Neurosis is a class of functional mental disorders involving distress but neither delusions nor
hallucinations, whereby behavior is not outside socially acceptable norms. It is also known
as psychoneurosis or neurotic disorder, and thus those suffering from it are said to be
neurotic.
History The term neurosis was coined by the Scottish
doctor William Cullen in 1769 to refer to "disorders of sense and motion" caused by
a "general affection of the nervous system". For him, it described various nervous disorders
and symptoms that could not be explained physiologically. It derives from the Greek word νεῦρον
with the suffix -ωσις -osis. The term was however most influentially defined by
Carl Jung and Sigmund Freud over a century later. It has continued to be used in contemporary
theoretical writing in psychology and philosophy. The American Diagnostic and Statistical Manual
of Mental Disorders has eliminated the category of "neurosis", reflecting a decision by the
editors to provide descriptions of behavior as opposed to hidden psychological mechanisms
as diagnostic criteria, and, according to The American Heritage Medical Dictionary,
it is "no longer used in psychiatric diagnosis". These changes to the DSM have been controversial.
Signs and symptoms There are many forms of neurosis: obsessive–compulsive
disorder, anxiety neurosis, hysteria, and a nearly endless variety of phobias as well
as obsessions such as pyromania. According to C. George Boeree, professor emeritus at
Shippensburg University, effects of neurosis can involve:
...anxiety, sadness or depression, anger, irritability, mental confusion, low sense
of self-worth, etc., behavioral symptoms such as phobic avoidance, vigilance, impulsive
and compulsive acts, lethargy, etc., cognitive problems such as unpleasant or disturbing
thoughts, repetition of thoughts and obsession, habitual fantasizing, negativity and cynicism,
etc. Interpersonally, neurosis involves dependency, aggressiveness, perfectionism, schizoid isolation,
socio-culturally inappropriate behaviors, etc.
Cause Psychoanalytical theory
As an illness, neurosis represents a variety of mental disorders in which emotional distress
or unconscious conflict is expressed through various physical, physiological, and mental
disturbances, which may include physical symptoms. The definitive symptom is anxieties. Neurotic
tendencies are common and may manifest themselves as depression, acute or chronic anxiety, obsessive–compulsive
tendencies, specific phobias, such as social phobia, arachnophobia or any number of other
phobias, and some personality disorders: paranoid, schizotypal, borderline, histrionic, avoidant,
dependent and obsessive–compulsive. It has perhaps been most simply defined as a "poor
ability to adapt to one's environment, an inability to change one's life patterns, and
the inability to develop a richer, more complex, more satisfying personality." Neurosis should
not be mistaken for psychosis, which refers to loss of touch with reality, or neuroticism,
a fundamental personality trait according to psychological theory.
According to psychoanalytic theory, neuroses may be rooted in ego defense mechanisms, but
the two concepts are not synonymous. Defense mechanisms are a normal way of developing
and maintaining a consistent sense of self, while only those thoughts and behavior patterns
that produce difficulties in living should be termed "neuroses".
Jung's theory
Carl Jung found his approach particularly fitting for people who are successfully adjusted
by normal social standards, but who nevertheless have issues with the meaning of their life.
I have frequently seen people become neurotic when they content themselves with inadequate
or wrong answers to the questions of life.
The majority of my patients consisted not of believers but of those who had lost their
faith.
[Contemporary man] is blind to the fact that, with all his rationality and efficiency, he
is possessed by "powers" that are beyond his control. His gods and demons have not disappeared
at all; they have merely got new names. They keep him on the run with restlessness, vague
apprehensions, psychological complications, an insatiable need for pills, alcohol, tobacco,
food – and, above all, a large array of neuroses..
Jung found that the unconscious finds expression primarily through an individual's inferior
psychological function, whether it is thinking, feeling, sensing, or intuition. The characteristic
effects of a neurosis on the dominant and inferior functions are discussed in Psychological
Types. Jung saw collective neuroses in politics:
"Our world is, so to speak, dissociated like a neurotic".
Horney's theory In her final book, Neurosis and Human Growth,
Karen Horney laid out a complete theory on the origin and dynamics of neurosis.
In essence, neurosis is a distorted way of looking at the world and at oneself, determined
by compulsive needs rather than by a genuine interest in the world as it is.
She proposes that it is transmitted to a child from his or her early environment, and that
there are a large number of ways this can happen, but:
When summarized, they all boil down to the fact that the people in the environment are
too wrapped up in their own neuroses to be able to love the child, or even to conceive
of him as the particular individual he is; their attitudes toward him are determined
by their own neurotic needs and responses.
