Talk:Obsessional neurosis

From No Subject - Encyclopedia of Psychoanalysis
Jump to: navigation, search

Sigmund Freud

'Obsessional neurosis' (Fr. névrose obsessionnelle) was first developed as a diagnostic category by Sigmund Freud in 1894.

Freud grouped together as one condition a series of symptoms, which include:

  • obsessions (recurrent ideas),
  • impulses to perform actions which seem absurd and/or abhorrent to the subject, and
  • 'rituals' (compulsively repeated actions such as checking or washing).

Jacques Lacan

Lacan, the term 'obsessional neurosis' denotes not a set of symptoms but an underlying structure (which may or may not manifest itself in the symptoms typically associated with it).

The subject may well exhibit none of the typical obsessional symptoms and yet still be diagnosed as an obsessional neurotic by a Lacanian analyst.

Lacan defines obsessional neurosis as one of the main types of neurosis.

In 1956, Lacan develops the idea that, like hysteria, obsessional neurosis is essentially a question which being poses for the subject.[1]

The question which constitutes obsessional neurosis concerns the contingency of one's existence, the question about death: "To be or not to be?", "Am I dead or alive?", or "Why do I exist?"[2]

The response of the obsessional]] is to work feverishly to justify his existence (which also testifies to the special burden of guilt felt by the obsessional); the obsessional performs some compulsive ritual because he thinks that this will enable him to escape the lack in the Other, the castration of the Other, which is often represented in fantasy as some terrible disaster.


For example, in the case of one of Freud's obsessional neurotic patient, whom Freud nicknamed the Rat Man, the patient had deeloped elaborate rituals which he performed to ward off the fear of a terrible punishment being inflicted on his father or on his beloved.[3]

These rituals, both in their form and content, led Freud to draw parallels between the structure of obsessional neurosis and the structure of religion.


Whereas the hysterical question concerns the subject's sexual position ("Am I a man or a woman?'), the obsessional neurotic repudiates this question, refusing both sexes, calling himself neither male nor female: "The obsessional is precisely neither one [sex] nor the other - one may also say that he is both at once."[4]


Lacan also draws attention to the way that the obsessional neurotic's questionj about existence and death has consequences for his attitude to time.

This attitude can be one of perpetual hesitation and procrastination while waiting for death,[5] or of considering oneself immortal because one is already dead.[6]

Other features

Other features of obsessional neurosis which Lacan comments on are the sense of guilt, and the close connection with anal eroticism.

In respect of the latter, Lacan remarks that the obsessional neurotic does not only transform his shit into gifts and his gifts into shit, but also transforms himself into shit.[7]


The term obsessional neurosis denotes a condition in which the patient's mind is intruded upon (against his or her will) by images, ideas, or words.

The patient's consciousness nevertheless remains lucid and his or her power to reason remains intact.

These uncontrollable obsessions are experienced as morbid inasmuch as they temporarily deprive the individual of freedom of thought and action.

Sometimes the defenses can eliminate the anxiety and the symptoms, but at the price of displacing characteristics of primitive obsession (uncontrollability, compulsions) onto the defense mechanisms.

Sigmund Freud's view of obsessional neurosis appeared as early as 1894.

In "The Neuro-Psychoses of Defence" (1894a) he broke with the conceptions of classical psychiatry and stipulated that the cause of obsessional neurosis lies in the existence of an intrapsychic conflict of sexual origin that mobilizes and blocks all flows of energy.

He thus opposed the classical theory of degeneration and the idea of innate weakness of the ego that Pierre Janet used as the basis for his description of psychasthenia.

Freud proposed a traumatic etiology for obsessional neurosis.

An early sexual event occurs before puberty; however, in contrast to what happens in hysteria, this event is a source of pleasure to the child.

The individual experiences strong feelings of guilt and is overcome by self-reproach.

These feelings are repressed and then replaced by a primary system of symptoms and traits: scrupulousness, shame, mistrust of self.

The success of these defenses allows the individual to go through an apparently healthy period.

But eventually these defenses are exhausted and there is a return of the repressed memories with the outbreak of the illness and its attendant symptoms.

In "The Disposition to Obsessional Neurosis: A Contribution to the Problem of Choice of Neurosis" (1913i), Freud defended the idea that the choice of this neurosis is linked to developmental inhibitions, and he stressed the role of fixation and regression to the anal-sadistic stage.

