And associated with the name of Sigmund Freud. Before Freud, the cause of neuroses was seen as a disease of the nerves. Today, as at the beginning of the twentieth century, the theory of neuroses, their symptoms and treatment are most fully explored within the framework of psychoanalysis.
From the point of view of psychoanalysis neurosis- this is the result of a conflict between unconscious desires, often of an aggressive and sexual nature, and a mental structure that evaluates the fulfillment of these desires as potentially dangerous. This definition is an adaptation of the formulation given by Sigmund Freud regarding the difference between neurosis and psychosis, stating that: neurosis is the result of a conflict between the ego and the id, while psychosis is a conflict in the relationship between the ego and the external world.
In other words, with neurosis, a person does not want to know anything about his internal reality - about his fantasies and desires, while with psychosis, testing of external reality is disrupted.
Thus, neurosis is a less severe psychopathological condition than psychosis. However, the degree of suffering caused by neurosis and its impact on quality of life is impressive.
Descriptions of mental states, which later became known as neurotic, began to appear at the end of the nineteenth century. But the final recognition and study of neuroses occurred thanks to psychoanalysis.
Today, approaches to neuroses are different. The International Classification of Diseases, Tenth Revision (ICD-10) includes the category of neurotic disorders. Within domestic psychiatry Disorders of the neurotic level are considered. While the American Diagnostic and Statistical Manual of Mental Disorders (DSM-5) does not have a category for neuroses, it does provide a number of disorders that are of a neurotic nature.
2. In psychoanalysis, neuroses include:
Obsessions are aimed at preventing a certain event or performing a certain action. These events and actions are aggressive or sexual in nature. With obsessive-compulsive neurosis, there is always a conflict between love and hate. Obsessive rituals express the realization of a loving or aggressive desire and a ban on the realization of this desire. That is, the first action is canceled by the second, this is called the destruction of what was done.
The result is that it appears as if neither action occurred, when in fact both occurred. Freud compared such magical thinking or animism to the rituals of primitive peoples trying to appease spirits. In the rituals of a person suffering from obsessive-compulsive neurosis, the same tendency can be traced when he, for example, performs a certain ritual action so that nothing happens to his loved ones or to him. Such a person has an unconscious motive of hatred for a loved one and at the same time love for him. The stronger both are, the stronger the obsessive symptoms.
Aggression in symptoms of obsession is manifested in the desire to control not only oneself, but other people, forcing them to participate in the performance of one’s rituals.
The expectation of bad events, as well as the fear of hurting oneself or committing suicide, are associated with a feeling of guilt for one’s own hatred, which is not realized.
Opposites in mental life with obsessive-compulsive neurosis they manifest themselves especially sharply. The world seems to be divided into good and evil. In compulsive rituals there is a desire to avoid “bad things” and deal only with “good” ones. Moreover, it can be difficult to understand the logic by which things are divided into good and bad.
People suffering from obsessions are usually very energetic by nature, but constant internal struggle leads them to indecision, doubt, and lack of strength.
At their core, these are very conscientious people, as in all neuroses; in obsessive-compulsive neurosis, guilt plays a large role. But there were events in their early history that prevented them from being in touch with their feelings, emotions and desires. As a rule, these are traumatic events or circumstances that occurred at an age when the child did not have the mental resources to cope with them. This causes excitement in the psyche, which is transformed into aggressive and sexual desires that overwhelm a person, and obsessions arise as a defense against the breakthrough of these impulses.
Obsessive symptoms act as a barrier to forbidden impulses, which is why severe anxiety occurs if you try to stop the symptoms by force of will. It is as if a person is deprived of restraining mechanisms and is left alone with the desires that frighten him.
Psychoanalysis makes it possible to explore the cause and meaning of the symptoms of obsessive-compulsive neurosis. Reconstruction of the past and its connection with the present helps the patient understand himself, reduce the need for obsessive symptoms, develop more adaptive mechanisms for coping with the onslaught of unbridled desires. When a person understands the meaning of his symptoms, he becomes able to find harmony with his inner world.
The meaning of the most intricate obsessive rituals can be understood if we trace how their appearance is associated in time with the patient’s experiences, determine when the symptoms appeared and with what events they are associated.
Repetition compulsion
Symptoms of obsessive-compulsive neurosis are very diverse and are described within various approaches, but the following manifestation of obsession has been studied mainly or even exclusively in psychoanalysis. It's about compulsive repetition. This is the inevitable fall of a person into the same circumstances. Certain life difficulties and tragic events can seem to haunt you throughout life. Moreover, the person himself feels such repetitions as an evil fate or the disfavor of fate. One's own contribution to the formation of obsessive situations is often not realized. However, there is always an unconscious motive to constantly experience the same situation.
An example is a series of relationships that surprisingly develop and end according to the same scenario. These could be love relationships, friendships, situations with colleagues at work, and so on. It’s as if the same circumstances find a person, or more correctly, he unconsciously finds them, as if deliberately choosing exactly the path where “that same rake” is hidden.
Treatment of neurosis with psychoanalysis helps to see the connection between the patient’s past and his current life, which makes it possible to get out of the vicious circle of the same situations.
6) Emotional lability
Instability in emotional sphere is another characteristic feature of neurosis.
The cause of emotional states and reactions often remains unclear both to those around them and to the neurotic individual himself. This happens because repressed desires and ideas, although not realized, continue to evoke feelings associated with them.
Among the feelings, the roots of which go back to unconscious fantasies and desires, we can name: shame, guilt, anger, resentment, despondency, envy, jealousy, fear.
One of the main feelings during neurosis, and even those that form neurosis, is guilt. Repressed sexual and aggressive desires associated with the Oedipus complex, although not realized, continue to be condemned by one’s own morality. The feeling of guilt is the most difficult to bear; it torments a person, but without the ability to understand its origins and cope with it.
Dissatisfaction, desperation to achieve love, internal conflicts, hatred, the causes of which remain in the unconscious, lead to aggressiveness and outbursts of indignation. If aggression is redirected towards oneself, depressed mood, despondency and depression occur.
Self-pity, discouragement, depression and low self-esteem often accompany neurosis. A negative emotional background and underestimation of oneself lead to isolation, lack of initiative, and missed opportunities. But an addiction to these experiences may also arise when the need for someone to pity, sympathize or feel guilty leads to fantasies about this or an open demonstration of one’s suffering. This, in turn, can shape traits masochism, in which pain and suffering begin to bring pleasure. As a result, a person unconsciously always tries to turn his cheek where there is a possibility of receiving a blow.
Hot temper and irritability, becoming character traits, can bring their owner hidden or not so hidden pleasure, a feeling of triumph over victims. This behavior is a manifestation sadism. But at the same time, it complicates relationships both with loved ones and in professional and other areas. A person may feel like a hostage to his own explosive temperament or bad character. Behind such manifestations are unconscious motives, the understanding of which in the process of psychoanalysis helps to curb one’s own temper.
Suspicion and suspiciousness can become a character trait that complicates a person’s life when one’s own aggressive impulses are projected externally and attributed to others. As a result, other people are perceived as bad and persecutory. This is an unconscious mechanism that allows you to maintain a sense of yourself as good, but violates the objective perception of other people.
Feeling of special treatment towards oneself, condemnation from others, even if it strangers on the street, arises under the influence of guilt.
Love heals many diseases. But in the context of the topic under discussion, questions arise: what is love and can it save you from a mental disorder?
