughts disintegrate, leaving no coherent links – yet paradoxically, there is a raw, unfiltered connection to the world, unmediated by psychic defenses. One feels disconnected and hyper-attuned at the same time, sensing that everything signifies something, though nothing specific.
One response to this altered state is agitation – pacing, grasping for distractions: food, alcohol, sex – anything to suppress the storm. Another
is paralysis – time freezes, and the self is transfixed in an endless, fracturing moment. Thoughts spiral, accelerating without anchor. Attempts at calming bring new associations, leaping across conventional paths, generating unfamiliar and unsettling ideas. Chris Oakley (2012, p. 174) calls this thinking without thought, that is ‘not think, but is a product of thought, indeed, can only have thoughts that have been implanted’, an architecture of a stage on which one is overtaken by the drama of another's mind. It is the madness of unresolved thought-knots, without solution, and yet it reveals a limit point – a threshold where rationality itself is brought into question.
The terror is existential – the fear of ceasing to exist, and the fear of continuing to exist. It may take years of analysis for someone to come to trust that they can survive this state. In time, anxiety, like all feelings, folds into something else. This realisation can be revelatory in the Jungian sense: the unveiling of a Self that extends beyond the ego, persona. Such transformation requires surrender – a trust in the process, a willingness to be carried by the experience. It involves entering transitional space – the ‘me’ and ‘not-me’ – and letting moments pass through, allowing one space to fold into another, sometimes called the third. Anxiety becomes a site of potential de-territorialisation, where boundaries blur and new relational constellations emerge: me and not-me and mother and self and teddy and image and smells, and sounds and thoughts AND …
Anxiety is a moment of crisis AND … potentiality. It destabilises the molar subject and opens towards transformation, both psychosocial and ontological. At this limit point of ‘being’ other possibilities of ‘becoming’ are opened in the experience of anxiety but at the same time existence as it is known – the sense of mastery, control and predicability – is put into question, with the possibility of either surrendering to the moment or remaining entrapped. Rephrasing in the language of existentialism, Rollo May talks of anxiety as arising from a tension between being and non-being – a signal of emerging potential. But as observed in clinical practice, the departing from the familiar – even when it brings suffering – can feel more threatening
than remaining trapped in self-defeating cycles. Familiarity, even when painful, becomes a comfort not because it alleviates suffering, but because its predictability offers a perverse kind of safety. Medard Boss describes it as a confrontation with the ‘death’ of an old way of being, often met with denial and retreat.
Minozzo notes that François Tosquelles took a radical approach to psychoanalysis, arguing that the proletariat should remain in contact with the unconscious rather than seek full consciousness as a route to emancipation. This position challenges Freud's early claim that bringing the unconscious into awareness would relieve suffering. In this light, staying true to the unconscious involves recognising that psychoanalysis does not merely theorise anxiety, it is embedded in it, inhabiting anxiety as the uncanny itself. Heidegger's concept of Dasein (being-there) deepens this view: it is both the nearest and the most distant to itself. This uncanny ex-istence is so unsettling because it reveals intensities that are profoundly intimate – yet obscured. It is what is most familiar and, at the same time, most hidden.
As Heidegger writes at the beginning of Being and Time: ‘Dasein is not only close to us – even that which is closest: we are it, each of us, we ourselves. In spite of this, or rather just for this reason, it is ontologically that which is furthest’ (Heidegger, 1962, p. 16). Dwelling, then, is paradoxically both within us and beyond us, hence anxiety. This uncanny ex-istence is so unsettling because it reveals intensities that are profoundly intimate yet external, as that which is most familiar and, at the same time, most hidden and unheimlich.
In the Unheimliche, or the uncanny, anxiety arises from secret knowledge that has surfaced – what was once hidden (heimlich) becomes unsettlingly familiar. As Freud describes, the uncanny emerges when something previously repressed returns in a distorted form, producing a sense of eerie familiarity (Freud, 1919). This surfacing evokes affect, particularly anxiety, as it confronts the subject with thoughts that feel external or intrusive – what Deleuze might call ‘thoughts from the outside’ (Deleuze, 1994, p. 139). Passing through anxiety, like experiencing a parapraxis (Freudian slip), opens a new perspective. Yet while parapraxes
reveal repressed thoughts, anxiety signals, for Freud, a threat to the ego, and for Lacan, an encounter with the Real. Anxiety is thus not the inverse of the Freudian slip, but its adjacent double – a moment where the subject begins to become other, forming a new unconscious assemblage in motion. In this sense, anxiety marks a crossing – a threshold at the edge of ego boundaries.
We can conceive of this vibration in Anxiety as Vibration: A Psychosocial Cartography as akin to a Möbius band as a way to capture the continuity and reversibility between the molar (structured, codified, socially legible) and the molecular (intensive, affective, unformed, or pre-symbolic). The twist of the band – where the surface folds and reverses – is precisely the vibrational point, the site of anxiety, where being is no longer stable, and becoming begins to flicker into view. This is the moment when the Real – unmediated, excessive, unsymbolisable – makes contact with the subject. In Minozzo's terms, vibration is not just metaphorical – it's an affective force, a remainder that cannot be represented or absorbed into the symbolic. In this reading, anxiety reveals the extimate nature of the psyche – Lacan's term that fuses intimacy and exteriority to suggest that what is most intimate is also radically Other, like a foreign body or an internal parasite (Miller, 2008).
Anxiety as a Vibration: A Psychosocial Cartography, by Ana , is an open-access book published by Palgrave Macmillan (2024),