Obsessive Neurosis: Symptoms, Causes and Treatment

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

What is obsessional neurosis?

Freud described obsessional neurosis as a psychic disorder whose sufferers are constantly preoccupied by 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 obsessional neurosis, since its symptoms can go unnoticed in many sufferers. But what are people who suffer from this condition like? It is often said that they are perfectionists. Their thoughts can dominate their behaviors and 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 learn about the definition of this disorder, in addition to its symptoms, causes and possible psychological treatments.

History of the concept

The French psychoanalyst Henri Ey conceptualizes obsessional neurosis as the inability to control the compulsivity of feelings, ideas or behaviors. This makes the affected person subject to the control of this type of neurosis.

Although the DSM-IV does not consider obsessional neurosis as an independent psychopathological entity, the different characteristics of the disorder have been treated, although with very different nuances than those proposed by Freud or those previously described by Henri Ey.

In contemporary diagnostic manuals, obsessional neurosis is included among anxiety disorders. In this way, 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 poorly adaptive. These symptoms generate notable restlessness and patients usually present compulsive behaviors, rituals, etc.

As we can see, there are significant differences between the disorder initially described by psychoanalysis with the term obsessional 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 obsessional neurosis derive from the psychological and cognitive alterations suffered by the patient. Obsessive thoughts flood the mind of the affected person.

Let’s see what types of thoughts those affected by obsessional neurosis suffer from.

1. Obsessive cognitions

Obsessive phenomena continually arise in the psyche of the affected person This can take the form of uncontrollable feelings of guilt, verification, obsession with order and cleanliness…

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

2. Defense mechanisms

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

However, these defense mechanisms also stem from 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 disorders Symptoms such as apathy, the feeling of unreality, confusion, strangeness or perplexity are very common characteristics among those affected by obsessional neurosis.

Symptoms

What are the most common symptoms of obsessional neurosis?

Causes

Studies on obsessional neurosis have revealed that it is a multicausal psychopathology (that is, it can be due to different causes). It seems that there are a series of factors that, together, can cause the disorder to appear.

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 abnormalities 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 environmental factors that can lead to the emergence of this disorder. Individuals who have experienced situations that they could not control have a greater predisposition to suffer from obsessional neurosis.

For example, childhood trauma, having been a victim of abandonment 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 illness.

3. Genetic factors

As 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 condition. Likewise, having a family history of obsessional neurosis is a risk factor for developing the same disorder.

Treatments

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

As for pharmacological therapy, the most effective medications are tricyclic antidepressants and selective serotonin hormone reuptake inhibitors. This type of pharmacological intervention allows the clinical condition to be stabilized, although it usually requires psychotherapeutic support. In this regard, cognitive-behavioral therapy is the most effective form of psychotherapy and the one that is usually best complemented by intervention with inhibitors.