neurosis

Neurosis is a class of functional mental disorders involving chronic distress, but neither delusions nor hallucinations. The term is no longer used by the professional psychiatric community in the United States, having been eliminated from the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) in 1980 with the publication of DSM III. However, it is still used in the ICD-10 Chapter V F40–48.

Neurosis should not be mistaken for ''psychosis'', which refers to a loss of touch with reality. Nor should it be mistaken for ''neuroticism'', a fundamental personality trait proposed in the Big Five personality traits theory.

Etymology

The term is derived from the Greek word ''neuron'' (νεῦρον, 'nerve') and the suffix ''-osis'' (-ωσις, 'diseased' or 'abnormal condition').

The term ''neurosis'' was coined by Scottish doctor William Cullen in 1769 to refer to "disorders of sense and motion" caused by a "general affection of the nervous system." Cullen used the term to describe various nervous disorders and symptoms that could not be explained physiologically. Physical features, however, were almost inevitably present, and physical diagnostic tests, such as exaggerated knee-jerks, loss of the gag reflex and dermatographia, were used into the 20th century. The meaning of the term was redefined by Carl Jung and Sigmund Freud over the early and middle 20th century, and has continued to be used in psychology and philosophy.

The ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) eliminated the ''neurosis'' category in 1980, because of a decision by its editors to provide descriptions of behavior rather than descriptions of hidden psychological mechanisms. This change has been controversial.Wilson, Mitchell. 1993. "DSM-III and the Transformation of American Psychiatry: A History." ''The American Journal of Psychiatry'' 150(3):399–410. Likewise, according to the ''American Heritage Medical Dictionary'', ''neurosis'' is "no longer used in psychiatric diagnosis."

Symptoms and causes

''Neurosis'' may be defined simply 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." There are many different neuroses, including:

* obsessive–compulsive disorder
* obsessive–compulsive personality disorder
* impulse control disorder
* anxiety disorder
* histrionic personality disorder
*dissociative disorder
* a great variety of phobias

According to C. George Boeree, professor emeritus at Shippensburg University, the symptoms of neurosis may involve:

Jungian theory

Carl Jung found his approach particularly effective for patients who are well adjusted by social standards but are troubled by existential questions. Jung claims to have "frequently seen people become neurotic when they content themselves with inadequate or wrong answers to the questions of life".Jung, Carl G., and Aniela Jaffé. 9611989. ''Memories, Dreams, Reflections''. New York: Vantage Books. . Accordingly, the majority of his patients "consisted not of believers but of those who had lost their faith". A contemporary person, according to Jung,

…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, Carl G., et al. 1964. ''Man and His Symbols''. New York: Anchor Books: Doubleday. .

Jung found that the unconscious finds expression primarily through an individual's inferior psychological function, whether it is thinking, feeling, sensation, or intuition. The characteristic effects of a neurosis on the dominant and inferior functions are discussed in his '' Psychological Types''. Jung also found collective neuroses in politics: "Our world is, so to speak, dissociated like a neurotic."

Psychoanalytic theory

According to psychoanalytic theory, neuroses may be rooted in ego defense mechanisms, though 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''). However, only those thoughts and behaviors that produce difficulties in one's life should be called ''neuroses''.

A neurotic person experiences emotional distress and unconscious conflict, which are manifested in various physical or mental illnesses; the definitive symptom being anxiety. Neurotic tendencies are common and may manifest themselves as acute or chronic anxiety, depression, an obsessive–compulsive disorder, a phobia, or a personality disorder.

