Neurosis

The definition of Adler

In 1913, Alfred Adler, founder of the individual Psychology, explains: “ One can include/understand each neurosis like an attempt to be released from a Sense of inferiority to pass to a feeling of superiority. But the way of the neurosis does not lead to the line of social activities and it does not arrive at the solution of the questions of life given. It emerges in small family circles and will lead to insulation.

mainly Diverted reality, the neurotic carries out a life in imagination. He makes use of a good number of easy ways enabling him to flee of the real requirements and to aspire to an ideal situation which enables him to be withdrawn from the responsibility and the social performance. These freedoms and the privilege of the suffering compose the substitute for the goal originating (but risky) of the superiority.

Ainsi the neurosis is presented in the form of an attempt to withdraw from each constraint community by a constraint (personal). This one is so that it can return indeed in opposition to the characteristic of the framework of the life and its real constraints. The contrary constraint is revolting. It will seek its substance in adapted emotional experiments or observations. The world of the ideas and the feelings of the neurotic is worried by such incentives but also by futilities so only they are able to divert the glance and the attention of the patient of the questions of the life. Logic also passes under the diktat of the contrary constraint. This process can go until the complete abolition of logic, as in the Psychose S.

All to want it and all aspirations of the patient are under the diktat of its policy of prestige. They always have recourse to pretexts to leave irresolute questions of the life and are turned automatically against the blooming of the feeling of community. ”

Classification (Nosologie)

With the development of the Psychoanalysis, the concept evolves/moves to finally find its place in the tripartite structure:

According to Freud, one can classify in the neurosis the following psychological disorders:

the Hysteria
the Obsessional neurosis
the Anxiety neurosis
the Depression
the psychoneurosis (Transference neurosis and Narcissistic neurosis)

Genesis of the neuroses

In this part, one will distinguish, starting from the writings of Freud, two kinds of anguish, one will specify the concept of traumatism psychic and one will include/understand how repression is at the origin of the symptoms nevrotic of which the compulsion to repeat forms part.

Freud, in 1926, written: “ the anguish, reaction originating to the distress in the traumatism is reproduced then in the situation of danger like alarm signal ” (Freud, 1926, Inhibition, symptom and distresses. Paris, PUF, p. 96). Via the pain which is the consequence of the object loss with a massive discharge of the of libido tensions in ego, it carries out the passage of the automatic anguish, hilflosigkeit, psychic distress frightening, which floods the organization of ego, with the anguish signal, which activates the reactions of ego to face the had a presentiment of danger. Indeed, that the displeasure is associated with the loss of the perception of the object, namely the mother whom the child invests because it is associated with the relief of the instinctual tensions (it nourishes it when he is hungry, etc), is the requirement with the emergence of the anguish signal. The experiences of satisfaction renewed still and still make it possible the child to become aware of the existence of the person who takes care on him and to invest it like source of pleasure. “ the passage of the body pain to the psychic pain corresponds to the transformation of the narcissistic investment into investment of object” (p. 101). The anticipatory function of ego depends on the force of this one, of its possibilities of binding affects and representations, i.e. to give a significance to the lived experiment. In the anguish unweaves, “ the affect primarily appears by an economic effect ” (Green, A., 1970, the affect in French Review of psychoanalysis, Paris, PUF, volume XXXIV n°5-6, Sept. 1970, p. 960), in the anguish signal, “ by an effect of symbolization ”. The anguish which is always the result of a conflict between two opposite tendencies discharges unbounded if the words miss to contain the discomfort. Freud, in 1933 (XXXII°conférence: Distresses and instinctual life in Nouvelles conferences of introduction to the psychoanalysis. Paris, Gallimard, 1984, p. 111-149), recall the distinction between realistic anxiety (external, conscious) and distress nevrotic (danger internal, nonconscious), which occurs in three different circumstances: - in the anxiety neurosis where it is floating anguish, - in the phobia where it is related to given representations but whose width is disproportionate, - in hysteria where it is focused on part of the body. The symptoms are created to avoid the irruption of the anguish. In the phobia, the displacement of the internal danger towards an external danger allows the avoidance by the escape - also to give a materiality to diffuse anguishes as in the phobia of the vacuum. In fact, he explains why it is the anguish, in front of an external danger but whose instinctual danger interns is a condition and a preparation, which causes repression. He adds that the external danger is castration for the boy and the loss of love in the girl, whose prototype is the pain of the infant generated by the absence of the mother. In other words, the risk is to lose something of essence to balance of the subject. In 1926, Freud put forth as the assumption as the situation of danger could be inflated of a certain quantity of instinctual anguish of nature " masochiste" because coming from the destructive instinct directed against the proper person. Dependant on the setting and life instinct to the service of the realization of an objective, this impulse results in character traits like combativeness, tenacity, perseverance, the ambition, etc the reversal of the aggressive impulses against oneself is something of frequent, especially when ambivalence (positive and negative feelings) with regard to a loved person is felt like condemnable or detrimental. Freud also affirms that the primal repression rises from anguish unweaves born of an overflowing overflow of excitations it me. This state where the pleasure principle fails to maintain homeostasis constitutes the traumatic factor. In 1923, it defined already the traumatism in the following way: “ We invite traumatic the enough strong external excitations to break the barrier represented by the means of protection. I believe that it is hardly possible to differently define the traumatism than by its reports/ratios, thus included/understood, with a means of defense, formerly effective, against the excitations ” (Freud, 1923, Beyond the pleasure principle in Essais of psychoanalysis. Paris Small Payot Library, 1968, p. 36). Secondary repressions result from the anguish signal. These considerations authorize to think that the antiquated traumatisms remain with the state of traces in the image of the body, kinds of feelings without direction because untied of all representations. In that, we do not move away from Freud when he wrote: “(...) the driven back mnemic-traces, being attached to its very first psychic experiments, do not exist at his place in a dependant state and are even to a certain extent incompatible with the secondary processes ” (p. 53). This report is the base on which Winnicott (1974) is based in its article “the fear of collapse” ( in International Review off Psycho-Analysis, n°1).

