Dealing with fear

D. W. Winnicott the psychoanalyst and paediatrician wrote brilliantly about the fear of breakdown. He points out that the fear is linked to past experiences when trauma inflicted shock and left wounds because what happened was, at the time, impossible to assimilate. In other words something dreadful happened but could not be experienced. The breakdown in the sense of self has already occurred.
Usually people defend against this fear of breakdown so it only emerges during periods of stress or in psychotherapy often after some progress has been made. Winnicott writes about it as fear of the organisation of the ego breaking down: ‘I can’t cope’, ‘I can’t go on’, and ‘I’m falling apart’.
As such it is a reversal of what he calls the maturational process which works as long as there is what he calls a facilitating environment. In other words as we develop through infancy the environment adapts to help us do so. He describes the facilitating environment as holding and containing and this then allows integration to take place and from this the capacity to relate to others. When we are very small then we are in a state of absolute dependence on the facilitating environment – totally dependent on those taking care of us, usually mothers and fathers who act as the infant’s ego by making decisions in the best interests of the baby. But, sometimes, they, for all sorts of reasons, are not able to do this and then the infant can be exposed to what Winnicott so wonderfully calls primitive agonies but which are essentially survival anxieties. His list of these include a return to an unintegrated state so the defence against this is disintegration; falling for ever with the defence as self-holding; loss of what he calls psychosomatic collusion and failure of indwelling with the associated defence as depersonalisation; loss of the sense of real with the defence as exploitation of primary narcissism, and the last one he lists (though he says there are others) is the loss of the capacity to relate to others especially the primary care-givers and the defence for this is autistic states and relating only to self.
The central theme that he explains is that all the primitive agonies that lead to a fear of breakdown have already happened – the breakdown has already taken place and our psyche is primed to prevent another such assault as ever happening again – hence the fear of breakdown as shown in panic attacks and free floating anxiety or anxiety states. But the past cannot stay in the past because the ego first needs to gather it into its own present time experience and gain some control over it; it has to be experienced – in psychotherapy this would be in the transference especially when the traumatised person feels that the therapist has let them down in some way. Gradually what was too much is restored to its rightful place and size through understanding and acceptance of what happened.
Both psychologically and spiritually healing can begin when we recognise what has taken place; this can happen in therapy or spiritual direction or when we recognise our experience through a book, in a poem, in a painting or through listening to music or a sermon. The Bible offers many stories of trauma and restoration. In the section of Jeremiah (chapters 30-33.26) called the Little Book of Consolation the state of exile is described and the pain is first acknowledged:
‘For thus says the Lord: Your hurt is incurable, your wound is grievous. There is no one to uphold your cause, no medicine for your wound, no healing for you.’
Yet out of this despair restoration is promised.