Hints from the Health Department. Leaflet from the archive of the Society of Medical Officers of Health. Credit: Wellcome Collection, London
[Report of the Medical Officer of Health for Twickenham]#
This page requires JavaScript
Anxiety.
The need compelling most urgent attention is the threat of danger. When
the danger is real and comprehended we usually feel afraid and take steps
either by hiding, fleeing or fighting either alone or with others, to deal with the
threat. But when the danger is not understood, and most especially when the
support of a person or group of persons is withdrawn and we feel rejected or
despised, then instead of fear we experience the dreadful sensation of anxiety.
In the acute form it is a feeling of extreme discomfort, tinged perhaps with an
element of panic. It is so distressing that we will do almost anything to avoid
it; it is all-powerful and compelling. It takes our whole attention and while it
lasts all thoughts of other activities are suspended.
Anxiety of the worst form is nearly always brought on by the feeling of
rejection. It may also be brought on by the threat of the loss of the means for
sustaining life, such as food, shelter and warmth, but for practical purposes
anxiety results from loss of prestige and esteem, the loss of the love of someone
held dear, the loss of a friendship, or the loss of the assistance afforded by
friends, relatives, workmates, subordinates, superiors, or family. The reason
is that without others we cannot exist adequately; the loss of the support of
those important to us is a biological threat to existence, it produces an anxiety
so acute as to be almost unbearable. It is a denial of the instinct to herd
together for mutual protection.
When anxiety of any degree of severity arises any time in our lives we
react at once with conduct calculated to lessen it. This conduct is nearly
always a reversion to one of the forms of conduct typical of some stage of childhood
or adolescence. To see what these stages are let us consider behaviour,
emotional development and biological needs from babyhood to adult life.
Babyhood.
A young baby needs attention, care, warmth and shelter; milk, fondling
and love; he makes his wants known by wriggling and crying. There is little
emotional development at first, but towards the end of the first year he gradually
becomes aware of himself as a separate individual.
Toddler Stage.
As a toddler the child is concerned only with his own selfish needs especially
comfort; he has to learn the control of bladder and bowel, and to conform to the
wishes of his parents. In addition to the needs of a baby he seeks help from
his parents and wants to feel wanted and loved by them. When his needs are
denied he indulges in crying, shrieking, demanding, ' creating,' and temper
tantrums; later he becomes resigned to disappointment, is apathetic, feels
insecure and develops a clinging attitude; he becomes fearful, disobedient and
hateful. If this type of conduct continues to adult life he will react by regression
to childish conduct in every trying situation. By incessant demands,
tears, and temper outbursts he constantly gains attention; he assumes too
9