neurosis

neurosis

[noo-roh-sis, nyoo-]
neurosis, in psychiatry, a broad category of psychological disturbance, encompassing various mild forms of mental disorder. Until fairly recently, the term neurosis was broadly employed in contrast with psychosis, which denoted much more severe, debilitating mental disturbances. The two terms were used regularly until 1980, when the American Psychiatric Association released a precise listing of known mental disorders excluding the two broad categories of "mild" and "serious" mental disorders.

Neurosis, according to Sigmund Freud, arose from inner conflicts and could lead to anxiety. In his formulation, the causal factors could be found roughly in the first six years of life, when the personality, or ego, is weak and afraid of censure. He attributed neurosis to the frustration of infantile sexual drives, as when severe eating and toilet habits and other restrictions are parentally imposed (see Oedipus complex), which appear in adulthood as neurotic symptoms (see psychoanalysis). Other authorities have emphasized constitutional and organic factors. Among the psychoanalysts, Alfred Adler and H. S. Sullivan stressed social determinants of personal adjustment, and Karen Horney emphasized insecurity in childhood as causes of neurosis.

Until 1980, neuroses included anxiety disorders as well as a number of other mild mental illnesses, such as hysteria and hypochondria. Anxiety disorders are fairly common, and generally involve a feeling of apprehension with no obvious, immediate cause. Such intense fears of various situations may be severe enough to prevent individuals from conducting routine activities. Phobias, the most common type of anxiety disorder, involve specific situations which cause irrational anxiety attacks. For instance, an individual with agoraphobia (fear of open spaces) may be too anxious to leave their house. Obsessive-compulsive disorder occurs when an individual relentlessly pursues a thought or action in order to relieve anxiety. Panic disorder is characterized by anxiety in the form of panic attacks, while generalized anxiety disorder occurs when an individual experiences chronic anxiety with no apparent explanations for the anxiety. Post-traumatic stress disorder, occurring in the wake of a particularly traumatic event, can lead to severe flashbacks and a lack of responsiveness to stimuli. Anxiety disorders are usually accompanied by a variety of defense mechanisms, which are employed in an attempt to overcome anxiety. Hypochondriasis and hysteria (now generally known as conversion disorder) are classified today as somatoform disorders, and involve physical symptoms of psychological distress. The hypochondriac fears that minor bodily disturbances indicate serious, often terminal, disease, while the individual suffering from conversion disorder experiences a bodily disturbance—such as paralysis of a limb, blindness, or deafness—with no clear biological origin. Treatment of neurosis may include behavior therapy to condition an individual to change neurotic habits, psychotherapy, and group psychotherapy. Various drugs may also be employed to alleviate symptoms.

See M. Trimble, Post-Traumatic Neurosis (1981); S. Henderson et al., Neurosis and the Social Environment (1982); J. Lopez Pinero, The Historical Origins of the Concept of Neurosis (tr. 1983); G. Russell, ed. The Neuroses and Personality Disorders (1984).

Mental disorder in which an individual experiences obsessions or compulsions, either singly or together. An obsession is a persistent disturbing preoccupation with an unreasonable idea or feeling (such as of being contaminated through shaking hands with someone). A compulsion is an irresistible impulse to perform an irrational act (such as repeatedly washing the hands). The two phenomena are usually, but not always, linked in the obsessive-compulsive person. Onset of the illness has been linked to malregulation of the neurotransmitter serotonin as well as to the ill effects of high stress.

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Mental and emotional disorder that affects only part of the personality, is accompanied by a less distorted perception of reality than in a psychosis, and is characterized by various physiological and mental disturbances (such as visceral symptoms and impaired concentration). The neuroses include anxiety attacks, certain forms of depression, hypochondriasis, hysterical reactions, obsessive-compulsive disorders, phobias, various sexual dysfunctions, and some tics. They have traditionally been thought to be based on emotional conflict in which a blocked impulse seeks expression in a disguised response or symptom. Behavioral psychologists regard them as learned, inappropriate responses to stress, which can be unlearned.

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This article describes the term in psychology. For the experimental metal band, see Neurosis (band).