In 1939, Freud notes clearly that “ the genesis of the neuroses is always brought back everywhere and to very early infantile impressions ” (Freud, 1939, Moïse and the monotheism. Paris, Gallimard, 1975, p. 100) and that the conjunction of this etiologic condition with a more fragile constitution contribute to pathology. It releases then the common characters of these traumatic events: - all took place in the first childhood, - all are in general forgotten, - “ it acts of impression of a sexual or aggressive nature and certainly also of early wounds made with ego (narcissistic wound)” (p. 101). It presents also the two characters of the symptoms nevrotic:

1) The first results from the effects of the traumatism which are of two orders. a) The positive effects “ constitute attempts to give the traumatism in value, i.e. to revive the memory of the forgotten incident or to make more exactly it real, to make it revive ” (p. 103). b) The negative reactions or defense reactions such as the phobic inhibitions and avoidances have an opposite goal. These two effects which are fixings with the traumatism or also called automatisms of repetition, also contribute to the formation of the character. “ the neurosis can be regarded as the direct demonstration of a “fixing” of these patients at one early time of their past ” (p. 105).

2) The second character of the symptoms nevrotic is their character compulsionnel, i.e. their psychic intensity makes inoperative the processes of thought adapted to the outside world and, therefore, the psychical reality interns supplants external reality. And Freud adds: “… and sees it towards the psychosis is thus opened ” (p. 105).

In this text, it lets foresee a way to locate the moments of derealisation of the state-limits, under the hegemony of the compulsion to repeat mortifère of the early traumatisms, narcissistic wounds to which, it attaches certain deficiencies of thinking (will infra).

The infantile traumatism causes modifications of ego, like scars, which re-appear after one latency period, probably due to physiological latency. The delayed effect of the traumatism appears when the requirements of external reality enter in conflict with the defensive organization of ego. “ the disease can be regarded as an attempt at cure, as an effort tried to gather the elements of ego that the traumatism had dissociated, to make of it a powerful whole opposite the outside world.” (p. 107). Freud, in the continuation of its talk, notes the conditions of the return of the repressed: - is the weakening of the power of the anticathexis, - is the reinforcement of the instinctual elements related to driven back, - is the emerged impression of the similarity between recent and old events which awakes driven back. “ In this case, the recent material is reinforced with all the latent energy of driven back and this last acts with the background of the recent impression and with its contest ” (p. 129). When we are tired, harassed with concern, our forces become exhausted, the anticathexis yields and our usual mechanisms of defense are less operative. We become irascible, sometimes at the edge of the tears and we crack for one anything. It happens that certain situations, of the particular events cause a reaction of which we are not explained the intensity until we establish a parallel with one moment of the past. When essential needs with our balance are not satisfied and that they are minimized or not recognized, of the images, the scenes of film or life, etc can poke the lack and start an emotion difficult to contain. Driven back it is a little as a brittleness with flower of skin which only waits to be effleurée to make surface.

Freud, in this text, stipulates the fact that the traumatism causes a dissociation of ego, a part being in adequacy with outside and the other, ravaged, that it is necessary to protect. He speaks about the neurosis either like result of an instinctual conflict but well like a formation intended to prevent a bursting of ego. Driven back would be this part cut off from ego or tested of distress which caused it. This point of view of Freud is very far away from the precedents where repression resulted from the intervention of the super-ego (the authority moralisatrice) fights about it with the instinctual requirements of that.

External bonds

Gheorghe Marinesco, general Theory of the neuroses, “Introduction to the psychoanalysis” (Talk of the theories of Freud - Section V), Re-examined General of sciences pure and applied , Volume 34, Gaston Doin Editor, Paris, 1923.
Sandor Ferenczi, neuroses of Sunday, Re-examined international for the psychoanalysis (Internationaler Psychoanaytischer Verlag, Vienna), 1919 (V, 46-48) B., III, 109.
university National College of psychiatry: course for submission to the medical students

See too

Arithmomanie
Bovarysme
Acting out

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