Passion, lust, addiction, habit can be mistaken for love, but the ability to experience a mature feeling is not available to everyone. Neurosis impairs a person's ability to enter into close, truly deep relationships.
According to one of the concepts of mental development, neurosis is associated with the erosion in early childhood of faith in unconditional love on the part of those closest to us. The ability for deep affection suffers from this. A person insures himself against the disappointment associated with a possible breakup, guided by the principle that he can only count on himself. This defense against attachments leads to loneliness, emotional closeness, and a lack of reciprocity and trust in relationships.
The ability to empathize and sympathize, to understand one’s own emotions and the feelings of others, can be significantly limited as a result of neurosis. But the longing for close relationships remains.
Hysteria is associated with the need to attract attention to oneself by any means, hence pretentiousness in behavior, drama, theatricality, and demonstrativeness. A person with such traits may nevertheless feel lonely and misunderstood, despite the increased interest in them. This is due to the fact that the relationship remains superficial.
Experience depression is a serious mental state that cannot be compared with bad mood. The psyche tries to get out of this state, resorting to desperate attempts. Inspiration arises, reaching the point of mania, when a person is overwhelmed with positive emotions, an irrepressible thirst for activity, as if the sea is knee-deep. But these states occur spontaneously without any reason; their nature is artificial and superficial. The desire to take on everything at once does not allow you to productively focus on one thing. Such outbursts of irrepressible fun are abruptly replaced by loss of spirit, depressed mood, and a depressive phase begins.
Emotional swings can manifest themselves in different situations and relationships. For example, in the form of an unpredictable change of anger to mercy and back in relationships with loved ones, with children, in social contacts. The treacherous onslaught of feelings can negatively affect your personal life and professional activities.
Mood lability and emotional instability are integral companions of neurosis, which treatment with psychoanalysis is designed to overcome. Awareness of the motives of the feelings that arise helps to achieve peace of mind.
7) Sexual disorders
Klimt G. «
Kiss
", 1907-1908.
Gustav Klimt led a very unbridled sex life. The artist had numerous affairs, but he was never married. Klimt is credited with up to forty illegitimate children. Psychoanalysis places great emphasis on the ability to build and maintain secure relationships. Sexuality is one of the fundamental components of life. Surprisingly, such a fundamental instinct becomes very fragile under the influence of neurotic disorders. Sexual function is, one way or another, affected by any mental disorder.
For example, with depression, along with general tone, sexual desire is also suppressed. Inadequate mental states hinder the development and maintenance of relationships and, accordingly, limit the possibility of a normal intimate life.
Mature sexuality is not limited to sexual intercourse. Mutual support, care for offspring, genuine intimacy in a broad sense—these are the components associated with the manifestation of libido. Violations of interpersonal relationships and inability to be sincerely intimate undermine openness and trust in a couple. As a result, serious difficulties arise in intimate life and personal life in general, which not everyone can resolve, so to speak, amicably.
Mental conflicts, unconscious inhibitions, fantasies that are felt as unacceptable and suppressed - all this underlies sexual disorders.
These include: impotence, which in most cases is of a psychogenic nature; in men, premature ejaculation or difficulty achieving orgasm; among women frigidity, sexual coldness, inability to achieve orgasm, vaginismus - contraction of the vaginal muscles before sexual intercourse, which makes penetration of the penis impossible; aversion to sex; psychogenic pain and discomfort from sexual intercourse without somatic reasons; neurotic experiences that interfere with the enjoyment of sex life, such as: fear, anxiety, paralyzing shame, guilt, latent homosexuality turning sexual relations of heterosexual partners into a kind of formal process.
A man who is afraid that he will not be sufficiently patented, courageous, will disappoint his other half, really loses potency from these experiences, which instills even more uncertainty and forms a vicious circle.
A woman may experience anxiety about whether she is attractive to a man, how much he will accept her, and whether she will lose control if she gives in to sexual pleasure. If such experiences are too intense, it prevents a woman from achieving orgasm or even enjoying sex.
It happens that female gender identity is violated by disappointment, which was transmitted to the girl in childhood by parents who openly or covertly show dissatisfaction with her gender. Rudeness or coldness on the part of one or both parents, a ban on sexuality as such - all this prevents one from accepting femininity and undermines sexual sensuality in the future.
Men have the so-called division of the female image into “Madonna and prostitute.” It manifests itself in the fact that a man is able to become sexually liberated and experience satisfaction only with a woman for whom he does not have tender feelings, while with one for whom he feels reverent love, sexual satisfaction is impossible.
Each specific case has its own unconscious causes of sexual disorders.
Some of these disorders can be overcome as a result of the emergence of trust in the couple.
If both partners are aimed at gaining each other’s trust, demonstrate acceptance, openness, and sensitivity, in the end they achieve harmony in their intimate life.
However, the neurotic foundations of sexual disorders can be quite deep; behind them there may be: unconscious hatred, fear, erosion of basic trust, envy, impaired sexual identity. When it comes to disruption of interpersonal relationships in general, this is also reflected in the sexual sphere.
In this case, psychoanalysis will help the patient establish contact with his inner world and with other people. Problems in the intimate sphere will be solved as a person begins to realize their hidden causes.
8) Going off into daydreams
Not only thoughts can be obsessive, but also fantasies, or, as Freud called them, daydreams. When a person would like to change external reality, but it is impossible to achieve immediate changes, he is consoled by a fantasy, where he can imagine himself as a hero, a winner, a desired object of love, a successful person, dream of taking revenge for grievances or asserting himself. Such comforting dreams are a normal component of mental life, but in the case of neurosis they seem to enslave the consciousness.
Neurosis is distinguished by the fact that it lacks mental strength try to change the real state of affairs. Instead, satisfaction occurs in fantasy. When a person is immersed in a dream world, he becomes disconnected from the real world, which further deprives him of the ability to set goals and achieve them. This position is akin to masturbation, which, with neurosis, can completely supplant attempts to build relationships with other people.
With neurosis, mental pain or unbearable excitement arising from various experiences, memories or vivid impressions, as if anesthesia, requires immersion in the comforting world of an alternative fantasy reality.
Addiction to the world of dreams can lead to pathological states of addiction, such as: gaming, alcohol, drug addiction, this also includes: extreme hobbies leading to injury and death, promiscuity or promiscuity, passion for everything related to risk and excitement . Adventurism can become second nature to a person.
There are many manifestations of addiction, one of the leading feelings with them is the excitement that arises, detachment from reality and severe anxiety if it is impossible to indulge in hobbies to which an addiction has developed.
Psychoanalytic treatment aims to help the patient understand what in his history prevented him from developing more mature ways of coping with reality. This study helps to understand the origins of social failures and learn how to adequately overcome difficulties. Tolerance to anxiety gradually develops, which previously could only be dealt with by escaping into the world of dreams.
5. Treatment of neurosis with psychoanalysis
Treatment of neurosis with psychoanalysis aimed at helping the patient understand the unconscious reasons for his experiences and even certain life circumstances, come to terms with repressed fantasies and desires, see the impact of childhood history and relationships with loved ones on today's life, and develop more mature and adaptive ways of coping with various difficulties.
The fact is that the development of neurosis is associated with the so-called secondary benefit from the disease, which is not only responsible for the occurrence of the disorder, but also makes it difficult to cope with it. The motives for illness with neurosis are to achieve a certain goal, the understanding of which is often not accessible primarily to the sick person himself.
