YDS: The Clare Spark Blog

November 16, 2009

Panic Attacks and Separation Anxiety

Manipulative Mother 1923 This slightly revised version of a Pacifica radio talk fits well into our recent discussions about the continuing relevance of Freud, and how liberal mental  health professionals thought about anxiety disorders in the early 1990s. I refer the reader to Freud’s Group Psychology and the Analysis of the Ego for a stimulating remark on “neurotic dread.”* I was asked to repeat the KPFK talk, and it was subsequently read by a practicing historian-psychoanalyst Peter Loewenberg. I got no criticisms from listeners who showed it to their therapists. I am not a therapist, but read in the history of medicine and psychiatry.

KPFK program Panic Attacks, hosted by Dr. Etta Enzyme, December 12, 1994. First in a projected series exploring the ways specific historical explanations (especially the causes of World War I, World War II, the Holocaust, the Cold War, ecocide etc.) affect mental and physical health, hence the possibility of constructive social change.

1.What is a panic attack?  Panic attacks are not fear responses to immediate threats like earthquakes.  Rather, harmless but symbolically laden internal body signals stimulate terror: of isolation, of loss of support, of loss of balance, of descent into madness; it is the state of mind most desired by practitioners of psychological warfare.  Persistent anxiety weakens the immune system.  Clinicians often see panic attacks as one instance of separation anxiety, itself symptomatic of an underlying narcissistic personality disorder.

2.Comment on Dr. Joycelyn Elders firing: how have journalists explained opposition to masturbation?  For instance, see Gina Kolata, “America Keeps Onan in the Closet,” The New York Times, 12/18/94, p. E5 for an ooh-la-la description of masturbation phobia since the 18th century “when sex became medicalized.”  Laughable consequences are listed, but none resembles the fear of critical thought (i.e., of separation from abusive authority) in D.H. Lawrence.  In a Letter to the Editor 12/20, Frederic C. Thayer writes, “Traditionally, masturbation is condemned because it wastes energy and sperm necessary for procreation, and is for selfish pleasure rather than social duty.  Masturbation is described as “self-abuse” that causes mental derangement.”

The hostile conservative response to masturbation is more complex than some timeless resistance to (anarchic) pleasure by ascetic, corporatist thinkers.  In Pornography and Obscenity Handbook for Censors, D.H. Lawrence rants on about the “self-abuse” he attributes to mass culture which, while apparently promoting “sex-secrecy,” “stealthily” inflames the flesh: the “mental energy” sometimes released leads solely to the “futility…nothingness…sentimentalities…self-analysis…impotent criticism…suppressed rage” which characterize (solipsistic) “modern literature” and “work[s] of science.”  “[Masturbation] is the deepest and most dangerous cancer of our civilization.”  Lawrence’s is a class-bound reactionary response to the “the grey ones left over from the nineteenth century,” i.e.,, to Victorian culture; his panicky diagnosis of [narcissism] reminds me of more recent, equally pessimistic  criticism.  What (other than the family) are the political and institutional sources of this anxiety?  How have mental health professionals accounted for panic attacks and related anxiety disorders, and what are some of the debates in the field?

3.Object inconstancy and its discontents.  Since the pioneering work of Bowlby, Winnicott, and Mahler, new thinking in clinical psychology and social work stresses the lifelong salutary effects of a strong and reliable maternal bond, experienced as object constancy.  Should there be a lack of steady parenting in early childhood, the damage may manifest itself later in panic attacks and related phobias and symptoms, especially during adolescence; appropriate separation is sometimes impeded by parents who ask their growing children to befriend them so as to contain the parents’ anxieties.  At all ages related symptoms may include insomnia (there is no internalized representation of the protective parent: only a surrogate close at hand will allow relaxation); hoarding; fears of being poisoned (e.g., by mass culture); school phobia (clinging to mom or exposure to “secular humanism”?); drug use to deaden the pain of loss; self-mutilation and adolescent suicide (only a violent act directed against the self can restore the maternal bond); agoraphobia; compulsive “taking care” of others to control them; clinging to masochistic relationships; the inability to cope with divorce; and in borderline personalities (close to psychotic), oscillations between depression over lost attachments and fears of being swallowed up and disintegrating.  One psychologist notes a common wish: the longing for the golden fantasy of a symbiotic [i.e., not draining?!!]) relationship with mother where all needs are met, hallowed by perfection.  (None of the dozens of psychology abstracts I consulted specifically alluded to authoritarian ideologies and peasant societies of the Right or Left where individuation would not force young people into agonized choices; cf. D.H. Lawrence, or T.S. Eliot and his hatred of “worm-eaten liberalism” aka “freethinking Jews,” the catalysts or enzymes of social disintegration.)

