Phobic form neurotic disorder is integral part phobic-anxiety neurosis, in which fears (phobias) become the main active disorder. They arise against the background of unpleasant memories, experiences, and difficult life events. Very often complaints look like obsessions ( obsessive states). Such patients are simply haunted by fears everywhere - at home, at work, in transport, on vacation. A person feels in constant danger, which leads to mental disorders and the functioning of the body as a whole. Such patients require consistent treatment of phobic neurosis.
Who is most susceptible to developing phobic neurosis and for what reasons?
This ailment can develop both as an independent disease against the background of existing specific character traits and temperamental characteristics, and as a complication of existing diseases - psychopathy, psychasthenia, alcoholism, drug addiction. Neurosis with fears can aggravate the course of diseases internal organs(myocardial infarction, stroke), oncological processes, endocrine pathologies.
Both men and women are susceptible to phobic neurosis. The primary development of symptoms of the disease is typical adolescence, as well as the transitional stage from maturity to old age. You can often observe phobias in women during menopause.
People's fears develop against the background of:
- chronic psychophysical fatigue and overstrain;
- received mental trauma;
- any long-term, debilitating disease;
- regular lack of sleep and poor nutrition;
Symptoms and manifestations of phobic neurosis
The main type of phobic neurosis is panic attacks. These conditions can occur at different frequencies, sometimes several times a day. The duration of the attack ranges from several minutes to 1-2 hours. Night attacks are especially painful. The impetus for their onset can be any strong irritation, such as external factors, and internal sensations, as well as stress, alcohol or drugs.
The patient develops:
- a painful feeling of fear with panic;
- feeling near death;
- pronounced vegetative manifestations – heavy sweating, body tremors, nausea and headache, stiffness of the body, especially the fingers, their coldness, numbness.
During the interictal period, malaise can be expressed as fear open places, or vice versa, closed. Some patients are afraid to go outside and are afraid of crowds of large numbers of people. Some patients cannot travel by transport, especially the subway. In these cases, treatment of phobic neurosis should be started as early as possible, otherwise the range of fears will expand, which can lead the sick person to suicidal thoughts.
A separate category of people suffering from phobias are hypochondriacs. Fears in this category are caused by the fear of contracting incurable and serious diseases - cancer, tuberculosis, stroke. AIDS, etc.
Some patients experience social phobias. Existing inferiority complexes can give a vivid picture of personal failure at work, in the family, or in any other situation. People around us often don’t understand that close person is simply sick, they begin to subject him to ridicule, which tightens the “vicious noose” even more.
Treatment of phobic neurosis
The main type of help for the development of this disease is psychotherapy. The psychotherapist directs his efforts to eliminating feelings of fear, anxiety, and obsessive experiences. The goal is gradually achieved by using individual psychotherapeutic techniques. The doctor uses methods of rational persuasion to achieve a therapeutic result. To enhance the effect of the therapy, hypnosis is additionally used. In this state, a person suffering from phobic neurosis is given a suggestion that helps to form therapeutic attitudes and get away from the dominant symptoms of fear.
After mitigating the main manifestations of the disease, group psychotherapy sessions are recommended, in which people with similar problems, using mutual induction created by a psychologist, try to eliminate the roots of their problems.
In cases of phobic neurosis, patients are advised to undergo acupuncture and other types of reflexology.
More severe cases in the treatment of phobic neurosis are corrected with medication.
Depending on the main symptoms, patients are prescribed:
- antidepressants (with pronounced degrees of mental depression);
- tranquilizers (to relieve stress reactions, allay fears);
- sleeping pills (helping to normalize night sleep);
In hospital conditions, in the treatment of phobic neurosis, physiotherapeutic procedures are actively used - electrosleep, manual therapy, calming, massotherapy, physiotherapy.
Phobic neurosis is also called anxious-phobic neurosis, which is one of the forms of neuroses and is manifested by fear, constant anxiety, panic in relation to events, people, and various objects. “Phobia” in translation means fear, therefore all types of pathological fears are classified as phobic neuroses.
