WE SAW IN THE PREVIOUS MODULE,
repression is a normal aspect of psychosexual development, according
to Freud; NEUROSIS too need not in every
instance be seen as negative. A neurosis is the formation of behavioral
or psychosomatic symptoms
as a result of the return of the repressed.
Freud writes that there are indeed cases in which the physician himself
must admit that the solution of a conflict by a neurosis is one of the
most harmless and most tolerable socially (Introductory Lectures
indeed, Freud goes so far as to argue that even "ostensibly healthy
life is interspersed with a great number of trivial and in practice
The neurotic that needs treatment simply has more debilitating symptom-formations
that prevent enjoyment and active achievement in life. A psychosis,
by contrast, refers to when a patient has completely lost touch with
reality. Freud originally distinguished between neurosis and psychosis
in the following way: in neurosis the ego
suppresses part of the id
out of allegiance to reality, whereas in psychosis
it lets itself be carried away by the id
and detached from a part of reality (5.202).
In general, a neurosis represents an instance
where the ego's
efforts to deal with its desires through repression,
etc. fail: "A person only falls ill of a neurosis if his ego
has lost the capacity to allocate his libido in some way" (Introductory
The failure of the ego
and the increased insistence of the libido
lead to symptoms
that are as bad or worse than the conflict they are designed to replace.
The ego generally
perceives "an advantage through illness," as Freud terms it;
the symptom, that is, allows the ego to side-step the conflict between
his ego and
his id through
that allows him to experience pleasure in an alternate (if often debilitating)
fashion. The symptom
is a substitute
for the instinctual
impulse but one that is so reduced, displaced,
and distorted that it is often not recognizable as a gratification but
looks more like a compulsion or even an illness. Example: the obsessional
neurotic's compulsion to clean. Once such a symptom
is put in place, the ego
will often reinforce it by rationalizing and taking advantage from the
behavior (it is good to be clean; look how much more conscientious I
am than others.) The more ingrained and rationalized a symptom
becomes, the more resistant it will be to the psychoanalytical cure.
Neuroses can be caused 1) by internal impulses
that are improperly repressed
by the ego and
that, therefore, find alternative expression; or 2) by external traumatic
events (a sexual encounter, sexual abuse, war trauma). Usually, a combination
of 1) and 2) is required for the neurosis to manifest itself; however,
Freud soon came to realize that the line between phantasy (1) and reality
(2) can be difficult to determine and, so, "we should equate phantasy
and reality"; indeed, we should "not bother to begin with
whether the childhood experiences under examination are the one or the
other," for "in the world of neurosisit is psychical
reality which is the decisive kind" (Introductory Lectures16.368). In other
words, memories of childhood trauma (incest with the father, viewing
one's parents copulating [what Freud terms the "primal phantasy"])
can sometimes be completely constructed (pure phantasy) and yet nonetheless
function as traumatically as if they had actually happened.
According to Freud, there are a number of classes of neuroses:
narcissistic neuroses: megalomania, melancholia. Freud saw these
neuroses as particularly difficult to cure because the patient has
developed in such a way as to refuse interaction with other people,
thus making a talking cure with an analyst difficult.Note
transference neuroses or "psycho-neuroses": when one's desire
for an external object is transferred to phantasies that then take
the place of real sexual gratification. Included under this general
hysteria, including 1) conversion hysteria, in which the symptoms
are manifested on the body (eg. psychosomatic illness); and 2) anxiety
hysteria, in which one feels excessive anxiety because of an external
object (eg. phobias).
obsessional neuroses: here a sexual impulse is substituted
by obsessive thoughts and compulsive behaviors (eg. obsessive cleaning
or minutely-repeated ceremonial acts).
traumatic neuroses: given that he experienced the results of the
first world war, Freud was especially familiar with the neuroses caused
by the trauma of war; however, any number of traumas can lead to neuroses
(eg. rape). See the next module
on trauma and transference. What distinguishes traumatic neuroses
from other neuroses is the fact that the cause of the symptoms does
not stem, for the most part, from the unconscious or psychological
conflicts but from an actual (and, often, immediate) traumatic event.
Freud also distinguished between actual neuroses and "psychoneuroses";
actual neuroses pointed to actual problems in sexual functioning (eg.
neurasthenia, which Freud saw as resulting from sexual excess, and anxiety
neuroses, which Freud saw as being caused by unrelieved sexual stimulation).
Psychoneuroses, by contrast, are the result of past events and psychological
conflicts involving the unconscious, and include all the transference
neuroses listed above.
The treatment of neurosis consists of making conscious some of the
unconscious until "we transform the pathogenic conflict into a
normal one for which it must be possible somehow to find a solution"
(Introductory Lectures 16.435).
However, simply stating the "truth" of a patient's neurosis
is often not enough, since the work of repression
is such that the patient may hear the analyst's words but not believe
them or perhaps allow the "truth" to stand alongside a continuing
A good example of this tendency for the truth
to stand alongside the symptom is in fetishism, the displacement
of sexual desire onto alternative objects or body parts (eg. a foot
fetish or a shoe fetish), caused by the subject's confrontation with
complex. Freud came to realize in his essay on "Fetishism"
that the fetishist is able at one and the same time to believe
in his phantasy and to recognize that it is nothing but a phantasy.
And yet, the fact of recognizing the phantasy as phantasy in
no way reduces its power over the individual. Zizek
builds on this idea in theorizing the nature of ideology.
Proper Citation of this Page:
Felluga, Dino. "Modules on Freud: On
Neuroses." Introductory Guide to Critical Theory. [date of last
update, which you can find on the home
page]. Purdue U. [date you accessed the site]. <http://www.purdue.edu/guidetotheory/psychoanalysis/freud4.html>.