How Anxiety Therapy Can Help You Face Fears and Inner Conflicts

Psychoanalytic thinking with Dr. Don Carveth – Clinical Series: Anxiety

Free Translation of the Podcast

In recent years, panic attacks have often been understood as a symptom of fear, a reaction to unresolved trauma, and people suffering from them are often considered traumatized. However, this view of panic attacks as strictly related to fear can be far too limited. These anxious states are, in fact, much more complex and can be interpreted from multiple perspectives. In many cases, they are not just a response to past trauma but can also reflect a range of other unwanted emotions, including anger, rage, or frustration. In this context, anxiety therapy can be an effective tool in exploring and deeply understanding these states. Discover more about online psychotherapy and its benefits in anxiety treatment.

An essential aspect in understanding these states is that in the mind, there is no clear distinction between thoughts and actions. For example, when a person allows themselves to feel anger, they may feel that those around them will begin to abandon them, as if that anger will destroy relationships. In reality, fantasies, feelings, and emotions are just mental contents and do not have the power to harm reality, but this is not perceived when the individual is in the midst of a panic attack. Anxiety therapy helps the patient become aware of these mechanisms and explore them in depth.

According to Freudian theory, fear can lead to the repression of anger, and this process can result in the return of anger in a disguised form, manifesting as panic attacks. Freud suggests that these panic attacks are, in essence, a way for repressed anger to return, like a volcano about to erupt, and the person is terrified of this potential eruption. This anger is often linked to unresolved trauma, and panic attacks become a way to express the repressed emotions without them being directly acknowledged. In this context, anxiety therapy can help address this repressed anger, facilitating the understanding and release of emotions. Find out how individual psychotherapy can help manage anxiety.

People with panic attacks are often considered traumatized, and sometimes this is true, but there is a tendency to overlook the fact that the primary reaction to trauma is, in fact, anger. Trauma generates anger and frustration, and frustration can lead to aggressive behaviors. In fact, people who have been traumatized are often angry, even if they do not want to acknowledge this or do not want to be angry. When anger reaches its peak intensity, it may erupt in the form of a panic attack. Thus, panic attacks are not only a response to fear but also an indirect response to anger. Anxiety therapy can help identify the sources of anger and assist the patient in managing it in a healthy way.

Although not all panic attacks are caused by anger, this element plays an essential role in understanding them. Freud discussed anxiety from a topological perspective, suggesting that repressed sexuality can lead to a "compulsion" of the libido, and that sexual energy, when it cannot find an outlet, transforms into anxiety. According to this theory, anxiety would essentially be a form of frustrated sexuality. However, in 1926, in his work *Inhibitions, Symptoms, and Anxiety*, Freud revised this theory, rejecting the idea that repression leads to anxiety and instead asserting that, on the contrary, anxiety leads to repression. Freud distinguishes two types of anxiety: traumatic anxiety, which arises as a result of an overwhelming experience, and signal anxiety, which is a lighter form of anxiety that serves as a warning before a greater, overwhelming anxiety occurs.

Traumatic anxiety arises when a person is overwhelmed by a situation, feeling helpless in the face of danger. A classic example is the trauma of birth: the baby is taken from the protective environment of the mother's womb, where it is safe, and exposed to a cold, unfamiliar environment, where it must learn to breathe and rely on caregivers to meet its basic needs. This is a fundamental model for all subsequent traumas—the dependence on a caregiver to meet the child’s basic needs. In this sense, we all have such traumas in the early part of our lives, and anxiety arises when there is a fear of being left behind or ignored.

In this early stage of development, the major danger is the loss of the mother. A baby who is separated from their caregiver may experience a sense of abandonment and helplessness. More broadly, we all experience this kind of signal anxiety when we notice a change in the behavior of those who care for us and are prepared for possible abandonment. Anxiety therapy can help process this fundamental anxiety and reduce the fear of abandonment. For more information about mental health and the available treatments, read our article dedicated to this topic.

