Obsessional neurosis

The obsessional neurosis (or neurosis of constraint), psychopathological category of the psychoanalysis, is a major form of Névrose released by Sigmund Freud in 1894. According to the psychoanalytical doctrines, it is the second great nervous disease of the class of the neuroses after the Hystérie. It is characterized, by the rigidity of its Mechanisms of defense. For the Psychoanalysis, the obsessional neurosis results from a conflict Inconscient between the erotic instinctual components and the destroying tendencies (love - hatred) with prevalence of these last. The Refoulement of destructiveness is unceasingly put in failure and it is this mechanism which produces the anguish and for example obsessional conduits around cleanliness or interminable checks. It is a question of making sure of the integrity of the object which could be destroyed by the destructiveness of the subject. This dialectical rests on complex mechanisms of any power of the thought: “I wanted the death of the rival relative in thoughts or in dreams and I must check in acts and in external reality that this desired evil left the intact object” (Oedipus). The private clinic can as reveal as conduits of constraints or obsessional rest in fact on more antiquated mechanisms, even psychotics. They can be connected with stereotypies psychotics, which it is then a question of treating according to the primary education disorder. “The symptom does not sign the structure” known as Jean Bergeret (psychoanalyst) in his writings. The neuroses not appearing more in DSM (Diagnosis and Statistical Manual off Mental Disorders) it was replaced in Psychiatrie by the compulsif obsessional Trouble (FAKE). If this disorder remains associated with the idea with neurosis, it is distinguished little from it, in what the symptom is perceived like the main issue. To treat the FAKE as if it were about an affection to the same stakes for all the patients, children, teenagers, adults, can prove to be dangerous.

The model of the Traumatism according to the First topics

The model of the Névrose initially compares it to a psychic Traumatisme Inconscient coming from childhood, and related to the infantile Sexualité. The traumatism is not current, it was subjected to the development but its Refoulement did not make it possible to discharge the Affect which is dependant for him.

Well after the trauma, in the Deferred action, the traumatism takes other significances. It is there that there are regression and formation of Symptôme S. The theory of the infantile trauma is then given up by Freud which will develop its theory of the phantasm. Thus, the infantile sexual trauma (the neurotica) supposed that all the fathers are of the perverts, moreover Freud tells us " there are no indices of reality in the inconscient".

Regression

anal Stage

The Genital stage is seen unobtrusive by a regression with the yearly tenure: the Anus is the érotisée area, and anal satisfaction is invested independently of the genital orgasm. The obsessional neurosis is the negative one of this Perversion, it is defense against this anal stage if disturbing.

The obsessional neurotic presents a latent Homosexualité , related to the interest for what Freud names the Cloaque. The Sadisme is particularly marked: it can be included/understood as concomitant of the influence on deposit, guarantor of cleanliness.

Absolute power

The absolute power of the obsessional neurosis is regression at the stage of any power of the thought. The neurotic is not satisfied in the Hallucination (the Principle of reality remaining more or less active), nor using magic gestures , but its thought is invested like all-powerful.

The thought is strongly érotisée, comparable with a capacity, an influence on the outside world. What is thought is thought like being really carried out. The neurotic thus has tendency to the rumination, which is included/understood like sexual satisfaction, but also to the doubt as a search for compromise.

Obsessional symptoms

The obsessional neurosis expresses nevrotic formations but Normal be, like the Rêve, of the symptoms present in other neuroses, like the insulation, the displacement, the condensation, the Dénégation, but also of the symptoms which are clean for him, like the Reaction-formation and the Undoing.

Insulation and Displacement

The affect, Representative-representation, psychic delegation of a Pulsion are separated from the Représentation to which it was until there dependant. The isolated affect can lead to Angoisse. It can also be moved on another representation before alleviating, which will cause the formation of an obsession seeming completely unjustified.

Condensation

Several latent elements, coming at the same time from unconscious, will be at the origin of the same conscious representation. The symptom in particular, is surdéterminé (and interpretation will have to consider several registers).

Denial

The denial is included/understood like art, subtle, to offer the truth all while denying it. The neurotic presents his unconscious as what is false , but it presents it nevertheless. Freud exposes the following case: a patient says to him that he dreamed of a woman. Freud thus requires of him which woman has T it dreamed. It what the patient answers " I do not know, all that I know, it is that it is not my mère".

Character traits

If the Character neurosis is not the subject of this article, Freud recognizes nevertheless character traits specific to the obsessional neurotic:

Avarice (according to the unconscious equation money = deposit)
Entêtement
Colère
Religiosité
Scrupulosité (often characterized by an excessive hygiene which, as avarice expresses the attempt at control of the impulses)

Reaction-formation

The reaction-formation could be obsession of cleanliness had regard of an anal desire; one can compare it with the inversion in his opposite of the impulse.

Sándor Ferenczi considers that many (but not all) members charity associations are neurotics. Good works in which they take part would reveal their driven back intentions: not that the Altruisme is simply false, but it very often hides a disproportionate hatred.

