When we speak of anxiety, we often mean a restless unease — the shakiness, a racing mind, a panicky belly, the sense that something unnamed is just slightly off. At this level, anxiety can be a messenger from the body, a signal that something in our life longs for safety, movement, or rest. This anxiety has more of an existential essence than a medical one.
There are also more clinical forms — those with biological or hereditary roots, where the chemistry of the brain and body conspire to generate waves of fear and agitation seemingly independent of outer circumstance. These can be supported through the healing arts of relational therapy, the conscious use of medication, and somatic regulation.
Beneath these surface layers, there exists another form — one that feels less like a symptom and more like an initiation. It’s what Heinz Kohut called disintegration anxiety, though in the language of alchemy, we might call it a nigredo — the dark ferment where the old structures of identity begin to dissolve.
When this level of anxiety arises, it can feel as though the self might come apart, that we might dissolve into chaos and never return. It is not merely the fear of death or failure, but the trembling of the ground of being itself — what Winnicott so hauntingly called the fear of “falling forever.”
I’ve sat with many courageous people in this place, and it asks everything of both of us. To remain in that vessel together — without rushing to fix, to interpret, or to soothe — is its own act of devotion. We must, for a time, set aside the understandable human longing for relief, and open instead to the underlying intelligence that shimmers beneath the chaos.
This kind of anxiety is not a mistake in the system. It signals that something buried, something vital, is beginning to stir. Often, this energy lives in the subcortical depths of the body — the belly, the throat, the solar plexus — where it was stored long ago, unheld and unspoken.
In those moments, I often imagine that we are descending together into the mythic underworld — where Persephone and Hermes tend the threshold, and where even the gods know the trembling of rebirth.
To meet this kind of anxiety requires not analysis but companionship, breath, and slowness. It asks for faith that what feels like disintegration may in time reveal itself as reorganization — that the chaos we fear may be the psyche’s way of reassembling around a deeper center of gravity.
The energy that once held the self together through contraction can become the very energy of aliveness. In this way, anxiety — even the most terrifying kind — is not the enemy of healing, but the guardian of the threshold, the trembling before new life.
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