Obsessive neurosis: symptoms, causes and treatment

We speak of obsessive neurosis to refer to a mental disorder linked to nervous tensions and mental problems of a different nature. Was Sigmund Freud, the famous Viennese psychoanalyst, who first described it.

What is obsessive neurosis?

Freud described obsessive neurosis as a mental disorder whose sufferers are constantly preoccupied with thoughts that do not interest them. The type of thoughts that these patients suffer are of a content that generates rejection, which can lead them to have unwanted behaviors.

Much has been written about the difficult detection and treatment of obsessive neurosis, since its symptoms can go unnoticed in many affected. But what are the people who suffer from this condition like? It is often said that they are perfectionists. Their thoughts can dominate their behaviors and their mood, so they can perform repetitive behaviors and compulsive to try to manage their discomfort.

This is a term that is no longer used in modern clinical psychology. It does not appear in either the DSM or the ICD. Obsessive neurosis is, however, a construct of great relevance in the history of psychopathology.

In this article we will know the definition of this disorder, as well as its symptoms, causes and possible psychological treatments.

History of the concept

French psychoanalyst Henri Ey conceptualizes obsessional neurosis as the inability to control compulsive feelings.of ideas or behaviors. This causes the affected person to be subjected to the control of this type of neurosis.

Although the DSM-IV does not consider obsessive neurosis as an independent psychopathological entity, it has dealt with the different characteristics of the disorder, although with very different nuances from those proposed by Freud or those previously described by Henri Ey.

In contemporary diagnostic manuals, obsessive neurosis is included among anxiety disorders. Thus, the set of symptoms corresponds to OCD, or obsessive-compulsive disorder. OCD is a disorder in which there are compulsions and obsessive thoughts that the affected person recognizes as irrational and maladaptive. These symptoms generate notable restlessness and patients often present compulsive behaviors, rituals, etc.

As we can see, there are significant differences between the disorder initially described by psychoanalysis with the term of obsessive neurosis and the psychopathology that is currently described in manuals, under the name of OCD (obsessive compulsive disorder).

main features

The symptoms and characteristics of obsessive neurosis derive from the psychological and cognitive alterations suffered by the patient. The obsessive thoughts flood the mind of the affected person.

Let's see what types of thoughts those affected by obsessive neurosis suffer from.

1. obsessive cognitions

In the psyche of the affected obsessive phenomena arise continuously. This can materialize in uncontrollable feelings of guilt, verification, obsession with order and cleanliness...

These recurring ideas often represent a constant problem and concern for the patient.

2. Defense mechanisms

People with obsessional neurosis develop various defense mechanisms to try to minimize his obsession.

However, these defense mechanisms are also based on obsessive behaviors and thoughts. Unlike obsessive cognitions, defense mechanisms can be carried out consciously and the subject reproduces them to try to reduce the discomfort of the former.

3. Other psychological and affective alterations

This disorder is usually accompanied by other emotional and affective affectations. symptoms like abulia, the feeling of unreality, confusion, strangeness or perplexity are very common characteristics among those affected by obsessive neurosis.

Symptoms

What are the most common symptoms of obsessive neurosis?

• The affected person presents obsessive ideas that appear in his mind against his will. They are compulsive and uncontrollable thoughts.
• The patient has a tendency to perform impulsive and aggressive behaviors, despite not being desired behaviors.
• They perform repetitive behaviors of a symbolic nature. They are defined as rites of magical thinking.
• Psychasthenia appears, since the subject maintains a struggle to try to stop her obsessions.

Causes

Studies on obsessive neurosis have revealed that it is a multi-causal psychopathology (that is, it can be due to different causes). It seems that there are a series of factors that, together, can lead to the appearance of the disorder.

Typically, scholars have classified three types of causes of obsessional neurosis: physical, environmental, and genetic factors.

1. physical factors

The symptoms associated with obsessional neurosis have been shown to be related to various neurochemical imbalances.

It seems that dysfunction in the orbito-fronto-caudate circuit could be a common factor in the appearance of the disorder.

Another hypothesis proposes that certain anomalies in the striatum and facilitation of serotonin transmission in the orbito-frontal region may also be risk factors.

2. Environmental factors

There may also be several factors in the environment that can lead to the emergence of this disorder. Individuals who have experienced situations that they could not control are more predisposed to suffering from obsessive neurosis.

For example, childhood trauma, having been a victim of neglect or sexual abuse, living in a broken home and being exposed to high levels of stress can also lead to the emergence of this psychological disease.

3. Genetic factors

As is the case with many mental disorders, it has also been reported that obsessional neurosis has a large genetic component.

This has been seen since in some families it is easy to detect several members with this affectation. Likewise, having a family history of obsessive neurosis is a risk factor for developing the same disorder.

Treatments

The usual symptoms of obsessive neurosis can be treated from two different (and often complementary) approaches: pharmacological and psychological treatment.

As for pharmacological therapy, the most effective drugs are those tricyclic antidepressants and selective hormone reuptake inhibitors serotonin. This type of pharmacological intervention makes it possible to stabilize the clinical picture, although they usually require psychotherapeutic support. In this regard, cognitive-behavioral therapy is the most effective form of psychotherapy and the one that is often best complemented by inhibitory intervention.

Bibliographic references:

• Freud, S. (1986). "About a case of Obsessive Neurosis (the "Rat Man")". Complete Works, Volume X. Amorrortu Editors.
• Jarne, A. and Talarán, A. (2015). "Manual of Clinical Psychopathology". Editorial Herder.
• Indart, J.C. (2001), “The obsessive pyramid”. Editorial Tres Haches.
• Lacan, J. (1984). “The Seminary. Book XI: The four fundamental concepts of psychoanalysis”. Editorial Paidos.