However, neurosis is not at all a voluntary choice of a person. Freud gives a metaphor, comparing neurosis to the instinctive impulse of an animal, replacing one difficult circumstance with another.
Let's imagine a traveler riding a camel along a narrow path along a steep cliff; a lion appears around the bend. There is nowhere to go. But the camel finds a solution; he escapes from the lion by throwing himself down with his rider. Symptoms of neurosis are not best way out, this is rather an automatic action, a lack of adaptation mechanisms since childhood. This choice does not allow one to cope with the situation; the solution is no better than the difficulty itself. But this is the only maneuver that the psyche of someone suffering from neurosis is capable of.
An ordinary conversation, no matter how confidential and warm it may be, is not capable of revealing the deep unconscious motives for the emergence of neurosis, and, consequently, of coping with it. The secondary benefit from the restrictions imposed by neurosis allows one to avoid certain circumstances, or, with the help of the symptoms of neurosis, to influence loved ones, to achieve a certain attitude towards oneself. All this makes nervousness a valuable acquisition, getting rid of which turns out to be unprofitable for mental economy. However, this way of solving problems is not mature; along with the advantages, often imaginary, neurosis brings severe mental suffering.
Difficulties arise in interpersonal relationships, adaptation to the environment is disrupted, a person loses the ability to adequately perceive his psychological needs and be in harmony with himself.
The psychoanalyst is not only able to treat the patient’s experiences with sympathy, but he also tactfully explores the questions: what do the symptoms of neurosis mean, why and why did the patient get sick?
The emergence of neurosis is associated with psychological trauma received in childhood and reactivated by a similar traumatic event in adulthood. The expression fits here: “Where it’s thin, that’s where it breaks.” Often these topics are associated with severe mental pain, which prevents us from approaching them directly.
Anything that prevents a person from understanding his inner world and overcoming neurosis in psychoanalysis is called resistance. Demonstrating to the patient the work of resistance and helping to overcome it is one of the main tasks of a psychoanalyst. It can be achieved by creating trusting and reliable relationships based on unconditional acceptance, empathy and the ability to discuss any topic. At the same time, confidentiality and respect for the patient’s identity are guaranteed.
At the dawn of psychoanalysis, when the method was just being formed, Freud achieved success in the treatment of neuroses by helping patients remember the scenes that led them to psychological trauma and were subsequently repressed from consciousness. However, it soon became clear that memories do not always eliminate the symptoms of neurosis, or the result is not permanent. In addition, in some cases, patients remember sad events and even realize their connection with their current condition, but this does not help cope with mental suffering.
Just remembering an event that the psyche chose to forget means making an unhappy person out of someone suffering from neurosis. That is, return him to the moment when he acquired his neurosis. Actually, neurosis would not have developed if the person was able to cope with life’s difficulties. Therefore, Freud came to the conclusion that when treating neurosis with psychoanalysis, in addition to memories of traumatic events, it is necessary to work through their consequences. Processing aims to make the patient mentally more mature, help him overcome mental suffering, strengthen his ability to withstand emotional stress and use more adequate means to solve life problems than those to which neurosis forced him to resort.
In conclusion, I would like to say about such an advantage of psychoanalysis as high standards of qualification. In psychoanalysis, a prerequisite for professional development is to undergo personal analysis. In order to be able to provide psychological assistance to patients, you need to understand yourself. Compliance with the ethical principles of psychoanalytic work is monitored by the professional community. Psychoanalysis is the most developed and researched method of depth psychotherapy, which has many directions. Entire institutes specialize in the study of psychoanalysis.
If you need psychological help, have experiences that you would like to sort out, relationships are not working out, difficult life circumstances have arisen - please contact me, I will be happy to help!
I am holding a reception in Moscow.
Martynov Yu.S.
Psychoanalysis arose within the framework of medicine and is the brainchild of a physician. However, the fact that psychoanalysis was initially presented in the form of a clinical theory, and the immense baggage of psychoanalytic observations, knowledge and interpretation algorithms was intended to comprehend the causality and essence of “ mental illness", dictated by other theoretical and practical motives.
We must not forget that Freud, abandoning the approach to observation practiced within the framework of somatic medicine, made a revolutionary revolution. According to Freud, certain symptoms, character traits and behavior patterns, the totality of which is commonly called “neuroses,” are not “diseases” caused by somatic pathological processes, but are the result of a special psychological processing of intra-psychic conflicts.
The psychodynamics underlying neurotic symptoms, as well as the corresponding defense mechanisms, are to a certain extent characteristic of a “normal” person in normal conditions. It is impossible to draw a clear demarcation line between “normal” and “pathological” states, since the idea of their polarity is nothing more than a convention. Thanks to psychoanalytic discoveries, the superficial pedantic description of the external manifestations of the disease was replaced by an analysis of much more significant mental dynamics.
IN late XIX century, when hysteria was still considered a neurological disease, monumental monographs were created, countless chapters of which were devoted to the description of individual forms of the disease (according to the damage to one or another part of the body, the little finger, the respiratory system or vision, caused by this “neurological affectation”). Meanwhile, Freud, already in 1895, managed in a much more compact article to characterize the essence of the “disorder” that underlies all these varieties of illness.
However, neither improvement nor successful application psychoanalytic theory in practice in the field of medicine and in many other areas of human activity, nor a decisive reorientation of theory taking into account the psychodynamic nature of mental and psychosomatic diseases were unable to create conditions for the abolition of the nosological concept of disease, and this is explained not only by the desire to remain faithful to tradition.
Sensational discoveries in the field of psychogenesis of so-called neuroses and the replenishment of medical and other knowledge through new information obtained by psychoanalytic methods did not serve as proof that a systematic typology is unnecessary. Despite significant difficulties, attempts to create a systematic psychoanalytic clinical theory are being made with the same energy. During the controversy over the “specificity” of individual conflicts or character structure (that is, their belonging to a certain symptomatology, a certain psychosomatic syndrome), which subsequently flared up within the framework of psychoanalytic psychosomatics, it turned out that even when classifying exclusively mental illnesses (psychoneuroses, psychoses, etc.) as well as intermediate disorders) it is quite difficult to solve this problem.
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- Freud and his time
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- The communicative function of dreams
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- Child psychoanalysis
- Childhood neurosis
- Features of child psychoanalysis
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- Research on Infants and Young Children
- Anxiety hysteria in young children
- Depression in infants and early childhood autism
- Psychoanalysis of infants
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- Transgenerational transmission and fantasy interaction
- Methods of child neuropsychiatry
- Movement and speech of a child in the psychotherapeutic process
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- History of psychoanalysis
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- Development of psychoanalysis in Latin America
- Modern psychoanalysis
- Therapeutic goals of psychoanalysis
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- Notes on Aggression Theory
- Notes on the theory of aggression. Part 2.
- Changing therapeutic goals and techniques in psychoanalysis
- About countertransference in psychoanalysis
- The problem of interpretation in psychoanalysis
- Application of psychoanalytic technique
- Technique of psychoanalysis. Part 2.
- Psychoanalysis and exploratory psychotherapy
- Transitional objects. "Not-I" object
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- Introspection, empathy and psychoanalysis.
- Multiple reality
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- On the problems of achieving insight in psychoanalysis
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- On therapeutic work in psychoanalysis. Part 2.
- Operational thinking
- Borderline personality organization
- Borderline personality organization. Part 2
- The role of homosexual cathexis in psychoanalytic treatment
- Capacity for loneliness
- Inhibition, symptom and fear: forty years later
- Inhibition and fear. Ending.
