Neurosis, the prison of emotional instability

Although neurosis is no longer considered a mental health diagnosis, psychology is still interested in this factor. It is considered a characteristic that accompanies clinical pictures dominated by negativity, anguish and emotional instability. In fact, there are those who, on average, are more prone to depression, excessive rumination, or the weight of guilt.

Although it was removed from the DSM-V in 2013, It is common to hear this terminology in the spheres of psychoanalysis. It accompanies those patients dominated by anxiety disorders and who see their psychosocial life very limited. Below, we provide you with more information about this concept that is so relevant in the history of psychology and psychiatry itself.

What does neurosis mean?

The meaning of neurosis dates back to the 18th century and It defines maladaptive behavior, tending to obsessive thinking and emotional instability. Now, it is very possible that this term is directly associated with the father of psychoanalysis, Sigmund Freud. But the truth is that this concept was coined in 1769 by the Scottish doctor William Cullen.

He labeled it as a type of sensory disorder caused by a disease of the nervous system that occurred, of course, without fever. Currently, however, it is not associated with any organic condition. In fact, it It is used informally and non-clinically, associating it with anxiety, somatoform, depressive, dissociative disorders, etc.

Evolution of neurosis

Although this term has been used since the 17th century, In 1980, this diagnosis was removed from later versions of the DSM..

Currently, its meaning is more linked to traits such as emotional instability, anxiety, irritability and other feelings of negative valence. We describe, however, briefly how this dimension has evolved:

Ancient Greece: Hippocrates, at the time, already laid the foundations for this condition when he spoke of the melancholic temperament. He defined, according to him, people with disturbed bodily fluids. Somehow, and for thousands of years, this more taciturn and nervous behavior was associated with a greater tendency to depression and anxiety. Phillippe Pinel: This French doctor published Traité mèdico-philosophique sur l’aliénation mentale in 1801. In this work he united William Cullen’s work on neurosis with the Hippocratic tradition. Neurosis at this time was conceived as a neurological condition combined with moral and behavioral characteristics.Psychoanalytic theory: in Freud’s work Cultural sexual morality and modern nervousness (1908), defined this term as a psychogenic condition whose symptoms have their origin in a childhood conflict. Both neurosis and psychosis would be functional alterations of the emotional apparatus. Pierre Janet: the philosopher and psychologist reformulates this terminology, understanding it as a clinical condition, and not as a functional disease. In this way, he frees it from the anatomical and physiological model. In the Chilean Journal of Neuro-Psychiatry they address how Janet described two nosological characteristics of this dimension: hysteria and psychasthenia.Psychoanalytic theory of Karen Horney: The neo-Freudian psychotherapist stated one of the best-known models of neurosis. For her it was the result of anxiety caused by interpersonal relationships. Her work, Our Internal Conflicts. A constructive theory of neurosis (1945), is his most representative work.Disappearance: with the DSM-III the term neurosis declines. While in the ICD-10 it was replaced as anxiety disorder.

Associated Features

In the past, Anxiety disorders, obsessive-compulsive disorder and somatization disorders were grouped under the term neurosis.. Advances in the understanding of psychopathology have led, as we have already described, to a reevaluation of this categorization. Now, this does not mean that some circles miss this label.

The disappearance of this psychiatric nosography has caused clinical categories to increase. Also, dilute this concept that, until not long ago, categorized a large number of characteristics such as the following:

Distressing emotional and psychological symptoms: People with this characteristic showed a wide-ranging clinical picture in which anxiety, depression, irrational fears, obsessions and compulsions could appear. These symptoms could be persistent and intensely affect your emotional well-being.Somatic symptoms: This disorder was associated with physical symptoms, such as headaches, gastrointestinal problems, palpitations or breathing difficulties… All without an apparent medical cause. These somatic characteristics were often the result of emotional tension and stress.Excessive worry and rumination: Patients with neurosis were described as men and women with a high tendency to worry excessively and ruminate on their problems. All of this led them to a cycle of negative thoughts and constant anxiety.Difficulties in interpersonal relationships: Neurotic disorders were defined as a condition that altered the quality of personal relationships. Worry, fears, anguish and negativity completely interfered with the person’s psychosocial life.Awareness of distress: Unlike some more serious disorders, people with neuroses were very aware that their symptoms were unusual or irrational. However, they could not manage them and fell into cycles of high anguish and helplessness.Maintaining contact with reality: Unlike psychotic disorders, in which contact with reality can be lost, in this condition there was a good understanding of reality.

Is “neurosis” the same as “neuroticism”?

It is important to clarify that the terms neurosis and neuroticism do not mean the same thing.. World Psychiatry magazine stated that neuroticism is one of the best established and validated personality traits. Let’s look at some characteristics of each one:

Neurosis: as we are describing to you, this is an obsolete psychological term that described several categories of mental disorders characterized by distressing emotional or psychological symptoms, such as anxiety, depression, irrational fears, etc.Neuroticism: It is a dimension of personality that is defined in the “Big Five personality” model that includes other traits such as extraversion, agreeableness, openness to experience and responsibility.

Neurosis today

You will be interested to know that this term is used in the psychoanalytic field. That is, professionals guided by Freudian theory continue to use neurosis to understand the symptomatology associated with negative emotionality. Thus, patients who demonstrate extreme anxiety, phobias, nerves and anguish receive this label.

Beyond this sphere, it is no longer used as it is considered obsolete.. In fact, this concept has been diversified and delimited in a wide range of clinical conditions defined in the DSM-V. They are the following:

Specific phobias. Anxiety disorders. Obsessive-compulsive disorder. Generalized anxiety disorder. Panic disorder or panic attack disorder. Substance- or medication-induced anxiety disorder.

How is it treated?

If you feel identified with the characteristics associated with neurosis, it is best to consult with a psychologist and psychiatrist to receive an appropriate diagnosis. Generally, this category is linked, as you have seen, to anxiety disorders. In these cases, the most effective psychotherapeutic model continues to be cognitive-behavioral therapy (CBT).

This approach helps you become aware of your irrational or dysfunctional thoughts, to shape a healthier mental and behavioral approach. Professionals also offer you tools to regulate your emotions, improve your social relationships, achieve goals, rationalize fears and empower yourself little by little in order to take control of your life.

Advances in psychiatric terminology

The understanding of mental disorders has evolved over time. Mental health professionals today prefer to diagnose and treat specific conditions. Neurosis was like a big catch-all where a wide spectrum of psychopathologies entered.

Currently, being able to define conditions such as generalized anxiety disorder, obsessive-compulsive disorder or panic disorder facilitates clinical approaches. However, given the relevance that this term has had in the history of psychology and psychiatry, it is inevitable to continue using it or referring to it.

You might be interested…