Undoing

The undoing is a magic form of belief: what was accomplished of evil can be demolishes. The undoing is not always present, it corresponds at a advanced stage of the neurosis. The neurotic seeks to repair what it made.

Freud says to us that the obsessional neurotic can have a very great plasticity in his symptoms more still than hysteria.

The Oedipus complex

The Oedipus complex is characterized by large a Ambivalence for the father: at the same time liked, respected, structuring fantasmatic life, and deeply haï and fears. This is why the death of the father is always a key question: like phantasm, it represents an intention heavily invested - as reality, it will then mark deeply the neurotic, who will be able to perhaps release himself from some prohibited.

The desire for the mother remains important, structuring, founder of the parental authority, then of the Culture like repression nelle Pulsion and sublimation. For Lacan it is the parternelle function which allows the installation of the neurosis, which is necessary not to rock in the psychosis. This paternal function is allowed by the Oedipus complex. The function can be incarnated in the figure of the father but it is also carried by the tradition (one does not do this or that, that is not done…) by external people carrying a certain law symbolic system.

Second topics and unconscious Culpability

The obsessional neurotic shows to have made something; the conscious culpability seems completely unjustified, because no real act seems to correspond to the violence of the remorse, in fact with the car-aggression. The Surmoi of obsessional is shown rather powerful; it can be an antiquated super-ego such as described the Melanie Klein. But this culpability becomes clear, if it is reported to thoughts that the neurotic does not know itself, that he drives back: the neurotic wants to be of it for an act that it did not make, but that the absolute power presents to him like tel.

To note that Freud does not speak only about one culpability which has its roots in the lived unconscious one, but well of a culpability in itself unconscious.

The neurotic it is the man of the impossible desire because of his culpability. Indeed to be able to wish the neurotic death (symbolic system) waits other. Thus its desire is always tinted of culpability.

psychoanalytical Cure of the obsessional neurotic

As a psychoneurosis (or neurosis of defense ), the obsessional neurosis is indicated for the psychoanalysis (in condition of a Demande of the subject).

The Man with the rats

The man with the rats was a patient who followed a psychoanalytical Cure at Freud, and which revealed to him many specificities of the obsessional neurosis. The private clinic was exposed by it by Sigmund Freud to the secret committee .

Difficulties

The obsessional neurosis would be a model of the neurosis which the psychoanalyst can treat. Nevertheless, the psychoanalysis of the obsessional neurosis raises difficulties: the cure can be lengthened, without appearing to advance; certain neurotics present little material, develop a negative transfer, etc

Obsessional neurosis and Psychiatry

The category of the neuroses appeared formerly in psychiatry, with a direction perhaps different from that in psychoanalysis, but showing the interest of many psychiatrists for the analytical theories. This bringing together tends to decrease. If DSM is a handbook of psychiatric psychopathology international, this situation is reflected nevertheless in France, although it is marked there. In the psychiatric medium the therapies cognitivo-behaviorists are sails very about it for the treatment of the FAKE. However, for those which resist these methods, it would be considered a neurosurgical intervention. It is enough to read again Freud and its theorization of resistances in the treatment of the neurotics to wonder about the need for coming to such solutions.

Obsessional neurosis and other pathologies

This neurosis was connected to other pathologies. It should be recalled here that an obsessional symptom is not enough to diagnose an obsessional neurosis, and that the statute of the diagnosis in psychoanalysis wants to be a tool for thought rather than a sufficient method.

Obsessional neurosis and depression

The depression does not constitute one of the psychopathological categories of the psychoanalysis, contrary to the Mélancolie. It can thus be found in all pathologies.

The obsessional depression is par excellence the mourning of the father, or an object compared to the paternal register.

Obsessional neurosis and Hysteria

There is in the obsessional neurosis a hysterical core : the same characteristics of psychic Bisexuality, phantasm of seduction, etc, are found there. But the essential difference is the impoverishment of the emotional life, whereas the emotion in hysteria can be seen put at the service of repression .

Obsessional neurosis and Paranoia

The obsessional neurosis is often included/understood like ultimate rampart against the psychosis. The regression with the anal sadistic Stade aiming at the retention (stage being used as model with the Introjection) thus protects from the psychosis, which aims at expulsion, the Projection of bad outside. The psychoanalysis does not admit possible slip between the structures (Névrose, Psychose and Perversion). However it is during the developmental stages of early childhood that the structure is determined. It is with the case of the Petit Hans that Lacan, after Freud, establishes that it is the phobia (symptom of the obsessional neurosis) which is a rampart against the Psychose.

The neurotic does not suffer from is delirious, but he does not recognize his Agressivité and reacts while rigidifying himself, while working for the good without recognizing his ambivalence (or: not to recognize it), while insulating themselves (and by demolishing associative bonds, bonds of thought), by adopting compulsives attitudes (and reactions vis-a-vis these attitudes), etc

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