The child's initial reality is then distorted by his or her parents' needs and pretenses.
Growing up with neurotic caretakers, the child quickly becomes insecure themselves, developing
basic anxiety. To deal with this anxiety, the growing child's own imagination goes to
work, creating an idealized self-image:
Each person builds up his personal idealized image from the materials of his own special
experiences, his earlier fantasies, his particular needs, and also his given faculties. If it
were not for the personal character of the image, he would not attain a feeling of identity
and unity. He idealizes, to begin with, his particular "solution" of his basic conflict:
compliance becomes goodness, love, saintliness; aggressiveness becomes strength, leadership,
heroism, omnipotence; aloofness becomes wisdom, self-sufficiency, independence. What—according
to his particular solution—appear as shortcomings or flaws are always dimmed out or retouched.
Once one identifies with the idealized image, a number of effects follow. One will make
claims on others and on life based on the prestige one feels entitled to because of
the idealized image. One will impose a rigorous set of standards on oneself in order to attempt
to actually measure up to what the idealized image is. One will cultivate pride, and with
that will come the vulnerabilities associated with pride that lacks a foundation of real
esteem. Finally, one will hate and despise oneself for all one's factual limitations,
which keep getting in the way and threatening to pop the bubble. Vicious circles operate
to strengthen all of these factors. Eventually, as one grows to adulthood, one
particular "solution" to all the inner conflicts and vulnerabilities will solidify. One will
be expansive and will display symptoms of narcissism, perfectionism, or vindictiveness.
Or one will be self-effacing, and be compulsively compliant and display symptoms of neediness
or codependence. Or one will be resigned, and display schizoid tendencies.
In Horney's view, milder anxiety disorders and full-blown personality disorders all fall
under her basic scheme of neurosis as variances in the degree of severity and in the individual
dynamics. The opposite of neurosis is a condition Horney
calls self-realization, which is when an individual responds to the world with the full depth
of his or her spontaneous feelings rather than just anxiety-driven compulsion, resulting
in the person growing to actualize his or her inborn potentialities, in a process Horney
compares with an acorn growing into a tree. See also
Catastrophization Neuroticism
Orgastic potency References
Further reading Angyal, Andras.. Neurosis and treatment: a
holistic theory. Edited by E. Hanfmann and R. M. Jones
Fenichel, Otto. The Psychoanalytic Theory of Neurosis. New York: Norton Publishing Company.
Freud, Sigmund. The Standard Edition of the Complete Psychological Works of Sigmund Freud.
Trans. James Strachey. 24 vols. London: Hogarth, 1953–74.
Horney, Karen. Neurosis and Human Growth." Norton, 1950.
Horney, Karen. Our Inner Conflicts." Norton, 1945.
Horney, Karen. The Collected Works. Norton, 1937.
Horwitz, A. V. and J. C. Wakefield. The Loss of Sadness: How Psychiatry Transformed Normal
Sorrow into Depressive Disorder. Oxford University Press, 2007. ISBN 978-0-19-531304-8.
Jung, C.G., et al.. Man and his Symbols, New York, N.Y.: Anchor Books, Doubleday. ISBN
0-385-05221-9. Jung, C.G.. Two Essays on Analytical Psychology,
Collected Works, Volume 7, Princeton, N.J.: Princeton University Press. ISBN 0-691-01782-4.
Jung, C.G. [1921]. Psychological Types, Collected Works, Volume 6, Princeton, N.J.: Princeton
University Press. ISBN 0-691-01813-8. Jung, C.G. [1961]. 'Memories, Dreams, Reflections,
New York, N.Y.: Vantage Books. ISBN 0-679-72395-1 Russon, John.. Human Experience: Philosophy,
Neurosis, and the Elements of Everyday Life. Albany: State University of New York Press.
ISBN 0-7914-5754-0 Nancy McWilliams. Psychoanalytic Diagnosis,
Second Edition: Understanding Personality Structure in the Clinical Process. Guilford
Press. ISBN 978-1-60918-494-0. Winokur, Jon. Encyclopedia Neurotica. 2005.
ISBN 0-312-32501-0. LADELL RM, HARGREAVES TH. "The Extent of Neurosis".
Br Med J 2: 548–549. doi:10.1136/bmj.2.4526.548. PMC 2055884. PMID 20267012.
External links Janov, Dr. Arthur. "Neurosis". Retrieved 2009-04-21.