• Bitter Crank
    8.7k
    Thus, I see the person with neurosis to often slip through the cracks of society, suffering silently. It would mean they are isolated, not understood, and perpetually in their own world. Most people throw out terms like "see someone", "cognitive-behavioral therapy", "medications", etc. Much of these are external ways of trying to deal with something that is very idiosyncratic and internal to the person who is experiencing the condition.schopenhauer1

    Neurosis or neuroticism... The difference doesn't matter that much. There is certainly a difference between the major psychoses (like bi-polar disorder or schizophrenia) and merely neurotic habits. Needing to check the stove, the faucets, the locked door, and the lights several times before one can leave the house is annoying to one's self (and others) but it is hardly life-threatening. Dealing with mild OCD isn't that difficult; more entrenched and severe OCD can be difficult to overcome.

    Whether neurotic behavior, or neuroticism, rises to the the definition of "mental illness" or not, it is a significant factor in life outcomes. Isolation, depression, anxiety, high levels of emotional arousal (like anger) indirectly affect longevity, physical health, productivity, relationships, and so on.

    I view personality as a combination of genetic determined traits, traits developed from infancy on up, shaped by good and/or bad experiences, given form by one's embodiment, one's milieu, and so on. By the time one reaches adulthood, the personality one has become is pretty much fixed. It has not hardened like concrete, but it isn't soft reshapeable clay, either.

    If one can make significant changes in one's personality, I don't think it can be done without substantial changes in one's environment. IF one's family or relationship is a very negative factor, then an exit from that family or relationship is probably necessary. IF work is driving one crazy (bad jobs can do that) then one needs to leave that job. A well-trained and skilled therapist will be helpful, and therapy should have a long duration--like a year or 50 hours.

    "Therapy means change, not adjustment." The difficulty shouldn't be soft-pedaled. It's hard, and it might take a crisis-kind of event to make the changes.
  • schopenhauer1
    4.2k
    Speaking for my self, I have experienced neurosis (depression, anxiety) and have had a fairly high level of neuroticism. For the last 8 years, I have experienced a sharp shift away from neuroticism. I have become less irritable, more tolerant, less anxious, more contented. I have felt much less depressed and anxious, but whether that is a result of declining neuroticism or effective medication, isn't clear.Bitter Crank

    Yes, I understand the distinction. I am talking about neurosis not a neurotic personality.
  • schopenhauer1
    4.2k
    Dealing with mild OCD isn't that difficult; more entrenched and severe OCD can be difficult to overcome.Bitter Crank

    Yeah, I think checking the stove a few times is one thing- it's when it gets irrational. Checking the stove a couple times is still tied to some rational outcome because the stove may actually cause damage if left on. What about if someone parks a car, but the tire has to be "just right" when it is parked. It is perfectly in the space, but the tire itself has to be a quarter inch to the right. If it isn't, the afflicted person will think about it all day. They cannot think about anything else. Then they go and move it, but each time, they are not hitting the "right" for tire placement. Either the person gives up and deals with the obsession internally, or they keep compulsing and manifest it externally. They may stop the compulsion but then they deal with the internal negative state. They give in and do the compulsion, they are are feeding the feedback loop and associating the ending of the negative feeling with the compulsion. Again, these are afflictions which are not as noticeable but cause considerable disruption.
  • TheMadFool
    5.9k
    But this is exactly the type of dismissive understanding I'm talking about. Neurosis, for the sufferer, is debillitative, it is just not as externally observable. But internally the sufferer is silently keeping themselves together. That's not to say this isn't a spectrum, but as you were saying, it's like an iceberg where people only see maybe a few odd behaviors. A lot of it is silent to others, but very present internally for the sufferer.

    I think it is also interesting because I wonder if tribal societies manifest "OCD" as superstitions and sufferers of OCD in this society might be celebrated as "medicine men" in some tribal societies.
    schopenhauer1

    I read the wikipedia article on neurosis and I was wrong but not completely wrong about what neurosis is.

    Neurosis is a class of functional mental disorders involving chronic distress but neither delusions nor hallucinations.

    Neurosis should not be mistaken for psychosis, which refers to a loss of touch with reality.

    The definitive symptom is anxiety.

    In Horney's view, mild anxiety disorders and full-blown personality disorders all fall under her basic scheme of neurosis as variations in the degree of severity and in the individual dynamics.The opposite of neurosis is a condition Horney calls self-realization, a state of being in which the person responds to the world with the full depth of his or her spontaneous feelings

    Horney compares this process to an acorn that grows and becomes a tree: the acorn has had the potential for a tree inside it all along.
    — Wikpedia

    From what I read it appears that neurosis is a maladjustment to reality and anxiety results when the world doesn't satisfy the needs of a distorted self-image.

