Aug 13, 2018 08:08 PM
(This post was last modified: Aug 13, 2018 08:10 PM by Magical Realist.)
https://www.nytimes.com/2012/04/01/sunda...-gone.html
"SOME cultural archetypes leave the stage with a flourish, or at least some foot stomping. All those pith-helmeted colonialists, absinthe-addled poets and hippie gurus founding 1970s utopias: They made some noise, if not always much sense, before being swallowed by history.
Yet one modern American type is slipping into the past without a rattle or even its familiar whimper — the neurotic.
For a generation of postwar middle-class Americans, being neurotic meant something more than merely being anxious, and something other than exhibiting the hysteria or other disabling mood problems for which Freud used the term. It meant being interesting (if sometimes exasperating) at a time when psychoanalysis reigned in intellectual circles and Woody Allen reigned in movie houses.
That it means little now, to most Americans, is evidence of how strongly language drives the perception of mental struggle, both its sources and its remedies. In recent years psychiatrists have developed a more specialized medical vocabulary to describe anxiety, the core component of neurosis, and as a result the public has gained a greater appreciation of its many dimensions. But in the process we’ve lost entirely the romance of neurosis, as well as its physical embodiment — a restless, grumbling, needy presence that once functioned in the collective mind as an early warning system, an inner voice that hedged against excessive optimism.
In today’s era of exquisite confusion — political, economic and otherwise — the neurotic would be a welcome guest, nervous company for nervous days, always ready to provide doses of that most potent vaccine against gloominess: wisecracking, urbane gloominess.
“I still use the term in my practice once in a while but it doesn’t really say much,” said Dr. Barbara L. Milrod, a professor of psychiatry at Weill Cornell Medical College. “We now have far more useful and specific ways of describing maladaptive behavior.”
Some of the reasons that “neurotic” has fallen out of colloquial usage are obvious. Freudian analysis lost its hold on the common consciousness, as well as in psychiatry, and some of Freud’s language lost its power. And scientists working to define mental disorders began to slice neurosis into ever finer pieces, like panic disorder, social anxiety and obsessive-compulsive disorder — all evocative terms that percolated up into common usage, not to mention into online user groups, rock lyrics and TV shows.
In 1994, after years of nasty debate with psychoanalysts, doctors assembling the Diagnostic and Statistical Manual, psychiatry’s encyclopedia of mental disorders, officially dropped the word neurosis from the book.
“The DSM is the lingua franca of psychiatry, and given what we know today the term feels old-fashioned and quaint,” said Dr. Michael First, a research psychiatrist at Columbia and a former editor of the manual. “With the general decline of value of Freud in our society, it is ultimately anachronistic.”
Still, the desire for precision and the decline of Freudian thinking do not entirely explain the disappearance of the neurotic. 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.
The answer may reside in the one area of social science where the spirit of the neurotic is still alive and well: research psychology.
“Neuroticism” is one of the “dimensions” of the so-called five-factor model of personality, the most studied measure in the field (other dimensions include conscientiousness and openness). It is rated using a simple questionnaire, in which people respond to statements like “I get irritated easily,” “I worry about things” and “I get stressed out easily.” Decades of research suggest that scores on those measures are relatively stable through life, and at least some of the differences in factors among people are rooted in genetic inheritance.
Over all, scores on those kinds of questionnaires have not changed much in adults in the United States since the 1950s. But recent studies have found that, among college students, neuroticism levels have increased by as much as 20 percent over the same period.
Are young people today really more anxious and troubled — more neurotic — than their parents were at the same age? Many parents undoubtedly think so (college was a long time ago), and some researchers do, too.
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.
“I think some of the qualities we once attributed to neurotics have simply been normalized,” said Peter N. Stearns, a historian at George Mason University in Fairfax, Va., and author of the forthcoming book “Satisfaction Not Guaranteed: Dilemmas of Progress in Modern Society.” “I don’t have hard evidence for this, but just look around and observe how we live. We’ve become so accustomed to people with continual worries and fears that it’s made the category obsolete.”
THE classic neurotic is still with us, all right — but with a lot more company, and everyone trying to talk over one another. “Put it this way,” Dr. Milrod said. “These are ridiculous times, and if it all makes sense to you, there’s probably something wrong.”
