NEUROTIC SYMPTOMS

Neurotic Symptoms

Neurotic Symptoms

Neurosis begins with the repression of an unacceptable wish (a “drive derivative”) in the face of internalized social norms of self-restraint. Repression is meant to be self-protective, as the repressed material is contradictory (and therefore dangerous) to one's self-concept. (Freud, 2008, 22-48)

However, repression results in the “splitting off” of that material (and the related physiological energy, or “affect”) from the rest of consciousness. Such material exists in an unintegrated (“strangulated”) and unconscious state that nevertheless exerts influence on the rest of consciousness as manifest in neurotic symptoms. Repression, therefore, is the beginning of a neurosis. (Freud, 2008, 22-48)

CBT will identify the self-defeating behaviors and then go after the internal prohibitions against success. Finding values that make the patient feel guilty and unworthy, CBT will clarify that those values are erroneous and inappropriate. With diligent work, the values may change, and more positive behaviors may be adopted. Even when the treatment goals are achieved, that is, the original self-defeating behaviors have stopped, there may be yet another hurdle. The ambitions may still be in place and are likely still secret. Will the change in values generalize to other manifestations of the same ambitions? It will depend on how thoroughly those values have been addressed and modified.

Psychodynamic therapy will go after the values to some extent, and will also work to bring the ambitions to light. Perhaps not as aggressive in targeting inappropriate values, the psychodynamic therapist will nonetheless be more focused on healing the shame that holds back awareness of the ambition. As these ambitions come more clearly to light, the patient will have a chance to re-evaluate. The solution is to grieve those parts of a five-year-old's ambition that are not realistic and to adapt those parts that have a place in adult life. (Freud, 2008, 22-48)

The purpose of abreaction is to discharge the physical energy and related ideas via discussion and conscious integration of traumatic material with other mental contents. As Freud observed, the affect that accompanies all experiences is typically discharged by talking about those experiences and, in so doing, integrating them with other mental contents. (Freud, 2008, 22-48)

Medication will not cure GAD, but it can keep the symptoms under control while the patient receives psychotherapy. Medications used for treating GAD include antidepressants, anti-anxiety drugs, and beta-blockers. However, as different types of drugs have varying side effects, recommended lengths of use, and amount ...