    Also you'll notice that Horney compares the neurotic to an acorn that can become a tree i.e. retains the potential for what she describes as self-realization. In my world that means neurosis isn't such a bad thing to have compared to, say, schizophrenia. I think the better way of putting it would be neurosis is the least worst of many possible mental illnesses we can be afflicted by.

    This doesn't mean that the suffering of neurotics can be ignored. It just means that there are other mental illnesses where the suffering is more. In terms of resource allocation we can see what that means - the neurotic is quite low on the priority list.


    The Diagnostic and Statistical Manual of Mental Disorders (DSM) eliminated the category "neurosis" in 1980, because of a decision by its editors to provide descriptions of behavior rather than descriptions of hidden psychological mechanisms. This change has been controversial — Wikpedia

    It appears that the psychiatrists don't want to bother themselves with unprovable theories of how neurosis develops and just want to focus on observable behavior patterns like anxiety, OCD, phobias, etc. and how to treat them. It's a more scientific approach given that explaining the origins of neuroses is a shot in the dark. Nevertheless it violates a principle of medicine - that we treat the cause and not the symptoms.
  • Bitter Crank
    8.7k
    People who have very rigid habits can make it work for them. They get to work on time, they get their work done. They get to the gym on time, they swim a mile, they bike 100 miles. They sleep well.

    I don't know what all fits into the category of neuroses these days. I guess depression, anxiety, OCD, phobias, compulsions, etc. I've never understood what "borderline personality disorder" was -- is that counted as a neurosis?

    "Neurosis" may be an obsolete word, but it seems to me useful to describe the set of screwy ideas that many people haul around, especially the self-defeating ideas, beliefs, habits, etc. that cause some people to fail again and again at projects that are well within their reach. (I know first hand of what I speak.) I've failed at a lot of stuff that was well within my operational capability.
  • Coben
    1.5k
    I think it is also interesting because I wonder if tribal societies manifest "OCD" as superstitions and sufferers of OCD in this society might be celebrated as "medicine men" in some tribal societies.schopenhauer1
    Can you link to something that supports this idea? I think this would actually support my thesis. If a pattern that causes suffering in one culture leads on to a position of authority in another culture, then ti makes parallels between what I have been calling collective neuroses and neurosis as traditionallly defined more likely.

    I am skeptical that medicine men are sufferers of OCD, however.
  • TheMadFool
    5.9k
    I think it is also interesting because I wonder if tribal societies manifest "OCD" as superstitions and sufferers of OCD in this society might be celebrated as "medicine men" in some tribal societies.schopenhauer1



    This raises an interesting question. What is normal? After all the whole panoply of mental disorders is defined as deviations from the normal.

    That OCD or other neurotic patients being celebrated as medicine men is true in some backward societies. Actually why stop at neurosis because presumably a medicine man, claiming all sorts of supernatural abilities, is psychotic. The proviso here is that this may not be entirely accurate. Think of Christians or Muslims or Jews. They're all normal people but to atheists, are suffering a delusion, a hallmark of schizophrenia. As you can see religious people are definitely NOT schizophrenic and their beliefs are simply cultural hand-me-downs. It's not a believer's fault/madness that s/he believes. You might want to look into that.

    Also, what of the genius or hyper-intelligent person? Discoveries and innovations are usually the work of one or a few individual(s). Take planes for example. The man/woman who talks of flight in 1000 BC will surely be labeled insane and immediately sent to the asylum. Yet air transport is a reality today. I guess I'm saying that there's a very very, almost imperceptible, line between genius and madness. In effect this questions the very rationale of normal. In fact I think may great artists and scientists were/are neurotic.

    I maybe a poor neurotic anxious, suffering, alone and sad in the 20th century but a great pioneering visionary in the 22nd century.
  • Coben
    1.5k
    This raises an interesting question. What is normal? After all the whole panoply of mental disorders is defined as deviations from the normal.TheMadFool

    I don't agree with everything I will quote Thomas Szasz on below, but your post made me think of his, and I thought he brings a bit to the thread as a whole.....

