An anxiety reaction consists of three components, ideational content,
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motor reaction and feeling tone (effect). One or several of these may be in the foreground of a neurosis. One combination appears unthinkable, i.e. the breaking through of ideational content and motor expression without the effect involved. A case is cited which seems to contradict this generally accepted opinion.
A medical student had been in analysis fourteen months, during which time he tenaciously resisted facing his anxiety. The personality was profoundly passive. Moods fluctuated imperceptibly, if at all. There was a chronic standstill of effectivity both within and outside of the analysis. One day while at a lecture, he had a momentary 'peculiar reaction' which was described as a sort of tightness in his scrotum and the 'pilimotor muscles' of his pubes. This arose from a stimulus to his unconscious passive homosexuality in a clinical demonstration. The situation was then related to the analyst and the same reaction repeated. He became aware that this had to do with his father approaching him with a knife which had occurred at the age of six or eight. The patient did not feel afraid when telling this, his heart beat fast, he 'had to' breathe rapidly, his muscles were sort of tremulous and 'that was all'. After this incident, the analysis resumed its routine of monotony. The same phenomenon was repeated in several dreams at this time.
In spite of its presence in consciousness, castrationanxiety seems to have been isolated by being made foreign to the ego. The method is to step out of the picture and watch the whole scene as an outsider. This appears to be a primitive response to an inordinate increase in tension. To ward off anxiety, the reality of the conflict must be denied. We then have a biological reaction devoid of psychological content. This sort of behaviour seems to usher in many catatonias. There is a pre-stuporous phase of transient shallow anxiety in which the effect is incomprehensibly concealed. Then there follows a very slow dissolution of the ego marked first by a sense of estrangement from the world and later by perceiving one's feelings as foreign to one's self. The effect does not disappear, it is withdrawn from the ego. It would seem that this patient handles his anxiety along these lines and that a psychotic solution of his conflict is most probable.
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Rothschild, L. (1934). Clinical. Int. J. Psycho-Anal., 15:76-77