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The term neurosis, coined in the eighteenth century by Cullen, first referred to a heterogeneous set of illnesses attributed to a crisis of nerves. During the nineteenth century, the classificatory [[system]] was revised based on individualization of illnesses as different as exophthalmic goiter (Graves' disease) and Parkinson's disease. The [[idea]] of consolidating characteristic [[mental]] disturbances (the [[madness]] of [[doubt]] and phobias) and a neurosis ([[hysteria]]) within a single framework occurred after the [[psychological]] [[nature]] of hysteria ("the great neurosis") was established at the end of the nineteenth century, by Charcot in [[Paris]] and [[Breuer]] in [[Vienna]]. Freud (Charcot's student and Breuer's collaborator) and Janet (Charcot's student) were [[responsible]] for the two principal [[theoretical]] constructions that established the unified theory of neurosis. These two constructions differed in their conceptualization of the mechanisms and causes of neurosis, and the two theories also approached the choice of neurosis very differently.
For Freud, the explanation of the choice of neurosis evolved directly from the theory of neurosis, initially described in 1896. This is expressed clearly in Freud's correspondence with [[Fliess]] (especially the letters dated January 1, May 30, and December 6, 1896) and in two articles, "Heredity and the Etiology of the [[Neuroses]]" (1896a) and "Further Remarks on the Neuro-[[Psychoses]] of [[Defence]]" (1896b), situated within the framework of the [[traumatic]] theory of neuroses: [[Nothing]] in the nature of the [[trauma]] itself enables us to differentiate the choice of neurosis; the [[cause]] must be sought for elsewhere. Initially, Freud referred to a disposition of attitude at the [[time]] of the trauma. [[Sexual]] incidents passively experienced during [[childhood]] predisposed the [[subject]] to hysteria, while those in which the [[child]] played an [[active]] [[role]] predisposed [[The Subject|the subject ]] to obsessive neurosis. This theory was soon abandoned in favor of a [[chronological]] approach, and a decade later, Freud repudiated it explicitly.
Its replacement, the chronological theory, was based on the [[principle]] that the dates of childhood events play a decisive role. Initially, the date of the trauma was considered crucial. But, in a January 1897 [[letter]] to Fliess, Freud modified his [[position]] and claimed the key [[moment]] took [[place]] at the time of [[repression]]. In a letter of November of that same year, he concluded, "It is probable, then, that the choice of neurosis (the decision whether hysteria or [[obsessional]] neurosis or [[paranoia]] emerges) depends on the nature of the wave of development (that is to say, its chronological placing) which enables repression to occur—i.e. which transforms a source of [[internal]] [[pleasure]] into one of internal disgust" (1950a, p. 271).
In this last [[text]], Freud describes the chronological factor as dependent on the development of [[infantile]] sexuality. But, while providing a now-classic description of the stages of this development, he suggests that the predisposition to the choice of neurosis has as much to do with the libidinal relationship to the [[object]] as it does to the ego [[defense mechanisms]] associated with each of the steps. He firmly maintains the chronological reference, as long as the development of the ego as well as that of the libido is taken into consideration.
This [[change]] in the [[Freudian]] outlook cannot be [[understood]] without reference to the early work of Karl [[Abraham]]. In a series of articles published between 1921 and 1925, Abraham made significant contributions to the establishment and refinement of the relation between [[Libidinal Development|libidinal development ]] and nosological [[categories]]. In 1924 he published "A Short Study of the Development of the Libido, Viewed in the Light of Mental Disorders," an essay that falls well within the bounds of the Freudian perspective but goes beyond it in its description of the neuroses, proposing a chronological model that explains all aspects of mental [[pathology]].
A few years before this, in "Stages in the Development of the [[Sense]] of [[Reality]]" (Ferenczi, 1913/1980), Ferenczi had expanded the hypothesis advanced by Freud according to which the choice of neurosis is determined by the development of the ego and the libido, specifying that development of the ego could be understood with reference to the sense of reality.
DANIEL WIDLÖCHER
See also: [[Constitution]]; Conversion; Doubt; [[Libidinal Stage|Libidinal stage]]; [[Organic]] repression; Somatic compliance.
[[Bibliography]]