    “If you talk to God, you are praying. If God talks to you, you have schizophrenia”
    ― Thomas S. Szasz

    “The plague of mankind is the fear and rejection of diversity: monotheism, monarchy, monogamy and, in our age, monomedicine. The belief that there is only one right way to live, only one right way to regulate religious, political, sexual, medical affairs is the root cause of the greatest threat to man: members of his own species, bent on ensuring his salvation, security, and sanity. ”
    ― Thomas Szasz

    “Doubt is to certainty as neurosis is to psychosis. The neurotic is in doubt and has fears about persons and things; the psychotic has convictions and makes claims about them. In short, the neurotic has problems, the psychotic has solutions.”
    ― Thomas Stephen Szasz
    “Classifying thoughts, feelings and behaviors as diseases is a logical and semantic error, like classifying whale as fish.”
    ― Thomas Szasz


    “The primary problem with modern psychiatry is its reduction of mental illness to bodily dysfunction. Objectification of those identified as mentally ill, by insisting on the somatic nature of their illness, may apparently simplify matters and help protect those trying to provide care from the pain experienced by those needing support. But psychiatric assessment too often fails to appreciate personal and social precursors of mental illness by avoiding or not taking account of such psychosocial considerations. Mainstream psychiatry acts on the somatic hypothesis of mental illness to the detriment of understanding people's problems.”
    ― Thomas Szasz, The Myth of Mental Illness: Foundations of a Theory of Personal Conduct
  • schopenhauer1
    4.2k
    People who have very rigid habits can make it work for them. They get to work on time, they get their work done. They get to the gym on time, they swim a mile, they bike 100 miles. They sleep well.Bitter Crank

    Sometimes this can get quite severe..Think people like Howard Hughes. Let's take OCD again.. Imagine that every you did X arbitrary (but overvalued) triggering event, you felt Y (psychosomatic) affect. So every time you mistakenly hit something with your left hand, the whole rest of the day you felt mentally impaired, like you cannot access your own memory or cognitive capacities to reason. Your whole mind seems to slow down. However, if you immediately hit the object with your right hand, your brain goes back to functioning normally. Let's say this triggering event happens frequently throughout the day. This will become mentally taxing for that person.

    People on the outside, might not even realize what's going on. Even if the person was to explain it to others or even a therapist, the experience would be so alien to them, it would be hard to find a solution that properly fits the internal world of the patient. The therapist would have no idea what it really feels like to go through the angst of having a diminished mental capacity based on some triggering event. They might say to just let the feeling ride out without compusling but then the person is "stuck" in that mode for the whole day.. possibly not wearing off and impeding the immediate tasks at hand. These are the reasons neurosis is quite tricky. It is the alieness of the idiosyncratic, internal feeling of the sufferer and the inability for others to really understand this world and thus to help them. They don't even really understand what's going on internally. There is a disconnect of the world of the OCD afflicted person and the people that are observing and listening to them on the outside. And, since each OCD sufferer might have a different manifestation, it is even that much harder as the nuances of each world is different. This is probably why people with more traditional forms of OCD would be more easily treated- people with religious scrupulosity, people who wash their hands a certain number of times, etc. The more individualized, different, and delusional the obsession/symptom, the more isolating, and harder to understand and treat from those on the outside.
  • schopenhauer1
    4.2k
    Can you link to something that supports this idea? I think this would actually support my thesis. If a pattern that causes suffering in one culture leads on to a position of authority in another culture, then ti makes parallels between what I have been calling collective neuroses and neurosis as traditionallly defined more likely.

    I am skeptical that medicine men are sufferers of OCD, however.
    Coben

    No I can't. This was just an idea I had. Do tribal people suffer neuroses like OCD? If so, is it just treated differently by those people?
  • schopenhauer1
    4.2k
    I maybe a poor neurotic anxious, suffering, alone and sad in the 20th century but a great pioneering visionary in the 22nd century.TheMadFool

    Ha, I would say we must separate personality-types from idiosyncratic and self-evaluated negative patterns. Someone like a Tesla for example was a bit "out there" with his ideas.. but a lot of them were spot on true for how electricity can be harnessed. That perhaps is a personality-related thing. However, he also seemed to have an actual neurotic disorder of OCD. He counted things in three, he was germaphobic. These are like mental baggage that impeded perhaps his abilities socially, and certainly took up mental space. I would guess even Tesla would not have wanted to deal with them.
  • Coben
    1.5k
    I did find this. I can't see the whole article...
    Could obsessive-compulsive disorder have originated as a group-selected adaptive trait in traditional societies?
    Polimeni J1, Reiss JP, Sareen J.
    Author information
    Abstract

    Obsessive-compulsive disorder (OCD) possesses distinctive characteristics inviting evolutionary and anthropological explanations. A genetically based condition with low fecundity persisting through generations is paradoxical. The concept of group selection is an evolutionary principle capable of clarifying the perplexing epidemiology of OCD. Using a group-selection paradigm, the authors propose that OCD reflects an ancient form of behavioural specialization. The majority of compulsions such as checking, washing, counting, needing to confess, hoarding and requiring precision, all carry the potential to benefit society. Focussing primarily on hunting and gathering cultures, the potential evolutionary advantages of OCD are explored.