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- Psychoanalysis by M. Balint
- Mikael Balint's contribution to psychoanalysis
- Origin of Interhuman Relations
- Ocnophilia and philobatism
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- The psychoanalyst's contribution to the process of psychoanalysis
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- Disadvantages of Hypnosis
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- Child psychologist about children and their mothers
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- C. G. Jung and analytical psychology
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A feature of our approach and our ideology is our focus on real help to a person. We want to help the client (patient) and not just “consult”, “conduct psychoanalysis” or “do psychotherapy”.
As you know, every specialist has behind him the potential of professional knowledge, skills and abilities that he believes in himself and invites his client to believe in. Sometimes, unfortunately, this potential becomes for the client a “Procrustean bed” in which he feels, with all his characteristics and symptoms, inappropriate, misunderstood, and unnecessary. The client may even feel out of place at an appointment with a specialist who is too passionate about himself and his ideas. Providing psychological assistance or offering “psychological services” are completely different things >>>
Theory of neuroses
Karen Horney's theory of neuroses is one of the most famous theories in this area of psychology. Horney believed that interpersonal relationships create basic anxiety, and neurosis is a kind of defense mechanism to cope with it. The psychologist divided neurotic needs into three large groups, in connection with which three stand out different types neurotic personality: helpless, aggressive and isolated. A balanced and well-adapted person successfully uses all three lines of behavior. A person becomes neurotic if one of them dominates.
Addiction
Neurosis of this type forces a person to constantly strive for the help and approval of others, confirmation by other people of his own rightness; only in this case does he feel valuable and significant. Such people need to be liked by others, to feel their sympathy, as a result of which they often become overly intrusive and emotionally dependent.
Power and control
Striving for high self-esteem, people try to reduce feelings of anxiety by imposing their power and trying to strictly control others. People with these needs appear to others as unkind, selfish, power-hungry, and control-obsessed. Horney argued that a person projects his hostility onto others in the course of mental process, which the psychologist called externalization, and then finds excuses for his cruel behavior.
Isolation
Neurosis of this type leads to antisocial behavior; To those around him, such a person seems indifferent and indifferent. This line of behavior is based on the idea that limiting contact with other people will avoid danger and moderate anxiety. The result is usually a feeling of emptiness and loneliness.
Within these three groups of neuroses, Horney identified ten neurotic needs:
Addiction
Need for love and approval– the desire to meet the expectations of others at all costs, to give them pleasure, to make them satisfied and happy, to please them. People with this need are very afraid of hostility or anger from others and are extremely sensitive to criticism and rejection.
The need for a leadership partner who will control his life. This need involves a strong fear of the prospect of being abandoned and forgotten and the belief that a permanent partner will help solve any problems that may arise in life.
Power and control
The need for power. People with this need control others and try to dominate because they hate weakness and admire strength.
Need for operation. People with such tendencies manipulate others. They are convinced that others exist only to use them. Connections and relationships with the rest of the world, from their point of view, are needed only in order to have control, sex or money.
The need for prestige. These people strive for public recognition and approval. Social status, material wealth, professional achievements, personal qualities, and even family ties and love relationships are assessed in terms of prestige. These people have a strong fear of negative public opinion.
The need for personal achievement. The desire to succeed is a completely normal quality. But a neurotic can become obsessed with this idea, and his desire for achievement is based on a feeling of insecurity. He is terribly afraid of failure, so he always needs to be better than others.
Need for admiration. Such people are characterized by narcissism, the desire to look ideal in the eyes of others - just to look, and not to actually be.
Isolation
The need for perfection. A person with such a neurosis is usually very afraid of his shortcomings and flaws and constantly tries to identify them in order to hide or get rid of them as quickly as possible.
Need for independence. In an effort not to depend on other people and not to be attached, a person often distances himself from the people around him. This leads to the formation of a “loner” mentality.
The need for life restrictions that allow you to remain within narrow limits. People who feel this need try to remain invisible and attract as little attention to themselves as possible. They usually underestimate their skills and talents, do not demand much from others, do not strive for material wealth, are content with very little and consider their needs and wants to be secondary.
Karen Horney's ideas had a huge impact on modern psychology. Her theory of neuroses as a mechanism for relieving anxiety and the classification of neurotic needs made a real breakthrough in science. And thanks to her strong rejection of the ideas of Sigmund Freud, based on the superiority of the male sex over the female, Horney earned a reputation as a defender of gender equality and a recognized master in the field of female psychology.
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Psychoanalytic theory of neuroses
Explanatory note
The purpose of the training course is an in-depth study of the fundamental classical and modern works and approaches to the psychoanalytic theory of neuroses in a historical perspective and within the framework of various psychoanalytic schools and directions.
Disclosure of the essence of the most important concepts, hypotheses and concepts discovered by Freud and developed by modern psychoanalysts on this topic is carried out in the context of a conceptual understanding of the principle postulated by Freud about the “inextricable connection” of theory and practice with the development of psychoanalytic thinking in students.
The course “Psychoanalytic theory of neuroses” allows you to show in detail and consistently the development of the psychoanalytic ideas of Freud and his followers from the psychoanalysis of individual clinical cases before the formation and transformation of the psychoanalytic theory of neuroses and the theory of therapy of neuroses.
The course is intended for 2nd year students of the Faculty of Clinical Psychoanalysis both theoretical and practical training to qualification
The objectives of the training course include:
- systematic and thorough study of the proposed material on the psychoanalytic theory of neuroses in a historical perspective, in the context of the development of the theory and practice of psychoanalysis
- formation of positive motivation in students for research activity within the framework of independent reading of texts (compare, contrast, draw conclusions, look for reasons)
- awakening interest in the beginnings of practical work. Training in applying theoretical knowledge acquired in the course to the practice of conducting a mock clinical interview with another person.
- awakening interest in research and knowledge of the hidden sides of one’s personality
- awakening interest in the application of the psychoanalytic research method in interdisciplinary fields (literature and art, philosophy, sociology, medicine, ethics, etc.)
- developing skills to recognize the developmental aspects and limitations of psychoanalytic science
- basic psychoanalytic concepts, hypotheses, concepts within the course “Psychoanalytic theory of neuroses” from the point of view of theoretical, technical and content-therapeutic approaches
- apply the acquired knowledge for the purpose of diagnosis and differential diagnosis of various neurotic, psychotic and borderline levels of personality organization.
- compare and navigate the body of various theories, trends and schools of psychoanalytic theory of neuroses.
- skills of recognition in the presented texts and on individual trial clinical material: anxieties and frustrations, symptoms, conflicts, phantasmatic activity, drives and defenses
- skills in establishing connections between current psychopathology and etiological aspects.
- skills in determining the location of a symptom at the mental level, at the behavioral level and at the somatic level.
- practical skills in studying psychoanalytic literature
- skills in recognizing transfer-countertransfer interaction
- Freud's identification of hysteria in the field of medicine
- Current professional context as a starting point for this discovery
- Influence of J.M. Charcot, P. Janet, I. Bernheim, E. Kraepelin on understanding the nature and essence of hysteria.
