last lecture most fragmentary and unsatisfactory information. I know
this, and I think you were probably most surprised that I did not
mention fear, which most nervous people complain of and describe as
their greatest source of suffering. It can attain a terrible intensity
which may result in the wildest enterprises. But I do not wish to fall
short of your expectations in this matter. I intend, on the contrary, to
treat the problem of the fear of nervous people with great accuracy and
to discuss it with you at some length.
Fear itself needs no introduction; everyone has at some time or other
known this sensation or, more precisely, this effect. It seems to me
that we never seriously inquired why the nervous suffered so much more
and so much more intensely under this condition. Perhaps it was thought
a matter of course; it is usual to confuse the words "nervous" and
"anxious" as though they meant the same thing. That is unjustifiable;
there are anxious people who are not nervous, and nervous people who
suffer from many symptoms, but not from the tendency to anxiety.
However that may be, it is certain that the problem of fear is the
meeting point of many important questions, an enigma whose complete
solution would cast a flood of light upon psychic life. I do not claim
that I can furnish you with this complete solution, but you will
certainly expect psychoanalysis to deal with this theme in a manner
different from that of the schools of medicine. These schools seem to be
interested primarily in the anatomical cause of the condition of fear.
They say the medulla oblongata is irritated, and the patient learns that
he is suffering from neurosis of the nervus vague. The medulla
oblongata is a very serious and beautiful object. I remember exactly how
much time and trouble I devoted to the study of it, years ago. But today
I must say that I know of nothing more indifferent to me for the
psychological comprehension of fear, than knowledge of the nerve passage
through which these sensations must pass.
One can talk about fear for a long time without even touching upon
nervousness. You will understand me without more ado, when I term this
fear _real_ fear in contrast to _neurotic_ fear. Real fear seems quite
rational and comprehensible to us. We may testify that it is a reaction
to the perception of external danger, viz., harm that is expected and
foreseen. It is related to the flight reflex and may be regarded as an
expression of the instinct of self-preservation. And so the occasions,
viz., the objects and situations which arouse fear, will depend largely
on our knowledge of and our feeling of power over the outer world. We
deem it quite a matter of course that the savage fears a cannon or an
eclipse of the sun, while the white man, who can handle the instrument
and prophesy the phenomenon, does not fear these things. At other times
superior knowledge promulgates fear, because it recognizes the danger
earlier. The savage, for instance, will recoil before a footprint in the
woods, meaningless to the uninstructed, which reveals to him the
proximity of an animal of prey; the experienced sailor will notice a
little cloud, which tells him of a coming hurricane, with terror, while
to the passenger it seems insignificant.
After further consideration, we must say to ourselves that the verdict
on real fear, whether it be rational or purposeful, must be thoroughly
revised. For the only purposeful behavior in the face of imminent danger
would be the cool appraisal of one's own strength in comparison with the
extent of the threatening danger, and then decide which would presage a
happier ending: flight, defense, or possibly even attack. Under such a
proceeding fear has absolutely no place; everything that happens would
be consummated just as well and better without the development of fear.
You know that if fear is too strong, it proves absolutely useless and
paralyzes every action, even flight. Generally the reaction against
danger consists in a mixture of fear and resistance. The frightened
animal is afraid and flees. But the purposeful factor in such a case is
not fear but flight.
We are therefore tempted to claim that the development of fear is never
purposeful. Perhaps closer examination will give us greater insight into
the fear situation. The first factor is the expectancy of danger which
expresses itself in heightened sensory attention and in motor tension.
This expectancy is undoubtedly advantageous; its absence may be
responsible for serious consequences. On the one hand, it gives rise to
motor activity, primarily to flight, and on a higher plane to active
defense; on the other hand, it gives rise to something which we consider
the condition of fear. In so far as the development is still incipient,
and is restricted to a mere signal, the more undisturbed the conversion
of the readiness to be afraid into action the more purposeful the entire
proceeding. The readiness to be afraid seems to be the purposeful
aspect; evolution of fear itself, the element that defeats its own
object.
I avoid entering upon a discussion as to whether our language means the
same or distinct things by the words anxiety, fear or fright. I think
that anxiety is used in connection with a condition regardless of any
objective, while fear is essentially directed toward an object. Fright,
on the other hand, seems really to possess a special meaning, which
emphasizes the effects of a danger which is precipitated without any
expectance or readiness of fear. Thus we might say that anxiety protects
man from fright.
