Neurosis
A neurosis (or psychoneurosis) is characterized primarily by emotional rather than physical symptoms although physical symptoms may be present. The neuroses are usually categorized according to the type of reaction that the patient exhibits in his attempt to resolve the underlying emotional conflict. All of them involve anxiety as a prominent symptom.
Anxiety Reaction
The anxiety reaction is probably the most widespread of all the neurotic response patterns. Although, as noted above, all the neuroses share anxiety as a symptom, the most common and outstanding characteristic of the anxiety reaction is a feeling of dread or apprehension that is not related to any apparent cause. The anxiety is caused by conflicts of which the patient himself is unaware but which may be stimulated by thoughts or events in his present life. For example, the junior executive who is constantly apprehensive that his employer will ridicule his work and dismiss his ideas may be expressing an anxiety reaction to a childhood fear that equated ridicule with abandonment or mutilation. While anxiety reaction symptoms are primarily mental or emotional, the patient feels inadequate or ineffectual, or behaves irrationally, anxiety is always accompanied by physiological changes such as sweating and heart palpitations. Fatigue and feelings of panic are also common symptoms.
Conversion Reaction
The conversion reaction (or conversion hysteria) describes a type of neurotic behavior in which the patient, instead of coming to grips with his underlying psychic conflict, manages to convert it into physical symptoms involving functions over which he ordinarily exerts complete control. Sometimes the physical symptoms are unimportant, but often they are markedly dramatic. For example, the soldier who becomes deaf to the sound of explosions even though there is no organic defect that would account for a loss of hearing has effectively obliterated a sensations too painful to acknowledge.
Obsessive-Compulsive Reaction
A person beset by persistent, unwanted ideas or feelings (obsessions), who is impelled to carry out certain acts (compulsions) ritualistically, no matter how irrational they are, is reacting to a psychic conflict in an obsessive-Compulsive manner. The obsession may involve a feeing of violence or sexuality directed toward a member of his own family. Usually the feelings will never lead to any overt action of the type imagined, but the idea is nevertheless persistent and painful. Obsessive-compulsive patients are typically exceptionally meticulous and conscientious, often intelligent and gifted in their work. But they expend and enormous amount of energy and time in observing compulsive acts. For example, they may take a dozen or more showers every day because they are dirty or carrying a contagious disease. By performing an apparently harmless compulsive act, the patient is temporarily relieved of the obsession.
Depressive Reaction
Most people have blue moods from time to time in their lives. Indeed, when faced with a personal tragedy like the death of a loved one, a normal healthy individual may well undergo a period of depression. A person suffering from the depressive reaction, however, has persistent feelings of worthlessness and pessimism unrelated to events that might depress a normal person. An inability to cope with problem situations is gradually magnified into an inability to cope with anything at all. Attempts to mask the crisis by putting on a "front" feigning cheerfulness and optimism give way to episodes of total hopelessness. Suicide is often considered and sometimes attempted. Threats of suicide from a depressed person should always be regarded seriously.
Common physical symptoms accompanying depression are fatigue, loss of appetite, and insomnia.
Phobic Reaction
A phobic reaction is the result of an individual's attempt to deal with an anxiety-producing conflict, not by facing up to the actual source of that conflict but by avoiding something else. The substitute whether it be an animal, closed places, or whatever is responded to with the intense anxiety that is really felt for the true source of anxiety. This process is known as displacement, and the irrational fears or dreads are known as phobias.
Thus, a person who had been regularly punished as a child by having been forcibly confined in a closet might be unable to deal with the anxiety of the experience consciously. The anxiety might be displaced and emerge later in life in the form of terror of crowded or confined places- claustrophobia.
Phobias can involve almost anything one encounters in life-including things that go on in one's body and one's mind. Some of the most common phobias have to do with disease- bacteriophobia, for example, the fear of germs.
Scores of phobias exist, ranging alphabetically from acrophobia, the fear of heights, to xenophobia, the fear of strangers. Other well-known examples are ailurophobia, the fear of cats; cynophobia, the fear of dogs; algophobia, the fear of pain; agoraphobia, the fear of open spaces; erythophobia, the fear of blushing; mysophobia, the fear of dirt and contamination; nyctophobia, the fear of the dark; and lyssophobia, the fear of rabies.
Dissociative Reaction
The dissociative reaction involves a basic disruption of the patient's personality. The dissociative reaction permits a person to escape from a part of his personality associated with intolerable anxiety. The escape is made in various ways: by forgetfulness or absent-mindedness, dream states (including sleepwalking), amnesia, and most seriously the adoption of multiple personalities, in which the patient behaves like one person at certain times and like an altogether different person at other times.
Binesh Das