- Freud as a scientist capable of processing and using the works, materials, data of his predecessors and creating his own innovative knowledge
- Hysteria as the first neurosis studied by Freud, and the key to his further research and development of the psychoanalytic understanding of neuroses
- Phenomenology. Symptoms and syndromes
- Basic forms of neuroses
- Etiology and pathogenesis
- Diagnosis and differential diagnosis
- Treatment and prevention
- Fundamental principle: hysteria as the prototype of all psychoneuroses. "The symptoms make sense"
- First hypothesis of the origin and treatment of hysteria
- The fundamental importance of mental trauma in the etiology of hysteria
- Hypothesis about the splitting of the content of consciousness
- The first statement about the specifically sexual nature of the trauma
- Sexuality as a factor motivating repression
- The transition from the cathartic method of treatment of J. Breuer to the method of free associations of S. Freud
- “Study of Hysteria”, 1895, “New Notes on Psychoneuroses of Defense”, 1896, “Etiology of Hysteria” 1896
- Phantasmatic life in connection with psychic bisexuality
- Symptoms, fantasies and dreams as symbolic embodiment of unconscious desire. Infantile sexuality
- Symptom of transformation as condensation of embodied phantasms
- Features of hysterical identifications
- The fundamental role of mental conflict
- Psychoneuroses as a negative perversion
- Psychoneuroses of defense
- - “Sexuality in the etiology of neuroses”, 1898, “Interpretation of dreams”, 1900, “Fragment of the analysis of one case of hysteria (Dora)”, 1905, “Three essays on the theory of sexuality”, 1905, “Hysterical phantasms and their relation to bisexuality”, 1909
- Differences and similarities between various neuroses
- Conditions for entering neurosis
- Symptom formation
- Difference mental mechanisms for hysteria, hysteria of fear and obsessive-compulsive neurosis
- Rationale for the similarity of all defense psychoneuroses. Their difference from narcissistic neuroses
- The role of suppression and the transformation of libido into anxiety in hysteria of fear
- — Analysis of the phobia of one five-year-old boy (Little Hans), 1909, “From the history of an infantile neurosis” (Wolf Man), 1918, “Notes on a case of obsessive neurosis” (Rat Man), 1909, “Metapsychology”, 1915, “Inclinations” and their fates", 1915, "Mourning and Melancholy", 1917, "Introduction to Psychoanalysis", 1916, "Lectures on Introduction to Psychoanalysis", 1916-17
- Revaluation of neuroses. Second structural theory
- Problems female sexuality. Questions of the pre-Oedipal phase of development.
- - “I and “It”, 1923, “Beyond the Pleasure Principle”, 1920, “Neuroses and Psychoses”, 1924, “Suppression, Symptoms, Anxiety”, 1926, Female Sexuality, 1933, “New Lectures on Introduction to Psychoanalysis ",1933
- First topic. Differentiation of the mental apparatus into the Unconscious-Preconscious-Conscious
- The second structural theory is “It-Ego-Super-Ego”. “Super-ego” as the heir of the Oedipus complex.
- Concept of ideal self
- Loading and anti-loading problems
- The relationship between the principles of pleasure and reality and primary and secondary processes
- Concept of conflict
- Drive theory. First and second
- Protection problems
- The first and second theories of fear/anxiety
- Affect theory
- Problems of aggressiveness, sadism, masochism
- Genetic approach from the point of view of drive-structure theory and from the point of view of object relations
- Psychosexual development and the development of object relations.
- Sources, goals and object of attraction
- Orality and incorporation
- Primary identifications
- Specific oral fears and fantasies
- Oral conflict - the first conflict of ambivalence
- Schizoparanoid and depressive positions
- Early Oedipus complex
- Sources, goals, object of attraction
- Second conflict of ambivalence
- Typical fears and defenses of the anal phase
- Formation of oppositional pairs – activity/passivity
- The meeting of narcissistic and object libido
- Narcissistic enhancement of feelings of omnipotence
- The problem of gender differentiation
- Psychosexual development and object relations in the phallic stage
- Uniting partial drives under the primacy of genitality
- The main fears and fantasies of the phallic stage in boys and girls. Child masturbation.
- Children's sex theories
- Primary scene. Identification.
- Sexual or narcissistic meaning in the development of symbolization
- Two functions of the development of the ideal of self and self: 1) as a replacement for lost narcissistic omnipotence and 2) a product of identification with parental figures
- Latency. Period of suppression and amnesia
- Puberty. Identity crisis in girls and boys.
- Object relation and object choice
- — “Transactional spiral” in the family
- — Object relations
- — Identity and identifications
- — Fantasies and phantasm
- — Children's fears and defenses
- Fixation, regression and traumatization
- Metapsychology of childhood (topological, dynamic, economic points of view)
- Narcissism and body image
- Aggression and action
- Mentalization
- Neurotic types of mental organization
- Childhood hysteria and hysteria of fear
- Obsessive mental organization
- Psychotherapy in children
- The concept of neurosis. Classifications. Neurotic level of personality development
- Individual neurosis according to the first and second topics of S. Freud
- Unconscious neurosis
- Symbolic and incestuous formations
- Modern concept of neurosis - family neurosis
- Typical symbolic incestuous relationships
- Mutual dependence and omnipotent control
- Implicit prohibitions. Language compromise
- The meaning of the symbolic role of the father
- Typological Oedipal core
- oedipal identifications
- oedipal castration
- Oedipal choice of object
- Pseudo-neurotic forms of psychopathology: fear neurosis, neurotic depression, phobic neuroses, character neurosis
- Clinic
- Manifestations
- personality and character neurosis (hyperactivity, rigidity, total sterilization)
- types of decompensation
- Connection with the threat of losing an object
- Authentic neuroses: conversion hysteria, hysteria of fear, obsessive-compulsive neurosis, psychoneuroses of defense
- Economic structure
- Main conflicts
- Concepts of libido, fear
- Hysterical relationships
- Hysteria and repression
- Hysteria and gender differentiation
- Hysteria and femininity
- Desire unsatisfied desire
- Masochism hysteria
- Hysterical identifications, mental contagion
- Bisexuality and homosexuality
- Hysteria and transfer
- Fear Hysteria Clinic
- The Case of Little Hans
- Counterphobic object
- Phobic bias
- A New Theory of Neurotic Fear: The Product of the Self and the Signaling Function of Fear
- Threat of castration
- symptom of affect isolation
- distancing from any affective intimacy
- obsessive omnipotent control
- obsessive character
- obsessive rituals
- The myth of Oedipus as a metaphor in a metapsychological concept. Familial narcissistic neurosis.
- The influence of deception and family secrets on the tragic fate of Oedipus
- Turning the unspoken into a negative message. And the predetermination/inevitability of a reaction in reality as a result.
- Barking as a metaphor for the narcissistic father
- Prohibition on knowledge
- Early stages of the Oedipal conflict according to M. Klein.
- The phantasm of the primal scene as a fundamental component of the Oedipus complex
- Hatred of knowledge, inhibition of the epistimophilic impulse due to a threat to the subject's safety
- The theme of loss as fundamental for the development of a depressive position and acceptance/rejection of the reality of the Oedipal couple
- Integration of the depressive position and development of the ability to symbolize
- Associated energies and symptoms
- Free energies, repetitive actions
- The pleasure principle as symbolic satisfaction in symptoms
- The principle of repetition compulsion as a reproduction of a traumatic scenario
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The knowledge gained as a result of mastering this course will allow students to:
A distinctive feature of this course is the understanding of the fundamental role of identifying a class of neuroses in the formation of a psychoanalytic method of research and therapy and the formation of psychoanalytic thought on this basis.