Types of phobic neurosis
A phobia is a variety of fears that are associated with an action, object, people or memories of them. Typically, all phobias develop in two ways:
Particularly common is agoraphobia or fear of open space, which leads to voluntary self-confinement at home. In contrast to this condition, a fear of closed spaces or claustrophobia may occur.
Fear of heights in medicine is called acrophobia and also refers to a type of phobic neurosis, and fear of animals is called zoophobia. The fear of being the center of negative attention from strangers is called social phobia. All these types of phobic neurosis are connected by one thing - mental disorders and signs of the disease.
IN medical practice There are three types of severity of phobias, and each subsequent form is more severe in relation to the previous forms:
Signs of phobic neurosis
Most often, the disease manifests itself in adolescence and young adulthood, when hormonal changes in the body occur. IN childhood Children exhibit character traits such as shyness, timidity, suspiciousness, and reticence, which, in the absence of proper attention, can easily go into a state of panic.
At first, fear in patients arises for some reason, and then it can manifest itself at the mere mention of the current situation, turning into obsessive fear. Despite understanding the situations, patients cannot do anything about the nature of fear. Many patients throughout their lives, realizing this, try to avoid situations that can provoke panic and fear in them.
Phobic neurosis is characterized, in addition to fears, by periodic depression, headaches, weakness, irregular heart rhythm, breathing and other symptoms characteristic of the group of neuroses. Moreover, all the signs of neurosis appear in those moments when the patient sees a threat to himself and is afraid of panic. Patients in these situations complain of persistent emotional overstrain and the inability to relax.
The behavior of patients with such a painful condition is typical - most of them try to consciously run away from the causes that cause them fear and switch their attention to other objects. This is especially pronounced in childhood - for example, a child who is afraid of his father tries to switch his attention to animals.
There are cases when stable situations that cause fear are well recognized and avoided by patients, and in this case the person may develop a phobic character. This behavior will continue until the patient’s panic situations get out of control, causing the person to have attacks of exacerbation of the disease. There are cases of the so-called hypochondriacal neurosis when the patient is haunted by thoughts about the presence of a disease (for example, cancer).
Treatment of phobic neurosis
Treatment of phobic neurosis must be carried out after consulting with a specialist. It is not recommended to treat with home remedies, self-medicate, or take medication. This can aggravate the patient's condition and cause complications of the disease.
If the patient’s condition is not advanced (especially in childhood), then anxious-phobic neurosis can be easily cured with the help of a competent psychoanalyst, who is able to find the cause of this condition and cure the patient in several sessions of psychotherapy.
Traditionally, in the treatment of phobic neurosis, there are several methods that can be used either individually or in combination:
Cognitive behavioral therapy, which is the gold standard in psychotherapy, and without which it is impossible to imagine the treatment of neuroses. This therapy helps to identify, remember, sort out situations that cause fear, and also find means to eliminate them. With the help of psychotherapy, you can teach the patient to control their emotions and anxiety.
Drug treatment - beta blockers, antidepressants, antipsychotics, sedatives are used in treatment nervous system drugs. But you need to know that phobic neurosis cannot be cured with medications alone (without psychotherapy).
Additional therapies, which include herbal medicine, acupuncture, relaxation massage, Spa treatment, the use of meditation techniques and yoga exercises.
Diagnosis of phobic neurosis is made on the basis of examination and medical history of the patient. In practice, phobic neurosis often accompanies schizophrenia, manic-depressive psychoses and other diseases with mental disorders.
Phobic neurosis symptoms
Phobic neurosis is a mental illness characterized by obsessive fears, thoughts, and memories. These obsessions are unpleasant for patients because they arise without their knowledge and are uncontrollable or difficult to control. Due to its negative connotation, an obsessive phobia is perceived by the patient as foreign, thus increasing his fear according to the “snowball” principle. Gradually, obsessive fear takes over the patient’s entire life, and he loses the ability to think about anything other than the phobia.
The occurrence of phobic neurosis may be due to:
What symptoms indicate phobic neurosis?
- Patients try to avoid phenomena, objects, conversations that directly or indirectly remind them of their fear.
