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October 1983

Panic and Anxiety-Reply

Author Affiliations

Department of Psychiatry Columbia University 722 W 168 St New York, NY 10032

Arch Gen Psychiatry. 1983;40(10):1149. doi:10.1001/archpsyc.1983.01790090111018

In Reply.—  Dr Weitzner agrees with us that Freud did not etiologically distinguish chronic anxiety and panic attacks. However, although it was not questioned in our article, he wishes to affirm that Freud made such phenomenologic distinctions. Actually, Freud went beyond a simple subcategorization of anxiety.In his 1894 article, "Obsessions and Phobias,"1 Freud stated: "In the case of agoraphobia etc., we often find the recollection of an anxiety attack; and what the patient actually fears is the occurrence of such an attack under the special conditions in which he believes he cannot escape it." In an earlier translation, supervised by Joan Riviere, the term "anxiety attack" is translated as "panic."Therefore, Freud not only made phenomenologic distinctions, he also saw the causal relationship between the primary panic attack, secondary fear of helplessness, and the development of avoidant behaviors.One can only speculate why Freud's clear recognition never became part of