Professionals disagree about the efficacy of antidepressants, or whether or not separation anxiety in infancy and early childhood explains panic attacks in adulthood.  To me, the most sensible suggestions for treatment were historical and sociological in approach: psychiatrist Terry Kupers says mental health professionals must be activists to provide public funding for the treatment of anxiety disorders; meanwhile in short-term care the patient should record the circumstances of every parting to detect lifelong patterns of separation anxiety in relationships.  Another stressed the need for family therapy to scrutinize the ways in which their interactions impede autonomy.  Another writer, in a similar vein, reminded me that the problems in separation cannot be described schematically, that particular families shape the difficult problem of growing up in their own unique and awful ways. [I doubt that there is an infinite variety of  histories.] In other words, individuals and their families are being taught to read themselves and the often subtle messages they communicate around issues of maturation and difference, to discover the patterns which contribute to serious mental and physical health problems, and which in turn will affect social action.

4. The larger institutional environment in which anxiety disorders have emerged.  Because the transition from pre-modern to capitalist social relations is incomplete, the humanities lag behind the hard sciences.  There are some sociologists, political scientists, and cultural anthropologists whose work is avowedly anti-science; Harold Lasswell was part of the moderate conservative movement of academics who explicitly separated the methodologies of the social sciences from the physical sciences in the 1920s.  In a related move, the history of science as an academic discipline was contrived by Harvard’s Robert Merton to demonstrate the socially constructed character of scientific knowledge; Merton’s project was candidly counter-Enlightenment.

The legitimacy of the exploring, self-directing individual is advocated by only a minority of liberal and Left intellectuals; scientists are necessary but suspect, like rationalism in general.  We give lip service to “cultural freedom,” but few of us are willing to live with its consequences.  Yet our official ideology in “the West” asserts numerous civil rights and obligations to participate in democratic processes.  What critical tools are required to make popular sovereignty rational and humane?  How have threatened élites discouraged the development of critical skills through psychological warfare in popular culture?  Have upper-class radicals, in the name of socialism, served reaction, not popular education?  What public policy demands should be advanced by liberals to educate citizens for mental and physical health?

5. On narcissism theory and recent prescriptions for its cure.  The derogatory term “narcissistic” denotes the selfishness of yuppies; for instance, some social democrats claim that “the culture of narcissism” (Christopher Lasch) has produced Generation X: abandoned, empty, confused and self-destructive.  The narcissistic disorder as I see it, is less moralistic in its diagnosis: Perhaps narcissism results from unreliable attachments in early childhood, and the repeated exposure to ambivalent systems of support inside and outside the family, in schools and other socializing institutions, including the media.  Because communication is often dishonest but unchallenged (“Be yourself, be original, but don’t make me too angry”), youthful egos are weakened while the source of domination is obscured.  Hence narcissists lack a sense of inner balance, competence in defending their interests (who dunnit to me?), and self-worth that would make them self-directed and socially responsible: creative, curious, lovable to others and effective reformers.  They may depend on omniscient others who feed their weak egos with flattery/conspiracy theories (we alone are the cognoscenti).  To restore the Golden Age, they will fuse with such heroic agitators, or with a glorified racial past, or with fetishized luxury goods.  As repressed facts of the material world return, idealizations are shattered.  The all-nurturing other (the object) may become a killer who must be destroyed (Otto Kernberg). [My reading:]  The switch occurs at the moment of disillusion, as artificially inflated self-esteem (grandiosity) ebbs or rushes away, leaving in its wake emptiness, uncontainable fear and anger.  The fear and anger (if suppressed) triggers the adrenalin that begins the panic attack; the ghastly irony lies in the misdirection of our anger toward the self; we may remain politely fastened to an object that was never there for us in the first place.  (Or perhaps as children we believed our anger caused the death of domineering or negligent parents and/or sibling rivals or the breakup of a family in divorce: any eruption of anger is unmanageable and world-destroying.)

