Various theorists have proposed that the term ‘anxiety‘ should be reserved for fear stemming from a source that is unknown [...]]]> The idea that anxiety is not a unitary phenomenon is not new. Many clinicians and theorists contend, for instance, that fear ought to be distinguished from anxiety. Two lines of argument support this decision.

Various theorists have proposed that the term ‘anxiety‘ should be reserved for fear stemming from a source that is unknown to the stricken individual. It occurs ‘without stimulation from … external situations’. When a person is aware of a threatening object or situation, we should speak of fear rather than of anxiety. This difference between specific and ‘free-floating’ proves difficult to maintain either in theory or in practice. It is obviously true that the person who steps from the kerb and looks up to find a speeding car bearing down on him is afraid of a specific eventuality. But not much of significance in our lives is determined by this kind of fear. Nor do we tend to experience unpleasant emotion when we have to cross the street.

The person who is beset by free-floating anxiety is afraid that ‘something terrible is going to happen’, but he dots not know what it is. Such anxiety is seen in psychiatric patients suffering from anxiety states, but it is uncommon in the general population. Between the specific and the diffuse apprehension lie most anxiety reactions. They are neither highly specific nor completely diffuse. The mother who worries incessantly about her children’s welfare is afraid of a multitude of occurrences. A man may be afraid that he will be injured in any one of a large number of different mishaps. At any particular moment, the fearsome stimulus is specific; in general, it is diffuse. It has been suggested that free-floating anxiety is a relatively infrequent occurrence because anxiety does not remain for very long in a free state. To be afraid is painful; not to know why you are afraid can be catastrophic because you are then deprived of any avenue of escape from the threatening danger. To forestall a complete emotional collapse, the regulatory mechanisms of the personality are thought to attach the free anxiety to some object or event which then comes to be feared. A usual characteristic of this object or event is that it can be avoided without seriously impairing the persons general functioning (most of us can do very well even if we never take an aeroplane trip). There will ordinarily be a small kernel of reality to the fear (one could fall from a high place), but the fear is greatly exaggerated in proportion to the actual fearsome aspect of the stimulus. Such a state is called a phobia.

A phobia is an exaggerated fear of a specific object or event when the probability of harm to the individual is very small. Phobias do exist, but the idea that they represent the investment of free-floating anxiety is not easy to verify. There is a kind of logic to the connection; one asks how a fear could become greatly exaggerated if it did not have an unclassified reservoir of anxiety to feed it. But logic, no matter how impeccable, cannot substitute for empirical verification.

The idea of a relationship between free-floating anxiety and phobia originated with Freud. Early psychoanalysts were very much concerned with the problem of identifying and treating phobias. Many years ago, a learned psychologist  compiled a list of 135 phobias, assigning to each the customary Greek derivative name, like claustrophobia (fear of enclosed places), algophobia (fear of pain), and taphophobia (fear of being buried alive). Contemporary mental health practitioners are little concerned with phobia, though it is still conventional to refer to any anxiety not thought to be free-floating as ‘phobic’. Interest in phobia has declined because it is usually difficult to determine when a fear is specific enough to be called a phobia. Obviously, peccatophobia (fear of committing a sin) is a common and partly idiosyncratic phenomenon. It is a rare person who will not avoid pain if he can; at what point should we refer to an algophobia ? Instances in which the fear is clearly a phobia seldom occur.

The distinction between anxiety and fear based on a specific source holds up only at extremes. It is appropriate for the relatively rare occasions in which the emotion is provoked by a sharply delineated object or situation, and for the state of the psychiatric patient who cannot ascribe a reason for his feelings; it is difficult to apply to a multitude of states which fall in the midrange.

Another suggested distinction is that fear is proportionate to a perceived, objective danger, whereas anxiety is a disproportionately intense reaction. Suppose, for example, that a person finds himself living in an epidemic area in which as many as one out of every four people is contracting a very serious disease. Manifestations of fear in the form of prophylactic measures that cause inconvenience, discomfort, pain, hardship and loss of pleasure would not be regarded as disproportionate. Now suppose that the incidence of the disease was one in 100,000 of the local population. The probability that any one person will contract the illness is so infinitesimal that extreme behaviour would reflect an exaggerated fear.

