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INHIBITIONS, SYMPTOMS AND ANXIETY

BY SIGMUND FREUD

IX

It now remains to deal with the relationship between symptom
formation and anxiety development. Two opinions about this
seem to be prevalent. One of them terms the anxiety itself a
symptom of the neurosis, the other conceives of a far more
intimate connection between the two. According to this latter
view, all symptom formation would be brought about solely in
order to avoid anxiety; the symptoms bind the psychic energy
which otherwise would be discharged as anxiety, so that anxiety
would be the fundamental phenomenon and the central prob-
lem of neurosis.

The at least partial justification of this second position can
be supplied by means of certain striking examples. If an
agoraphobic who has been accompanied whenever he went out
on the street is left alone there, he produces an attack of
anxiety; if a compulsion neurotic is prevented from washing
his hands after touching something, he becomes a prey to
almost insupportable anxiety. It is clear, therefore, that the
stipulation of being accompanied and the compulsion to wash
had as their purpose, and also their result, the averting of an
outbreak of anxiety. In this sense, every inhibition also that
the ego imposes on itself can be termed a symptom.

Since we have reduced the development of anxiety to a
response to situations of danger, we shall prefer to say that the
symptoms are created in order to remove or rescue the ego
from the situation of danger. If symptom formation is pre-
vented, then the danger actually makes its appearance–that is
to say, a situation analogous to birth comes about, a situation
in which the ego finds itself helpless against the ever increasing
strength of the instinctual demand in question; in other words,
we have present the first and earliest of the determinants of
anxiety. For our point of view the relationships between
anxiety and symptom prove to be less close than was supposed,

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the result of our having interposed between the two the factor
of the danger situation. We can also say, in supplement to
this, that the development of anxiety induces symptom forma-
tion–nay more, it is a sine qua non thereof, for if the ego did
not forcibly arouse the pleasure-pain mechanism through the
development of anxiety, it would not acquire the power to-put
a stop to the danger-threatening process elaborated in the id.
At the same time there is an obvious tendency on the part of
the ego to restrict the development of anxiety to a minimum,
to employ anxiety only as a signal, for otherwise there would
merely be experienced somewhere else the unpleasure threat-
ened by the instinctual process–a result which would not
accord with the purpose of the pleasure principle, although
often enough coming about, it is true, in the neuroses.
Symptom formation thus has the actual result of putting an
end to the danger situation. It has two aspects: one of them,
which remains concealed from us, causes in the id that altera-
tion by means of which the ego is preserved from danger; the
other, visible to us, reveals what it has created in place of the
instinctual process thus modified, namely, substitute formation.
We should express ourselves more accurately, however, if we
ascribed to the process of defense what we have just said of
symptom formation, and used the term symptom formation
itself as synonymous with substitute formation. It then seems
evident that the defensive process is analogous to flight, by
means of which the ego avoids a danger threatening from with-
out, and that it represents, indeed, an attempt at flight from an
instinctual danger. The considerations which weigh against
this comparison will themselves prove illuminating. In the
first place, the objection to it might be raised that object loss
(loss of the object’s love) and the threat of castration are just as
much dangers threatening from without as is for example a
ravening beast, and are therefore not instinctual dangers. Yet
the case is not at all the same. The wolf would probably
attack us, regardless of how we behaved towards it; but the
beloved person would not withdraw his love, we should not be
threatened with castration, if we did not cherish within our-

417

selves certain feelings and desires. Thus it is these instinctual
impulses which become the precondition of the external
danger, its conditio sine qua non, and thereby themselves a
source of danger; and we can now combat the external danger
by measures taken against dangers from within. In the animal
phobias the danger seems still to be perceived entirely as an
external one, just as in the symptom also it undergoes an
external displacement. In compulsion neurosis the danger is
to a far greater degree internalized; that part of the fear of the
superego which may be called social anxiety still represents an
internal substitute for an external danger, while the other part,
fear of conscience, is entirely endopsychic.

A second objection would be to the effect that in the attempt
to escape from a threatening external danger all that we do, in
fact, is to increase the distance in space between us and that
which threatens. We do not put ourselves in an attitude of
defense against the danger, we do not try to change anything
in the danger itself, as would be the case if we attacked the
wolf with a club or shot at it with a gun. But the defensive
process seems to go beyond what would correspond merely to
an attempt at flight; it actually interferes with the threatening
instinctual process, suppresses it somehow, deflects it from its
aim, and thereby renders it harmless. This objection appears
to be a very cogent one, and one we shall have to take into
account. We believe it may well be that there are defensive
processes which can with justice be compared to an attempt at
flight, while in the case of others the ego offers resistance of a
far more active kind, undertaking vigorous counteractive
measures. But it is possible that the comparison of defense
with flight is rendered untenable by the fact that the ego and
the instinctual drive in the id are in fact parts of the same
organization, and do not have, as the wolf and the child do, a
separate existence from each other; so that every form of
behavior on the part of the ego must have a modifying influ-
ence upon the instinctual process.