- Phobic neurosis can manifest itself in various forms. So, with agoraphobia, the patient will be afraid to be in crowded places, in open spaces. Other forms of the disease are also possible. The most common:
- acrophobia - fear of heights;
- claustrophobia - fear of closed spaces;
- nosophobia - fear of contracting a fatal disease;
- social phobia - fear of social contacts;
- thanatophobia - fear of death.
- With various forms of phobic neurosis, a person tries to compensate for the influence of obsessions. Then compulsions (rituals) appear, designed to alleviate negative thoughts. A person with this form of phobic neurosis can check many times whether he has closed front door before leaving, did you turn off the light? Almost always the ritual is accompanied by counting the number of actions performed. At severe forms a person can wash their hands or close/open a cabinet door for hours and end up not even leaving the house. It is worth noting that compulsions can manifest themselves not only as actions, but also as compensatory thoughts aimed at combating obsessive fear.
- Panic attacks are sudden attacks of severe anxiety. Accompanied by lack of air, rapid heartbeat, and fear of dying. The patient's seizures are not controlled.
- Allow fear to exist freely. As soon as you stop opposing him, he will immediately weaken. Remember that most of our fears are irrational, meaning there is no real reason to worry.
- If you are tormented by obsessive ideas, vivid images of fear, fixate on this mental image. Regular analysis of your phobia will allow you to slightly reduce your level of anxiety.
- The disease greatly depletes the psyche. Relaxing baths will help you cope with this. essential oils: ylang-ylang or clary sage. Drinking mint tea and other soothing herbs can also help.
- Walk on fresh air and regular sports activities can distract the patient from unpleasant thoughts and fears.
- Primary conditioning (for example, the emergence of a fear of boarding a plane after experiencing an unsuccessful landing once)
- Secondary conditioning (for example, the emergence of fear of suffocation during a ringing telephone or fire truck siren, if a previous, severe asthma attack occurred at the same time as these events.
It is impossible to cure this disease on your own. The fact is that the fight against obsessions only increases anxiety, closing a vicious circle for the patient. Not thinking about it is an impossible task. The patient would be happy to get rid of the obsessive fear, but is not able to. Not because he doesn’t have an iron will and doesn’t know how to control himself. Phobic neurosis is a disease, and, like bronchitis, you cannot get rid of it by willpower.
What should I do?
We recommend contacting a good psychiatrist. We know that deciding to make an appointment is not easy - fear, fear of misunderstanding gets in the way. But you should understand that it is impossible to do without the help of a doctor, and you cannot solve the problem on your own.
Treatment of phobic neurosis is carried out comprehensively. Medications and cognitive behavioral therapy can relieve the patient of obsessive fears, thoughts, and memories. Also, the love and support of loved ones will be a good help on the path to recovery.
To get help from a psychotherapist, just make an appointment by phone.
To reach your goal, you must first of all. go.
Phobic neurosis most often occurs in people with a pronounced anxious-suspicious component in their character structure and a tendency to delay affect (retention). It means that various situations, coinciding in time with a feeling of fear, as a rule, cause this fear when these situations reoccur.
The development of a phobia can occur in two ways:
Typically, phobic neurosis is distinguished by the presence of independent fears that arise in certain situations. The foundation of phobic neurosis is the “attachment” of anxiety to a characteristic situation or characteristic object, after which a phobia arises. So, a phobia is fears associated with a characteristic object, action, memory or fantasizing about them.
The difference between phobias and other fears (for example, with anxiety neurosis) is that phobias are always associated with a characteristic object.
There are a great many phobias, but, usually, phobias related to health and phobias characterizing the position of the physical body somewhere arise more often than others. The first category includes: fear of death (thanatophobia), fear of getting cancer (oncophobia), AIDS, or any other dangerous disease(nosophobia). The second category is agoraphobia (fear of open space), claustrophobia (fear of enclosed spaces), fear of heights or depths, etc.
Fears are formed, usually not associated with a past state of affect, and are perceived by patients as alien to their inner feeling and self-awareness.
