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DEFINING ANXIETY: SEMANTIC DIFFICULTIES
Anxiety, like other emotions, is difficult to describe. The words used to describe it only approximate our inner experience and may lead to confusion.
Any examination of the phenomenology of anxiety is colored by the lexicon in which it is conducted. The English word anxiety comes from the Latin word anxietas and/or anxius. These words contain the root Angh, which appears in Greek and in the Thesauraus Latinae Linguae in words meaning “to press tight,”
“to strangle,” “to be weighed down with griefs.” In the Oxford English Dictionary anxiety means: “1. uneasiness about some uncertain event, 2. solicitous desire to effect some purpose, 3. a condition of agitation and depression, with a sensation of lightness and distress in the precordial region.”
Jablensky (1985) notes that the English word “anxiety” does not cover the same semantic space as the French anxiete or the Spanish ansiedad although they all derive from a common root.
In French, angoisse is used as a near-synonym for anxiety but connotes more strongly the physical sensations accompanying the experience and may be closer to the English “anguish” than to “anxiety.” And the German word angst implies, besides “anxiety” and “anguish,” “agony, dread, fear, fright, terror, consternation, alarm and apprehension.” English-speaking patients will use words like “edgy,”
“uneasy,” “nervous,” “tense,” “anxious,” “fearful,” “scared,” “frightened,” “alarmed,” “terrified,” “jittery,” and “jumpy” to describe their experience.
These semantic difficulties have led to a variety of definitions. Confusion over definition occurs because some of the definitions refer to the emotions while others refer to clinical symdromes. The delineation of clinical syndromes is particularly problematic.
After an extensive review of many of the historical and current definitions of anxiety, Lewis (1970) developed the following list of characteristics common to most definitions of clinical anxiety: (1) it is an emotional state with the subjectively experienced quality of fear or a closely related emotion; (2) the
emotion is unpleasant; (3) it is directed towards the future; (4) there is either no recognizable threat, or the threat is by reasonable standards, quite out of proportion to the emotion it seemingly evokes; (5) there are subjective bodily discomforts during the period of the anxiety; (6) there are manifest bodily
disturbances.
These characteristics are congruent with our clinical experience. In line with Lader (1972) and Lewis (1970), we define anxiety as follows: It is a feeling of uneasiness and apprehension about some undefined threat.
The threat is often physical with intimations of bodily harm or death, or psychological with threats to self-esteem and well-being. The feeling is diffuse and ineffable, and the indefinable nature of the feeling gives it its peculiarly unpleasant and intolerable quality.
If the threat can be identified, we refer to the feeling as fear. The term stress is often equated with anxiety. Lay people, in particular, use the terms anxiety, stress and tension interchangeably. There is little agreement in the scientific community as to the definition and nature of stress, and the term is best avoided as it only causes confusion. On the other hand, it is sometimes useful to refer to a stressor, a stimulus, or event, that causes psychological and/or physiologic change, and to refer to the change as the stress response.