By contrast, some romantic conservatives account for the pervasive “narcissism” and related social problems (including the rise of fascism, a narcissistic disorder) as the result of weakened paternal authority in the family.  The newly triumphant figures of modernity have sapped the authority of the paternalistic father: vampirish specters appear as Goldfinger the international Jew (designer and profiteer of mass culture and consumerism) in cahoots with mad scientists, femmes fatales, and perfectionist puritan mothers.  Feminized and jewified, modernity has produced, what else?  The Masturbator!  Similarly, the terror-gothic genre (horror movies and gothic fiction) confronts the viewer with appalling images of the inquisitive, wandering, goal-directed imagination exploring the sensuous material world (D. H.Lawrence’s “nosy Hebrew”).  Persistently feeling one’s own unhappiness and the common pain of suffering humanity, asking authority “why” it devises particular damaging social policies, demanding access to state secrets, can lead only to bloody revolution, ripping and shredding of the social fabric, and finally, the Bomb (e.g., the theme of Pandora’s Box in Kiss Me Deadly, a classic of film noir).

One would hope that progressive intellectuals would be alert to such right-wing tactics, but no.  As one KPFK listener put it, intellectuals today latch onto traditions which make them comfortable; the idea of the detached, disinterested seeker following the truth wherever it leads is held to be a bourgeois illusion, the Big Lie of objectivity and positivistic science that delivered scientific racism.  Some poststructuralists say that (relatively) accurate readings of the world are impossible, that there is only “intertextuality” for ballast, that the goals of “objectivity,” or of universally valid moral standards are (in fact!) a stealthy imposition of a totalitarian ideology.  Such irrationalist  [1] ideas should be vigorously opposed in the culture wars raging in our universities, and not just by the libertarian Right. Liberal Freudians are not irrationalists; rather they believe that rational processes (historical memory and the reconstruction of power relations in socializing institutions) can at least diminish the extent to which we are misdirected by self-destructive behavior. (Irrationalists have said that such fantasies are disseminated by Jews, consummate peddlers of false utopias; see the excellent description of the right-wing agitator in Leo Lowenthal and Norbert Guterman, Prophets of Deceit, 1949).

Are panic attacks a health risk of middle-management?  Historians revise and reconfigure the past, finding material causes for socially-induced catastrophes; we seek clarity and balance, not chaos, but threaten illegitimate authority.  Because democratic pluralists seem to support critical thought (but in practice are unevenly committed to it), institutions are vague and abstract in their demands.  Be original, but not too destabilizing, we are advised, echoing the family.  But how far to go too far?  We don’t know the rules until we break them.  So, to keep our jobs, we may betray the real and the good, not daring to hold authority accountable; all relations remain shallow and there is, in fact, little reliable support.  In such a deceptive and self-deceptive society, anyone and everyone can turn on us–whenever we demand that our arguments be engaged, calling love and support into question.  People too attached to their creative work must be “monomaniacs,” like Melville’s Captain Ahab.

If my analysis is valid, what are the implications for the treatment of anxiety disorders?  As long as institutions are unwilling to be tested and challenged, as long as they blunt critical tools, no amount of individual or group therapy or pills will alleviate our distress; perforce we will adjust to a world without many enduring attachments.  The fearful may continue to follow false friends and false prophets: screaming, hysterical demagogues and paranoids who will divide us when only species cooperation can protect the planet.  Idealizing the father-driven family will not solve the problems conservatives are (often rightly) worried about.  Accurate readings of our bodies, our histories, our loves and friendships, the origin and development of all institutions and of the natural world which we are fast destroying, should be the goal of education.  Workers in mental health cannot neglect these aspects of their training, lest the good work they do be nullified by the strange world outside the clinic. [12-27-94]

* From Freud (1922): “Dread in an individual is provoked either by the greatness of a danger or by the cessation of emotional ties (libidinal cathexes [Libidobesetzungen]); the latter is the case of neurotic dread. In just the same way panic arises either owing to an increase in the common danger or owing to the disappearance of the emotional ties which hold the group together; and the latter case is analogous to that of neurotic dread.” Group Psychology and the  Analysis of the Ego, Chapter V, transl. James Strachey. Apply this suggestion to the assimilating immigrant or upwardly mobile ethnic individual or group. This view eliminates the problem of separation from the mother, but rather extends panic and anxiety to other situations in any society with fluid class boundaries. Imagine the fear of loss of status or the fear of abandoning one’s neighbors and ancestors. (For another blog on this topic, see http://clarespark.com/2012/09/03/eros-and-the-problem-of-solidarity/.)

