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Greenacre, P. (1941). The Predisposition to Anxiety. Psychoanal Q., 10:66-94.

(1941). Psychoanalytic Quarterly, 10:66-94

The Predisposition to Anxiety

Phyllis Greenacre


Freud considers that anxiety is the reaction to danger, and that birth is the prototype of the anxiety reaction. He sees this, however, as operating through the assimilation into the constitution (genetically) of the endless procession of the births of our forefathers. He doubts the importance of the individual birth experience in influencing the quantum of the anxiety response, largely because the birth experience is without psychological meaning; at the same time, nevertheless, he emphasizes the continuity of the intrauterine and the postnatal life.

From the various experimental and clinical observations cited, the question arises whether we may not look at this in a different way. The anxiety response which is genetically determined probably manifests itself first in an irritable responsiveness of the organism at a reflex level; this is apparent in intrauterine life in a set of separate or loosely constellated reflexes which may become organized at birth into the anxiety reaction. How much this total reaction is potentially present but not elicited before birth, and how much birth itself may, even in the individual life, play a reënforcing or an organizing rôle, is not clearly determinable at present. Certainly, however, 'danger' does not begin with birth but may be present earlier and provoke a foetal response which is inevitably limited in its manifestations and exists at an organic rather than a psychological level. Variations in the birth process may similarly increase the (organic) anxiety response and heighten the anxiety potential, causing a more severe reaction to later (psychological) dangers in life. Painful or uncomfortable

situations of the earliest postnatal weeks, before the psychological content or the means of defense have been greatly elaborated, would similarly tend to increase the organic components of the anxiety reaction.

Observations on the special reactions of the foetus in intrauterine life and at birth give rise to new questions as to the effect of these on the later libido development. Further, where there is an increase in the early anxiety there is an increase in the narcissism. This situation favors an inadequate development of the sense of reality and furnishes additional predisposition to the development of especially severe neuroses or borderline states.

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