Horney's theory

In her final book, ''Neurosis and Human Growth'', Karen Horney lays out a complete theory of the origin and dynamics of neurosis.Horney, Karen (1950). ''Neurosis and Human Growth: The Struggle Toward Self-Realization''. W.W. Norton & Company, Inc. . In her theory, neurosis is a distorted way of looking at the world and at oneself, which is determined by compulsive needs rather than by a genuine interest in the world as it is. Horney proposes that neurosis is transmitted to a child from their early environment and that there are many ways in which this can occur:

The child's initial reality is then distorted by their parents' needs and pretenses. Growing up with neurotic caretakers, the child quickly becomes insecure and develops basic anxiety. To deal with this anxiety, the child's imagination creates an idealized self-image:

Once they identify themselves with their idealized image, a number of effects follow. They will make claims on others and on life based on the prestige they feel entitled to because of their idealized self-image. They will impose a rigorous set of standards upon themselves in order to try to measure up to that image. They will cultivate pride, and with that will come the vulnerabilities associated with pride that lacks any foundation. Finally, they will despise themselves for all their limitations. Vicious circles will operate to strengthen all of these effects.

Eventually, as they grow to adulthood, a particular "solution" to all the inner conflicts and vulnerabilities will solidify. They will be either

* expansive, displaying symptoms of narcissism, perfectionism, or vindictiveness
* self-effacing and compulsively compliant, displaying symptoms of neediness or codependence
* resigned, displaying schizoid tendencies

In Horney's view, mild anxiety disorders and full-blown personality disorders all fall under her basic scheme of neurosis as variations in the degree of severity and in the individual dynamics. The opposite of neurosis is a condition Horney calls ''self-realization'', a state of being in which the person responds to the world with the full depth of their spontaneous feelings, rather than with anxiety-driven compulsion. Thus the person grows to actualize their inborn potentialities. Horney compares this process to an acorn that grows and becomes a tree: the acorn has had the potential for a tree inside it all along.

See also

* Individuation
* Neurotics Anonymous
* Positive disintegration

References

Bibliography

* Angyal, Andras. 1965. ''Neurosis and Treatment: A Holistic Theory'', edited by E. Hanfmann and R. M. Jones.
* Fenichel, Otto. 1945. ''The Psychoanalytic Theory of Neurosis.'' New York: Norton.
* Freud, Sigmund. 1953–1974. ''The Standard Edition of the Complete Psychological Works of Sigmund Freud.'' (24 vols.)'','' translated by J. Strachey. London: Hogarth.
* Horney, Karen. 1937. ''The Collected Works.'' (2 vols.). Norton.
* —— 1945. ''Our Inner Conflicts''. Norton.
* 1950. ''Neurosis and Human Growth''. Norton.
* Horwitz, A. V. and J. C. Wakefield. 2007. ''The Loss of Sadness: How Psychiatry Transformed Normal Sorrow into Depressive Disorder''. Oxford University Press. .
* Jung, Carl G. 9211971. '' Psychological Types'', ('' The Collected Works of C. G. Jung'' 6). Princeton University Press. .
* —— 1966. ''Two Essays on Analytical Psychology'', (''The Collected Works of C. G. Jung'' 7). Princeton University Press. .
* Jung, Carl G., and Aniela Jaffé. 9611989. ''Memories, Dreams, Reflections''. New York: Vantage Books.
* Jung, Carl G., et al. 1964. '' Man and His Symbols''. New York: Anchor Books / Doubleday. .
*Ladell, R. M., and T. H. Hargreaves. 1947.
The Extent of Neurosis
" ''British Medical Journal'' 2(4526):548–49. . . .
* López-Piñero J.M. (1983) ''Historical Origins of the Concept of Neurosis'' (Translated by D. Berrios) Cambridge, Cambridge University Press
* McWilliams, Nancy. 2011. ''Psychoanalytic Diagnosis: Understanding Personality Structure in the Clinical Process'' (2nd ed.). Guilford Press. .
* Russon, John. 2003. ''Human Experience: Philosophy, Neurosis, and the Elements of Everyday Life.'' Albany: State University of New York Press.
* Winokur, Jon. 2005. ''Encyclopedia Neurotica.'' .

External links

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Psychoanalytic theory
Stress-related disorders
Psychopathological syndromes