Systematic and analytical reading of original author's texts on the psychoanalytic theory of neuroses, practical use of clinical material, including the use of psychoanalytic literature unpublished in Russia, ensures the most complete mastery of the course material. The course program is formed in the context of international teaching and learning practices.
The author's concept is based on many years clinical experience, training experience within the International Psychoanalytic Association, as well as teaching experience. The established methodology involves a detailed and regular study of the works of Freud and modern psychoanalysts belonging to various directions and psychoanalytic schools as part of the course. The concept is based on a systematic study of literary and clinical material and combines the principles of research and generalization of both theoretical and practical experience.
Topic 1. Historical background for the creation of the psychoanalytic theory of neuroses
The mystery of hysteria since ancient times. Understanding hysteria as a phenomenon at the intersection of medicine, social issues and culture
Collaboration with J. Breuer
Topic 2. Psychiatric understanding of neuroses
Psychiatric understanding of neuroses:
Medical understanding of neuroses in Freud's time and in modern psychiatry.
Isolating the concept of hysteria from the psychiatric nosography of its time
Topic 3. Stages of formation of the psychoanalytic concept of neuroses
Joint work with J. Breuer and its result: “Study of Hysteria”, 1895
Second stage of formation psychoanalytic concept neuroses. 1897-1909
The third stage in the formation of the psychoanalytic concept of neuroses. Hysteria in the service of metapsychology. 1909 – 1918
The fourth stage in the formation of the psychoanalytic concept of neuroses.
Topic 4. Problems of metapsychology
Topological (structural) approach
Topic 5. Genetic approach
The concept of orality. K. Abraham. Influence of M. Klein and her school (U. Billon)
The concept of anality. Influence of K. Abraham, D. Winnicott
The concept of phallicity. Contribution of S. Ferenczi, O. Fenichel.
Topic 6. Theory of the pediatric clinic
Topic 7. Neurotic structures
Topic 8. Conversion hysteria
Topic 9. Hysteria of fear
Topic 10. Obsessive neurosis
Clinic of obsessive neurosis:
Thinking like a screen
Regression to the anal level
Sadomasochistic context. Identification with the aggressor
Fear of castration, fear of loss of control
Oedipal conflict expressed in pregenital language
Sexual and narcissistic. Narcissistic depression.
Differential diagnosis with borderline conditions
Topic 11. Neurotic depression - as a sign of narcissistic ego weakness
The main method of neurotic decompensation is the result of devaluation of the narcissistic self-image.
Manifestations: rumination, masked forms, neuroses of fate, failure, abandonment, disorders of a functional nature.
Connection with neuroses. Differences in the mechanisms and manifestations of neurotic depression in hysterical and obsessive neurosis
The possibility and ability of mental processing of depressive pain as a sign of the neurotic nature of depression (as opposed to melancholic depression).
The paradox of neurotic depression. Possibility of negative and positive forecasts.
Topic 12. Narcissistic dimension of the Oedipal configuration
Topic 13. Oedipal situation and depressive position. M. Klein and her school
Topic 14. Economic approach to hysteria based on the concept of injury
Hypothesis of two traumatic nuclei in hysteria
— Differences between the pleasure principle and the repetition compulsion principle
The relationship between sexual trauma and object loss trauma
The structuring role of the fantasy scenario
Tendency to recreate infantile painful events in transference, regardless of the pleasure principle
The painful experience of “inadequacy”, “absence” in the unconscious takes shape through fantasies of seduction.
Based on the above principles, psychoanalysts try to carry out adequate diagnostics and create a “flexible” classification that allows one to outline general guidelines, but does not plunge a living person into a Procrustean bed of clinical similarity and does not assign him a specific cell on the rack of neuroses. Moreover, the expediency of such a system lies in the fact that it allows one to keep in view several dimensions at the same time, which are to a certain extent independent of each other, but under certain conditions can have mutual influence. On the basis of reflections, observations and terminological "experiments" connected with the concept of hysteria, which is now being questioned, I too have attempted to create a quick sketch of a theory of neuroses.
Considering the practice of using the concept “neurosis” as a unit of disease as an anachronism, I proposed that diagnostics should be carried out taking into account at least three dimensions.
We are talking about the nature of the key conflict, current state ego/structures and processing modalities. Using the latter terms, I tried to characterize not only obvious symptoms, but also latent psychodynamics. Firstly, these three dimensions can be varied - slightly, carefully and at the same time not entirely arbitrarily and independently of each other.
Secondly, a separate method of processing should be regarded as a “defensive strategy” (tactics of protection and compensation), which, in principle, can be applied everywhere and, under certain circumstances, be deviated or filled with new content. In my opinion, such a “flexible” diagnostic model allows not only to classify the so-called atypical neuroses, which, however, are found in clinical practice much more often than the so-called typical neuroses, but also to understand the internal psychodynamic pattern of mysterious “leaps” from one syndrome to another.
An approach based on three-dimensional diagnostics can hardly be called an absolute innovation. It has long been practiced by many specialists who combine symptomatic diagnosis with structural. Moreover, it is obvious that the structure is a combination of the state of the ego and the nature of the conflict, while the symptom corresponds rather to the modality of processing.
I'm pointing out Special attention on the fact that the processes, the development of which is recorded in these three dimensions, occur to one degree or another independently of each other, and this creates the conditions for their adequate understanding. At the same time, the proposed paradigm implies a current diagnosis, subject to constant changes, which seems to me more of an advantage than a disadvantage, since under these conditions nothing prevents further progress along the path of understanding and comprehending the essence of dynamic development within the framework of therapy. And finally, no less important, it seems to me that the analysis of significant processes occurring at the three above-mentioned levels can and should be carried out not only from the point of view of individual psychology, but also taking into account object relations.
This initiative provided the impetus for the creation of a new psychodynamic classification of psychotic and non-psychotic disorders, within which individual illness patterns and associated defense complexes are classified according to the degree of their attraction to the narcissistic pole of the self or to the pole of object relations. Thus, it is possible to place between such extreme manifestations of the disorder as autism and fusion, transitional syndromes of persecutory mania, delusions of relationships, love mania, and ecstatic state.
In accordance with this principle, it is possible to carry out a meaningful psychodynamic classification of types borderline disorder personality, affective-psychotic states, so-called abnormal personality types and psychoneurotic states.
Neurosis (from the Greek neuron - fiber, nerve) or neurotic disorder - nervous disease, which is functional but often has physically painful consequences. It is an expression of a person's inability to cope with the demands of everyday life, his "flight into illness."
Neurosis is a state of constant internal conflict between one's own needs and the impossibility of satisfying them. This is the inability to creatively adapt to the environment in order to ensure the fulfillment of desires, good mood and well-being, a sense of personal success and fulfillment. This is constant anxiety and worry, lack of faith in one’s strengths, capabilities, and talents. This is a denial given to oneself in the importance and significance of one’s own inner world.
The variety of theories of neuroses tells us about a thorough and comprehensive study of these psychogenic disorders. Various authors offer us their views on this problem.
Psychoanalytic causal sexual theory of neuroses by S. Freud.