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14 Comments »

  1. […] Take the terror of aging for one example. We stigmatize pedophiles, while promoting the beauty ideal in  very young girls (or boys!), with perfect skin and little body fat, for breasts and bellies remind men of their mothers, from whom separation has never been achieved, or is at best, ambivalent. The mother-son dyad is probably the key to misogyny and few will talk about “attachment theory” for John Bowlby and his followers in psychiatry don’t sit well with feminists on the lam from the boredom of early child-rearing (see http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/). […]

    Pingback by Ray Rice and domestic abuse of women | YDS: The Clare Spark Blog — September 12, 2014 @ 6:11 pm | Reply

  2. Clare,

    I have read this article several times and always found something new to respond to.

    Over the past year, I have been working through the implications of Ayn Rand’s theory of tabula rasa, i.e., there are no innate ideas. If true, then Freud and most of modern psychology cannot be valid theories of human behavior. “Separation anxiety” and other various sub-conscious motivators don’t mean much to me. I have had a strained, but happily separate life from my mother.

    Yet, I have experienced panic attacks and dread. What, then, is their source?

    I like your theory that these emotions are a hazard of “middle management,” the world view that there are no certainties, only chaos that must be managed. I admit that my fears were not of a particular thing, but of a sense that I had lost my place and direction, that God had turned against me, and that my fate was entirely in the hands of others who didn’t have the slightest idea who I was.

    These thoughts and emotions rarely bother me any more — I believe I have found my way. But for a good ten year period, I had given up on living the life I had idealized, and thought that I had no value as a human being. My dread and anxiety of the 1990s was the realization that the world I thought I lived in, where living neither in extremes nor giving offense would lead to a happy and prosperous life — the middle management ideal, you might say — was unrealistic. Religion helped fill the gap, but it, too, was another dead end, a perpetual promise that could never be attained in life.

    The right path, the one I have chosen, is to make reason and seeking truth, wherever it leads, an intellectual primary. Subsequently, I reject thinking in terms of groups, group consciousness and group grievances. I think about relating to other people as individuals, not templates, and I rationally pursue my own self-interests. We all have ideals. Ideals are necessary to guide choices. But if those ideals are not realistic or motivated by a misplaced sense of duty and unchosen obligation, then you have ideals that do not work, do not satisfy, and which causes gnawing internal conflict.

    You are critical of romantic conservatives who idealized the paternalistic family, but feminism, at least in the form propounded by progressives, has indeed weakened the traditional, father-centric family. This has had devastating consequences by denying men the ability to pursue the only role-model they know, the hero and provider. When young men are denigrated for being “sexist” and dominant around women, they either stop showing respect for women or retreat into anti-masculine behavior. Similarly, women, particularly those who did not grow up with a strong positive male presence, are equally confused in that they can never find the “right” man to satisfy all their domestic and sexual fantasies. Under the feminist ideal of the neutered man, the best that a woman can expect in finding a (male) mate is a man who is incapable of acting manly and who cannot recognize and appreciate her femininity. Women who have been indoctrinated with feminism are unprepared for the realities of a (heterosexual) marriage and child rearing, especially when raising boys whom they have been taught to believe are the next generation of gender oppressors.

    When I was a young man and father, I felt extremely guilty just for being a man, though I knew in my heart that this guilt was misplaced and that I did not deserve the condemnation I believed was more appropriate for earlier generations of men. I’ll withhold the details, but I married women who were not my equals and who held conditioned suspicions that my motives were sexist and evil. I played my role as husband and father poorly at times, but I was never as manipulative and oppressive as was claimed. Nonetheless, two messy divorces and two additional broken serious relationships within six years was enough to convince any man that he’s no man at all.

    In sum, I attribute my anxiety and panic due to my guilt at not being able to realize unrealizable ideals. My misguided choices, fostered by invalid integrations, led to the miseries that followed. Thinking more clearly about my choices gives me better control over my decisions and my reactions to challenges.

    Comment by StereoRealist — January 23, 2014 @ 3:27 am | Reply

    • You should not blame “feminism” for the peculiarities of the second wave of the movement, which was conditioned more by the antiwar/hippie movement than by any sane assessment of family life.

