A functional personality disorder characterized by disturbing emotional symptoms such as morbid fears, obsessive thoughts, or depressive states, but without gross personality disorganization or loss of contact with reality. The terms neurosis and psychoneurosis are interchangeable.
Neurotic symptoms are generally viewed as exaggerated defense mechanisms arising out of unconscious attempts to cope with internal conflicts and the anxiety they produce—for example, one person screens out his difficulties by becoming preoccupied with repetitive thoughts (obsessions), while another may escape from an unbearable situation by forgetting who he is (amnesia).
These faulty reactions weaken the individual’s effectiveness and generate intense feelings of distress and unhappiness. The psychoneurotic therefore needs help in changing his basic reaction patterns so that he can deal more successfully with the problems and demands of life.Many authorities of today believe it is theoretically possible to draw a continuous line from normal behavior through psychoneurosis to psychosis.
A psychoneurosis is considered to be an exaggeration and distortion of ordinary human tendencies, such as keeping conflicting impulses apart or performing rituals as a means of feeling more secure. The normal individual uses such techniques sparingly and on a conscious level. With some people, however, they become automatic, standard, overworked methods of handling all problems and conflicts.
These people may eventually arrive at a point where the faulty techniques have a controlling effect on their behavior and interfere with their evaluation of themselves, their efficiency in work, and their relationships to other people.
In that case they may be described as neurotic.Even though psychoneurosis may differ from psychosis in degree more than kind, a number of fairly definite distinctions can be made. In spite of the fact that he uses faulty adaptive patterns, the neurotic’s personality remains relatively intact and he is fully in touch with everyday reality.
He may show many psychological and somatic symptoms, yet he is still well oriented and not afflicted with delusions, hallucinations, emotional blunting, or bizarre behavior. Although his general efficiency may also be impaired, and he is apt to be a difficult person to get along with, he is not totally incapacitated for work or social life.
He may be desperately in need of help, but he is unlikely to require institutionalization either for the treatment or for the protection of society.Finally, the psychoneurotic knows he is ill, usually wants to get well, and has some insight into his behavior even though he is not aware of its underlying sources.
In other words, his thinking processes are not seriously impaired. In contrast, the personality of the psychotic is disorganized; he rarely has any appreciable insight into his illness, frequently becomes disoriented, loses contact with reality, may sometimes engage in uncontrollable behavior that is dangerous to himself or others, cannot play an effective role in work or social life, and usually has to be treated in an institution.
It might, however, be stressed that these are not all-or-nothing characteristics, since there are many kinds and degrees of both psychoneurosis and psychosis. There are also many borderline cases which show a mixture of both types of reactions. On the other hand, it is interesting that only a few recognized neurotics, possibly less than 5 per cent, become psychotic.
This fact lends itself to different interpretations. Some authorities argue that it means that the neurotic’s defenses are usually strong enough to withstand the stresses he ordinarily faces, and that many more would become psychotic if the pressures were increased. Others take the low figure as evidence of a difference of kind as well as degree between neurosis and psychosis
