Neurosis

Neurosis is a class of funct ional ment al disorders involving chronic dist ress, but neit her
delusions nor hallucinat ions. The t erm is no longer used by t he professional psychiat ric
communit y in t he Unit ed St at es, having been eliminat ed from t he Diagnostic and Statistical
Manual of Mental Disorders (DSM) in 1980 wit h t he publicat ion of DSM III. However, it is st ill
used in t he ICD-10 Chapt er V F40–48.

Neurosis

Other names Psychoneurosis, neurotic disorder

Specialty Psychiatry, clinical psychology

Neurosis should not be mist aken for psychosis, which refers t o a loss of t ouch wit h realit y. Nor
should it be mist aken for neuroticism, a fundament al personalit y t rait proposed in t he Big Five
personalit y t rait s t heory.

Etymology

The t erm is derived from t he Greek word neuron (νεῦρον, 'nerve') and t he suffix -osis (-ωσις,
'diseased' or 'abnormal condit ion').

The t erm neurosis was coined by Scot t ish doct or William Cullen in 1769 t o refer t o "disorders of
sense and mot ion" caused by a "general affect ion of t he nervous syst em." Cullen used t he t erm
t o describe various nervous disorders and sympt oms t hat could not be explained physiologically.
Physical feat ures, however, were almost inevit ably present , and physical diagnost ic t est s, such
as exaggerat ed knee-jerks, loss of t he gag reflex and dermat ographia, were used int o t he 20t h
cent ury.[1] The meaning of t he t erm was redefined by Carl Jung and Sigmund Freud over t he early
and middle 20t h cent ury, and has cont inued t o be used in psychology and philosophy.[2][3]

The Diagnostic and Statistical Manual of Mental Disorders (DSM) eliminat ed t he neurosis
cat egory in 1980, because of a decision by it s edit ors t o provide descript ions of behavior rat her
t han descript ions of hidden psychological mechanisms.[4] This change has been cont roversial.[5]
Likewise, according t o t he American Heritage Medical Dictionary, neurosis is "no longer used in
psychiat ric diagnosis."[6]

Symptoms and causes

Neurosis may be defined simply as a "poor abilit y t o adapt t o one's environment , an inabilit y t o
change one's life pat t erns, and t he inabilit y t o develop a richer, more complex, more sat isfying
personalit y."[7] There are many different neuroses, including:

obsessive–compulsive disorder

obsessive–compulsive personalit y disorder

impulse cont rol disorder

anxiet y disorder

hist rionic personalit y disorder

dissociat ive disorder

a great variet y of phobias

According t o C. George Boeree, professor emerit us at Shippensburg Universit y, t he sympt oms of

neurosis may involve:[7]

... 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.
Jungian theory
…
Carl Jung found his approach part icularly effect ive for pat ient s who are well adjust ed by social
st andards but are t roubled by exist ent ial quest ions. Jung claims t o have "frequent ly seen people
become neurot ic when t hey cont ent t hemselves wit h inadequat e or wrong answers t o t he
quest ions of life".[8]: 140  Accordingly, t he majorit y of his pat ient s "consist ed not of believers but
of t hose who had lost t heir fait h".[8]: 140  A cont emporary person, according t o 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.[9]: 82 

Jung found t hat t he unconscious finds expression primarily t hrough an individual's inferior
psychological funct ion, whet her it is t hinking, feeling, sensat ion, or int uit ion. The charact erist ic
effect s of a neurosis on t he dominant and inferior funct ions are discussed in his Psychological
Types. Jung also found collect ive neuroses in polit ics: "Our world is, so t o speak, dissociat ed like
a neurot ic."[9]: 85 

Psychoanalytic theory
…
According t o psychoanalyt ic t heory, neuroses may be root ed in ego defense mechanisms,
t hough t he t wo concept s are not synonymous. Defense mechanisms are a normal way of
developing and maint aining a consist ent sense of self (i.e., an ego). However, only t hose t hought s
and behaviors t hat produce difficult ies in one's life should be called neuroses.

A neurot ic person experiences emot ional dist ress and unconscious conflict , which are
manifest ed in various physical or ment al illnesses; t he definit ive sympt om being anxiet y. Neurot ic
t endencies are common and may manifest t hemselves as acut e or chronic anxiet y, depression,
an obsessive–compulsive disorder, a phobia, or a personalit y disorder.

Horney's theory
…
In her final book, Neurosis and Human Growth, Karen Horney lays out a complet e t heory of t he
origin and dynamics of neurosis.[10] In her t heory, neurosis is a dist ort ed way of looking at t he
world and at oneself, which is det ermined by compulsive needs rat her t han by a genuine int erest
in t he world as it is. Horney proposes t hat neurosis is t ransmit t ed t o a child from t heir early
environment and t hat t here are many ways in which t his can occur:[10]: 18 

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 init ial realit y is t hen dist ort ed by t heir parent s' needs and pret enses. Growing up wit h
neurot ic caret akers, t he child quickly becomes insecure and develops basic anxiet y. To deal wit h
t his anxiet y, t he child's imaginat ion creat es an idealized self-image:[10]: 22 

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 t hey ident ify t hemselves wit h t heir idealized image, a number of effect s follow. They will
make claims on ot hers and on life based on t he prest ige t hey feel ent it led t o because of t heir
idealized self-image. They will impose a rigorous set of st andards upon t hemselves in order t o
t ry t o measure up t o t hat image. They will cult ivat e pride, and wit h t hat will come t he
vulnerabilit ies associat ed wit h pride t hat lacks any foundat ion. Finally, t hey will despise
t hemselves for all t heir limit at ions. Vicious circles will operat e t o st rengt hen all of t hese
effect s.

