A Psychodynamic Perspective of Generalized Anxiety Disorder
- Adam Pierce
- Mar 23
- 4 min read
Generalized Anxiety through Freudian Theory
Generalized anxiety disorder (GAD) is marked by pervasive worry, psychological tension, and internal unrest that impairs functioning (American Psychiatric Association [APA], 2022). From a Freudian psychodynamic perspective, anxiety may be understood as an emergence of unconscious conflict between internal psychic structures of the id, ego, and superego, with each structure exerting different drives and moral demands upon the personality (Bornstein, 2005; Bornstein et al., 2020; Cervone & Pervin, 2023). The ego is the rational, grounded part of the psyche that mediates between the id's instinctual demands and the superego's moral constraints to maintain psychological balance (Bornstein, 2005; Bornstein et al., 2020; Cervone & Pervin, 2023). Within this context, the characteristic nervousness associated with GAD may represent the ego’s inability to mediate internal tensions, especially when early developmental experiences have reinforced repressive defenses and unresolved developmental fixations (APA, 2022; Bornstein et al., 2020; Craighead et al., 2017; Zhang, 2024). Alternatively, this unease may emerge when the ego becomes overwhelmed by persistent intrapsychic tension branching from repressed fears or unresolved conflicts (Bornstein et al., 2020; Craighead et al., 2017; Zhang, 2024).
A Freudian Perspective on Personality Structure and Process Underlying GAD
The personality structure in Freudian theory comprises enduring intrapsychic agencies (Cervone & Pervin, 2023). Freud’s structural model views personality as a balance of the id’s instinctual drives, the superego’s moral constraints, and the ego’s role as a mediator (Bornstein et al., 2020; Cervone & Pervin, 2023). For individuals with GAD, an overactive superego and a weakened ego may result in heightened guilt, personal criticism, and repression of instinctual drives (Bornstein, 2005; Bornstein et al., 2020; Cervone & Pervin, 2023). This personality structure of a fragile ego is then unable to reconcile internal conflicts, which leads to chronic anxiety (Cervone & Pervin, 2023; Zhang, 2024). This tension may become an enduring trait, aligning with structural personality traits that are observed to underlie neuroticism and guilt-proneness, which then stimulates the individual’s personality processes (Bornstein et al., 2020; Cervone & Pervin, 2023; Pawlack et al., 2024). Freud describes this process dimension of personality through defense mechanisms, which can be reasoned for GAD as automatic and unconscious ways people cope with anxiety (Bornstein et al., 2020; Cervone & Pervin, 2023; Zhang, 2024). Defenses like repression, displacement, and projection then dominate behaviors and function unconsciously to protect the ego from perceived threats (Bornstein, 2005; Bornstein et al., 2020). These processes, while initially adaptive, may then become rigid and maladaptive when overused and result in chronic worry and the impaired functioning associated with the clinical diagnosis of this disorder (APA, 2022; Bornstein et al., 2020; Cervone & Pervin, 2023; Zheng, 2024).
Developmental and Clinical Implications of GAD from a Psychodynamic Perspective
From a developmental dimension of personality, GAD symptomologies reflect arrested growth and development due to unresolved conflicts in Freud’s early psychosexual stages (APA, 2022; Bornstein, 2005; Cervone & Pervin, 2023; Zhang, 2024). This may originate in the phallic or latency stages, where internalization of fear or punishment disrupts healthy ego development (Bornstein et al., 2020; Cervone & Pervin, 2023). The personality fails to associate effective coping mechanisms, resulting in maladaptive responses to stress and uncertainty (Bornstein et al., 2020; Cervone & Pervin, 2023). Fixation during these stages may produce enduring dependency or authority anxieties, predisposing individuals to obsessive worry and emotional dysregulation requiring therapeutic intervention (APA, 2022; Bornstein, 2005; Cervone & Pervin, 2023; Zhang, 2024). Freudian theory emphasizes uncovering unconscious material or impediments and strengthening the ego to address psychopathology and therapeutic change (Bornstein, 2005; Cervone & Pervin, 2023; Crits-Christoph et al., 2004). This may develop from making the unconscious conscious through insight-oriented therapy, which aims to resolve repressed conflicts and allow for greater psychological integration and flexibility (Bornstein et al., 2020; Crits-Christoph et al., 2004). Psychodynamic therapy aims to uncover early relational patterns and repressed conflicts, enabling insight and ego strengthening (Bornstein, 2005; Cervone & Pervin, 2023; Crits-Christoph et al., 2004). This therapeutic change is achieved not solely through symptom reduction but by restructuring internal psychic dynamics (Crits-Christoph et al., 2004). By working through these unconscious processes, individuals may achieve greater psychological integration and symptom relief (Cervone & Pervin, 2023; Crits-Christoph et al., 2004).
Closing Thoughts
Freud’s psychodynamic theory provides a distinctive framework to approach generalized anxiety disorder as rooted in unconscious conflict and developmental disruption (Bornstein, 2020; Cervone & Pervin, 2023). Its enduring relevance lies in revealing the internal architecture of anxiety from inner structures for understanding the disorder and guiding therapeutic growth (Bornstein, 2005; Cervone & Pervin, 2023; Crits-Christoph et al., 2004). Future discussions will explore trait-oriented and biological approaches to explain GAD's development, maintenance, and treatment.
I invite readers to join this deepening of understanding.
References:
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.; DSM-5-TR).
Bornstein, R. F., Maracic, C. E., & Natoli, A. P. (2020). The psychodynamic perspective. In V. Zeigler-Hill & T. K. Shackelford (Eds.), The SAGE handbook of personality and individual differences: Volume I (pp. 27–47).
Bornstein, R. F. (2005). Reconnecting psychoanalysis to mainstream psychology Challenges and opportunities. Psychoanalytic Psychology, 22(3), 323–340. https://doi.org/10.1037/0736-9735.22.3.323
Cervone, D., & Pervin, L. A. (2023). Personality: Theory and research (15th ed.). Wiley.
Craighead, W. E., Miklowitz, D. J., & Craighead, L. W. (Eds.). (2017). Psychopathology: History, diagnosis, and empirical foundations (3rd ed.). Jossey-Bass.
Crits-Christoph, P., Gibbons, M. B. C., Losardo, D., Narducci, J., Schamberger, M., & Gallop, R. (2004). Who Benefits from Brief Psychodynamic Therapy for Generalized Anxiety Disorder? Canadian Journal of Psychoanalysis, 12(2), 301-324,369-371. https://www.proquest.com/scholarly-journals/who-benefits-brief-psychodynamic-therapy/docview/222771759/se-2
Pawlak, M., Schmidtler, H., & Kopala-Sibley, D. C. (2024). Neuroticism and extraversion as predictors of first-lifetime onsets of depression, anxiety, and suicidality in high-risk adolescents. Development and Psychopathology. https://doi.org/10.1017/S0954579424000130
Zhang, Z. (2024). A comprehensive overview on the generalized anxiety disorder – etiology and treatment. SHS Web of Conferences, 193, 03008. https://doi.org/10.1051/shsconf/202419303008
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