Psychoneurotic disorders are purely psychological disorder. There is no relevant organic pathology present in these orders of the behaviour and thus may be clearly distinguished from the psycho-physiological disorders which are known as the disorders of the psyche as well as body. Neurotic disorders in a real sense represent the typical ways of dealing with frustrations and conflicts and the anxiety that result from these frustrations and conflicts.
Neurotic and psychotic behavior:
Neurotic person talks rationally and does not show marked distortion of external reality. He perceives his environment well within the normal range. Since he is not affected by bizarre ideas, hallucinations or illusion, it is not difficult to follow his train of thought.
Emotional distortions in neuroses are mild and not so severe as in psychoses. For examples, a neurotic may at times be depressed but his depression is not so severe as to affect seriously his thought processes and general behaviour as in the case of psychotic personality.
The cognitive distortion is relatively mild in neuroses. The intellectual functioning in a neurotic personality more or less remain unaffected, whereas in psychotic behaviour the cognitive distortion is severe and cause impairment of the intellectual functioning.
The social relations in neurotic behaviour are not as much disturbed as in the case of psychotic behaviour. A neurotic, although disturbed and disorganized, does not live in some other world as a psychotic does. He is not much handicapped by his behaviour pattern as to make his social adjustment impossible.
In neuroses, no severe disorganization of personality, as in psychoses, in found. A neurotic therefore, remains well integrated.
In comparison to a psychotic, the neurotic proves less harmful to others and the symptoms of his behaviour deviation are not severe to cause anxiety to others. Neurotic are not usually hospitalized in mental hospitals but psychotic generally all hospitalized.
Specific forms or types of Neurotic behaviour:-
The anxiety neurosis represents a behaviour dominated by anxiety reactions which interfere with the individual’s personal and social adjustment. The anxiety involved here is a free floating anxiety characterized by the following:-
- No relevant or rational explanations can be given by the individual for his anxiety reactions.
- Quite often, a very minute danger or stress situation gives rise to disproportionately strong anxiety reactions in the individual.
- In anxiety neurosis, unlike other neurosis, the anxiety is experienced directly and not indirectly in the form of phobias or compulsions.
Hysterical neurosis represents such neurotic reaction in which the person resorts to conversion or dissociation for controlling his anxiety or solving psychological conflicts. Hence, there are two types of hysterical neurosis-conversion type and dissociative type.
Person’s anxiety or psychological conflict is converted into a physical symptom like paralysis of legs or inability to hear. The distinction between conversion hysteria and psycho-physiological disorders is summarized below in the words of Kisher.
“When the symptom is expressed through the sensory or motor pathways of the control nervous system, the condition is called a hysterical conversion neurosis. However, when neurotic symptoms involve the autonomic nervous system, the maladaptive behaviour is called pyscho-physiological disorder.”
Person tries to control his anxiety or psychological problem by the dissociation of his self. Disturbances in consciousness and/or loss of personal identity are the main characteristic. The four major types of such reactions are somnambulism, amnesia, fugue and multiple personality.
A person experiences persistent, intense, irrational fear of a specific situation or object. In spite of his rational knowledge that his fear is unrealistic and overwhelming, he is forced to experience great apprehension and anxiety symptoms while in contact with the phobia object or situation.
Obsessive compulsive neurosis:-
Obsessive behaviour represents maladaptive behaviour in which an individual is haunted with the persistent recurrence of unwelcome, absurd and disturbing idea or thought. Although the patient realizes the absurdity and irrelevance of such thoughts, still he is unable to get rid of them.
Obsessive behaviour, as a step further becomes compulsive behaviour. Compulsions are obsessions translated into action. Compulsive behaviour, in this way may be defined as maladaptive behaviour in which a person is seen to perform repeated actions of unreasonable nature such as washing his hand again and again.
Disproportionate reactions to distressing stress situations like the death of loved one, an occupational set back or a financial failure. In such distressing stress situations, there is nothing abnormal to have feelings of grief and despair in a reasonable amount. It is when these feelings become much exaggerate in intensity and duration and began to interfere with personal or social adjustment of an individual, that they turn into behaviour disorder.
This type of neurotic behaviour is characterized by the feelings of unreality and “estrangement from the self-body or surroundings”. Consequently, the patient does not feel real or feels that what is done by him is a play rather than an actual life event.
Excessive concern for physical health and persistent fear of illness, disease or dysfunction.
Complaints of easy fatigability, irritability lack of energy, chronic weakness and pains and aches in different part of the body.
Causes of Psychoneurotic Disorder:-
The most important causative factors of all neuroses are psychological. The early unhappy experiences, repressed wishes and unresolved conflicts initiate the process. Later, the unfavourable circumstances, stresses and strain provide sufficient cause for learning neurotic reactions. In many cases psychoneurotic reactions often represent learned maladaptive behaviour pattern.
The psycho-neurotic disorders vary in respect of their nature and causation. Therefore, there is no common treatment. However, in general, patients are curable. Treatments for major types of neurosis are summarized below.
Chemical therapy, sedative or mild tranquillisers. In chronic cases insulin therapy. Psychological treatment through
i) supportive Psychotherapy
ii) insight therapy
iii) group psycho therapy.
Hypnosis, Supportive Psychotherapy, group therapy reductive therapy.
Insight therapy, relaxation and desensitization (de-conditioning). Implosion (or flooded therapy), Adaption therapy.
Obsession- Compulsive Neurosis:
“Though stopping” technique. Even lobotomy, a brain operation in which the nerve pathways between the frontal lobes of the brain and the thalamus and hypothalamus are cut, has often resulted helpful.
Psychotherapy measures are the other better alternative.
Drug therapy, Elector-convulsive therapy (ECT), Psychotherapies like supportive psychotherapy and in sign psychotherapy. Modifying the stress environmental situation. In extreme cases of depression, electric shock therapy is needed.
Difficult to treat as the person resists recognizing that the problems are not physical. He derives satisfaction in being ill. However, the psychological treatment proves uneful.