When I am mentally healthy, I am integrated and woven into the world to such an extent that my body and my feelings remain largely hidden from me. They disappear in the practical flow of my daily life because I am already geared to my situation, seamlessly living through the medium of my body without explicitly reflecting on it. In this state of everydayness, there is no separation between self and world; the world appears spontaneously to me as something that I understand, that I belong to, and am ‘at home’ in. It shows up as real, secure, and reliable, and others show up for me as equally real, secure, and reliable. In this state, I have what Laing calls “ontological security” (1960, 39, 42). Secure in my being, I can pre-reflectively move through the world, handle various situations, and affectively involve myself in the lives of others. From the perspective of existential therapy, psychopathology begins to emerge when this embodied connection breaks down, shattering my sense of self. Without the unified bond of being-in-the-world to integrate and hold my identity together, I feel as if I am losing myself, as if I am becoming nothing. Existentialists usually refer to this uncanny dissolution of the self in terms of ‘anxiety’ or Angst.
Again, anxiety is not to be reduced to a bio-chemical reaction to a perceived threat. It is not a medical condition but a structure of being human, a basic experience that discloses the nothingness that underlies my everyday being-in-the-world. Existentialists make it clear that anxiety is not to be confused with fear. Fears can be located, understood, and managed because they are always of something; they relate to external objects or things. Anxiety is a fear of nothing, and this why it is so terrifying. I have the unsettling feeling that the meaningful structure of being-in-the-world that holds my identity together is slipping away, but I cannot point to or explain what it is I am anxious about because I am the source of it. Anxiety discloses the fact that it is my identity or being itself that is nothing, that I am not a stable, substantial, and enduring thing, but a ‘being-possible,’ a ‘being-toward-death.’ This is why Heidegger says, “So if the ‘nothing’ exhibits itself as that in the face of which one has anxiety, this means that [human existence] itself is that in the face of which anxiety is anxious” (1962, 187–188). Anxiety, in other words, emerges out of my own structural nothingness, and this I why I cannot point to what is that I am anxious about; it “threatens [from] nowhere” (186).
The fact that I cannot explain or locate the source of my anxiety makes the feeling all the more horrible, creating a sense of profound helplessness that begets even more anxiety. To defend against this, most of us are able to displace it, turning the overwhelming fear of nothing into a fear of something. In this way, as Kierkegaard puts it, “the nothing which is the object of anxiety becomes, as it were, more and more a something” (1944, 55). Through this displacement, the fear of my own nothingness becomes something ordinary and manageable, transposed into a much less threatening fear of flying, fear of heights, or fear of public speaking. Such displacement allows me to be reabsorbed into the flow of the world, solidifying the illusion of my own being as something enduring and real. But for those with a diminished sense of ontological security, transforming anxiety into fear is not so easy. For such people, anxiety continually “attacks from all directions at once” (May 1950, 2256), and the self is under a constant threat of annihilation.
This experience is characterized by a collapse in the fluid synergy between my body and the world, where even the most basic tasks of everyday life — standing up and moving, reaching out and taking hold of things, and interacting with others — become difficult. Overwhelmed by anxiety, my body loses its transparent grip on the world and begins to obtrude as a brute thing or object, as something clumsy and foreign that inhibits my engagement with the world. Laing describes this experience in terms of ‘the unembodied self.’ “In this position,” he writes, “the individual experiences his self as being more or less divorced and detached from his body. The body is felt more as one object among other objects in the world than as the core of the individual's own being” (1960, 69). Dissociated from my own body and from the world in this way, I am unable to meaningfully participate in the lives of others. Their gestures, words, and actions appear as lifeless and unreal to me as my own body does. This experience can result in feelings of ‘depersonalization’ where I feel as if I am not actually there and the world is not real (see Fuchs 2005). In this state, I know there is a world out there, but I can no longer feel it. It doesn't resonate emotionally as something substantial, meaningful, or significant to me. For clinicians, patient descriptions of this experience include statements like: “This seems unreal,” “This is like a dream,” “Nothing seems to be touching me,” and “This is not happening” (Laing 1960, 78).
When the world collapses in this way, not only does my identity slip away, but also others now appear to me as a threat because they expose the frailty and uncertainty of my being. When I interact with people who seem to be integrated, substantial, and whole, I am reminded of my own fragile and vulnerable state, that I have to put on a mask when I'm in public in order to “play at being sane” (148). To protect against this, the tendency is to withdraw and isolate oneself from others. But isolation further diminishes my sense of self, exacerbating the feeling of unreality. This is because, on the existentialist view, my identity exists only insofar as it is publicly acknowledged. I can understand myself as the person that I am — as a teacher, a husband, or a father — only in relation to how others see me. In other words, who I am and how I interpret myself is constituted by my being-with-others. This is why Sartre writes, “The Other holds a secret — the secret of what I am. He makes me be and thereby possesses me” (1956, 475). Without this inter-human relation, I am cut off from the world and my publicly interpreted identity begins to die. One of the goals of existential therapy, then, is to reestablish a sense of relation with others, to reintegrate the patient back into the public world so that a stable sense of identity can emerge and ontological security can be reestablished. But the primary aim is much more than this. The existential therapist wants the patient to learn from the experience, to recognize that anxiety is not necessarily a sign of insanity or a bio-chemical disorder. It is a teacher that reveals a painful but inescapable truth about the human situation, namely, that we are nothing, that we are “not real” (see Loy 1996). This is a radical way to rethink psychopathology. From the existential perspective, the individual who is overwhelmed with anxiety and experiences the collapse of the world may not be deluded; he or she may actually be glimpsing the truth of the human situation. As Laing writes: