Precipitation anxiety

Therapy with autistic and psychotic children led the author to introduce the concept of precipitation anxiety. Freud's first theory of the instincts was expressed in the dynamics of conflict, but his subsequent development of life and death instincts is better understood in terms of a gradient of energy between two extremities of the same axis. Object relations result from a caesura (Bion) which creates a gradient of psychic energy experienced initially as a precipice which, if left unregulated, generates intolerable anxiety. Satisfactory emotional encounters with the mind of the object bring about the necessary adjustments to the slope of the gradient. Autistic mechanisms may block off precipitation anxiety, but they also prevent mental growth. Both the dynamics of conflict and the dynamics of the gradient are vital for psychic development, but the very existence of the former is contingent on successful negotiation of the energy gradient (working through). After illustrating his thesis with clinical material drawn from a group therapeutic setting, the author discusses points of convergence and divergence with two other fundamental notions: the aesthetic conflict (Meltzer) and premature psychic birth (Tustin). The proposed model furthers our understanding of the therapeutic process and stresses the importance of the containing object in the transference situation.