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(1962). International Journal of Psycho-Analysis, 43:89-97

Anxiety and Depression-Withdrawal: The Primary Affects of Unpleasure

George L. Engel

For some years our research has been concerned with the transitions between states of health and disease. Regardless of whether the disease state is manifest ultimately in somatic, in psychological, or in behavioural terms, these transitions are commonly accompanied, if not heralded, by affect changes. The everyday expression 'How do you feel?' is a tacit acknowledgement of this. This has imposed upon us the necessity of conceptualizing and categorizing affects in terms which are both operationally useful and theoretically sound. In this paper we shall make some comments about affects in general, then focus attention on anxiety and depression-withdrawal, which we have come to regard as the two primary affects of unpleasure.

Ontogenetically, the problem of affects is first of all a biological and not a psychological one. In 'Inhibitions, Symptoms and Anxiety, ' Freud said,

If we go further and inquire into the origin of anxiety—and of affects in general—we s

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