Z. Freud focused his attention on the manifestations of neurotic disorders, believing that their occurrence is not accidental and each symptom has a special meaning for the patient. At the same time, the meaning of the symptom “always and everywhere” is unknown to the patient, hidden from him, being a derivative of unconscious processes, since “symptoms are not formed from conscious processes.” “Neurotic symptoms,” he wrote, “are in their own way connected with the lives of the persons in whom they are found. They represent a substitute for what did not come to fruition... and was repressed from consciousness.” Their basis is an excessive fixation on a certain segment of the past from the life of a particular person, the inability to free oneself from it, the desire to “hide” from problems. It is the affective fixation on a certain phase of the past that is determined by the most essential characteristic of neurosis. The mechanism is a person’s forced refusal to satisfy his sexual desires, the connection of libido with their infantile sexual experiences, which can be depicted in the form of an etiological equation of neuroses (Figure 1.1):
Figure 1.1 Etiological equation of neuroses
According to S. Freud, with a normal sexual life there cannot be actual neurosis. At the same time, the neurotic mechanism begins to form in early childhood (usually in the first three years of life), when the child develops a number of sexual desires, which he regards as forbidden, illicit. In the process of upbringing, the child learns that all these drives are forbidden, and they are suppressed, not allowed into consciousness, being forced out by the so-called censorship into the unconscious sphere. Thus, complexes are formed that deepen as they grow older and form a readiness for neurotic symptoms. The latter can arise when the “energy of repressed sexual desire” is not translated (not sublimated) into other types of activity permitted by “censorship”.
Noogenic theory of neuroses by W. Frankl.
The basis of neurogenesis, in accordance with the ideas of V. Frankl, is not psychogeny, but existential frustration (vacuum), when a person, for various reasons, loses the “meaning of life”, when his desire to find specific meaning in personal existence is blocked (the will to meaning). The author called this type of neuroses noogenic (from the Greek “noos”, meaning mind, spirit, meaning). Noogenic neuroses arise not from conflicts between drives and consciousness, but from conflicts between different values (moral conflicts), from spiritual problems and, first of all, from the loss of meaningfulness of existence.
The noogenic theory of neuroses differs from the psychoanalytic one in that it is not limited and does not confine itself to the instinctive activity of a person and his unconscious processes, but analyzes spiritual realities. It focuses on the potential meaning of existence, on a person’s awareness of what he really strives for “deep down in his soul,” on the actualization of values. To define noogenic neurogenesis, V. Frankl often used Nietzsche’s statement that “he who has something to live for can withstand almost any how.”
The theory of “neurotic tendencies” by K. Horney.
The essence of neurosis, according to K. Horney, is the neurotic structure of character, and its central links are neurotic inclinations, each of which constitutes a unique core of this structure within the personality, and each of these substructures closely interacts with other similar substructures. At the same time, neurotic tendencies give rise not only to specific anxiety, but also “specific forms of behavior, a specific image of the “I” and a specific idea of \u200b\u200bother people, specific pride, a specific form of vulnerability and specific internal prohibitions.”
Dividing neuroses into “simple situational” and “character neuroses,” K. Horney wrote that “a pathogenic conflict, like a volcano, is hidden deep inside a person and is unknown to him.” As a result, understanding neurosis is impossible without tracing its deep roots - neurotic tendencies. The author identifies ten pathogenic neurotic tendencies, which she distinguishes from similar “normal” tendencies that do not lead to neurotic conflict and neurotic symptoms. K. Horney considers their distinctive essence to be illusory, caricatured, deprived of freedom, spontaneity, meaning and a utilitarian focus on safety and solving all problems. Neurotic tendencies, according to K. Horney, include (table 1.1):
neurotic disorder stress tolerance imagination
Table 1.1
Ten neurotic needs
|
Excessive demand |
Manifestations in behavior |
|
1. In love and approval |
An insatiable desire to be loved and admired by others; increased sensitivity and sensitivity to criticism, rejection, or unfriendliness. |
|
2. In the managing partner |
Excessive dependence on others and fear of rejection or being alone; overestimation of love - the belief that love can solve everything. |
|
3. Within clear limits |
Preferring a lifestyle in which restrictions and routine are of paramount importance; undemandingness, contentment with little and subordination to others. |
|
4. In power |
Dominance and control over others as an end in itself; contempt for weakness. |
|
5. Exploiting others |
Fear of being used by others or of looking "dumb" in their eyes, but unwilling to do anything to outsmart them. |
|
6. In public recognition |
Desire to be admired by others; self-image is formed depending on social status. |
|
7. Admiring yourself |
The desire to create an embellished image of oneself, devoid of flaws and limitations; the need for compliments and flattery from others. |
|
8. In ambition |
A strong desire to be the best, regardless of the consequences; fear of failure. |
|
9. In self-sufficiency and independence |
Avoidance of any relationship that involves taking on any obligations; distancing from everyone and everything. |
|
10. In perfection and irrefutability |
Trying to be morally infallible and blameless in every way; maintaining an impression of perfection and virtue. |
The basis of neurogenesis, according to K. Horney, most often becomes a conflict between several neurotic inclinations, when following one inclination will constantly interfere with the implementation of the opposite ones. In such a situation, a person “comes to a dead end” and, even despite independent searches for ways to compromise, the neurotic character structure does not will allow him to resolve the neurotic conflict of inclinations. This is due to the fact that, as a rule, according to K. Horney, a neurotic person does not even suspect that these particular neurotic inclinations are driving forces in his life. The formation of themselves is a product of even earlier disorders and conflicts that took place in human relationships.
Experimental neuroses. I. P. Pavlov.
The research of I. P. Pavlov and his students played a significant role in the study of pathophysiological mechanisms and the essence of neuroses. Especially many valuable facts in the study of biological mechanisms were obtained during the creation of experimental models of neuroses.
At the same time, the following most important points were established: neuroses arise more quickly and easily in animals with a weak and unbalanced type of nervous system. Under the influence of certain influences that weaken the body, neuroses can also arise in animals with a balanced type of nervous system. The main disturbances in experimental neuroses are expressed in the weakening of nervous processes, their disorganization and the appearance of hypnotic phase states. In addition, it was shown that in an experiment it is possible to create special pathological points in the cerebral cortex, which are characterized by inertia, stagnation of the inhibitory or irritable process. Expressed functional disorders nervous activity in animals with experimental neuroses often entail the appearance of a number of somatovegetative abnormalities (disorders of cardiovascular activity, digestive functions, respiration, excretion, etc.). Naturally, the data obtained in experiments on animals cannot be unconditionally transferred to the analysis of neuroses in humans. Considering the presence of a second signaling system only in humans and its role in the occurrence of neuroses, I. P. Pavlov classified hysteria and psychasthenia as purely human neuroses. It is also known that I.P. Pavlov, based on the relation signaling systems divided all people into three main types of higher nervous activity: the artistic type with a predominance of the first signal system over the second, the mental type with a predominance of the second signal system over the first, and the average type with a balance of the first and second signal systems. Almost any person with one type of nervous system or another who finds himself in an extremely difficult situation may experience a breakdown in higher nervous activity and develop neurosis.
Thus, neuroses depend on the initial type of nervous system. Thus, people of the “artistic type”, who perceive reality very emotionally, are more prone to hysteria; “mental type” - to obsessive-compulsive neurosis, and the mean between them - to neurasthenia.
By neurosis, I.P. Pavlov understood a long-term disorder of higher nervous activity caused by overstrain of nervous processes in the cerebral cortex due to the action of external stimuli of inadequate strength or duration. In Pavlov’s concept of neuroses, what is essential is, firstly, the psychogenic occurrence of a breakdown of higher nervous activity, which outlines the boundaries between neuroses and reversible disorders of a non-psychogenic nature, and secondly, the connection between the clinical forms of neuroses and the types of higher nervous activity, which allows us to consider the classification of neuroses not only with clinical, but also from a pathophysiological point of view.
