Neurosis is a term used in a number of ways in the field of mental health. The term refers both to certain types of mental disorders and to a particular type of psychological mechanism.
Neurosis as a disorder
Most psychiatrists and other mental health experts use the term neurosis, or neurotic disorder, for any of a group of mild mental illnesses. Neuroses are characterized by such symptoms as anxiety, insecurity, depression, and unreasonable fears. Most people have these feelings occasionally. But a person who suffers a neurotic disorder has them frequently or even constantly. Such feelings interfere with the individual's life and relations with others.
Neurotic disorders seldom disable a person totally. Individuals who have a neurotic disorder recognize the symptoms as unacceptable and strange. Unlike those with more severe mental illnesses called psychoses, people with a neurosis can distinguish between reality and imagination. Neurotic disorders do not include mental problems that seem to have a physical cause. One such problem is the loss of memory that sometimes occurs with aging.
Neuroses formerly made up one of the major diagnostic groups of mental disorders as classified in the United States, the United Kingdom, and elsewhere. This group included such conditions as anxiety neurosis, phobias, hypochondriasis, and obsessions and compulsions. Anxiety neurosis is a disorder characterized by intense, baseless worry. Phobias are unreasonable fears of certain situations or activities, such as open spaces or travelling in aeroplanes. Hypochondriasis is an abnormal fear that one has a disease. Obsessions and compulsions are senseless thoughts and acts that a person feels forced to repeat.
In 1980, psychiatrists in the United States reorganized their diagnostic classifications and adopted more specific terms for many disorders. The revised classification was adopted in a number of countries, including the United Kingdom. The neuroses classification was dropped, and the conditions formerly in that group were placed in other categories. Many mental disorders were renamed. For example, the term anxiety neurosis was replaced by panic disorder and generalized anxiety disorder. Many psychiatrists disagreed with the elimination of neuroses as a diagnostic group.
Neurosis as a psychological mechanism forms part of the theory developed by the Austrian psychiatrist Sigmund Freud and his followers. In this theory, the term neurosis describes a neurotic process that produces certain symptoms. The process begins with an unconscious conflict between opposing desires or between a desire and a prohibition. For example, an unconscious feeling of aggression, such as a desire to harm someone physically, might conflict with feelings of guilt. The unconscious awareness of the conflict produces a mental barrier called a defence mechanism. This barrier keeps unwanted feelings out of a person's conscious awareness. To avoid feeling guilty, an individual might repress (hold back) a desire to harm someone. Such a defence mechanism, in turn, produces a symptom. For example, the person might have an abnormal fear of objects that could be used to actually carry out the repressed desire to cause harm. Freud believed such disturbances arose from distressing experiences that had occurred during childhood.