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.
I'm interested in your observations about facebook. I've been wondering about it and the behaviours it encourages. Here's something I wrote about it's addictive quality. And this is coming from a woman approaching 50 with busy work, kids, fulfilling hobbies etc.
"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"
Incorrect. The changes have only narrowed the category 'normal'. The so-called 'treatments' too often involve long-term prescription of benzodiazepines, with dire results.
"Neurotic" used to be used in popular speech the way "bipolar" is today: wrongly and as a pejorative. It is interesting, though, to see how many of Freud's ideas get rediscovered without the slightest hint of correct attribution. The NY Times a while back had a large article talking about how the unconscious parts of the mind strongly control the conscious. The author used a drawing as an illustration which was almost exactly what Freud described in the 1920's. No attribution (yes, I wrote to him about it).
Have you seen Dinah lately? Just curious?
Nope, I'll keep you posted.
oops. sorry. Thought you said 'rob'
As my post on this article said, "I'm right here." How can I help you?
If you are hoping for the "normal" label, give it up my friend. Normal, if it you take it to mean someone with no diagnosis in the DSM is not the definition of the word. "Normal" is a casually tossed around social term defining insider from outsider or who is Okay and who isn't Okay. But I actually view/ viscerally experience "normal" people as boring and dull. These things you are not Rob. No one "normal" who feels so critically of psychiatry (not their own medical specialty) would follow this blog so closely.
Maybe you weren't aiming at a definition of "normal" for yourself. I just wanted to delineate between social norms and psychiatry because there is a line which we as shrinks must always work at making brighter so psychiatry is not a tool of social normalization as it has been in the past (involuntary hospitalization of wives on the husbands say so/homosexuality as a diagnosable disease, etc.)
She is flying out to have lunch with me here in Seattle. I am totally excited. I am going to a write up on your book with the author interview--all last minute you know!!!
OK that was a joke but it kind of beats the other schedule I have planned.
Wait a second: No one who is normal would follow this blog??? I object. Should my next poll...er...survey...be Are You Normal?
Roy is normal. He doesn't follow the blog very closely. Hence my question.
While I've heard people label me the most "normal psychiatrist" they've met, I shun this term "normal." Normal does indeed feel bland and boring to me; but what I do, and have suggested to others, is to not be concerned about being "normal", just be yourself, be honest.
That's one of the few things I like about Rob... he can be strident and annoying (as I can be, as well) but is consistent and not afraid to say how he feels about something (even if he is usually wrong -- jk!).
Maybe you should have a post called "What ever happened to normal and who really cares?"
For the record, Roy is not that normal.- Dinah
Wait, Dinah. Sideways did not say no one who is normal would follow this blog. She said "No one "normal" who feels so critically of psychiatry (not their own medical specialty) would follow this blog so closely." The operative term is "critical of psychiatry."
Jesse once again gets to the fine edge of something someone has said, thus clarifying the situation and also sowing seeds of understanding. Tell us Shrink Rapers, do you know this Jesse to speak to? Can you tell us (or can you Jesse tell if you are) is s/he muy normal, tipo de lo normal, extraño, or excéntrico?
Inquiring minds want to know.....
Sideways: I'm actually wicked-critical of Pediatrics. What made you assume I'm not?
I don't know, you don't say anything about pediatrics. The point is that your only vested interest seems to be in the dissolution of psychiatry or in your enjoyment of criticizing it. This is the wrong place: it is like going to a convention of Elvis impersonators and saying you hate Elvis. I'm not even annoyed anymore. Shrinks have heard it all. You can join the chorus of patients who have the airing of their grievances. But what are your actual, lived grievances against psychiatry? If you won't say what they are, your comments will simply be perceived as that of a disengaged gadfly. (Anonymity has its advantages.)
I prefer "humanist" or "defender of liberty and human dignity", but I'll go with "disengaged gadfly". It sounds more like the curmudgeonly, grumpy middle-aged man that I coming to resemble.
Sorry, I should have left it there, but since you insist.
I am a physician, and I have seen the havoc wreaked by psychiatry and psychiatrists upon the lives of the children and families that chose me as their pediatrician. Perhaps that will not fit your concept of 'lived experience'. More's the pity.
Then if it your issue is about the impact of psychiatry on the public health of children and familles you should double down and start a heath education/lobbying organization to try to stop these ill effects. I have started a nonprofit with a board of directors to provide sliding scale psychiatric care to uninsured adults who are not "poor enough" to qualify for Medicaid or Medicare. To revise Malcolm X, the revolution (or any actual change) will not be podcasted or take place one the blogosphere."
Do something actual to change the ill effects of psychiatry you find harmful to humankind. You will feel more engaged. I am not going to engage you on this subject again. This is my offering to you, advice wise.
My dear Sideways,
I "do something actual" for real children every day. I fight to keep them from being sucked into the psychiatric/State vortex. I find that a much more direct and satisfying approach. One kid at a time.
P.S. I believe it was Gil Scott Heron who said the revolution will not be televised, not Malcolm X!
He said it in a song..........
More like a rap. Way ahead of his time in 1971
I agree with Sideways, I don't get Rob's interest either. It's been a long time of the same few mantras, in a way that still makes no sense to me. And it is coming to an Elvis concert when you don't like Elvis. Why not start your own Anti-psychiatry blog, I don't think the Shrink Comment section gets a whole lot readers (our posts on the other hand...)
And it's good Rob's protecting society's children from the evil of psychiatrists. Who's protecting them from being denied access to treatment that might help them?
While you are at it, please let Rob know that the differences between a song and a rap are more politically than aesthetically based.Thank you.
Anon, message received and understood. I don't have a clear definition of 'song' to work with. Thinking a lot about that during this Passover when we sing the Song of Sea, without knowing if the 'song' was actually sung to a tune. Perhaps it was a rap. We'll never know.
And Dinah, you know better than to suggest that children in my practice are denied access to treatment that might help them. In the modern malpractice world, those are incendiary words. Nothing could be farther from the truth. I wish you'd come up and visit my office. We'll chat.
Tomorrow night we leave for Israel for two weeks. We're excited and grateful and blessed for the opportunity.
Rob, Have a lovely time in Israel.
No, I don't know what you do with children who need psychiatric treatment (how would I know that?), I'm responding to "I fight to keep them from being sucked into the psychiatric/State vortex. I find that a much more direct and satisfying approach. One kid at a time."
You sound like the psychiatric vigilante savior.
Go for it, but why here?
If you're in the Druze village and there is a guy throwing about glass showing how it doesn't break, please pick me up one of the water pitchers. I loved it, but apparently you can throw it, but it falls off the counter, it shatters, and I miss it. The pink one was nice.
Any mental disturbance can be cured by a good psychiatrist. Just visit to www.spectrumpsychiatry.com to get the best solution.
Oh oh oh, I found something for rob lindeman!
Steve Novella — an “academic clinical neurologist” has a post on mental illness denialism.
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