Clinical pathogenetic theory of human neuroses by V. N. Myasishchev.
V. N. Myasishchev developed a clinical pathogenetic theory of human neuroses, which explains their occurrence and course. Understanding neurosis is based on a synthesis of the specific historical conditions of human development, the characteristics of his personality determined by them, his relationships with people and reactions to difficult circumstances in the current situation. This approach is based on data from psychology, physiology and pathophysiology of human higher nervous activity. It is not just conflict with people and life difficulties, but at the same time the inability to correctly resolve these difficulties that formed the basis for understanding neurosis and its pathogenesis.
For neurosis as a psychogenic illness of the individual, the initial and determining factor is a violation of relationships, from which a violation of processing and a disorder of mental functions follow, depending on how the person processes or experiences reality. Since the pathogenicity of external life circumstances manifests itself only in combination with the corresponding meaningful relationship to them, then what matters is not so much the objective difficulty of the problem as the subjective attitude towards it. The decisive role in the pathogenesis of neurosis is played by psychological, that is, internal, conflict, which represents incompatibility, a clash of contradictory personality relationships. Experiences inherent in conflict become sources of illness only when they occupy a central place in the system of relationships of the individual and when the conflict cannot be processed so that the pathogenic tension disappears and a rational, productive way out of the situation is found.
The theory of anticipations by V. D. Mendelevich.
In recent decades, thanks to the work of domestic psychologists, the problem of probabilistic forecasting and anticipation has begun to be actively developed. Anticipation refers to a person’s ability to anticipate the course of events, predict the development of situations and their own reactions, behavior and experiences. Probabilistic forecasting is the ability to compare incoming information about a current situation with information stored in memory about the corresponding existing experience and, based on this comparison, build an assumption about upcoming events, attributing a degree of reliability to them. The difference between anticipation and probabilistic forecasting is quite conditional and lies in the fact that probabilistic forecasting can be defined as a mathematical distribution of probabilities, and anticipation also includes an activity aspect - a person’s development of a strategy for his own behavior in a multi-probability environment.
Significant information can become pathogenic for the individual and cause neurosis. An equally important parameter of neurogenesis should be the predictability of a significant situation and the creation by a person of “escape routes” in the event of a tragic or undesirable combination of circumstances. A number of studies have been devoted to the analysis of the predictability of life events that lead a person to neurosis. As clinical studies have shown, the events that caused neurosis were unexpected for 62.7% of patients with neuroses, 12.0% of patients assumed that “this could happen,” but “did not attach importance to their thoughts about the future,” and 25.3%, retrospectively assessing the unexpectedness of the situation, they pointed to the fact that “they always thought that the most difficult thing (which included a psychotraumatic event) would “definitely happen” to them. That is, we can say that for the vast majority of patients who fell ill after a psychotrauma neurosis, the event that caused the disease turned out to be unpredictable.
As clinical observations and pathopsychological experiments show, the monovariant type of probabilistic forecasting predominates in patients with neuroses. It consists in the fact that the patient predicts only one subjectively highly probable outcome of events, excluding any others. In addition to the monovariant type of probabilistic forecasting, a polyvariant type of probabilistic forecasting turned out to be typical for patients with neuroses, when the patient’s forecast is dissolved in a large number of proposed options for the development of events. Unlike patients with neuroses, a “neurosis-resistant personality” tends to put forward two or three highly probable options for the development of an event, preparing a program of behavior in both cases of desired and undesirable outcomes.
Literally, the theory of anticipation can be characterized as a person’s inability to foresee an unfavorable outcome of events for himself.
According to Freud, the symptoms of mental illness are harmful or useless acts that a person often complains of as being forced and associated with trouble or suffering. Their main harm lies in the mental costs they themselves incur and the costs necessary to overcome them. With intensive development of symptoms, costs can lead to impoverishment of the individual in terms of managing his vital energy.
The neurotic symptom is the result of a conflict arising from a new type of libidinal satisfaction. The id and ego meet in the symptom and seem to be reconciled through a compromise - the formation of symptoms. That is why the symptom is so stable - it is supported on both sides. It is known that one of the parties to the conflict is an unsatisfied libido, rejected by reality, forced to look for other ways to satisfy itself.
The question of where a symptom comes from is answered by impressions that come from the outside, were once, by necessity, conscious, and since then, thanks to forgetting, can become unconscious. The purpose of a symptom, its meaning, its tendency, is an endopsychic process that may have been conscious at first, but it is no less likely that it was never conscious and remained forever unconscious
Neurotic symptoms, like erroneous actions, like dreams, have their own meaning and, like them, are in their own way connected with the life of the persons in whom they are found.
It is known that the ego shows some interest in the emergence and subsequent existence of neurosis. The symptom is supported by the ego because it has a side through which it satisfies the repressive tendency of the ego. In addition, resolving the conflict through the formation of a symptom is the most convenient and desirable way out of the situation. There are times when even a doctor must admit that resolving a conflict in the form of neurosis is the most harmless and socially acceptable solution. If we can say that every time a neurotic person is faced with a conflict, he flees into illness, then we must admit that this flight is completely justified, and the doctor, who understands this state of affairs, will step aside, sparing the patient. More details: http://www.gumer.info/bibliotek_Buks/Psihol/freyd/07.php
Classical psychoanalysis Freud includes a theory of the psychological origin of neuroses. He distinguishes the following types of neuroses.
Psychoneurosis is due to causes related to the past and is explainable in terms of personality and life history. There are three types of psychoneuroses: hysterical conversion, hysterical fear (phobia) and obsessive-compulsive neurosis. The symptoms of these neuroses can be interpreted as a conflict between the ego and id.
Actual neurosis is due to causes relating to the present and is explainable in terms of the patient's sexual habits. It is a physiological consequence of disorders in sexual functioning. Freud distinguished between two forms: neurasthenia, as a result of sexual excesses, and anxiety neurosis, as a result of the lack of relief from sexual arousal. There are differences in the symptoms of actual neuroses and psychoneuroses: in both cases, the symptoms originate from the libido, but the symptoms of actual neuroses - pressure in the head, sensation of pain, irritation in any organ - are exclusively somatic processes, in the occurrence of which all complex mental mechanisms.
Narcissistic neurosis in which a person is incapable of forming a transference.
Character neurosis - in this case, the symptoms are character traits.
Traumatic neurosis - which is caused by shock. Freud noted that in traumatic neuroses, especially those caused by the horrors of war, there is no doubt for us the egoistic motive of the ego, striving for protection and benefit, which alone does not yet create the disease, but sanctions it and supports it if it has already begun.
With transference neurosis, which is caused during psychoanalysis, the patient shows an obsessive interest in the psychoanalyst.
According to S. Freud, the content of these neuroses is uncertain and unstable. The named forms of neurosis are sometimes found in their pure form, but more often they are mixed with each other and with a psychoneurotic disease.
Both in the cause and in the mechanism of all possible forms of neuroses the same factors are always at work, only in one case one of these factors acquires the main importance in the formation of symptoms, in another - another. Thus, fantasies turning into symptoms are nowhere more clearly manifested than in hysteria; Opposite or reactive formations of the ego dominate the picture of obsessive-compulsive neurosis. I present it according to: Enikeev, M.I. General and social psychology. M.: Republic, 2006. 210 - 211 p.
That., neurotic symptom is the result of a conflict arising from a new type of libido satisfaction; conflict between id and ego.