There are three types of severity of phobias. The first type of phobia is felt by directly touching an object. The second type is when a person expects this objective touch, and the third type is only when imagining the likelihood of touching the object of the phobia.
Patients realize the absurdity of their phobias, but cannot cope with them.
It happens that, along with the primary phobia, second-order fears arise, linked to the original object. In addition to the fear of heights, there may be a fear of being on the roof, going out onto the balcony, driving over a bridge, or living on high floors.
It is obvious that despite the groundlessness and absurdity of phobias that are recognized by patients, these phobias, as a rule, affect their lifestyle and behavior.
The presence and improvement of rituals—characteristic patterns of behavior, the implementation of which “should ward off misfortune” or “attract good luck”—changes the way of life even more. Rituals may be linked to the primary phobia; (for example, mandatory taking 7 tablets of nitroglycerin in the morning, with cardiophobia), or completely independent of it (spit five times through left shoulder, before bedtime). Over time, rituals tend to become more complex, further changing the patient's life.
Phobic neurosis is characterized by somatic manifestations, which usually appear at the same time as the phobia. These manifestations are very diverse: disruption of activity gastrointestinal tract, convulsive states, palpitations, feeling of shortness of breath, dizziness, weakness in the legs, etc.
Typically, a feature somatic manifestations may be related to the nature of the phobia. Typically, this can be seen in cardiophobia, when a feeling of fear is accompanied by pain in the heart, heaviness in the chest, palpitations, and sensations in cardiac activity.
It is necessary to distinguish between a true phobia and phobic syndrome, differential diagnosis which can be very difficult and complex.
Phobic syndrome may be accompanied by schizophrenia, manic-depressive psychosis, organic brain lesions and others. mental illness. The diagnosis is made by identifying the symptoms of the underlying disease.
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Phobic anxiety disorder
Recently, the concept of “panic attack” has become firmly established in our lives. This is an attack of panic, or uncontrollable fear, that occurs in certain situations. Main feature A panic attack is its irrationality, that is, the reason that caused the fear is not actually threatening to the person. Most people have experienced an irrational panic attack at least once. If panic attacks are repeated and negatively affect the quality of life, we are talking about an anxiety disorder.
Phobic anxiety disorder or anxious-phobic neurosis is a disease in which a person reacts to safe stimuli with an attack of fear.
There may be one reason for a panic attack, or less often - several. This disease is also called a phobia, with a prefix in Greek denoting a reason for fear:
- claustrophobia (fear of closed spaces),
- agoraphobia (fear of open space),
- aquaphobia (fear of water, fear of swimming),
- anthropophobia (fear of people, communication), etc.
- uncontrollable fear that occurs in a specific situation or when interacting with a specific object;
- irrationality of fear (in fact, the cause of fear is not dangerous);
- avoiding a situation or object that causes panic attacks;
- fear of anticipation (with this neurosis, a phobia may begin at the thought of an upcoming situation);
- vegetative reaction - symptoms that occur during phobic neurosis (palpitations, dizziness, nausea, sweating, weakness), characteristic of any attack of fear and provided by the hormonal reaction of the body.
Anxious personality disorder significantly impairs a person's quality of life. Often those around him do not understand him, even to the point of ridicule. But the fact that others do not consider the “irritant” dangerous and are trying to convince a person with phobic neurosis of this does not in any way affect the strength of fear, but, on the contrary, can aggravate the situation. This can lead to withdrawal from communication and familiar circles, which also increases the strength and frequency of attacks, because it is very difficult for people with phobias to be alone.
If you or someone you know is having seizures irrational fear, rejection of any situation, accompanied by a panic attack - the help of a specialist is needed, because self-medication, as well as avoiding the situation, are unacceptable here.
Anxiety-phobic disorder: symptoms
In phobic anxiety personality disorder, symptoms typically include:
The reasons that caused the development of phobic neurosis can be either primarily organic (increased work of the body's sympathetic-adrenal system and deterioration in the functions of its antagonists) or psychological (an unpleasant situation in the past, especially in childhood). One way or another, with phobic neurosis there is always a so-called constitutional background - a special type of personality (after all, not everyone has unpleasant situations from childhood that cause a subsequent phobia). There is also a certain hereditary predisposition to the development of anxiety disorders.