This example is unusual. In many instances, it is no simple matter to determine the reality of the situation except, perhaps, in rather crude terms. For example, there is always some danger that something untoward will happen to a child who is permitted to go downtown by himself. Obviously, one does not allow this licence to a four-year-old. At what age or stage of development, or under what circumstances, should a child be allowed to undertake this venture? At what point does parental anxiety cease being reality-orientated and become disproportionate? The determination is complex and difficult to make apart from a specific child and a specific circumstance. The proportionality argument is very much like the matter of source. It can be maintained only at the extreme, but is otherwise lacking in applied value. Finally, it should be noted that no difference between anxiety and fear, no matter how they arc conceptualized in theory, is reflected in physiological concomitants. The human body reacts in much the same fashion whether the anxiety is considered to be specific, diffuse, exaggerated or realistic.

The distinction between anxiety and fear is no more than theoretical, at least at present. Experimentalists consider the terms to be interchangeable, with perhaps different minor shadings of meaning.

The word stress is used constantly in connection with emotional states; it appears almost as often in discussions of anxiety as does the word ‘anxiety’ itself. The expression seems to be employed in a number of different ways, usually without a specific explanation of the user’s intent. This usage has resulted in a fair amount of confusion, and suggests that there is no consensus on its meaning. But the word is so well implanted in the scientific literature on emotion that it cannot be ignored in any systematic treatment of anxiety. Stress is a construct which psychology and medicine have taken over from the physical sciences. Physical stress is force exerted on a structure or system which, if increased beyond a certain intensity, will result in deformity of the structure or system. Hans Selye, the great proponent of stress as a factor in medicine, sought to apply the construct to dysfunction of the human body.’ Despite its salience in his philosophy of medicine, Selyc) is none too clear about what he means by stress. At one point he says that stress is purely an abstraction. At another point, he refers to stress as a condition of the organism measured in terms of its reactions. And again, he calls it something which is brought about by a ‘stressor’.

This confusion is carried on in the psychological literature. Varying contexts indicate that stress, to different experimenters and theorists, means:
. A particular stimulus situation, without reference to the reactions of the subject;
2. A particular reaction or set of reactions of the individual, without reference to the situation;
3. A particular situation and a particular response or group of responses; or
4. A state of the individual which brings about a particular set of reactions.

The multiplicity of uses of the word very much resembles the employment of the word ‘anxiety‘ itself. The inference is that stress is being used approximately synonymously with anxiety, or with any other emotional state with which the experimenter or theorist is dealing. Anxiety and stress arc ‘homomorphisms’, as one theorist puts it. The value of a word like stress appears to be that its syntactical properties permit the writer to employ more graceful phrasings, that is, ‘stressful’ rather than ‘anxiety-evoking’, or ‘stressed’ instead of ‘subjected to an anxiety-evoking stimulus’.
To avoid any possible misunderstanding, I will indicate the specific terms under which stress will be used, in this book, to refer to anxiety.

1. A ‘stress’ or ‘stressful’ situation is one containing stimuli or circumstances calculated to arouse anxiety in the individual.
2. ‘Under stress or ‘stressed’ refer to an individual who is faced by, or in the midst of, a stress situation.
3. A ‘stress reaction’ is an alteration of the individual’s condition or performance which comes about presumably as a result of being under stress.

It seems wise to use ‘stress’ as a generic term for the whole area of problems that includes the stimuli producing stress reactions, the reactions themselves and the various intervening processes…. Stress is … a collective term for an area of study. … As used here, it will be nothing more than a general label like motivation or cognition. It defines a large, complex, amorphous interdisciplinary area of interest and study.

Tension is another physical concept closely allied to stress. Literally, something that is tensed is stretched taut or distended by pressure or stress. If the stress continues past a certain point, the taut object will break.
In an analogous fashion, psychological tension refers to a state of the organism created by stress. The appropriateness of the concept is enhanced by the fact that an actual tensing of the musculature of the body is an ordinary concomitant of emotional arousal. Tension is also conceptualized more broadly as a state of disequilibrium brought about by some psychological need, leading to behaviour that tends to satisfy the need and thereby restore equilibrium. In this sense, the tension of anxiety can be thought of as the result of a need to behave in a manner calculated to reduce the anxious feeling. Often, the anxiety is not experienced consciously because of the buffering effect of the defence mechanisms . The subsequent feeling is popularly known as ‘nervous tension’. Tension thus may have two meanings with reference to anxiety and stress. Less commonly, it refers to a condition of the musculature which accompanies anxiety, or which may be an anxiety residual. More often, tension means a vague feeling of disquiet, a restlessness, a diffuse, unidentified wanting to do something that is a consequence of anxiety occurring at a level below conscious awareness. In this sense, tension is an intervening variable, a state which links unconscious anxiety to manifest behaviour.

