Neurosis

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Neurosis

Definition

Neurosis is a term generally used to describe a nonpsychotic mental illness which triggers feelings of distress and anxiety and impairs functioning.

The word neurosis means “nerve disorder,” and was first coined in the late eighteenth century by William Cullen, a Scottish physician. Cullen’s concept of neurosis encompassed those nervous disorders and symptoms that do not have a clear organic cause. Sigmund Freud later used the term anxiety neurosis to describe mental illness or distress with extreme anxiety as a defining feature.

There is a difference of opinion over the clinical use of the term neurosis today. It is not generally used as a diagnostic category by American psychologists and psychiatrists any longer, and was removed from the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders in 1980 with the publication of the third edition (it last appeared as a diagnostic category in DSM-II). Some professionals use the term to describe anxious symptoms and associated behavior, or to describe the range of mental illnesses outside of the psychotic disorders (such as schizophrenia , delusional disorder ). Others, particularly psychoanalysts (psychiatrists and psychologists

KAREN HORNEY (1885–1952)

The German-born American psychoanalyst Karen Danielsen Horney was a pioneer of neo-Freudianism. She believed that every human being has an innate drive toward self-realization and that neurosis is essentially a process obstructing this healthy development.

Horney focused on the central position of conflict and solutions to conflict in neurosis in Our Inner Conflicts (1945). She saw the neurotic child feeling helpless and isolated in a potentially hostile world, seeking a feeling of safety in compulsive moves toward, against, and away from others. Each of these moves came to constitute comprehensive philosophies of life and patterns of interpersonal relating. The conflict between these opposed moves she called the basic conflict and recognized that it required the individual to resort to means for restoring a sense of inner unity. These means she called the neurotic solutions.

Neurosis and Human Growth (1950) was Horney’s definitive work, in which she placed her concept of healthy development in the foreground. She viewed the real self as the core of the individual, the source of inherent, constructive, evolutionary forces which under favorable circumstances grow and unfold in a dynamic process of self-realization. She presented “a morality of evolution,” in which she viewed as moral all that enhances self-realization and as immoral all that hinders it. The most serious obstacle to healthy growth was the neurotic solution, which she called self-idealization, the attempt to see and to mold oneself into a glorified, idealized, illusory image with strivings for superiority, power, perfection, and vindictive triumph over others. This search for glory inevitably leads the individual to move away from himself (alienation) and against himself (self-hate). “At war with himself,” his suffering increases, his relationships with others are further impaired, and the self-perpetuating neurotic cycle continues.

who follow a psychoanalytical model of treatment, as popularized by Freud and Carl Jung), use the term neurosis to describe the internal process itself (called an unconscious conflict) that triggers the anxiety characteristic.

Resources

BOOKS

American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th edition, text revised. Washington, DC: American Psychiatric Press, Inc., 2000.

Fenichel, Otto M. The Psychoanalytic Theory of Neurosis: 50th Anniversary Edition. New York: W.W. Norton and Son. 1995.

The Gale Encyclopedia of Mental Health