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Although the term “neurotic” has more recently fallen out of favor, it was used by psychiatrists for most of the 20th Century to describe a broad category of conditions that were associated with poor functioning, anxiety and depression, but were clearly differentiated from “psychotic” in that in constrast to individuals in the latter category, neurotics maintained contact with reality and were rarely engaged in highly deviant, socially unacceptable behavior.(A factoid worth noting is that the term “borderline”, of borderline personality disorder fame, originated from the conceptual space between neurotic and psychotic.Finally, our verbal beliefs are networked into systems of justification that provide us with theories about ourselves in the world.Cognitive psychotherapy became widespread because it helped individuals realize that at the roots of much suffering were maladaptive interpretations or beliefs about how the world ought to be.The problem is that, carried out over the long term, the habitual patterns are maladaptive. Stressed all day, riddled with achievement and relational anxieties, alcohol becomes a short term, medicating balm.Unfortunately over time, it comes with significant costs (hangovers, weight gain, health problems, etc).
Often, however, the problem isn’t that an individual is feeling too much, but that he or she is walled off from some or all of their emotions.
At pm Susan called Brian on his cell, upset, asking him in a somewhat panicked voice, “Where are you? ” Here Susan’s anxious-dependency needs drove her to reach out for contact and assurance.
However, the response was “neurotic” because the likely consequence was that her actions probably worked against her long- term goals.
Originally, borderline individuals were those who generally maintained contact with reality, but under duress exhibited extreme volatility and primitive defenses and were not good candidates for psychoanalysis).
For a host of reasons, I hope the term makes a comeback, and I describe here the various ways the term is still used and how it can be helpful in framing human problems and suffering.