When the psychologist says that a person is anxious, the statement may be interpreted in either of two ways. It may mean that the individual is anxious at the moment, or it may mean that he is an anxious person. The two interpretations arc quite different. The former refers to an immediate and probably ephemeral state, whereas the latter is a constant condition without a time limitation. The interpretations arc usually differentiated by applying the adjectives acute and chronic, words commonly used to describe states of human pathology. ‘Acute’ means of high intensity and relatively short duration; ‘chronic’ means of relatively low intensity and indefinite duration.

‘Acute’, as a descriptive term, applies reasonably well to pathological anxiety states. The ‘acute anxiety attack’ that brings a person to the psychiatrist’s office seldom lasts very long, at least not in its initial, intense form. This high level of intensity is rarely encountered in experimental situations in which anxiety is being studied. The stressed laboratory subject often experiences an upsurge of anxiety, but it hardly ever achieves the proportions seen in naturally occurring psychopathology. We might therefore distinguish between acute as referring to the psychiatric patient, and situational or transient, as describing the noticeable, but lesser, anxiety of the stressed subject.
Following general usage, chronic anxiety should mean a continuing state of relatively low anxiety. This conception is in conflict with the available facts. The acutely anxious person is characterized by a horrible awareness of his feelings, though he may not always be able to identify thefeeling as anxiety. Continuous anxiety of low intensity is simply never reported. In theory, most of us may be characterized by a constant, low level of anxiety, of which we arc ordinarily unaware. The individual who is regarded as chronically anxious, the ‘worrier’, is identified not by a degree of anxiety but by a high frequency of occurrences and objects that evoke a detectable degree of anxiety in him. ‘Chronic’, in the sense of constant or continual, is misleading when applied to an emotional state like anxiety. What is actually meant is a high proneness or predisposition to experience anxiety. The anxiety-prone individual is one who has a noticeable upsurge of feelings of anxiety on a relatively large number of occasions, under more circumstances and in a larger number of different situations than do his peers.

Situational anxiety is a transitory state which is ephemeral, occurs in response to a stimulus and is likely to vary in intensity as a function of the stimulus, and is characterized by a variety of associated physiological reactions. Anxiety-proneness is a relatively unfluctuating condition of the individual which exerts a constant influence on his behaviour. Such conditions of the individual are usually regarded as personality traits . Spielberger has pointed out that anxiety-prone individuals – those who arc high on ‘A-trait’ – will experience ‘A-state’ more frequently than those who arc low on A-trait, but they will not necessarily experience A-state more intensely. In any given situation, the anxiety-prone individual is more likely to experience anxiety, but the intensity of his feelings will be a function of the nature of the situation as well as of his personal characteristics. Since we do not expect a perfect correlation between trait and state, it is invariably important to know which of the two meanings is intended by an experimenter or theorist when he employs the terms ‘anxiety’ or ‘anxious’. Meaning is determined by the operational criterion of anxiety, the instrument or device that is used to measure it in the experiment.

Anxiety and its allied concepts are, like many of the phenomena with which behavioural science deals, constructs. They arc inventions of the scientist, so to speak, which arc used to explain observable behaviour, but have no clear physical existence themselves. Theoretical distinctions among anxiety, fear and phobia are based on the degree to which the emotion is specific to a stimulus, or its appropriateness to a situation. These criteria are difficult to maintain pragmatically except for occasional extreme instances. For all practical and experimental purposes, anxiety and fear arc indistinguishable. The terms ‘stress’ and ‘tension’ are used frequently with reference to anxiety. The former appears to be a kind of operator word which is applied in connection with emotion-evoking situations and reactions. Analysis suggests that it is customarily employed in a more or less synonymous fashion with the particular emotion under investigation. Meditation can help with anxiety.
Tension may refer either to a condition of the musculature of the body which indicates the presence of anxiety, or to a vague feeling of restlessness which suggests the presence of anxiety at a level below conscious awareness.
The terms ‘acute’ and ‘chronic’ do not appear to be suitable for describing anxiety. For experimental purposes, the appropriate adjective to describe a temporary upsurge of anxiety is ‘situational’. The individual to whom the word ‘chronic’ is commonly applied might better be described as a person with a high predisposition or proneness to experience anxiety. Constructs like anxiety and fear may be defined purely in vernacular terms for purely theoretical purposes. In the scientific investigation, constructs are defined in terms of operations and responses. Operational definitions arc seen as partial definitions of the construct. An eventual demonstration of relationships among various partial definitions would verify the existence of a unitary construct. In this sense, behavioural science has not yet demonstrated that ‘anxiety’ actually does exist.