      Comment by clarelspark — January 23, 2014 @ 3:35 am | Reply

  3. […] Above all, however, read the post-Freudian attachment theorists: you won’t find many feminists recommending them, for they  emphasize the danger of careless separations between mothers and infants: John Bowlby, Donald Winnicott and Margaret Mahler. (For my summary of how hasty maternal separation from infants and small children can cause panic attacks and separation anxiety, see http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/.) […]

    Pingback by Friendship in the era of anti-Freud | YDS: The Clare Spark Blog — May 18, 2013 @ 9:09 pm | Reply

  4. Reblogged this on YDS: The Clare Spark Blog and commented:

    Anxiety and separation anxiety are the mental diseases of our time. Famous authors have turned against “Victorian culture” with hilarious and scary objections.

    Comment by clarespark — March 3, 2013 @ 4:20 pm | Reply

  5. […] How neurotic are we, or are most of us rationally reacting to an objectively terrifying world? (For a related blog see http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/.) […]

    Pingback by Neurotic vs. objective anxiety: DSM-IV and beyond « YDS: The Clare Spark Blog — December 9, 2012 @ 11:03 pm | Reply

  6. […] Herbert Marcuse was correct when he warned of “repressive desublimation.” The fashion and cosmetic industry, plastic surgeons, hair stylists, and a host of women’s magazines urged  all women to cultivate their sexual attractiveness, even into old age. The sex could be dark, as fashion photographer Bruce Weber and others eroticized the submission to male fetishes, for instance, stiletto heels. (For a more extended commentary on the regnant S-M, see http://clarespark.com/2009/07/13/eros-and-the-middle-manager-s-m-with-implications-for-multiculturalism/. On the link between misogyny and antisemitism see http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/.) […]

    Pingback by The Sexual Revolution (2) « YDS: The Clare Spark Blog — October 3, 2012 @ 9:46 pm | Reply

  7. […] separation anxiety from the mother, with remarks on modernist rejections of Victorian culture see http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/.%5D Like this:LikeBe the first to like this. Leave a […]

    Pingback by Eros and the problem of solidarity « YDS: The Clare Spark Blog — September 3, 2012 @ 7:58 pm | Reply

  8. […] past that could have contributed to the separation anxiety that is called panic or other names. See http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/. If there is something amiss with mother-infant bonding, the patient must resort to inferences […]

    Pingback by History as trauma (2), Rosebud version « YDS: The Clare Spark Blog — March 18, 2012 @ 8:20 pm | Reply

  9. “What is a panic attack? Panic attacks are not fear responses to immediate threats like earthquakes. Rather, harmless but symbolically laden internal body signals stimulate terror: of isolation, of loss of support, of loss of balance, of descent into madness; it is the state of mind most desired by practitioners of psychological warfare. ”

    Having experienced this myself, I can say that it is a very terrifying, yet numbing state (hence the panic). I felt that I had no more bearings in the world, that nothing made sense, and I could not think clearly or rationally. I was very much in hell.

    Happily, one can — and I did — recover. Recovery meant having to shed illusions, disdaining comfort, and accepting and integrating harsh truths. I often find myself standing outside society in order to embrace it.

    Comment by stereorealist — January 8, 2012 @ 8:22 pm | Reply

  10. Clare,

    This is beautifully, powerfully, intelligently written! I’ll have to read it multiple times before I can get my mind entirely around it, let alone embrace the many implications for self and society that come out of it. It seems as if it should be an essay in a stand-alone book on The Anxiety Culture, or something like Totem and Tabloid, just to be tongue-in-cheek about it. Kubrick’s Strangelove might be the perfect film to explore as a corollary to your ideas about paralysis and mental warfare, weakened fathers and compensatory “small” or injured men, self-destruction and irrational flagellation, let alone species cooperation — I believe you are exactly right — as the pure antithesis it is, or was, to Cold War (narcissal) culture.

    Comment by david syracuse — February 19, 2010 @ 5:46 am | Reply

  11. […] noir, Jewish hucksters/merchants, Marx, Revolutionary Road In my reposted blog on panic attacks http://clarespark.com/2009/11/16/panic-attacks-and-separation-anxiety/, I mentioned the use by Eric Gill of Durer’s famous image (umlaut over the “u”). […]

    Pingback by Melencolia I and the apocalypse, 1938 « YDS: The Clare Spark Blog — November 17, 2009 @ 9:02 pm | Reply


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