    It's just a hypothesis, but if you read the verbs they mention one can see how they might benefit the group.
  • schopenhauer1
    4.2k
    It's just a hypothesis, but if you read the verbs they mention one can see how they might benefit the group.Coben

    Oh, I really like that one! That is an interesting idea to explore- is OCD a maladaptive version of what might have been beneficial in the adaptionary setting in more limited capacities. It's an overabundance of traits that if balanced, were necessary for survival. Someone with a tendency for precision, counting, hoarding could have been useful. This trait taken too far and in the wrong setting can be deleterious to the person who has this trait.
  • Coben
    1.5k
    I think it might have even been useful if they were out of balance. They were the one who checked the sentries, the nets, the cave opening many times. They were mostly a pain in the ass, but once in a while they saved the whole tribe.
  • schopenhauer1
    4.2k
    I think it might have even been useful if they were out of balance. They were the one who checked the sentries, the nets, the cave opening many times. They were mostly a pain in the ass, but once in a while they saved the whole tribe.Coben

    Good point. But that's not the whole experience of OCD. It's when one is caught in an aggressive loop that this now has no positive impact for the individual. There's people who take the phrase literally, "step on a crack and break your mother's back". You think that's balanced? They persistently find a pattern to "undo" the stepping on the crack as this might cause future harm for someone. Living with this anxiety of "changing the world" is too stressful to overcome the compulsion to go back and "not" step on the cracks in the right pattern.
  • Bitter Crank
    8.7k
    All of these conditions exist on a continuum, of course. Over on the left side of the continuum are habits and practices that are helpful. On the opposite side, these beneficial habits and practices have become crippling compulsions. On the left side one has a few superstitious behaviors like not walking under ladders (probably a sensible precaution anyway). On the other end of the continuum superstitions become threatening delusions.

    Brains turn repeated behavior into habits, strongly followed practices, rote behaviors, and so on. It isn't just us -- it happens to other animals too. Domestic animals develop habits that can become minor problems -- the dog's insistence that a snack be handed to her in a certain way, and no other way. Typing is a very rigid habit -- so rigid that one can feel an error in one's fingers (if one does enough of it). Back when the telegraph was an important communication tool, operators could identify each other by the way their hands operated the equipment. This was useful during WWII when intelligence officers listened to radio-telegraph transmission from German-occupied countries: the identity of the telegraph operator was recognizable by the habitual way the telegraph key was operated.

    So maybe it isn't surprising that habit prone brains sometimes go overboard and turn habits into compulsions.

    I'm not sure what tips a habit (checking to make sure the stove is off, the car is locked...) into a compulsion; I suppose it is stress. We experience stress when many aspects of our lives start becoming unhinged. Too much chaos; too many unpredictable events happening; disturbing events popping up all over the place. Establishing a secure zone (one's apartment) by multiple checks to make sure everything is OK when one leaves relieves stress a bit, so the checking becomes fixed.
  • schopenhauer1
    4.2k
    I'm not sure what tips a habit (checking to make sure the stove is off, the car is locked...) into a compulsion; I suppose it is stress. We experience stress when many aspects of our lives start becoming unhinged. Too much chaos; too many unpredictable events happening; disturbing events popping up all over the place. Establishing a secure zone (one's apartment) by multiple checks to make sure everything is OK when one leaves relieves stress a bit, so the checking becomes fixed.Bitter Crank

    I think stress is a huge factor, but more in the fact that it magnifies the compulsive affects that are already there in the OCD person. For example, a job interview would most likely increase the symptoms as now there is something at stake and things have to be done a certain way to ensure it. But, the initial compulsion might come from uncertainty. So let us say that the OCD person took the spoon from the drawer and used it to scoop sugar in a cup of coffee.. He did not stir the coffee with the spoon. There is no residual sugar on the spoon either (maybe microscopic grain or two). The person used the handle of the spoon but did not touch the spoon part itself. The person deems 50/50 to put back or in the washing machine. He puts it in washing machine. He goes to other room. Now he obsesses that was the wrong move. The right move was the drawer. But maybe it was too used.. But either way, the logic is long gone, and now it is simply an angsty residual feeling. The idea of the spoon being put in "wrong" place is all prevading and hours go by with this feeling. Finally, the person moves the spoon. It didn't work and tries another combination..wash the spoon manually then use again, then wash again, then put in drawer. You can see how this initial feeling of uncertainty started the whole thing, even if that was long ago not the issue at stake anymore but what to do with the "wrong decision" that was made.
  • Bitter Crank
    8.7k
    You seem to have a lot of familiarity with the details of OCD thinking -- are you OCD?

