For many years, countless clinical cases have been presented, with obvious physical symptoms such as paralysis, pain, allergies and even loss of voice, for which a probable physiological cause has never been found. These pathologies have long been treated as symptoms with a psychological etiology, that is, psychic conflicts that impact the body, diagnosed as hysteria. In Psychology-Online we explain What is hysterical neurosis, what are possible symptoms and its treatment.
What is hysterical neurosis
In order to explain what is hysterical neurosis, I believe that first of all it is necessary to understand what a symptom is. In general terms we could say that from Freud’s theory, the symptom is an act that is harmful or useless for life. People with these symptoms clearly state that they are feeling them against their will and that it evidently causes them a great deal of suffering.
In hysterical neurosis there are no standardized tests for its diagnosis. The diagnosis of hysterical neurosis generally involves evaluating the existing symptoms and thus ruling out any neurological disease or some other medical condition that may be causing them.
We understand then that the hysterical neurosis is a clear physical alteration but with unknown cause, in clinical terms, idiopathic. With this we can understand that the symptoms clearly exist, and are not invented by the patient as they are in factitious disorder.
Another type of neurosis is obsessional neurosis. In obsessional neurosis, the diagnosis is made based on positive symptoms and signs (distressing somatic symptoms and abnormal thoughts, feelings and behaviors in response to these symptoms), rather than on the absence of a medical explanation for the somatic symptoms.
Symptoms of hysterical neurosis
Hysterical neurosis can generate different types of symptoms and these cause significant deterioration. Between the most frequent symptoms the following can be mentioned:
- Tremors.
- Weakness or paralysis.
- Dificulty to walk.
- Loss of phonological function.
- Sensation of having a lump in the throat.
- Paresthesia.
- Seizures.
- Hearing impairment (hearing loss).
- The symptoms become central axes in the patient’s life.
- Symptoms related to swallowing.
More than two symptoms can appear at the same time. Variations in symptom presentation are possibly the result of the interaction of multiple factors within cultural contexts, which affect the way in which individuals identify and classify bodily sensations, perceive the illness, and seek medical attention for them. Therefore, somatic presentations can be considered as expressions of personal suffering within a certain cultural and social context.
Characteristics of hysterical neurosis
According to Sigmund Freud (1923) we understand that neurosis is the result of a conflict between the ego and its id, while psychosis is the analogous outcome of a similar disturbance in the links between the ego and the outside world. For Freud, then, what characterizes a neurosis is precisely a intrapsychic conflict “between the id and the ego”However, what characterizes the genesis of a psychosis is a conflict between the self and external reality.
The repression
In other words, the ego does not want to welcome or process a drive emotion that pushes from the id. What happens is that the ego defends itself through the mechanism of repression – the curious thing is that later all that repressed content turns against that repressive sense and manages in one way or another to escape repression through a substitutive commitment: the symptom. -. In the following article you can see more information about .
The replacement
As we analyzed in previous paragraphs, the symptom, which is a formation of commitment that in some disguised and substitutive way, allows the return of the repressed, thus the ego, instead of fighting against that content that came from the id, continues its fight but now against the symptom, what is then formed is a picture of neurosis.
We then understand, through the analysis of Freud’s theory, that the ego enters into a conflict with the id and gives priority to its other two vassals: the superego and reality. When The ego operates to the benefit of reality and the superego and to the detriment of the id.it’s a neurosis.
The difference with somatizations
A distinctive feature of hysterical neurosis is that it is not the somatic (physical) symptoms themselves, but the way they are presented and interpreted. The integration of behavioral, affective and cognitive components will provide a broader and more precise exploration of the true clinical picture.
Discomfort
People with a hysterical neurosis are characterized by the way they express and perceive their physical symptoms (for example, manifesting with a lot of anguish and anxiety the somatic symptom and also manifest catastrophic thoughts of the same “attribute some terminal illness as the cause of their condition” and thus lead to behaviors of constant exploration of their symptom).
It should be kept in mind that it is not appropriate to diagnose a person with hysterical neurosis just because a medical cause cannot be demonstrated. Furthermore, the presence of a medical diagnosis does not exclude the possibility of a concomitant hysterical neurosis.
Treatment of hysterical neurosis
Hysterical neurosis can be treated from different perspectives:
Psychoanalysis
In the preface to his translation of Charcot’s Polyclinic Lectures, Freud summarizes the working style of the French:
I have highlighted the concepts of entité morbide, series, type and formes frustées, because their application expresses a central character of the French way of working clinically. Such a way of appreciating things is foreign to the German way; Here, symptomatology or type does not play a main role, but a feature stands out that is explained from the history of the development of German clinicians, namely, the inclination towards the physiological interpretation of the pathological state and the links between the symptoms. Freud symptoms (1892).
This “German way”, which reinforces the interpretation of pathological states, will later predominate in the way in which Sigmund Freud would approach the study of hysterical phenomena.
This type of intervention was achieved through collaboration with Breuer. In 1882 Freud learned of a specific variant of the hypnotic method. While Charcot used hypnosis to make psychic content conscious until then inaccessible, Breuer and Freud used it to interrogate the patient about the history of the emergence of his symptom, which the individual could not communicate completely, but only in an incomplete way in a state. of vigil.
We observe the treatment proposed in psychoanalysis for hysterical neurosis in this quote, where we clearly see the way in which, from the early phases of Freudian thought, interest began to be directed towards what would constitute the central theme of his therapeutic interventions: “the elaboration of the subject’s life history.” Thus the hysterical patient begins the vital historical elaboration and the process of understanding his suffering.
Other psychotherapies
There are also other effective ways to treat hysterical neurosis and it is through various psychotherapies, below we share some of them:
This article is merely informative, at Psychology-Online we do not have the power to make a diagnosis or recommend a treatment. We invite you to go to a psychologist to treat your particular case.
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References
- Sigmund Freud. (1923). Complete Works Sigmund Freud Volume XIX, The Ego and the Id and Other Works. Amorrortu editors.