comes too often; who feel a constantly pressing need to be amusing and to entertain; who flee to too many movies
they have no desire to see and to too many gatherings they have no desire to attend; who sacrifice any vestige of
independent self-confidence to an obsessive concern with what others think of them; who long to be emotional
dependents or to be depended upon; who succumb to periodic spells of unaccountable depression; who submerge
their existence in the dreary passivity of unchosen routines and unchallenged duties and, as they watch their years
slip by, wonder, in occasional spurts of frustrated anguish, what has robbed them of their chance to live; who run
from one meaningless sexual affair to another; who seek membership in the kind of collective movements that
dissolve personal identity and obviate personal responsibility—a vast, anonymous assemblage of men and women
who have accepted fear as a built-in, not-to-be-wondered-about fixture of their soul, dreading even to identify that
what they feel is fear or to inquire into the nature of what which they seek to escape.
It is generally recognized by clinical psychologists and psychiatrists that pathological anxiety is the central and
basic problem with which they must deal in psychotherapy—the symptom underlying the patient's other symptoms.
Sometimes, the other symptoms represent direct physical consequences of anxiety, such as headaches, choking
sensations, heart palpitations, intestinal ailments, dizziness, trembling, nausea, excessive perspiration, insomnia,
painful bodily tensions, and chronic fatigue. Sometimes, they represent defenses against anxiety, such as hysterical
paralyses, obsessions, compulsions, and passive depression. But in all cases anxiety is the motor of neurosis.
The neurotic's essential attribute, his chronic response to the universe, is uncertainty and fear. Not every neurotic is
the victim of obsessive thoughts or compulsive actions; not every neurotic dreads heights or open spaces; not every
neurotic develops somatic ailments for which there is no somatic cause. But every neurotic is afraid. A cheerful
neurotic, confident of his ability to deal successfully with life, is a contradiction in terms.
What is the nature and cause of pathological anxiety?
To answer this question, one should begin by noting a conspicuous and significant attribute of this anxiety: its
metaphysical character. The fear seems to be directed at the universe at large,