    I am quite certain that OCD is real and can be disabling, but an interesting aspect of most mental illnesses is that most of the features of MI are manifested in mild form by people who are not, by any definition, mentally disturbed. OCD is a good example. Take your spoon: you have to decide what to do with it. I've had to pause to think about it -- is the spoon I measured baking powder with still clean, or not? The answer is an irrational "no". How about the tops of canned food; after using the can opener on them, some of the juice gets on top of the can, then runs back into the can. Oh oh, is that still clean?

    Some of us have scarcely conscious obsessions about 'ritualistic purity', superstitions about what can be touched by what. One sees this in young children, sometimes -- the potato can't touch the carrots on their plate. Children often dislike texture contrasts -- so horror of horrors, no shredded vegetables and chopped nuts mixed into the Jello. These superstitions can resemble the kosher rules of the ultra-orthodox--all sorts of restrictions.

    I am annoyed at church events when someone collects the unused silverware from the tables and wants to put it back in the drawers. NO! NO! Look, it's been handled at least twice (putting it on the table, taking it off) and who the hell knows how many more times. Just run it through the wash. Same with glasses. Here comes somebody carrying glasses with their fingers inside the glasses saying they are clean. The machine is doing the washing, and it doesn't care if it has a few more to clean. I just follow the rule of "once touched, into the washing machine".

    We make irrational exceptions to our cleanliness rules. We may worry if someone's hands were washed before slicing a loaf of bread, but aren't worried enough about cleanliness to prevent us from having sex with a stranger.

    Point is, despite what we may think we are, we are pretty irrational, frequently given to thoughts and behaviors which do not pass muster as "rational", "reasonable", or "sensible".
  • schopenhauer1
    4.2k
    I am quite certain that OCD is real and can be disabling, but an interesting aspect of most mental illnesses is that most of the features of MI are manifested in mild form by people who are not, by any definition, mentally disturbed. OCD is a good example. Take your spoon: you have to decide what to do with it. I've had to pause to think about it -- is the spoon I measured baking powder with still clean, or not? The answer is an irrational "no". How about the tops of canned food; after using the can opener on them, some of the juice gets on top of the can, then runs back into the can. Oh oh, is that still clean?Bitter Crank

    Yes, this is a good observation. Much of the OCD symptoms are a spectrum, and even non MI people, might have a touch of it on the very weak part of the spectrum. It is these uncertainties that seem to be the birthing places for the more pronounced and actual MI manifestations.

    I am annoyed at church events when someone collects the unused silverware from the tables and wants to put it back in the drawers. NO! NO! Look, it's been handled at least twice (putting it on the table, taking it off) and who the hell knows how many more times. Just run it through the wash. Same with glasses. Here comes somebody carrying glasses with their fingers inside the glasses saying they are clean. The machine is doing the washing, and it doesn't care if it has a few more to clean. I just follow the rule of "once touched, into the washing machine".Bitter Crank

    Right so the uncertainty ground is already fertile in a "well-adjusted" mind let alone one prone to OCD. These uncertanties could be the start of OCD tendencies, though that's just a theory.

    We make irrational exceptions to our cleanliness rules. We may worry if someone's hands were washed before slicing a loaf of bread, but aren't worried enough about cleanliness to prevent us from having sex with a stranger.

    Point is, despite what we may think we are, we are pretty irrational, frequently given to thoughts and behaviors which do not pass muster as "rational", "reasonable", or "sensible".
    Bitter Crank

    Agreed. So what to do about them?
  • Bitter Crank
    8.7k
    Agreed. So what to do about them?schopenhauer1

    We cope as well as we can. (Not much option, really.). I spent a number of years being somewhat dysfunctional. Not so dysfunctional that I couldn't work, but dysfunctional enough that I wasn't working close to standard. Dysfunctional enough that I was a problem to myself--hard to live with. I was fairly reckless for a time--not a good example of self-control and probity.

    I took anti-depressants and Xanax or Ativan for decades. I received psychotherapy. I "coped" more or less. I never did find THE WAY to feel really good. But... I did get better, eventually. I can't claim credit because the relief came long after psychotherapy and I still take a low dose of antidepressant (Effexor). Maybe 8 or 9 years ago or so, I just started to feel a lot better. It wasn't anything I did that made it better. It was like a switch was thrown and all the sturm and drang evaporated.

    If I could put whatever it was in a bottle and sell it, I would have a blockbuster drug. Alas.
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