Through the study of the situations which.occasion anxiety
we have had to envisage with what might be called rational

418

idealization the behavior of the ego in defense. Every danger
situation corresponds to a given period of life or stage of
development of the psyche, to which it appears appropriate.
In early infancy the organism is not really equipped to cope
psychically with large amounts of excitation reaching it from
without or within. At a certain period of life it is in actual
fact to the individual’s greatest interest that the persons upon
whom he is dependent shall not withdraw their tender care.
When the boy perceives the powerful father as his rival for the
mother and becomes aware of his aggressive tendencies against
his father and his sexual desires towards his mother, he is quite
right in being afraid of him; and the fear of being punished by
him may, when reënforced phylogenetically, be expressed as
fear of castration. On his becoming a social being, fear of the
superego, conscience, becomes a necessity, omission of this step
the source of severe conflicts and dangers. But at this point a
new problem enters.

Let us for the moment try the experiment of substituting
for the affect of anxiety some other affect, for example that of
grief. We consider it entirely normal that a little girl should
weep bitterly at the age of four if her doll is broken, at the
age of six if her teacher reprimands her, at the age of sixteen
if her sweetheart neglects her, at the age of twenty-five, per-
haps, if she buries her child. Each of these grief-occasioning
situations has its proper time and vanishes with its passing; but
the later and more definite ones remain operative throughout
life. We should be rather surprised, in fact, if this girl, after
she had become a wife and mother, should weep over some
knicknack getting broken. Yet this is how neurotics behave.
Although in their mental apparatus there have long since
developed all the agencies necessary for dealing with a wide
range of stimuli, although they are mature enough to be able
to gratify the greater part of their needs themselves, although
they know perfectly well that castration is no longer practised
as a punishment, they nevertheless behave as though the old
danger situation still existed, they remain under the spell of
all the old causes of anxiety.

419

The answer to all this will prove somewhat prolix, for it
will have in the first place to sift the actual facts of the case.
In a large number of instances the old causes of anxiety have
in reality become inoperative, but only after having first
brought neurotic reactions into existence. The morbid fear
of being alone, of the dark, and of strangers, on the part of the
smallest children, which is almost to be labeled normal, disap-
pears for the most part at a somewhat later age; such fears are
“outgrown”, as we say of many other disturbances of child-
hood. The phobias of animals so frequently met with share
this same fate; many of the conversion hysterias of childhood
are not carried over into later life. In the latency period the
practice of ceremonials is of extremely frequent occurrence,
yet only a very small percentage of these cases later develop a
full-blown compulsion neurosis. The neuroses of children, so
far at least as concerns upper class urban children of the white
race, are regularly occurring episodes in development, although
too little attention is still paid to them. In not a single adult
neurotic do the indications of a childhood neurosis fail of
occurrence, while on the other hand by no means all children
who show them become neurotic subsequently. Therefore in
the course of growing up the anxiety-determinants which once
existed must have been relinquished, the situations originally
endowed with danger have lost their significance. To this
must be added that certain of these danger situations survive
into a later period of life by means of a modification, in
keeping with that later period, of the character of what gives
rise to anxiety. Thus for example castration anxiety persists
in the guise of syphilophobia, after it has been learned that
castration is no longer customary as a punishment for giving
the sexual appetites free rein but that serious diseases threaten
instinctual freedom instead. Certain other of the things that
occasion anxiety are destined not to disappear at all, but are to
accompany the human being throughout life, such as for
example the fear of the superego. The neurotic is then dis-
tinguished from the normal person in that his response to these
dangers is disproportionately increased. Yet against the return

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of the original traumatic anxiety situation even maturity offers
after all no adequate protection; there may exist for every one a
limit beyond which his psyche fails in the attempt to cope with
the demands which the excitation in question makes upon him.

These minor reservations cannot possibly be taken as mili-
tating against the fact which we have been discussing: the fact,
namely, that in their response to danger so many people remain
infantile, continuing to react with anxiety to situations which
should have long ceased to evoke it; to dispute this would be
to deny the very fact of neurosis, for it is exactly such persons
whom we call neurotics. But how does this situation come
about? Why are not all neuroses merely episodes in the indi-
vidual’s development which become a closed chapter when the
next stage of development is reached? Whence comes the
element of permanency in these reactions to danger? Whence
springs the preference over all other affects which the affect of
anxiety seems to enjoy in alone evoking reactions which we
distinguish from others as abnormal and which in their inex-
pediency obstruct the stream of life? In other words, we find
ourselves abruptly confronted once again by the oft repeated
riddle: What is the source of neurosis, what is its ultimate, its
specific, underlying principle? After decades of analytic effort
this problem rises up before us, as untouched as at the
beginning.

X

Anxiety is the reaction to danger. One cannot escape the
thought, indeed, that the very nature of danger has a bearing
upon the fact that the affect of anxiety is able to command
pride of place in the mental economy. But the dangers in
question are those common to all mankind; they are the same
for everybody; so that what we need and do not have at our
disposal is some factor which shall enable us to understand the
basis of selection of those individuals who are able to subject
the affect of anxiety, despite its singularity, to normal psychic
control, or which on the other hand determines those who must
prove unequal to this task. I have in mind two attempts