Phobic anxiety disorders: treatment
If you or your loved ones are diagnosed with phobic neurosis, treatment of this disease should be handled exclusively by a specialist - a psychotherapist. Treatment of phobic anxiety disorders is complex - includes both medications and psychotherapy (individual and in groups).
It is important to note that phobic neurosis is not only a disease of adults. If phobic anxiety disorder is identified in childhood, treatment is carried out by a child psychotherapist.
You should not delay contacting a specialist and let the situation take its course - it is difficult to cope with the disorder on your own, but with the support of a specialist this will happen quickly and comfortably.
We have many years of successful experience working with people suffering from anxiety-phobic disorders. Modern medications with a mild effect, psychotherapy in groups and individually, creative and movement techniques are a guarantee of getting rid of the disease and the path to a new one, full life without fears and restrictions.
Phobic neurosis
Phobic (or anxiety-phobic) neurosis is one of the many types of neuroses. The main manifestation of this disorder is an uncontrollable feeling of fear and anxiety as a reaction to a specific object (object, action, memory, etc.). This feeling is so strong that a person is unable to control himself, even if he realizes that the fear is groundless and his life and health are not in danger.
When does a phobia develop?
A person can develop a phobia in two cases:
The development and occurrence of phobic neuroses are influenced by:
- heredity;
- person's character: increased anxiety, constant state of anxiety, excessive responsibility, suspiciousness;
- emotional stress and physical exhaustion;
- dysfunction endocrine system body;
- sleep disturbance and poor diet;
- infections and bad habits causing significant harm to the body.
- mild degree– fear arises from direct contact with the object of fear;
- average degree– fear arises in anticipation of contact with the object of fear;
- severe– just the thought of the object of fear seizes a person into panic.
- panic attacks;
- irregularities in work autonomic system organs ( the cardiovascular system, respiratory, etc.);
- headache;
- general weakness;
- sleep disorders;
- depression;
- emotional tension.
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Often these disorders occur against the background of another disease: schizophrenia, obsessive-compulsive disorder, psychasthenia, obsessional neurosis.
The risk of phobic neurosis increases during certain periods of a person’s life: during puberty, early adulthood and immediately before menopause.
Types of phobic neuroses
The most common phobia in this moment is a fear of open spaces - agrophobia. A person suffering from this disorder, depending on the severity of the disease, either tries not to leave the house unnecessarily, or is unable to force himself to even leave his own room.
The opposite of this phobia is claustrophobia. A person is seized with fear at the moment when he is in a closed space. This is especially true for elevators.
According to the severity of manifestation, phobic neuroses are divided into three groups:
Most often, phobias arise in adolescence against the background of hormonal changes in the body, and then can develop into obsessive fears or, conversely, disappear. The beginning of such disorders is always direct or indirect contact with a future object of fear, which is negative in nature. Patients are critical of their illness and may realize the groundlessness of their own fears, but at the same time they are not able to get rid of them.
Signs of phobic nephrosis
TO general symptoms phobic neuroses include:
All these signs are easy to detect when the patient comes into contact with the subject of the phobia.
In medicine, all symptoms are divided into 4 groups:
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Phobic neurosis, the symptoms of which manifest themselves in the form of fear, panic and anxiety, is a serious disease. Phobic neurosis is considered a form of neurosis that occurs quite often.
The concept of “phobia” means strong fear, and therefore all types of fears that are recognized as pathological are classified as phobic neuroses.
Types of phobic neurosis
- A phobia is a strong fear of some action, object or person. Sometimes just memories are enough to cause panic. As a rule, all known phobias in the world develop in two ways, namely: Primary reflex - fear may appear when performing some specific work, if the first attempt was unsuccessful and led to negative consequences
- . For example, a person is afraid to make tea after getting a burn.
Secondary reflex - fears arise, for example, during a conversation on the phone, because the last time during this there was a fire or some kind of unpleasant accident.
