[Psychodynamic understanding of anxiety]

Anxiety as a state of arousal--Is it the same thing in pathology as in the ordinary experience of every human being? The outward show of anxiety is evidently the same, but what exactly do we mean by anxiety? Anxiety is one of the less welcome sides of man's superiority over the animals, stemming from a consciousness of one's own being, the freedom to make choices about the future and to plan ahead, the need to develop one's own personality, to create an identity for oneself in an environment where the means for such self-fulfillment appear always to be insufficient. This existential anxiety becomes pathological through symptoms; it manifests a specific weakness for each psychopathological structure. There are two different, but not irreconcilable approaches to understanding the mechanisms of anxiety: one biodynamic , the other psychodynamic. These two approaches should complement rather oppose one another. Anxiety is the cry of a self in the process of becoming, it is expressed through language. Administration of an anti-anxiety drug has a biochemical impact, but this should not be sufficient in itself. When a doctor prescribes an anti-anxiety drug, he should always encourage the patient to talk. Drug therapy thus becomes a means rather than an end in itself: It enables the patient to find the words to express his anxiety.