Event ually, as t hey grow t o adult hood, a part icular "solut ion" t o all t he inner conflict s and
vulnerabilit ies will solidify. They will be eit her

expansive, displaying sympt oms of narcissism, perfect ionism, or vindict iveness

 self-effacing and compulsively compliant , displaying sympt oms of neediness or
codependence

resigned, displaying schizoid t endencies

In Horney's view, mild anxiet y disorders and full-blown personalit y disorders all fall under her
basic scheme of neurosis as variat ions in t he degree of severit y and in t he individual dynamics.
The opposit e of neurosis is a condit ion Horney calls self-realization, a st at e of being in which t he
person responds t o t he world wit h t he full dept h of t heir spont aneous feelings, rat her t han wit h
anxiet y-driven compulsion. Thus t he person grows t o act ualize t heir inborn pot ent ialit ies. Horney
compares t his process t o an acorn t hat grows and becomes a t ree: t he acorn has had t he
pot ent ial for a t ree inside it all along.

See also

Individuat ion

Neurot ics Anonymous

Posit ive disint egrat ion

References

1. Bailey, Hamilton (1927). Demonstrations of physical signs in clinical surgery (1st ed.). Bristol: J. Wright
and Sons. p. 208.

2. Russon, John (2003). Human Experience: Philosophy, Neurosis, and the Elements of Everyday Life.
State University of New York Press. ISBN 0-7914-5754-0.

3. Jacobson, Kirsten. 2006. "The Interpersonal Expression of Human Spatiality: A Phenomenological

Interpretation of Anorexia Nervosa." Chiasmi International 8:157–74.

4. Horwitz and Wakefield (2007). The Loss of Sadness. Oxford. ISBN 978-0-19-531304-8.

5. Wilson, Mitchell. 1993. "DSM-III and the Transformation of American Psychiatry: A History." The
American Journal of Psychiatry 150(3):399–410.

. The American Heritage Medical Dictionary (https://archive.org/details/americanheritage00ahde) .

Houghton Mifflin. 2007. ISBN 978-0-618-82435-9.

7. Boeree, C. George (2002). "A Bio-Social Theory of Neurosis" (http://webspace.ship.edu/cgboer/genpsyn

eurosis.html) . Retrieved 2009-04-21.

. Jung, Carl G., and Aniela Jaffé. [1961] 1989. Memories, Dreams, Reflections. New York: Vantage Books.
ISBN 0-679-72395-1.
 9. Jung, Carl G., et al. 1964. Man and His Symbols. New York: Anchor Books: Doubleday. ISBN 0-385-
05221-9.

10. Horney, Karen (1950). Neurosis and Human Growth: The Struggle Toward Self-Realization. W.W. Norton
& Company, Inc. ISBN 978-0-393-30775-7.

Bibliography
…
Angyal, Andras. 1965. Neurosis and Treatment: A Holistic Theory, edit ed by E. Hanfmann and R.
M. Jones.

Fenichel, Ot t o. 1945. The Psychoanalytic Theory of Neurosis. New York: Nort on.

Freud, Sigmund. 1953–1974. The Standard Edition of the Complete Psychological Works of
Sigmund Freud. (24 vols.), t ranslat ed by J. St rachey. London: Hogart h.

Horney, Karen. 1937. The Collected Works. (2 vols.). Nort on.

—— 1945. Our Inner Conflicts. Nort on.

1950. Neurosis and Human Growth. Nort on.

Horwit z, A. V. and J. C. Wakefield. 2007. The Loss of Sadness: How Psychiatry Transformed
Normal Sorrow into Depressive Disorder. Oxford Universit y Press. ISBN 978-0-19-531304-8.

Jung, Carl G. [1921] 1971. Psychological Types, (The Collected Works of C. G. Jung 6). Princet on
Universit y Press. ISBN 0-691-01813-8.

—— 1966. Two Essays on Analytical Psychology, (The Collected Works of C. G. Jung 7).
Princet on Universit y Press. ISBN 0-691-01782-4.

Jung, Carl G., and Aniela Jaffé. [1961] 1989. Memories, Dreams, Reflections. New York: Vant age
Books. ISBN 0-679-72395-1

Jung, Carl G., et al. 1964. Man and His Symbols. New York: Anchor Books / Doubleday. ISBN 0-
385-05221-9.

Ladell, R. M., and T. H. Hargreaves. 1947. "The Ext ent of Neurosis (ht t ps://www.bmj.com/cont e
nt /2/4526/548) ." British Medical Journal 2(4526):548–49. doi:10.1136/bmj.2.4526.548 (ht t p
s://doi.org/10.1136%2Fbmj.2.4526.548) . PMC 2055884 (ht t ps://www.ncbi.nlm.nih.gov/pmc/ar
t icles/PMC2055884/) . PMID 20267012 (ht t ps://pubmed.ncbi.nlm.nih.gov/20267012) .

López-Piñero J.M. (1983) Historical Origins of the Concept of Neurosis (Translat ed by D.

Berrios) Cambridge, Cambridge Universit y Press
 McWilliams, Nancy. 2011. Psychoanalytic Diagnosis: Understanding Personality Structure in the
Clinical Process (2nd ed.). Guilford Press. ISBN 978-1-60918-494-0.

Russon, John. 2003. Human Experience: Philosophy, Neurosis, and the Elements of Everyday
Life. Albany: St at e Universit y of New York Press. ISBN 0-7914-5754-0

Winokur, Jon. 2005. Encyclopedia Neurotica. ISBN 0-312-32501-0.

External links

Classification D
ICD-10: F40 (https://icd.who.int/browse10/201
9/en#/F40) -F40.8

Janov, Art hur (1991). "Neurosis" (ht t p://www.cont inuum-concept .org/reading/neurosis.ht ml) .
Ret rieved 2009-04-21.

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