You have probably noticed the ambiguity and vagueness in the use of the
word "anxiety." Generally one means a subjective condition, caused by
the perception that an "evolution of fear" has been consummated. Such a
condition may be called an emotion. What is an emotion in the dynamic
sense? Certainly something very complex. An emotion, in the first place,
includes indefinite motor innervations or discharges; secondly, definite
sensations which moreover are of two kinds, the perception of motor
activities that have already taken place, and the direct sensations of
pleasure and pain, which give the effect of what we call its feeling
tone. But I do not think that the true nature of the emotion has been
fathomed by these enumerations. We have gained deeper insight into some
emotions and realize that the thread which binds together such a complex
as we have described is the repetition of a certain significant
experience. This experience might be an early impression of a very
general sort, which belongs to the antecedent history of the species
rather than to that of the individual. To be more clear: the emotional
condition has a structure similar to that of an hysterical attack; it is
the upshot of a reminiscence. The hysteric attack, then, is comparable
to a newly formed individual emotion, the normal emotion to an hysteria
which has become a universal heritage.
Do not assume that what I have said here about emotions is derived from
normal psychology. On the contrary, these are conceptions that have
grown up with and are at home only in psychoanalysis. What psychology
has to say about emotions--the James-Lange theory, for instance--is
absolutely incomprehensible for us psychoanalysts, and cannot be
discussed. Of course, we do not consider our knowledge about emotions
very certain; it is a preliminary attempt to become oriented in this
obscure region. To continue: We believe we know the early impression
which the emotion of fear repeats. We think it is birth itself which
combines that complex of painful feelings, of a discharge of impulses,
of physical sensations, which has become the prototype for the effect of
danger to life, and is ever after repeated within us as a condition of
fear. The tremendous heightening of irritability through the
interruption of the circulation (internal respiration) was at the time
the cause of the experience of fear; the first fear was therefore toxic.
The name anxiety--angustial--narrowness, emphasizes the characteristic
tightening of the breath, which was at the time a consequence of an
actual situation and is henceforth repeated almost regularly in the
emotion. We shall also recognize how significant it is that this first
condition of fear appeared during the separation from the mother. Of
course, we are convinced that the tendency to repetition of the first
condition of fear has been so deeply ingrained in the organism through
countless generations, that not a single individual can escape the
emotion of fear; not even the mythical Macduff who was "cut out of his
mother's womb," and therefore did not experience birth itself. We do not
know the prototype of the condition of fear in the case of other
mammals, and so we do not know the complex of emotions that in them is
the equivalent of our fear.
Perhaps it will interest you to hear how the idea that birth is the
source and prototype of the emotion of fear, happened to occur to me.
Speculation plays the smallest part in it; I borrowed it from the native
train of thought of the people. Many years ago we were sitting around
the dinner table--a number of young physicians--when an assistant in the
obstetrical clinic told a jolly story of what had happened in the last
examination for midwives. A candidate was asked what it implied if
during delivery the foeces of the newborn was present in the discharge
of waters, and she answered promptly "the child is afraid." She was
laughed at and "flunked." But I silently took her part and began to
suspect that the poor woman of the people had, with sound perception,
revealed an important connection.
Proceeding now to neurotic fear, what are its manifestations and
conditions? There is much to be described. In the first place we find a
general condition of anxiety, a condition of free-floating fear as it
were, which is ready to attach itself to any appropriate idea, to
influence judgment, to give rise to expectations, in fact to seize any
opportunity to make itself felt. We call this condition "expectant fear"
or "anxious expectation." Persons who suffer from this sort of fear
always prophesy the most terrible of all possibilities, interpret every
coincidence as an evil omen, and ascribe a dreadful meaning to all
uncertainty. Many persons who cannot be termed ill show this tendency to
anticipate disaster. We blame them for being over-anxious or
pessimistic. A striking amount of expectant fear is characteristic of a
nervous condition which I have named "anxiety neurosis," and which I
group with the true neuroses.
A second form of fear in contrast to the one we have just described is
psychologically more circumscribed and bound up with certain objects or
situations. It is the fear of the manifold and frequently very peculiar
phobias. Stanley Hall, the distinguished American psychologist, has
recently taken the trouble to present a whole series of these phobias in
gorgeous Greek terminology. They sound like the enumeration of the ten
Egyptian plagues, except that their number exceeds ten, by far. Just
listen to all the things which may become the objects of contents of a
phobia: Darkness, open air, open squares, cats, spiders, caterpillars,
snakes, mice, thunder-storms, sharp points, blood, enclosed spaces,
crowds, solitude, passing over a bridge, travel on land and sea, etc. A
first attempt at orientation in this chaos leads readily to a division
into three groups. Some of the fearful objects and situations have
something gruesome for normal people too, a relation to danger, and so,
though they are exaggerated in intensity, they do not seem
incomprehensible to us. Most of us, for instance, experience a feeling
of repulsion in the presence of a snake. One may say that snakephobia is
common to all human beings, and Charles Darwin has described most
impressively how he was unable to control his fear of a snake pointing
for him, though he knew he was separated from it by a thick pane of
glass. The second group consists of cases which still bear a relation to
danger, but this is of a kind which we are disposed to belittle rather
than to overestimate. Most of the situation-phobia belong here. We know
that by taking a railroad journey we entail greater chance of disaster
than by staying at home. A collision, for instance, may occur, or a ship
sink, when as a rule we must drown; yet we do not think of these
dangers, and free from fear we travel on train and boat. We cannot deny
that if a bridge should collapse at the moment we are crossing it, we
would fall into the river, but that is such a rare occurrence that we do
not take the danger into account. Solitude too has its dangers and we
avoid it under certain conditions; but it is by no means a matter of
being unable to suffer it for a single moment. The same is true for the
crowd, the enclosed space, the thunder-storm, etc. It is not at all the
content but the intensity of these neurotic phobias that appears strange
to us. The fear of the phobia cannot even be described. Sometimes we
almost receive the impression that the neurotic is not really afraid of
the same things and situations that can arouse fear in us, and which he
calls by the same name.
