Fear of Breakdown

In this account, Winnicott contends that a fear of breakdown expressed by some patients in sessions refers to an experience of a breakdown earlier in life which cannot be returned to without help. The experience is defended against because unthinkable anxieties or ‘primitive agonies’ prevail. There is no self to sustain facing this experience again, and even a psychotic illness may be preferable. This fear is characterized by feelings of falling forever, a loss of reality sense and a loss of the capacity to relate to objects. Often analysis feels unproductive or futile because this state has not yet been identified. Persistent fears of a death that has happened and not been faced as well as feelings of annihilation, emptiness and nonexistence all feature in this symptom. A clinical example is given of this ‘fear of breakdown’.