Nervous Anxiety States and Their Treatment

views updated


This book, for which Sigmund Freud wrote a fore-word, was a compromise between Wilhelm Stekel's view, that all neuroses were rooted in a psychological conflict, and the position of Freud, that anxiety states were caused by the toxic effect of supposed sexual mis-steps. The contents were discussed by Stekel with Freud in a series of weekly meetings during 1907-1908; Stekel persuaded his mentor that at least some anxiety states had a psychological etiology and for such cases Freud proposed the term "anxiety hysteria."

The first part of the book, on anxiety neuroses, presents a large amount of case material indicating the successful treatment of a number of anxiety equivalents through the removal of the sexual mis-practice. The second part, which deals in a similar way with different forms of anxiety hysteria, has an introductory section by Freud himself (acknowledged only in the third and fourth editions). A third part includes chapters on the diagnosis and therapy of anxiety states, and on the technique of psychotherapy. There it is revealed that Stekel has given up using the couch, and is sitting beside his patients at a desk.

The second and subsequent editions of the book, which appeared in 1912, 1921, and 1924, formed the first of a ten-volume work, Störungen des Trieb- und Affektlebens. Over the course of these volumes, Stekel increasingly distanced himself from Freud. The latter's rather lukewarm foreword was dropped in later editions.

The main characteristic of this book is its abundance of fascinating case material. Unlike Freud, who was inclined to theorize on the basis of paradigm cases, Stekel presented as much material as possible and was inclined to avoid "sterile theoretical considerations." (Stekel, 1908, p. 180) The book includes much medial detail, particularly in the chapter on therapy where the use of opium and bromide are discussed. Both Eugen Bleuler and Carl Gustav Jung reviewed the book favorably. The fact that Arthur Schnitzler read it is some pointer to its impact.

Frances Clark-Lowes

See also: Stekel, Wilhelm.

Source Citations

Stekel, Wilhelm. (1908). Nervöse Angstzustände und ihre Behandlung. Berlin-Wien: Urban and Schwarzenberg.

Freud, Sigmund. (1908). Preface: Stekel's "Nervous anxiety-states and their treatment." SE, 9: 250-251.


Bleuler, Eugen. (1908). Dr Wilhelm Stekel, spezialarzt für psychotherapie in Wien: nervöse angstzustände und ihre behandlung. Münchner medizinische Wochenschrift, 32, 1702-1703.

Jung, Carl Gustav. (1908b). Review of W. Stekel: "Nervöse angstzustände und ihre behandlung." In Collected Works, t. 18. London: Routledge and Kegan Paul.

Stekel, Wilhelm. (1907). Die ursachen der nervosität. Neue ansichten über deren entstehung und verhütung. Vienna: Knepler.

. (1950). The autobiography of Wilhelm Stekel. The life story of a pioneer psychoanalyst. New York: Liveright.