All the more reason to preserve a word that expands the definition of normal in the best American tradition and restores to anxiety its soul. It preserves privacy, for one thing, when it might be very important to do so. Saying “she’s neurotic” implies a difficult, self-conscious personality without giving a precise medical label. It’s closer to “stressed out” than it is to “disturbed” and implies a condition that waxes and wanes as a part of dealing with daily life.
“Sometimes vagueness has its virtues, and ‘neurotic’ sounds more garden-variety troubled than really troubled,” Dr. First said. “There’s a value in communicating that, a convenience, and neurotic is more descriptive of a personality than of symptoms — it’s an adjective describing how a person is, divorced from medical symptoms.”
Vagueness may also have some value clinically, especially in an area as poorly understood as mental health. In a series of books, including the forthcoming “The Rise and Fall of the Nervous Breakdown — and How Everyone Became Depressed,” the historian Edward Shorter has argued that in some cases, like splitting anxiety disorders from depression, precision backfires. Sadness and worry are intimate partners for many people who visit psychiatrists, and the drugs known as antidepressants are widely prescribed for anxiety as well.
The term neurosis encompasses both, and in fact predates Freud by a century. It originally referred to a problem of the nerves, not the mind, in direct contrast to “psychosis,” which implies a break in logical thinking of the sort characteristic of schizophrenia.
“We’ve lost this view of nervous illness as an illness of the whole body, and now call it a mood disorder,” Dr. Shorter said. “And sad to say, telling people they have a mood disorder misleads them. They think it’s all in their head, when in fact they feel it in their body; they’re fatigued, they have these somatic aches and pains, the pit in the stomach — it’s experienced in the whole body.”
In the original late-18th-century formulation, neurosis also was free of any genetic connection. “The knowledge that someone was ‘nervously ill’ was not necessarily a clap of doom for subsequent generations in the way that news of a family member being ‘mentally ill’ was,” Dr. Shorter wrote in “From Paralysis to Fatigue,” a history of psychosomatic illness. “Daughters of mentally ill parents might not make good marriages, the prospective in-laws all dreading the prospect of inherited insanity; those of nervously ill parents would find their prospects less impaired.”
Honestly now, who wouldn’t jump at the chance to have their prospects less impaired? It amounts to one more vote for “neurosis” as a state of mind to which we can reliably retreat in strange times — if not in psychiatric treatment, at least among friends and colleagues."
"SOME cultural archetypes leave the stage with a flourish, or at least some foot stomping. All those pith-helmeted colonialists, absinthe-addled poets and hippie gurus founding 1970s utopias: They made some noise, if not always much sense, before being swallowed by history.
Yet one modern American type is slipping into the past without a rattle or even its familiar whimper — the neurotic.
For a generation of postwar middle-class Americans, being neurotic meant something more than merely being anxious, and something other than exhibiting the hysteria or other disabling mood problems for which Freud used the term. It meant being interesting (if sometimes exasperating) at a time when psychoanalysis reigned in intellectual circles and Woody Allen reigned in movie houses.
That it means little now, to most Americans, is evidence of how strongly language drives the perception of mental struggle, both its sources and its remedies. In recent years psychiatrists have developed a more specialized medical vocabulary to describe anxiety, the core component of neurosis, and as a result the public has gained a greater appreciation of its many dimensions. But in the process we’ve lost entirely the romance of neurosis, as well as its physical embodiment — a restless, grumbling, needy presence that once functioned in the collective mind as an early warning system, an inner voice that hedged against excessive optimism.
In today’s era of exquisite confusion — political, economic and otherwise — the neurotic would be a welcome guest, nervous company for nervous days, always ready to provide doses of that most potent vaccine against gloominess: wisecracking, urbane gloominess.
“I still use the term in my practice once in a while but it doesn’t really say much,” said Dr. Barbara L. Milrod, a professor of psychiatry at Weill Cornell Medical College. “We now have far more useful and specific ways of describing maladaptive behavior.”
Some of the reasons that “neurotic” has fallen out of colloquial usage are obvious. Freudian analysis lost its hold on the common consciousness, as well as in psychiatry, and some of Freud’s language lost its power. And scientists working to define mental disorders began to slice neurosis into ever finer pieces, like panic disorder, social anxiety and obsessive-compulsive disorder — all evocative terms that percolated up into common usage, not to mention into online user groups, rock lyrics and TV shows.
