Monday, April 09, 2012

Neurotic


Benedict Carey has a good read in last week's New York Times about the gradual disappearance of the Freudian term "neurotic," as in "The neurotic is always half-drowning in anxiety, and always being half-rescued." (Mignon McLaughlin, The Neurotic's Notebook, 1960).

Carey's analysis reviews the history of this term, and explains how is was expelled from the DSM back in 1994. He quotes Michael First, MD, "With the general decline of value of Freud in our society, it is ultimately anachronistic." In fact, it made me realize that I almost never use this word. When I do hear it in a professional context, especially as a noun referring to a person, it is generally by someone a good 15 years my senior.
Psychiatrists don’t ultimately shape the language we use, after all — we all do — and neurosis has at least as much going for it as other Freudian keepers, like ego and id.

 And I never hear about, nor talk about, the id.

So, the story talks about how we used to put everything into the neurotic bucket, but have since split things up into multiple, more narrowly-defined, terms, such as social phobia, generalized anxiety disorder, and obsessive-compulsive disorder. These used to all fall under the neurotic label.

The good part about this change is that defining these types of anxiety disorders has led to improved treatments, and has allowed us to accept more common, less disabling, concerns as just a spectrum of normality. Carey points out, though, that our new technologies have turned many of us into unlabeled neurotics.

But another way to read those numbers is not as a measure of mental makeup but of cultural change. People of all ages today, and most especially young people, are awash in self-confession, not only in the reality-show of pop culture but in the increasingly public availability of almost every waking thought, through Facebook, Twitter and other social media.

If chronic Facebook or Twitter posting is not an exercise in neurosis, then nothing is.