There remains a third group of phobias which is entirely unintelligible
to us. When a strong, adult man is afraid to cross a street or a square
of his own home town, when a healthy, well-developed woman becomes
almost senseless with fear because a cat has brushed the hem of her
dress or a mouse has scurried through the room--how are we to establish
the relation to danger that obviously exists under the phobia? In these
animal phobias it cannot possibly be a question of the heightening of
common human antipathies. For, as an illustration of the antithesis,
there are numerous persons who cannot pass a cat without calling and
petting it. The mouse of which women are so much afraid, is at the same
time a first class pet name. Many a girl who has been gratified to have
her lover call her so, screams when she sees the cunning little creature
itself. The behavior of the man who is afraid to cross the street or the
square can only be explained by saying that he acts like a little child.
A child is really taught to avoid a situation of this sort as dangerous,
and our agoraphobist is actually relieved of his fear if some one goes
with him across the square or street.
The two forms of fear that have been described, free-floating fear and
the fear which is bound up with phobias, are independent of one another.
The one is by no means a higher development of the other; only in
exceptional cases, almost by accident, do they occur simultaneously. The
strongest condition of general anxiety need not manifest itself in
phobias; and persons whose entire life is hemmed in by agoraphobia can
be entirely free of pessimistic expectant fear. Some phobias, such as
the fear of squares or of trains, are acquired only in later life, while
others, the fear of darkness, storms and animals, exist from the very
beginning. The former signify serious illness, the latter appear rather
as peculiarities, moods. Yet whoever is burdened with fear of this
second kind may be expected to harbor other and similar phobias. I must
add that we group all these phobias under _anxiety hysteria_, and
therefore regard it as a condition closely related to the well-known
conversion hysteria.
The third form of neurotic fear confronts us with an enigma; we loose
sight entirely of the connection between fear and threatening danger.
This anxiety occurs in hysteria, for instance, as the accompaniment of
hysteric symptoms, or under certain conditions of excitement, where we
would expect an emotional manifestation, but least of all of fear, or
without reference to any known circumstance, unintelligible to us and to
the patient. Neither far nor near can we discover a danger or a cause
which might have been exaggerated to such significance. Through these
spontaneous attacks we learn that the complex which we call the
condition of anxiety can be resolved into its components. The whole
attack may be represented by a single intensively developed symptom,
such as a trembling, dizziness, palpitation of the heart, or tightening
of breath; the general undertone by which we usually recognize fear may
be utterly lacking or vague. And yet these conditions, which we
describe as "anxiety equivalents," are comparable to anxiety in all its
clinical and etiological relations.
Two questions arise. Can we relate neurotic fear, in which danger plays
so small a part or none at all, to real fear, which is always a reaction
to danger? And what can we understand as the basis of neurotic fear? For
the present we want to hold to our expectations: "Wherever there is
fear, there must be a cause for it."
Clinical observation yields several suggestions for the comprehension of
neurotic fear, the significance of which I shall discuss with you.
1. It is not difficult to determine that expectant fear or general
anxiety is closely connected with certain processes in sexual life, let
us say with certain types of libido. Utilization, the simplest and most
instructive case of this kind, results when persons expose themselves to
frustrated excitation, viz., if their sexual excitation does not meet
with sufficient relief and is not brought to a satisfactory conclusion,
in men, during the time of their engagement to marry, for instance, or
in women whose husbands are not sufficiently potent or who, from
caution, execute the sexual act in a shortened or mutilated form. Under
these circumstances libidinous excitement disappears and anxiety takes
its place, both in the form of expectant fear and in attacks and anxiety
equivalents. The cautious interruption of the sexual act, when practiced
as the customary sexual regime, so frequently causes the anxiety
neurosis in men, and especially in women, that physicians are wise in
such cases to examine primarily this etiology. On innumerable occasions
we have learned that anxiety neurosis vanishes when the sexual misuse is
abandoned.
