Dr. Pablo Martinez - Psychiatrist

Existential anxiety: between faith and despair

“There is a God-shaped void in the heart of each man which cannot be satisfied by any created thing but only by God the Creator” (Blaise Pascal)

Anxiety is one of the most common medical conditions today affecting about 20 percent of the population. Almost half of the patients seen by a family doctor have some kind of anxiety related disorder. Many body symptoms are caused by anxiety: headaches, lack of breath, dizziness, muscle pains, sexual dysfunctions, etc. It is my view that we cannot reduce anxiety to a mere biochemical disturbance of the brain. Anxiety is a multidimensional problem where social and also spiritual-existential factors play a key role: uncertainty about the future, insecurity in personal relationships, crisis in trust and faithfulness, all these make a fertile ground for the increase of anxious people in our materialistic world. One of the most neglected causes of anxiety is the lack of meaning and purpose in life. This is what we call existential anxiety.

Certain schools of psychotherapy, the so-called existential schools, maintain that man's central problem lies in his lack of meaning in life. Authors such as Victor Frankl and L. Binswanger identify a person's basic problem as the absence of vital meaning with its inevitable results: desperation, the sense of cosmic disorientation, the nausea of which Sartre speaks. This disturbing inner unrest, called existential anxiety, goes far beyond the symptoms of clinical anxiety (panic attacks, obsessive thoughts, phobias, etc.). What is the origin of such a deep rooted condition that is not relieved by anti-anxiety drugs nor by psychotherapy? According to the existential therapists the solution lies in finding significant and enriching relationships. Man's therapeutic key is to be found in encounters with others: a genuine relationship is the main healing instrument.

This viewpoint of the existential schools partially coincides with the biblical diagnosis of human nature. God created human beings with a great need for relationships. It is not good that man should be alone, I will make him a helper fit for him (Genesis 2:18) said God, from the very beginning. This ought not to surprise us since humans were made in the image and likeness of their Creator who, from eternity, enjoys a harmonious and intimate relationship among the persons of the Trinity. This helps us understand that human beings are born with that profound desire of having contact with a “you”.

Many people, nevertheless, seem to have satisfactory “social” relationships and yet they do not have peace, that inner harmony that the Bible describes as shalom, their life continues to be empty, missing something they find difficult to describe. G. Steiner, renowned thinker and scholar, refers to this void as a nostalgia for the Absolute which, he says, is the result of the moral and emotional emptiness in Western culture due to the decline of formal religious systems. Steiner is certainly pointing in the right direction. As the deer pants for the water brooks... my soul thirsts for God, for the living God (Psalm 42:1-2). Man can proclaim the death of God, as Nietzsche did, but he cannot eliminate the thirst for God. We find here the key answer to existential anxiety: our need for relationships is -and will always be- two-dimensional: with our fellow human beings, but also with our Creator. Such was man's original situation, as biblical truth describes it to us.

The most vital relationship is the relationship with our Creator. In Genesis 1 and 2, human beings did not have emotional problems: there was no fear, no shame, no pain, because there was a perfect relationship between God and man, and that gave total fulfilment. But, as soon as man drifts away from God this harmony is broken and conflicts within himself arise, fear and shame occur for the first time, as well as with his neighbour Cain attacked his brother Abel and killed him (Genesis 4:8). It is in this sense that the separation from God is the ultimate source of anxiety because our deepest need is not being met. Jung himself, in a very famous quotation, said that I have never seen a single case of neurosis that ultimately did not have an existential origin.

This existential loneliness and anxiety may sometimes become very disturbing and almost unbearable. Jesus' words on the cross: My God, my God, why have you forsaken me? (Matthew 27:46) remind us of the intense pain of this reality. How right was the Spanish mystic author St. John of the Cross when he wrote about the dark night of the soul without God! Yes, being away from God is a terrible experience, probably the most disturbing any human being can ever face. This is Hell, banishment from relationship with God.

This is precisely where Christian faith becomes the antidote that reaches the deepest cause of anxiety. How is this therapeutic effect accomplished? There are two key words: hope and prayer. Ultimately the problem of anxiety requires a firm hope, a hope that is not utopia, but based on the person and work of our Lord Jesus Christ. It is a hope that provides certainty and meaning to our existence -both present and future- because it does not arise primarily from mere subjective feelings –“a religious experience”- but from objective facts. It is striking to notice that whenever the apostle Paul refers to God´s promises and to future life he uses the verb “we know”, he does not say we imagine or we feel. A solid hope, described as an anchor for the soul, firm and secure (Hebrews 6:19) is a soothing balm to our deep restlessness and anxiety.

The Christian faith also relieves existential anxiety through the therapeutic tools of prayer and Bible meditation. Inasmuch as they provide us with a personal contact with God, they both return us to the first original relationship (with the obvious limitations imposed upon us by our fallen nature). Thus prayer and meditation enable us to rebuild the very foundations of our existence, and give back to a person the true purpose of their life: relationship with God. As they restore free and constant dialogue with our Creator. Prayer and meditation allow us to meet our deepest longing, our thirst for God. They contain the most therapeutic element to relieve existential anxiety for which there is no substitute.

As a practising psychiatrist I am convinced that the Christian message provides the supreme antidote against existential anxiety because Christ alone, the image of the invisible God, is the only one fully able to fill that God shaped void that only God can fill.

This article was originally published in “Triple Helix”, a magazine of the “Christian Medical Fellowship (UK)”.

MEDICINE of the Person

Every person is a unity of body, psyche and spirituality inseparable in turn from the history of his life.
“Medicine of the Person, founded by the Swiss physician Paul Tournier, seeks to treat each pacient as a human being of great value.

What is...?

Dr. Pablo Martinez

Dr. Pablo Martinez - Psiquiatrist

Graduated in Medicine at the University of Barcelona, he runs a private practice. Renowned international lecturer, he has been a guest speaker in more than 35 countries. Author of several books translated into 20 languages.

Who is...?

Areas of expertise

On Relationships and Dialogue

«Dialogue is not a battlefield, but a field of cultivation; it does not seek to defeat but to sow.»

On Listening and Communication

«We do not speak to win, but to understand each other, because there is no point in winning without convincing.»

On Listening and Communication

«You hear with your ears, but you listen with your eyes.»

About Words

«In this digital society we have to recover the word. Words with soul and life, words that transform people and situations.»