Evening star., 1935-05-14

The unendurable torment OF anxiety
may be the kick-from- within which
constitutes the chief driving force of
mans social and mental evolution.
1t is thus pictured by DR.. William
A. White, superintendent Of st. Eliza
beth's Hospital, in the third Salmon
lecture before the New York Academy
of Medicine
Anxiety. as defined by DR.. White,
Is sort Of internal loss of balance.
1t is quite different from fear. One is
afraid of that which threatens from
the outside. A man fears being run
over by an automobile, killed in bat
tie or discharged from his job. He is
not, strictly speaking, anxious about
these possibilities. The vague, tortur-
ing sense of anxiety may come entire
ly independent of anything in the
outward environment of which to be
afraid.
But psychically the organism is very
delicately balanced. In order to live
in society one must repress or subli-
mate various instinctual drives which
are inherent in life. There is, for ex-
ample. the instructive impulse to de-
stroy that which gets in the way. 1t
must be repressed, and this neces-
sity Of repression is perhaps a funda-
mental basis for human morals. Or it
may be transformed by the psyche
logical process known as sublimation
into virtue.
The processes of repression and
sublimation have gone on in every
one until balance is reached. 1t Is
probably slightly different balance
for each individual. Ordinarily no.
body Is conscious of it. 1t is only
when the organization, so delicately
built up to get along in the world, be-
gins to break down that the indi-
vidual becomes aware of the extreme
internal discomfort-the cause of
which cannot be athomed-known as
anxiety. 1t is one of the earliest and
most frequent symptoms of a mental
collapse. It also serves as q spur to
changes in ways of life or ways of
looking at things. One struggles to
retain the internal balance Just as
one struggles to retain the external
balance. If there Is complete failure
it is a case for the psychiatrist. 9th
erwise the regained balance becomes
part Of changed pattern of things.
VERY few persons could 60 through
life" said DR.. White, without from
time to time experiencing, if ever SO
lightly, the symptom of anxiety. It
results when sublimations threaten to
fail and repressive forces are on the
verge of being overwhelmed by in
stinctual demands. 1t is an indication
that the balance Of power within the
psychic systems Is moving in the di-
rection of the instinctual processes.
Anxiety itself constitutes an sx-
ceedingly painful state of mind. In
its more severe manifestations it is
uncomfortable and almost any means of
escape from its torment may be chosen
by the patient. At any given time
wnen the instinctual forces are
strengthened or the repressing and
sublimating forces are weakened anx-
iety may develop, and under these cir
cumstances one of the solutions pre-
sented to the patient as a means of
escaping the torment is to do those
things which will reconstitute the su-
premacy of sublimation and repres-
sion-in other words, to move in q d.
rection away from the instinctual
forces and toward those processes
which make for development in the
direction conceded to be evolutionary.
so we may assume, I believe, that
anxiety is one of the outstanding
forces which drive man along the
path of development and civilization.
I should dislike to think that it was
the only force, for if that be so. then
all mans virtues could be explained