Posted 1st June 2020

What is ‘neurotic’?

Neurotic.... The term is loosely applied to innumerable aspects of modern life, but how is it clinically used?

To ask for information or to arrange an appointment,
please call Kenneth Demsky, PhD on 020 7435 6116
or send an e-mail to enquiry@drkennethdemsky.co.uk

The term comes to us directly from Freud, the sometimes maligned father of psychotherapy. It was he who first articulated much of our understanding of the human mind, although, naturally, there has been huge growth in our knowledge of the subject in the 81 years since his death.

Generally speaking, a neurosis exists when there is an imbalance of power between the Superego and the Id—which, with the addition of the Ego comprise Freud's Tripartite Model of the mind. The resulting struggle results in a ‘neurosis’, an mental accompanied by anxiety. Since only the Ego is fully conscious, the battle between the Super Ego and the Id which remains submerged in the Unconscious, until revealed through the profound guided introspection of psychotherapy.

Briefly put, the Id contains our primitive urges and desire, our wishes to avoid pain and to seek pleasure. The Super Ego has two parts: our Conscience (which tells us what would be considered wrong) and our Ego Ideal (which tells us what would be considered perfect). The Ego mediates between these two and negotiates with external reality in an attempt to satisfy to some degree their competing needs.

The classic ‘neurotic’ conflict is described as ‘wish versus fear’, ie, wishing and fearing the same thing simultaneously. For instance, someone with a transgender nature may wish to transition to living fully as the other gender and thereby achieve gender congruence. However, at the same time this individual might fear that to do so would be somehow ‘wrong’, reflecting societally-induced transphobia in that person’s Conscience. Additionally, that person’s Ego Ideal might define the best way to live as remaining in the birth-assigned gender. Psychotherapy would first help the individual become aware of the conflict-- in keeping with Freud’s directive “to make the Unconscious conscious”—allowing it to be examined with all the powers of one’s mind.

The most frequent manifestation of someone having a ‘neurotic’ response is when that individual is unable to be objective on a certain topic. When an individual displays a ‘neurotic’ response, there is a display of idiosyncratic emotion—ie, a response that would not be displayed by most people facing the same stimulus. This is thought to be a reflection of the underlying, unresolved and (at least initially) unconscious conflict.

Posted 1st June 2020