Types and Reactions of Psychoneuroses

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Information on Types and Reactions of Psychoneuroses

The several types and reactions of the psychoneuroses are the following:


The anxiety reaction:

In this type of emotional illness there are attacks of an unsettled state of mind with apprehension, nervous tension, physical and mental fatigue, and panic.  There may be nightmares.  The attack is often accompanied by vomiting, diarrhea, and urinary urgency.  There may be an overpowering dread of some imminent disaster.  The attack can last a few minutes or for longer periods.  Usually the problem relates to some intolerable situation in the patient's experience, past or present.


The dissociative reaction:

This is similar to the anxiety reaction but more intense.  The individual actually loses control of certain mental functions so that he experiences stupor or loses his memory or conducts himself automatically, unaware of his reactions.  He may resort to aimless running.


The conversion reaction (Hysteria):

In this reaction the individual subconsciously converts energy pent up as a result of intense anxiety or frustration into abnormal behavior or supposed illness which tends to protect the individual from the unbearable situation.  This is an unhealthy solution to life's problems.  The conversion reaction imitates many symptoms of disease, such as paralysis, anesthesia, blindness, or loss of consciousness.  Often the physician's skill is taxed to tell the difference between the conversion reaction and actual disease.


The phobic reaction (phobias):

In the phobic reaction the person manifests an unreasonable, unjustified anxiety regarding some situation.  Consciously he recognizes that no actual danger is involved, but he finds himself unable to control his intense fear.  Phobias may be directed toward high places, closed spaces, elevators, dirt, danger of contamination, cancer, or certain animals.  Phobias represent a carry-over of some unresolved conflict.  It is assumed that the phobia becomes symbolic of this conflict to the extent that he puts the true conflict our of consciousness by focusing on the phobia.


The depressive reaction:

In this psychoneurosis the person becomes downcast, pessimistic, unhappy.  He feels he is inadequate.  He lacks energy and loses interest in activities about him.  Crying for insufficient cause is a cardinal evidence of depression.  The depressive reaction may be accompanied by loss of appetite, constipation, headache, and sleeplessness.  There is often anxiety.  The discouragement may become so profound that the victim contemplates suicide and may attempt it.  Proper precautions should be taken so that the patient is not left alone.


The obsessive-compulsive reaction:

An obsession is an almost uncontrollable urge to follow the same line of thought over and over.  Often the thought is unwelcome, but the person finds it nearly impossible to banish it from his thinking.  A compulsion is an unreasonable urge to perform some act, even though the act is unnecessary and may be foolish.  A person may become obsessed with the thought that he is carrying a germ which could infect other members of his family and even cause their death.  As a result he washes his hands frequently, before eating, after shaking hands, or perhaps at fifteen-minute intervals.  Mild degrees of the obsessive-compulsive reaction may occur in persons who live normally.  This tendency may show itself in the immaculate housekeeper or in the meticulous accountant.  A person may develop the obsession that he is changing in appearance, and this prompts the compulsion to look in the mirror repeatedly for evidences of such change.  A person with an obsession may be constantly troubled by obscene thoughts out of harmony with his standards of conduct.  A religious person may be obsessed by doubts regarding the foundation of his beliefs.  A person may develop the compulsion that he must remove his clothes in a certain routine.  This may become so troublesome that if anything interferes with the routine, he will have to put his clothes on again and start the routine all over.  A compulsive person may feel he is forced to touch all power poles as he passes them on the sidewalk.  The obsessive-compulsive reaction is supposed to be a subconscious form of penance associated with guilt and self-condemnation.  The individual who develops these obsessions and compulsions is not consciously aware of the background of his reactions.


Treatment of the Psychoneuroses:

Frequently the psychoneurotic will benefit by a series of conversations with a psychiatrist intended to help him recognize the relationship between his present symptoms and the unsolved problems which lie at their foundation.  The patterns of thinking and acting are usually so firmly established that a mere explanation of the cause of the symptoms will not enable the person to overcome them.  He must have time to reorient his thinking to accept the facts of his unfavorable circumstances and plan ways of being realistic rather than hide behind excuses or dodge the real issues.


The physician can often aid the patient during his period of reorientation by prescribing one of the modern tranquilizers to relieve anxiety or by using one of the antidepressant drugs to help the patient rise above his periods of depression.


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