He suggested "the possibility that a chronological outstripping of libidinal development by ego development should be included in the disposition to obsessional neurosis.

A precocity of this kind would necessitate the choice of an object under the influence of the ego-instincts, at a time when the sexual instincts had not yet assumed their final shape, and a fixation at the stage of the pregenital sexual organization would thus be left" (p. 325).

Thus, in the object relation, hate will precede love and "obsessional neurotics have to develop a super-morality in order to protect their object-love from the hostility lurking behind it" (p. 325).

This opposition between love and hate for the object was underscored by Freud in the case of the "Rat Man," related in "Notes upon a Case of Obsessional Neurosis" (1909d).

He saw it as the source of the doubt, compulsions, and ambivalence that are characteristic of obsessional functioning.

In "Inhibitions, Symptoms and Anxiety," Freud described the two main defense mechanisms in obsessional neurosis that replace repression: undoing what has been done and isolation.

The first of these, undoing (Ungeschehenmachen), means making something that has already happened "unhappen" by means of a symbolic motor action; it is also found in magical practices, folk customs, and religious rituals.

The second, isolation, involves the motor sphere and consists in the fact that after an unpleasurable event there is a pause during which nothing further can happen, no perception is possible, and no action can take place.

Motor isolation functions to guarantee a break in the connection of thoughts.

In the same way that the obsessional patient enacts the taboo against touching (because he fears that contact with the object will force him to face his unbound ambivalence between love and hate), the isolation of an impression or an activity, by means of a break in the chain of thoughts, symbolically indicates that he does not want to allow thoughts relating to it to "contaminate" other thoughts.

This mechanism is present in normal people in their everyday mental activities involving concentration.

The fundamental rule of free association involves asking the ego to give up this defense.

The patient suffering from obsessional neurosis finds it particularly difficult to follow this rule.

This is why, paradoxically, psychoanalysis is both the most indicated treatment for these patients and at the same time the most difficult to implement.

Like Freud, the psychoanalysts who came after him always placed the accent on the obsessional structure rather than on symptoms.

This poses problems of terminology.

The term obsessional neurosis is not the exact equivalent of the German Zwangsneurose : Zwang refers not just to compulsive thought or obsessions (Zwangsvorstellungen), but also to compulsive acts (Zwangshandlungen) and compulsive affects (Zwangsaffekte).

Certain French authors therefore prefer to use the term névrose de contrainte, and some American authors prefer the term compulsive neurosis.

Obsessional functioning is the preferred term for the group of processes and defense mechanisms that characterize obsessional neurosis, but which are also present, to a lesser degree, in other patients, in the form of obsessive personality traits or a system of defenses put up as an alternative to a costlier mode of psychic functioning, psychotic functioning.

In this regard, let us note that because organized obsessional neuroses are sometimes extremely debilitating, the categorization of this pathology has been questioned and it has been compared with the psychoses.

Several factors present in the former are lacking in the latter: self-recrimination by the ego, adherence to insistent preoccupations, and the deployment of elaborate defenses.

In the obsessional patient, affective isolation allows the ego to cut itself off from desire, whereas in psychosis the ego is cut off from reality.

obsessional neurosis Psychol., a disorder in which the main symptom is the occurrence of obsessional thoughts; obsessive-compulsive disorder. obsessional neurotic n. and a. Psychol., (a) adj., a person with an obsessional neurosis; (b) adj., of or relating to obsessional neurosis or obsessional neurotics. 1918 E. JONES Papers on Psych

an obsessive-compulsive disorder in which obsessive thinking predominates with little need to perform compulsive acts

See Also


  1. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p.174
  2. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p.179-80
  3. Freud 1909.D.
  4. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p.249
  5. Lacan, Jacques. Écrits: A Selection. Trans. Alan Sheridan. London: Tavistock Publications, 1977. p.99
  6. Lacan, Jacques. The Seminar. Book III. The Psychoses, 1955-56. Trans. Russell Grigg. London: Routledge, 1993. p.180
  7. Lacan, Jacques. Le Séminaire. Livre VIII. Le transfert, 1960-61. Ed. Jacques-Alain Miller. Paris: Seuil, 1991. p.243
  1. Freud, Sigmund. (1913i). The disposition to obsessional neurosis: A contribution to the problem of choice of neurosis. SE, 12: 311-326.