Throughout development, we learn to anticipate and protect ourselves from potential traumas, and signal anxiety becomes a defense mechanism. For example, a child who notices that their mother is about to leave may experience anxiety as a signal of a possible loss. In this sense, signal anxiety is not a reaction to a real threat but an anticipatory response designed to protect us from a potential trauma. It can be understood as a form of defense that helps prevent greater, overwhelming anxiety. Psychotherapy for anxiety is essential to help individuals understand and manage these defensive mechanisms.

Freud proposes that the major dangers generating signal anxiety change throughout life. In the early years of life, the danger is the loss of the mother; later on, the danger becomes the loss of the mother's love, and around the age of three, the danger of castration arises, meaning the loss of the ability to attract the attention and love of others. In this sense, anxiety is linked to the idea of loss: the loss of an important object or a fundamental relationship can trigger a state of anxiety. Psychotherapy for anxiety can help patients cope with these life-long dangers and reduce their emotional impact. If you're wondering hoe to choose a good psychotherapist, check out our complete guide to make the right choice.

However, it is not only the loss of an object or an important relationship that can cause anxiety. Freud emphasizes that, in the face of a threat from the Superego, anxiety becomes a defense mechanism against a possible sanction or attack from a harsh internal authority. The Superego is an internal judge, who criticizes and punishes, and the fear of its attacks can provoke anxiety.

Rage and repressed anger are an important source of anxiety, especially when the Superego threatens severe punishment for behaviors perceived as inappropriate. Thus, anxiety can arise not only in the face of sexual or aggressive instincts, but also in the presence of an overly harsh Superego that judges the individual's behaviors and thoughts.

Additionally, anxiety is not only related to internal impulses and psychological conflicts, but it can also arise in the face of external reality. Anxiety in response to external demands, such as paying bills or fulfilling responsibilities, can be a significant source of stress and panic. However, sometimes reality can be distorted, and anxiety may arise due to an exaggerated perception of external threats. Psychotherapy for anxiety can help the patient regulate their emotional responses to these external stresses, teaching them to cope more effectively with daily challenges. Learn more about the role of the psychotherapist and how it can contribute to your anxiety management.

Melanie Klein's theory adds an additional dimension to understanding anxiety. Klein makes a distinction between persecutory anxiety and depressive anxiety. Persecutory anxiety arises when an individual feels threatened by an external object targeting them, while depressive anxiety occurs when the individual feels guilt toward the other, regretting having attacked or harmed them. This guilt can arise when the desired object, whether it is the mother or another significant person, is perceived as both good and bad. In this context, anxiety can be a reaction to the awareness of one's own aggressions and the desire to repair the harm done. Psychotherapy for anxiety can help process this guilt and relieve the patient of emotional burdens.

Wilfred Bion, similarly, suggests that most mental pathologies stem from the avoidance of suffering. People try to escape mental pain, but this often leads to pathologies because true resolution lies in learning to tolerate suffering. This aligns with Kierkegaard's idea of existential anxiety: suffering is part of the human condition, and the freedom to choose and live with responsibility is a burden that causes anxiety. Psychotherapy for anxiety can provide the necessary tools to face this suffering and find meaning in the process of self-discovery.

Kierkegaard argues that the only way to face existential anxiety is to accept it and continue living, making choices and taking responsibility for them. Therefore, anxiety cannot be avoided but must be accepted and integrated into our lives. If we try to escape the anxiety of freedom, we fall, according to Sartre, into the trap of "bad faith," living in a false sense of freedom that prevents us from making authentic choices.

You can make an appointment to a psychotherapy office in order to start your healing process.

Psychotherapy for anxiety is essential in managing and deeply understanding fears and complex emotions. It helps identify and address the underlying causes of anxiety, which may be related to trauma, internal conflicts, or unresolved fears. Through therapy, individuals can learn to tolerate emotional distress and develop effective strategies to cope with stress and panic. Psychotherapy for anxiety provides a safe space for exploring thoughts and feelings, contributing to a more balanced life and a deeper understanding of one's own reactions.

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