Neurosis, also known as psychoneurosis or neurotic disorder, is a term that refers to any mental imbalance that causes distress, but, unlike a psychosis or some personality disorders, does not prevent or affect rational thought. It is particularly associated with the field of psychoanalysis.

History and use of the term

To differentiate between neurosis and neurotic: "Neurotic", or affected by neurosis, has come to describe a person with any degree of depression or anxiety, depressed feelings, lack of emotions, low self-confidence, and/or emotional instability.

The term 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 neuron (nerve) with the suffix -osis (diseased or abnormal condition). The term was however most influentially defined by Carl Jung and Sigmund Freud over a century later.

The American DSM-III (Diagnostic and Statistical Manual of Mental Disorders) has eliminated the category of Neurosis. This largely reflects a decline in the fashionability of psychoanalysis, and the progressive expurgation of psychoanalytical terminology from the DSM. It follows a trend to provide overt behavioral descriptions as opposed to terms referring to hidden psychological mechanisms due to diagnostic difficulties. Those who retain a psychoanalytical perspective, which would include a majority of psychologists in France, continue to use the term 'neurosis'. According to The American Heritage Medical Dictionary it is "no longer used in psychiatric diagnosis.

Psychoanalytical account of neurosis

As an illness, neurosis represents a variety of psychiatric conditions in which emotional distress or unconscious conflict is expressed through various physical, physiological, and mental disturbances, which may include physical symptoms (e.g., hysteria). The definitive symptom is anxieties. Neurotic tendencies are common and may manifest themselves as depression, acute or chronic anxiety, obsessive-compulsive tendencies, phobias, and even personality disorders, such as borderline personality disorder or obsessive-compulsive personality disorder. 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.

The term connotes an actual disorder or disease, but under its general definition, neurosis is a normal human experience, part of the human condition. Most people are affected by neurosis in some form. A psychological problem develops when neuroses begin to interfere with, but not significantly impair, normal functioning, and thus cause the individual anxiety. Frequently, the coping mechanisms enlisted to help "ward off" the anxiety only exacerbate the situation, causing more distress. It has even been defined in terms of this coping strategy, as a "symbolic behavior in defense against excessive psychobiologic pain [which] is self-perpetuating because symbolic satisfactions cannot fulfill real needs."

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 (i.e., an ego), while only those thought and behavior patterns that produce difficulties in living should be termed neuroses.

Effects and symptoms

There are many different specific forms of neurosis: pyromania, obsessive-compulsive disorder, anxiety neurosis, hysteria (in which anxiety may be discharged through a physical symptom), and an endless variety of phobias. According to Dr. George Boeree, 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.

Treatment

Neurosis can be treated by different methods. There is psychotherapy, behavior therapy, and various drugs to alleviate the symptoms. Antidepressants and anti-anxiety medications will help the sufferer, and some drugs will boost up self-worth and self esteem. These methods will usually help neurotic sufferers in 4-5 weeks.

Jung's theory of neurosis

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 (Jung, [1961] 1989:140).

The majority of my patients consisted not of believers but of those who had lost their faith (Jung, [1961] 1989:140).

[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, 1964:82).

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" (Jung, 1964:85).

References

  • Freud, Sigmund. The Standard Edition of the Complete Psychological Works of Sigmund Freud. Trans. James Strachey. 24 vols. London: Hogarth, 1953-74.
  • Horney, Karen. The Collected Works. (2 Vols.) 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. (1964). Man and his Symbols, New York, N.Y.: Anchor Books, Doubleday. ISBN 0-385-05221-9.
  • Jung, C.G. (1966). Two Essays on Analytical Psychology, Collected Works, Volume 7, Princeton, N.J.: Princeton University Press. ISBN 0-691-01782-4.
  • Jung, C.G. [1921] (1971). Psychological Types, Collected Works, Volume 6, Princeton, N.J.: Princeton University Press. ISBN 0-691-01813-8.
  • Jung, C.G. [1961] (1989). 'Memories, Dreams, Reflections, New York, N.Y.: Vantage Books. ISBN 0-679-72395-1
  • Winokur, Jon. Encyclopedia Neurotica. 2005. ISBN 0-312-32501-0.

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