In 1994, after years of nasty debate with psychoanalysts, doctors assembling the Diagnostic and Statistical Manual, psychiatry’s encyclopedia of mental disorders, officially dropped the word neurosis from the book.
“The DSM is the lingua franca of psychiatry, and given what we know today the term feels old-fashioned and quaint,” said Dr. Michael First, a research psychiatrist at Columbia and a former editor of the manual. “With the general decline of value of Freud in our society, it is ultimately anachronistic.”
Still, the desire for precision and the decline of Freudian thinking do not entirely explain the disappearance of the neurotic. 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.
The answer may reside in the one area of social science where the spirit of the neurotic is still alive and well: research psychology.
“Neuroticism” is one of the “dimensions” of the so-called five-factor model of personality, the most studied measure in the field (other dimensions include conscientiousness and openness). It is rated using a simple questionnaire, in which people respond to statements like “I get irritated easily,” “I worry about things” and “I get stressed out easily.” Decades of research suggest that scores on those measures are relatively stable through life, and at least some of the differences in factors among people are rooted in genetic inheritance.
Over all, scores on those kinds of questionnaires have not changed much in adults in the United States since the 1950s. But recent studies have found that, among college students, neuroticism levels have increased by as much as 20 percent over the same period.
Are young people today really more anxious and troubled — more neurotic — than their parents were at the same age? Many parents undoubtedly think so (college was a long time ago), and some researchers do, too.
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.
“I think some of the qualities we once attributed to neurotics have simply been normalized,” said Peter N. Stearns, a historian at George Mason University in Fairfax, Va., and author of the forthcoming book “Satisfaction Not Guaranteed: Dilemmas of Progress in Modern Society.” “I don’t have hard evidence for this, but just look around and observe how we live. We’ve become so accustomed to people with continual worries and fears that it’s made the category obsolete.”
THE classic neurotic is still with us, all right — but with a lot more company, and everyone trying to talk over one another. “Put it this way,” Dr. Milrod said. “These are ridiculous times, and if it all makes sense to you, there’s probably something wrong.”
All the more reason to preserve a word that expands the definition of normal in the best American tradition and restores to anxiety its soul. It preserves privacy, for one thing, when it might be very important to do so. Saying “she’s neurotic” implies a difficult, self-conscious personality without giving a precise medical label. It’s closer to “stressed out” than it is to “disturbed” and implies a condition that waxes and wanes as a part of dealing with daily life.
“Sometimes vagueness has its virtues, and ‘neurotic’ sounds more garden-variety troubled than really troubled,” Dr. First said. “There’s a value in communicating that, a convenience, and neurotic is more descriptive of a personality than of symptoms — it’s an adjective describing how a person is, divorced from medical symptoms.”
Vagueness may also have some value clinically, especially in an area as poorly understood as mental health. In a series of books, including the forthcoming “The Rise and Fall of the Nervous Breakdown — and How Everyone Became Depressed,” the historian Edward Shorter has argued that in some cases, like splitting anxiety disorders from depression, precision backfires. Sadness and worry are intimate partners for many people who visit psychiatrists, and the drugs known as antidepressants are widely prescribed for anxiety as well.
The term neurosis encompasses both, and in fact predates Freud by a century. It originally referred to a problem of the nerves, not the mind, in direct contrast to “psychosis,” which implies a break in logical thinking of the sort characteristic of schizophrenia.
“We’ve lost this view of nervous illness as an illness of the whole body, and now call it a mood disorder,” Dr. Shorter said. “And sad to say, telling people they have a mood disorder misleads them. They think it’s all in their head, when in fact they feel it in their body; they’re fatigued, they have these somatic aches and pains, the pit in the stomach — it’s experienced in the whole body.”
In the original late-18th-century formulation, neurosis also was free of any genetic connection. “The knowledge that someone was ‘nervously ill’ was not necessarily a clap of doom for subsequent generations in the way that news of a family member being ‘mentally ill’ was,” Dr. Shorter wrote in “From Paralysis to Fatigue,” a history of psychosomatic illness. “Daughters of mentally ill parents might not make good marriages, the prospective in-laws all dreading the prospect of inherited insanity; those of nervously ill parents would find their prospects less impaired.”
Honestly now, who wouldn’t jump at the chance to have their prospects less impaired? It amounts to one more vote for “neurosis” as a state of mind to which we can reliably retreat in strange times — if not in psychiatric treatment, at least among friends and colleagues."
