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Panic often arrives abruptly — a surge of dread, shortness of breath, a racing heart, a feeling that something is catastrophically wrong. Many describe it as coming from nowhere, with no identifiable trigger.

Anxiety can be immediate and physical — a quickening heart, shallow breath, a sense of dread. But beneath these sensations is often something more difficult to name. In psychoanalytic work, we take seriously the idea that anxiety has a structure — that it’s not random, even when it feels that way.