Neurotic Therapy of Sigmund Freud

Emil Kraepelin is considered the father of modern diagnostic classification, where he tried to study those who suffer from emotional disorders and disturbances in thinking, in order to identify common symptoms and general characteristics. In addition, he developed a theory of their cause, allocating treatable and incurable illnesses.

It is interesting that he included a manic-depressive psychosis in the first category and schizophrenia – then known as “dementia praecox” and is considered an organic brain damage. “Lunatics” were treated as patients suffering from one of several possible ailments described.

The founder of psychoanalysis, Sigmund Freud, adopted many terms of Emil Kraepelin that describe the mental and emotional disorders, but he went beyond simple descriptions and the establishment of the simplest patterns – to the more speculative theoretical formulations. Among other advantages of Freud’s theory of evolution has used sophisticated explanations in contrast to the simple options of internal or external causes. Anyway, Sigmund Freud sought to treat psychopathology on the existing categories. For example, if a person suffers from obsessions (eg. a patient of Sigmund Freud “Wolf-Man” suffered from obsessive-compulsive neurosis. By the end of his work, Freud began to distinguish the state of human obsession as a part of the obsessive-compulsive character. Later, psychotherapists and psychoanalysts make a distinction between: 1) obsessive man who suffers from mental delusions and uses repetition in order to avoid complete psychological decompensation, 2) a man whose obsession is a part of the boundary structure of his personality; 3) obsessive personality with normal-neurotic personality organization (obsessive neurosis).

Before the existence of “borderline” category in the mid – XX century, therapists who were under the influence of psychoanalysis followed Sigmund Freud making distinction between neurotic and psychotic levels pathology. The first was characterized by a full understanding of reality, the second – losing contact with her. Neurotic woman somewhere inside herself was aware that the problem lies in her own mind; psychotic thought that the world is not all right. When Sigmund Freud put forward his structural model of the psyche the difference took the form of comments to the psychologist’s personal psychological infrastructure: neurotics were considered affected by the fact that their ego – protection were too mechanical and rigid and cut them off from the energy of the ID which could be used for creation: psychotic people were regarded as patients suffering from the fact that the defense was too weak, leaving them helpless flooded by primitive ID.

The distinction between neurotic and psychotic had important clinical applications. Some of them are still taught in the simplest forms in some hospitals. The essence of the clinical application of this nosology, when supported by Sigmund Freud’s structural model of the psyche, has become a neurotic therapy aimed at reducing its protection and for access to the ID, so that its energy could be released for more constructive activities. On the other hand, psychotherapy with psychotic patients should be aimed at strengthening defenses to cope with primitive breakthroughs, as well as developing the ability to more easily experience the real circumstances of stress, depression, to improve the testing of reality and pushing off a raging ID back into unconsciousness. It was as if the neurotic was like a pot in the oven with the lid closed too tightly, and the problem would be a psychologist to give the couple to leave, while a “psychotic pot” boil away and the therapist had to close the lid and the stronger reduce heat.

Many analysts realized that we needed to attack the defense, if the patient was healthier and keep them in situations with schizophrenia and other psychotic. With the advent of antipsychotic drugs this statement was the widespread tendency not only to medical treatment – often compensatory response to psychotic anxiety levels – but also to the formation of the belief that medical treatment can be a solution to the problem and it needs to be done in a lifetime.