Anxiety and its manifestations

Psychotherapy for anxiety disorders.

Anxiety is a fairly common experience in everyone’s daily life; in some people, anxiety becomes persistent and out of proportion to the reason for it, creating a disruptive condition that prevents them from dealing with situations and experiencing emotions.

What is anxiety and how widespread is it

Anxiety is a universal experience that we all experience in certain situations, such as before an important exam or public event. It is a natural response of our body to a perceived threat, often helpful in preparing us to face a difficulty. However, when anxiety becomes excessive, constant, or out of proportion to stimuli, it can turn into a disorder that impairs daily well-being.

According to the World Health Organization (WHO), anxiety disorders are among the most common mental disorders in the world, affecting about 4 percent of the global population. In Italy, an estimated 2 million people suffer from a diagnosable anxiety disorder, although the real number could be much higher due to underestimation or missed diagnosis.

Their increasing prevalence is closely linked to the social, economic, and cultural changes we experience: accelerated pace of life, job uncertainties, social isolation, and the constant impact of technology on our daily lives all contribute to increased levels of anxiety.

Anxiety in everyday life

If we reflect carefully, anxiety is not something foreign or rare: it is an integral part of our existence, often acting as a useful “wake-up call” to protect us from danger. However, what may seem to be a common emotion is more deeply rooted in some people.

Have you ever felt a sense of agitation without knowing exactly why? Or feel your heart beating faster at the thought of a future situation, even though rationally it did not seem threatening? Anxiety, in its most complex forms, is not always related to a real or conscious danger, but often manifests itself as an unconscious urge rooted in the past.

On this page, we will attempt to explore anxiety disorders from a psychoanalytic perspective, trying to answer a fundamental question: what does anxiety want to tell us? Why does our unconscious seem to be activated in such a disruptive way?

Anxiety according to psychoanalysis

In psychoanalysis, anxiety is not regarded as a mere psychological symptom, but as a manifestation of deeper inner conflicts. According to Sigmund Freud, anxiety is the result of a conflict between the Id, the instinctive and unconscious part of the psyche, and the Superego, the critical and moral voice representing the internalization of social norms. This conflict can cause frustration that, if not resolved, results in feelings of anxiety.

Freud argued that anxiety could be a signal from the unconscious, an attempt by our ego to warn us about repressed desires or perceived threats. For example, a childhood trauma or an unprocessed loss can trigger anxiety, often unconsciously. In this case, anxiety is not just a response to a current danger, but a return of unresolved emotions and feelings from the past.

Other psychoanalytic authors, such as Melanie Klein and Donald Winnicott, expanded the Freudian view, focusing on the role of early life experiences. Klein, in particular, introduced the concept of “primitive distress,” which is linked to childhood experiences of separation or abandonment that may persist in the adult and manifest as anxiety.

Finally, the psychoanalytic literature distinguishes different types of anxiety, which may be conscious or unconscious. Separation anxiety concerns the fear of losing a loved one, while castration anxiety is the fear of damage to one’s body. Moral anxiety is the fear of the consequences of transgressing one’s values, while annihilation anxiety is the fear of being overwhelmed and destroyed. Fragmentation anxiety concerns the fear of disintegration of the self. Persecutory anxiety and irrational fears of harming others are explained as a result of difficulty in dealing with hostile and destructive feelings.

These anxieties, if tolerable in magnitude, are common, but if persistent and disproportionate, they indicate a psychopathological condition.

The types of anxiety

Anxiety can come in different forms, and not all experiences of anxiety are pathological. There is, in fact, normal anxiety that arises as a response to external stimuli or stressful situations. Anxiety becomes problematic when it is excessive, continuous, and interferes with daily life. Here are some of the main types:

1. Generalized anxiety: characterized by constant and disproportionate worry about everyday events.
2. Social anxiety: related to the fear of being judged or not measuring up in social interactions.
3. Panic attacks: sudden and intense episodes of fear, accompanied by physical symptoms such as palpitations, sweating, and difficulty breathing, and psychological symptoms such as confusion and feeling of imminent death.
4. Phobias: irrational fears of specific objects or situations, such as flying or enclosed spaces.

Each of these forms can be interpreted, according to psychoanalysis, as the result of a conflict between unconscious desire and external reality that has not been adequately resolved in the course of life. The symptom constructed in this case involves a lower level of anxiety, however, than the person would experience if he or she consciously relived the conflict. The unconscious acts as a kind of “gatekeeper” that tries to protect the person from unprocessed painful emotions.

Working on anxiety through transference

Another central concept in psychoanalysis is transference, a phenomenon in which the patient projects onto his interlocutors, and particularly the therapist, emotions, desires and conflicts that go back to important figures in his past life (such as parents or other significant figures). For example, a patient with a strong inner conflict might experience his relationship with the therapist as being a replica of his relationship with an authority figure, triggering anxiety and resistance.

Transference is a powerful therapeutic tool because it offers direct visibility of the patient’s unconscious conflicts. Working on transference allows one to understand and resolve those relationship patterns that keep repeating themselves in the patient’s life, often contributing to his or her anxiety. The analyst, with his or her attention and sensitivity, helps the patient recognize and reframe these projections, facilitating a change in mental patterns.

The link between anxiety, primary relationships, trauma and dreams

From a psychoanalytic perspective, anxiety is closely linked to the quality of the early relationships experienced by the infant and then the child during infancy. Winnicott, for example, emphasized the importance of “support” in the early stages of life: an unstable or insufficiently supportive family environment can give rise to a number of primitive anxieties, such as fear of abandonment. These traumas, if unresolved, can manifest in adulthood as generalized anxiety or panic attacks.

Psychoanalysis provides a space where patients can reframe old traumas, exploring not only their emotional impact, but also trying to attribute meaning to them. Understanding and integrating traumatic experiences, even if they are painful, can reduce their power to generate anxiety. This process requires long and delicate work, but it can lead to a significant reduction in anxiety symptoms and an improvement in psychological well-being.

In addition, dream interpretation, according to Freud, is another psychoanalytic tool that can reveal hidden aspects of the psyche. Dreams are considered a gateway to unconscious desires and deep fears, and through their interpretation, the therapist and patient can unveil the roots of unconscious anxieties.

In conclusion

Anxiety, then, is not just an unpleasant emotion, but an important signal that our unconscious sends us to warn us of unresolved conflicts. Understanding the psychoanalytic roots of anxiety can help us not only manage it, but also decipher hidden messages that our unconscious tries to communicate to us.

Psychoanalysis offers a deep and transformative path to explore these roots. Far from being a simple treatment to “calm anxiety,” psychoanalytic therapy helps the patient reveal and understand unconscious conflicts, making it possible to process them. Often, once brought to light, these conflicts lose much of their power, and the individual can develop a greater awareness of self and his or her desires.

In summary, anxiety should not be seen as an enemy to be defeated, but as a complex phenomenon that can teach us a lot about ourselves, our fears, and the experiences we have accumulated throughout life.

Anxiety may seem like a difficult condition to deal with, but when interpreted in the light of psychoanalysis, it becomes an opportunity for growth and understanding. If you feel overwhelmed, remember that you are not alone and that it is possible to embark on a path of awareness that will help you live a more peaceful and fuller life.