Who Is Neurotic?

THE investigation of neuroses has made decided progress during the last few years. As recently as two decades ago the concept of neurosis was familiar only to a few specialists. Through the popularization of psychoanalysis and its allied systems a superficial knowledge of neurotic behavior reached wider circles. The difficulties which formerly we took to be nervousness, timidity, anxiety, pathological doubting, or which under the labels of hysteria, neurasthenia, and compulsive disorders dragged out an involved and misunderstood existence between the field of internal medicine and that of psychiatry — all these, in consequence of the changes in our fundamental point of view, are now made accessible to understanding, and hence to a more fruitful treatment.

The increased knowledge of the unity of body and mind has made it possible to define a neurosis as an illness, always psychically conditioned, but expressing itself psychically and physically. As long as the psychologists cut man up into separate physical and psychic functions, insight into the unity of his purposeful behavior was denied them. When they learned to centre their study upon the whole personality, they discovered the single meaning in all the contradictory ways of acting which we designate as neurotic behavior.

Now we know that timidity and impudence, stupidity and cunning, secretiveness and the mania for gossip, all come from one and the same root, and we believe we know the reason. Anxiety, compulsions, manias, crimes, and perversions are no longer regarded as illnesses in themselves, but are conceived as different forms of man’s various withdrawals from life — that is, from life with others. For, to make this plain at the outset, all neurotic phenomena are the expression of a disturbance in our relationships to others. This disturbance is the essence of the neurosis; the type of disturbance is the particular variation. Whether a man is afraid to cross a street (agoraphobia), or tears himself to pieces in conflicts with his marital partner, whether he lives only to cherish his health (neurasthenia, hypochondria), or breaks into a safe-deposit vault, whether he continually counts, broods, doubts, or washes his hands (compulsion neurosis), whether he establishes no relations with the other sex, or only such as tend toward perversions, in any case he is severing his relation to his fellows and turning his interest in upon himself.

With this general characterization the field of neurosis is broadly marked out, and the way prepared for a formulation of the answer to the question in our title. Neuroses are certain complex ways of behavior in reference to social life, which have the purpose of evading the demands and the tasks of life while at the same time maintaining self-esteem. This goal is unattainable; therefore every neurosis leads inevitably into a state of suffering, even when the means chosen for reaching the goal are not in themselves a cause of suffering. The neurotic is therefore the man who, doubting his own productive capabilities, turns off from the way of common humanity into the antisocial or asocial path. How he does it, whether through brutality or weakness, through poison or convulsions, through theft or homosexuality, is immaterial, conditioned apparently by a thousand internal and external factors.

The neurotic is he who continually takes more than he gives, who perpetually demands without being ready to reciprocate, who disturbs the harmony of mutually compensatory social life in order to enrich himself, whether emotionally or materially, at the expense of others. To be neurotic is invariably cheating and swindling, plain weakness, exploitation of the good faith of the unsuspecting. Since, however, neurotic behavior is carried on unconsciously, — that is, without the comprehension of the neurotic himself, — its correction belongs, not in the hands of the judge, as the sentence before this might lead one to suspect, but in the province of the doctor-educator. Neurotic behavior is not a moral problem, but one of mental hygiene, to be solved only through the removal of the false ideas on which it is based. This is why authority and severity never lead to the cure of a neurotic, unless preceded by his discovery of his mistaken way of living. After this discovery, however, they are almost always superfluous.

The neurotic must learn that his behavior is inadequate and therefore wrong. The judgment right or wrong, if it is to be valid, demands a fixed point of reference. The frame of reference for one’s attitude toward life is the immediate and the wider community within which life is lived. If you compare our social life — for we are only concerned with this — to a theatre, it will be clear at once that in both cases we have to do with an organization which needs certain rules for its continuance and functioning. In both cases there is a performance to be put on, a performance which promotes a perhaps voluntarily hidden yet still common purpose. On this performance depends the very existence of the organization. To rise in the organization is possible in the long run only through the improvement of the performances. Each individual is part of the whole; even a star is part of the group to whose service he devotes his powers. A star who works at the expense of the ensemble is not a star long.

Life has even less demand for stars than the theatre; it does demand good ensemble playing. The troupe in the theatre corresponds in life to one’s fellows, to the cultural group, the community into which one is born. Everyone receives from the community at birth a sort of contract of mutuality. The community undertakes the task of bringing up, caring for, and educating the individual, and in return demands his active coöperation in its continuance and advancement. These laws, though unwritten, are highly binding and effective; everyone without exception is subject to them, and everyone, whether he admits it or not, recognizes them. Of that he gives daily and hourly proof. Where his recognition is open, he complies with them through positive social actions within the narrower or wider bounds of his possibilities. In the case of hidden recognition, he seeks some legitimate weakness or illness which will serve to release him from the demands of the environment, demands which he himself recognizes as justified. The built-up, cultivated, and cherished appearance of illness only confirms our assumption here. Why should a man need to excuse himself if he had a good conscience? Qui s’excuse . . .

To discuss in detail why and how a neurosis is built up would overstep the bounds of this article. In general, people who build up neuroses find the demands of society too heavy for them, and seek ways to evade them. They may be fundamentally weak or physically defective; they may have been inadequately prepared for the future by a too-loving, overindulgent bringing-up, or by an oversevere or negligent one. Causes are always on hand in great numbers, and no neurotic is at a loss for explanations. Rarely, however, does a cause appear which justifies the evasion of society’s demands. How otherwise could a cure be possible?

Thick volumes have been written about the problem of neurosis without covering it; inexhaustible as life itself, the neuroses offer new riddles, new phenomena, with each individual case. They are, as it were, the negative of life, its cruel image in a distorted glass. Neurosis is — so much will be clear from these fragmentary suggestions — a flight from responsibility in life, a retreat, blind egotism at all costs in a thousand variations. Fear of genuine participation in life misleads the neurotic into evasive manœuvres which finally cost him dear. Wherever he flees, his neurosis serves as a painful alibi for the supposedly too-difficult conflict of life. Thus he deceives himself in a tragic struggle for the very results he sought to avoid, and reaches the very situation from which he was trying to escape when he devised his futile life: inferiority, misery, loneliness.

The neurotic way of life, however you look at it, is a bad business. The scanty winnings from pretense of power are not enough in the long run to cover the deficit for the expenses of this mode of living. The deficit consists in suffering. It is the task of a therapeutic treatment to show the neurotic the instability of his system, and to hold before him the effects which follow inevitably upon his persistent behavior. If he comes to understand the error in his reckoning, we have satisfied the chief condition for his cure.