Anxiety has long been recognised in psychiatry as one of the most common symptoms of mental disorder. Psychiatric descriptions of anxiety generally refer to both mental phenomena (apprehension, worry) and bodily phenomena (breathlessnes, palpitations, muscle tension, fatigue, dizziness, sweating and tremor). Psychiatrists also distinguish between generalised anxiety states, when 'free-floating anxiety' is present most of the time, and 'panic attacks', which are 'intermittent episodes of acute anxiety' (Hughes, 1981: 48-9). The German term employed by Freud (Angst) can have the psychiatric sense described above, but is by no means an exclusively technical term, being also in common use in ordinary speech. Freud developed two theories of anxiety during the course of his work. From 1884 to 1925 he argued that neurotic anxiety is simply a transformation of sexual libido that has not been adequately discharged. In 1926, however, he abandoned this theory and argued instead that anxiety was a reaction to a 'traumatic situation' - an experience of HELPLESSNEss in the face of an accumulation of excitation that cannot be discharged. Traumatic situations are precipitated by 'situations of danger' such as birth, loss of the mother as object, loss of the object's love and, above all, castration. Freud distinguishes between 'automatic anxiety', when the anxiety arises directly as a result of a traumatic situation, and 'anxiety as signal', when the anxiety is actively reproduced by the ego as a warning of an anticipated situation of danger. Lacan, in his pre-war writings, relates anxiety primarily to the threat of fragmentation with which the subject is confronted in the mirror stage (see FRAGMENTED BODY). It is only long after the mirror stage, he argues, that these fantasies of bodily dismemberment coalesce around the penis, giving rise to castration anxiety (Lacan, 1938: 44). He also links anxiety with the fear of being engulfed by the devouring mother. This theme (with its distinctly Kleinian tone) remains an important aspect of Lacan's account of anxiety thereafter, and marks an apparent difference between Lacan and Freud: whereas Freud posits that one of the causes of anxiety is separation from the mother, Lacan argues that it is precisely a lack of such separation which induces anxiety. After 1953, Lacan comes increasingly to articulate anxiety with his concept of the real, a traumatic element which remains external to symbolisation, and hence which lacks any possible mediation. This real is 'the essential object which isn't an object any longer, but this something faced with which all words cease and all categories fail, the object of anxiety par excellence' (S2, 164). As well as linking anxiety with the real, Lacan also locates it in the imaginary order and contrasts it with guilt, which he situates in the symbolic (Lacan, 1956b: 272-3). 'Anxiety, as we know, is always connected with a loss . . . with a two-sided relation on the point of fading away to be superseded by something else, something which the patient cannot face without vertigo' (Lacan, 1956b: 273). In the seminar of 1956-7 Lacan goes on to develop his theory of anxiety further, in the context of his discussion of PHOBIA. Lacan argues that anxiety is the radical danger which the subject attempts to avoid at all costs, and that the various subjective formations encountered in psychoanalysis, from phobias to fetishism, are protections against anxiety (S4, 23). Anxiety is thus present in all neurotic structures, but is especially evident in phobia (E, 321). Even a phobia is preferable to anxiety (S4, 345); a phobia at least replaces anxiety (which is terrible precisely because it is not focused on a particular object but revolves around an absence) with fear (which is focused on a particular object and thus may be symbolically worked-through) (S4, 243-6). In his analysis of the case of Little Hans (Freud, 1909b), Lacan argues that anxiety arises at that moment when the subject is poised between the imaginary preoedipal triangle and the Oedipal quaternary. It is at this junction that Hans's real penis makes itself felt in infantile masturbation; anxiety is produced because he can now measure the difference between that for which he is loved by the mother (his position as imaginary phallus) and that which he really has to give (his insignificant real organ) (S4, 243). Anxiety is this point where the subject is suspended between a moment where he no longer knows where he is and a future where he will never again be able to refind himself (S4, 226). Hans would have been saved from this anxiety by the castrating intervention of the real father, but this does not happen; the father fails to intervene to separate Hans from the mother, and thus Hans develops a phobia as a substitute for this intervention. Once again, what emerges from Lacan's account of Little Hans is that it is not separation from the mother which gives rise to anxiety, but failure to separate from her (S4, 319). Consequently, castration, far from being the principal source of anxiety, is actually what saves the subject from anxiety. In the seminar of 1960-1 Lacan stresses the relationship of anxiety to desire; anxiety is a way of sustaining desire when the object is missing and, conversely, desire is a remedy for anxiety, something easier to bear than anxiety itself (S8, 430). He also argues that the source of anxiety is not always internal to the subject, but can often come from another, just as it is transmitted from one animal to another in a herd; 'if anxiety is a signal, it means it can come from another' (S8, 427). This is why the analyst must not allow his own anxiety to interfere with the treatment, a requirement which he is only able to meet because he maintains a desire of his own, the desire of the analyst (S8, 430). In the seminar of 1962-3, entitled simply 'Anxiety', Lacan argues that anxiety is an affect, not an emotion, and furthermore that it is the only affect which is beyond all doubt, which is not deceptive (see also Sl l, 41). Whereas Freud distinguished between fear (which is focused on a specific object) and anxiety (which is not), Lacan now argues that anxiety is not without an object (n'est pas sans objet); it simply involves a different kind of object, an object which cannot be symbolised in the same way as all other objects. This object is objet petit a, the object-cause of desire, and anxiety appears when something appears in the place of this object. Anxiety arises when the subject is confronted by the desire of the Other and does not know what object he is for that desire. It is also in this seminar that Lacan links anxiety to the concept of lack. All desire arises from lack, and anxiety arises when this lack is itself lacking; anxiety is the lack of a lack. Anxiety is not the absence of the breast, but its enveloping presence; it is the possibility of its absence which is, in fact, that which saves us from anxiety. Acting out and passage to the act are last defences against anxiety. Anxiety is also linked to the mirror stage. Even in the usually comforting experience of seeing one's reflection in the mirror there can occur a moment when the specular image is modified and suddenly seems strange to us. In this way, Lacan links anxiety to Freud's concept of the uncanny (Freud, 1919h). Whereas the seminar of 1962-3 is largely concerned with Freud's second theory of anxiety (anxiety as signal), in the seminar of 1974-5 Lacan appears to return to the first Freudian theory of anxiety (anxiety as transformed libido). Thus he comments that anxiety is that which exists in the interior of the body when the body is overcome with phallic jouissance (Lacan, 1974-5: seminar of 17 December 1974).