In the modern world, agoraphobia is very common - a case when a person is terrified of open space. As a result, he quite voluntarily stays indoors all the time and tries not to go anywhere. The opposite of phobic neurosis is claustrophobia, when a person is very afraid of closed spaces and always tries to be in the most spacious rooms or on the street. panic fear to be the center of attention, then in this case social phobia is present. The number of phobias today is very large, but they all have one thing in common: a person has a fairly serious mental disorder and this shows all the signs of a problem.
Experts distinguish three different types, in which panic fear is expressed. Each following type is considered more severe and is much more difficult to treat than the previous one:
- a person very often touches objects that have become objects of his panic fear;
- the person is constantly in anticipation that soon there will be a touch in the object, which became the cause of the development of the phobia;
- a person only imagines that he is touching an object of fear, and this already becomes the reason that he begins to be afraid.
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How does phobic neurosis manifest?
In most cases this serious problem begins to manifest itself in adolescence or young adulthood. At this time, active hormonal changes occur in the child’s body, which can provoke more or less minor psychical deviations. Symptoms of phobic neurosis in childhood can include character traits such as timidity, suspiciousness, and shyness. The child communicates and talks very little with peers; if he is not given the required amount of attention, then he immediately begins to develop panic and even hysteria.
On initial stage development of the disease, fear can manifest itself as a result of certain reasons, but soon enough it arises only at the mere mention of some situation or object, which ultimately turns into obsessive fear. Even if a person understands that he is sick and perceives the real state of the situation, he cannot do anything about his fear, which arises against his will. Many people who understand that they have a problem such as phobic neurosis, throughout their lives try to avoid situations that could provoke fear or panic.
Phobic neurosis, in addition to strong fear, has other unpleasant symptoms. These may include frequent intense headaches, prolonged depression, heart and breathing problems. In addition, other individual symptoms may arise that characterize a person as suffering from neurosis. It is worth noting that all signs of the disease appear only in those situations when a person sees this or that object in front of him or finds himself in a situation that causes panic. As practice shows, most patients complain that at such moments they feel intense tension and cannot relax, no matter how much they want to.
As a rule, patients with phobic neurosis have a specific behavior, which consists in the fact that they try to avoid the causes of fear, trying to switch all their attention to other objects and situations. This is especially noticeable when the problem occurs in a child. For example, if a baby is afraid of one of his parents, then he tries to pay as much attention as possible to animals or certain games.
There are cases when even a stable situation can cause panic. A person is aware of this and tries to avoid such situations. As a result, over time, he begins to develop a phobic neurosis. The patient will behave this way until the situation is completely out of his control, and then the problem will become more complicated and worsen. Sometimes a person experiences a development, the essence of which is that the patient is haunted by thoughts about the presence of some rather serious disease in his body, for example, cancer.
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How to treat phobic neurosis in humans
Treatment for a problem such as phobic neurosis can begin only after the sick person visits a specialist. Under no circumstances should you treat neurosis at home or rely on your own strength and knowledge. In addition, treatment should under no circumstances be carried out using various types of medications. This can not only cause numerous complications, but also provoke a more intense development of phobic neurosis.
If the sick person’s condition has not yet advanced, and the problem is just beginning to develop (this can most often be found in childhood), then this type of neurosis can only be cured with the help of good specialist in the field of psychology. He will be able to literally determine the cause of the problem in just a few treatment sessions; several more visits will be needed to eliminate the phobic neurosis.
As a rule, several methods are used to treat phobic neurosis.
They can be used individually or all together, even simultaneously.
Cognitive behavioral therapy is used quite often. This method treatment is considered the most effective and is one of the standard treatments in psychotherapy. No application this method It is unlikely that it will be possible to cure neurosis. With the help of such therapy, you can easily and quickly remember, as well as determine what exactly causes fear. Cognitive behavioral therapy helps the patient understand himself and finds a way that helps eliminate this fear. Psychotherapy allows you to teach a sick person to properly and fully control their emotions, remove anxiety and overcome panic.
