Integrating the dissociated: From the dominance of fear to the power of angst – Angst as a ‘presence of feeling’

Abstract

The author addresses contemporary clinical practice, where we encounter individuals, seemingly incapable of getting in touch with their own existential dimension, who communicate their detachment, at times even total, from their feelings and fears, wilfully committed as they are to avoid experiencing the inevitable angst that may accompany them through life. This dissociation from the angst-producing emotion is revealed to the clinician through either detachment or a simple action. This feeling that generates both detachment and its opposite, perhaps a hypomanic reaction, proves to be “absent,” and is not perceived by the patient. In this way, angst can be avoided and indeed seems “absent,” but what is experienced is the complete range of raw emotions connected to it, such as fear, terror, panic, detachment, apathy, and anhedonia. The author sets out to clarify the terms “fear,” “anxiety,” and “angst” as they have been historically used in philosophy, psychoanalysis, psychiatry, and psychology. Ultimately, she explains her reason for her choice of the word “angst” instead of “anxiety” in her distinct and explicit handling of this subject matter.

Key words:

• fear
• anxiety
• angst
• dissociation
• affect
• contemporary clinical practice

Additional information

Notes on contributors

Anna Maria Loiacono

Anna Maria Loiacono is a relational/interpersonal psychotherapist and psychoanalyst who lives and works in Florence, Italy. She is President of the “H.S. Sullivan” Institute of Florence, and a faculty, training, and supervising analyst at the Institute of Analytic Psychotherapy of Florence. She is also vice president of the Italian Psychoanalysts Organization, Federation and Register (OPIFER), executive and delegate member of the International Federation of Psychoanalytic Societies, and editorial reader for the International Forum of Psychoanalysis. She has published clinical and theoretical articles, some in English, and the Italian version of The unformulated experience by D.B. Stern. Her book La teoria interpersonale di H.S. Sullivan e la Clinica della Dissociazione (The interpersonal theory of H.S. Sullivan and the clinical treatment of dissociation; Ed. Termanini, Genova), was published in 2016. She was the chair of the XX IFPS Forum, held in Florence, October 17–20, 2018, on “The new faces of fear. Ongoing transformation in our society and in clinical practice.”