Cormac Gallagher – High Anxiety – A Theoretical and Clinical Challenge to Psychoanalysis

THE LETTER 06 (Spring 1996) pages 1-23


You will have recognised that the title ‘High anxiety’ has nothing original about it and is in fact borrowed from Mel Brooks’ comedy about the antics of psychiatrists and psychoanalysts.

I chose it as a way of reminding myself that in our often grim profession anxiety can introduce us to comedy as well as tragedy and that wit and humour can be used as tools for transforming unpleasure into pleasure. One of my clients, when she feels particularly anxious, whispers a line from that film to herself: ‘Baby steps, baby steps’. The legend goes that Freud, when asked to give an attestation that he had been well treated in the anxiety-ridden days before he left Vienna, scrawled: ‘ I can recommend the Gestapo to anyone!’

But in fact we know that such a partial transformation of the vinegar of anxiety back into the wine of sexual excitation is not easy to achieve and that the anxiety which drives a client to consult us in the first place or which may suddenly erupt in the course of an analysis confronts us and our method with a severe challenge.

I must admit that on several occasions, at the end of an initial interview, I have recommended highly anxious patients to consult a psychiatrist or a cognitive-behavioural therapist rather than embark on an analysis. Yet I am not at ease with that way of avoiding the question because the whole literature of psychoanalysis, and in particular the work of Freud from beginning to end, could be said to be organised around the use of the talking cure to understand and treat anxiety, making of this most unpleasurable experience a way for the sufferer to gain access to the truth of his or her subjectivity. So that to recommend to someone seeking analysis that they should take the route of suppressing anxiety, by psychological or…

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