Psychoanalysis

Anxiety is at the core of the psychoanalytic theory of affects (feelings), and from the beginning of psychoanalytic thought has been recognized as central to an understanding of mental conflict (for it is through bad feelings that conflicts are felt and known). In his early work, Freud, in keeping with his early discharge model of mental function, considered anxiety to be a "toxic transformation" of undischarged libido. This failure of discharge could either be physiological ("realistic"), as in coitus interruptus or other incomplete or unsatisfactory sexual practices, resulting in "actual neuroses" or "anxiety neuroses"; or it could arise from repression (or its failure), as a symptom of the continued pressure of unacceptable desires, which led to the "psychoneuroses"—hysterias and obsessions.

In 1926 Freud radically revised his ideas about anxiety, abandoning the distinction between neurotic and realistic anxiety, and the claim that repression caused anxiety. In this new theory, Freud distinguished two types of anxiety, a traumatic, reality-oriented "automatic" anxiety in which the system was overwhelmed, and a secondary, "neurotic" anxiety in which reprisals of these situations were anticipated, thus setting in motion defensive processes. "Automatic anxiety" was an affective reaction to the helplessness experienced during a traumatic experience. The prototype for this experience lay in the helplessness of the infant during and after birth, in which the danger proceeded from outside, and flooded a psychic system essentially unmediated by the (as yet unformed) ego.

The second form of anxiety originated within the psychical system and was mediated by the ego. This "signal anxiety" presaged the emergence of a new "danger situation" that would be a repetition of one of several earlier, "traumatic states." These states, whose prototype lay in birth, corresponded to the central preoccupations of different developmental levels, as the infant's needs become progressively abstracted from the original situation of immediate sensory overload to more sophisticated forms of need regulation capable of synthesizing the many elements facing it (from the reality and pleasure principles and the object world). These moments—loss of the object, loss of the object's love, the threat of castration, and the fear of punishment by the internalized objects of the superego—which were experienced serially during the developmental process, could reemerge at any time in a person's subsequent adult life, typically brought on by some conflation of reality and intrapsychic conflict, as a new edition of anxiety.

This new way of conceptualizing anxiety was an outgrowth of Freud's late revisions of his theory (c. 1923) with the structural theory and his formulation of the mediating agency of the ego, and it had the effect of shifting clinical work on anxiety into the realm of the ego. The correlation of the dangerous situations with developmental stages also suggested a diagnostic aspect to anxiety, with the earlier types of anxiety indicating earlier fixations. In the work of later theorists, the presence of the earliest anxieties in clinical work were thought to be indicative of pre-Oedipal disturbances in development, and of corresponding structural deficits in the ego.

Despite his later formulations, Freud never explicitly abandoned his first idea of anxiety, and the two theories continued to coexist uneasily in Freudian metapsychology long after Freud's death.