So far as I know, the connection between sexual restraint and conditions
of anxiety is no longer questioned even by physicians who have nothing
to do with psychoanalysis. But I can well imagine that they do not
desist from reversing the connection and saying that these persons have
exhibited a tendency to anxiety from the outset and therefore practice
reserve in sexual matters. The behavior of women whose sexual conduct is
passive, viz., is determined by the treatment of the husband,
contradicts this supposition. The more temperamental, that is, the more
disposed toward sexual intercourse and capable of gratification is the
woman, the more will she react to the impotence of the man, or to the
_coitus interruptus_, by anxiety manifestations. In anaesthetic or only
slightly libidinous women, such misuse will not carry such consequences.
Sexual abstinence, recommended so warmly by the physicians of to-day,
has the same significance in the development of conditions of anxiety
only when the libido, to which satisfactory relief is denied, is
sufficiently strong and not for the most part accounted for by
sublimation. The decision whether illness is to result always depends
upon the quantitative factors. Even where character formation and not
disease is concerned, we easily recognize that sexual constraint goes
hand in hand with a certain anxiety, a certain caution, while
fearlessness and bold daring arise from free gratification of sexual
desires. However much these relations are altered by various influences
of civilization, for the average human being it is true that anxiety and
sexual constraint belong together.
I have by no means mentioned all the observations that speak for the
genetic relation of the libido to fear. The influence on the development
of neurotic fear of certain phases of life, such as puberty and the
period of menopause, when the production of libido is materially
heightened, belongs here too. In some conditions of excitement we may
observe the mixture of anxiety and libido and the final substitution of
anxiety for libido. These facts give us a twofold impression, first that
we are concerned with an accumulation of libido, which is diverted from
its normal channel, second that we are working with somatic processes.
Just how anxiety originates from the libido we do not know; we can only
ascertain that the libido is in abeyance, and that we observe anxiety in
its place.
2. We glean a second hint from the analysis of the psychoneuroses,
especially of hysteria. We have heard that in addition to the symptoms,
fear frequently accompanies this condition; this, however, is free
floating fear, which is manifested either as an attack or becomes a
permanent condition. The patients cannot tell what they are afraid of
and connect their fear, through an unmistakable secondary elaboration,
with phobias nearest at hand; death, insanity, paralysis. When we
analyze the situation which gave rise to the anxiety or to symptoms
accompanied by it, we can generally tell which normal psychologic
process has been omitted and has been replaced by the phenomenon of
fear. Let me express it differently: we reconstruct the unconscious
process as though it had not experienced suppression and had continued
its way into consciousness uninterruptedly. Under these conditions as
well this process would have been accompanied by an emotion, and we now
learn with surprise that when suppression has occurred the emotion
accompanying the normal process has been replaced by fear, regardless of
its original quality. In hysteric conditions of fear, its unconscious
correlative may be either an impulse of similar character, such as fear,
shame, embarrassment or positive libidinous excitation, or hostile and
aggressive emotion such as fury or rage. Fear then is the common
currency for which all emotional impulses can be exchanged, provided
that the idea with which it has been associated has been subject to
suppression.
3. Patients suffering from compulsive acts are remarkably devoid of
fear. They yield us the data for our third point. If we try to hinder
them in the performance of their compulsive acts, of their washing or
their ceremonials, or if they themselves dare to give up one of their
compulsions, they are seized with terrible fear that again exacts
obedience to the compulsion. We understand that the compulsive act had
veiled fear and had been performed only to avoid it. In compulsion
neurosis then, fear, which would otherwise be present, is replaced by
symptom development. Similar results are yielded by hysteria. Following
the process of suppression we find the development, either of anxiety
alone or of anxiety and symptom development, or finally a more complete
symptom development and no anxiety. In an abstract sense, then, it would
be correct to say that symptoms are formed only to evade development of
fear, which otherwise could not be escaped. According to this
conception, fear is seen to occupy the center of the stage in the
problems of neurosis.
Our observations on anxiety neuroses led to the conclusion that when the
libido was diverted from its normal use and anxiety thus released, it
occurred on the basis of somatic processes. The analyses of hysteria and
compulsion neuroses furnish the correlative observations that similar
diversion with similar results may also be the consequence of a
constraint of psychic forces. Such then is our knowledge of the origin
of neurotic fear; it still sounds rather vague. But as yet I know no
path that would lead us further. The second task we have set ourselves
is still more difficult to accomplish. It is the establishment of a
connection between neurotic fear, which is misused libido, and real
fear, which is a reaction to danger. You may believe that these things
are quite distinct and yet we have no criterion for distinguishing the
sensations of real and neurotic fear.