Various types of antidepressants, beta blockers, antipsychotics and special drugs that can quickly calm the nervous system of a sick person are used as treatment with medications. At the same time, it is worth remembering that with the help of only drug treatment It is impossible to overcome phobic neurosis. The use of medications must be combined with visits to a psychotherapist.
OBSESSIVE NEUROSIS (OBESSIVE-PHOBIC NEUROSIS)
This neurosis includes a number of neurotic conditions, in which patients experience obsessive fears, thoughts, actions, memories, which they themselves perceive as alien and unpleasant, painful; at the same time, patients cannot free themselves from their obsessions.
In the origin of the disease important role constitutional and personal predisposition plays a role. Among the patients, people who are prone to reflection (self-analysis), as well as anxious and suspicious ones, predominate.
Most often, the leading symptoms of neurosis are fears (phobias). There is a predominant fear of contracting severe somatic or infectious diseases(cardiophobia, cancerophobia, syphilophobia, speedophobia, etc.). For many patients, a feeling of fear is caused by staying in confined spaces, transport (claustrophobia); they are afraid to go outside or be in crowded places (agoraphobia); in some cases, fear arises when patients only imagine this difficult situation for them. Neurotics, in the presence of phobic disorders, try in any way to get rid of those situations in which they have fears. Many of them constantly turn to various doctors to make sure there are no heart diseases (cardiophobia), cancer(cancerophobia). Close attention to the functioning of one’s internal organs contributes to the formation of hypochondriacal disorder.
Sometimes neuroses develop in connection with a disruption of any habitual activity, while patients are in a state of anticipation of failure in its implementation. A typical example may be the occurrence of a psychogenic weakening of adequate erections in men, which subsequently leads to a fixation of attention on a possible “failure” when it is necessary to get closer to a woman and the formation of “expectation neurosis” (E. Kraepelin, 1910).
In more rare cases, the characteristics of neurosis are characterized by a predominance of obsessive thoughts. In addition to their desire, patients experience, for example, intrusive memories that they cannot get rid of; some patients senselessly count the steps on the stairs, the number of passing cars of any one color, ask themselves various questions many times and try to answer them (why are there four letters in the word “chair”, and five letters in the word “lamp”; why is a chair - it is a chair, not a table, although both words have four letters, etc.). In this case, the phenomenon of “mental chewing gum” is formed. Patients understand the pointlessness of such thoughts, but cannot get rid of them. Particularly difficult for them are obsessive thoughts about the need to commit some shameful actions, for example, swearing obscenely in public, killing their child (contrasting thoughts, “blasphemous” thoughts). Although patients never realize such tendencies, they have a hard time experiencing them.
In addition to such disorders, obsessive actions (compulsions) may occur, for example, compulsive washing of hands to achieve ideal cleanliness (up to 100 times or more per day), returning home to check whether the door is closed, whether the gas or iron is turned off. In some cases, obsessive actions (rituals) arise in order to eliminate obsession. For example, a patient must jump 6 times and only after that he can leave the house, because he is calm and knows that nothing bad will happen to him today, etc.
In the dynamics of obsessive-compulsive neurosis (N. M. Asatiani), three stages are distinguished. At the first stage, obsessive fear arises only in a situation where the patient is afraid of something, at the second - at the thought of being in a similar situation, at the third - a conditionally pathogenic stimulus is a word that is somehow connected with the phobia (for example, in cardiophobia such words can be “heart”, “vessels”, “heart attack”; for cancerophobia - “tumor”, “cancer”, etc.).
Some patients experience “panic attacks” - repeated attacks of severe fear, most often fear of death, or loss of consciousness, which are accompanied by palpitations, shortness of breath, painful sensations. These conditions can last quite a long time, patients subsequently fear their recurrence, do not go out alone or move with accompanying persons. Most of these autonomic paroxysmal attacks with palpitations and shortness of breath are closely associated with chronic stress and occur against the background of overwork. IN domestic psychiatry such conditions were described as sympathoadrenal crises or designated as diencephalic syndrome.
The course of obsessional neurosis most often lasts for long time, the formation of neurotic personality development occurs.
