Existential anguish describes the sort of anguish that emerges from the need, at a certain point, to have a life project and, hence, it’s always associated with people’s direction in their lives, their plans/goals to implement it. It starts in adolescence and shows up, in adulthood, in unexpected circumstances in which people’s course of life was broken, for any reasons. The most important characteristic of existential anguish is a deep general feeling of lack of orientation, as if one’s psychological basis has disappeared, and they have lost direction. This is a circumstantial/real anguish since it is precipitated by external world restraints or real losses. Such distinction is relevant because it makes us consider anguish from a broader perspective, i.e, as a “huge package” that, ultimately, unfolds into different categories. In other words, although anguish is an innate condition- what drives us to give meaning and purpose to life-, it also manifests itself in different ways, which are the result of conflicts of different sources. Teenagers face pathological (neurotic) anguish coming from introjected identity models in childhood, besides existential anguish. How can we distinguish between them? Neurotic anguishes are rooted in hidden conflicts, from the past, that people are not aware of, because they are felt, by consciousness, as a “threat” to individuals’ emotional health. These anguishes are brought up by internal impediments and are, always, disproportionate to reality (real events/facts). There is also a third sort of anguish concerning circumstances that are independent of individuals’ motivation or behaviors. This sort of anguish is expected to appear in face of real restraints, such as job losses, grief, etc. We will call them circumstantial anguishes (following Dias terminology) or real anguishes, as proposed by Freud. Everyone has these three kinds of anguishes during sexual identity development.
Finally, we believe it is crucial to bear in mind:
1) Circumstantial and existential anguishes- come from external impediments. They are proportionate to real challenges and difficulties.
2) Pathological/neurotic anguish is always disproportionate to reality. It is triggered by conflicting situations, in the present, that repeat a threatening atmosphere, from the past, which patients are not aware of.
The distinction aims at:
1) Identifying the sort of anguish that emerges in adolescence and that is typical of this stage- existential anguish,
2) Offering a clinical distinction, for diagnostic purposes, between conflicts associated with traumatic experiences/atmospheres (neurotic ones), from the ones that come from vicissitudes (external world), and those which, despite being triggered by internal conflicts, are not neurotic, such as anguishes associated with emergence of sexual energy/eroticism in pubers and adolescents (both of them, producers of circumstantial/real anguishes).
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