Disposition to neuroses

from Wikipedia, the free encyclopedia

Disposition to neuroses or neurotic disposition describes characteristics of a person that persist over time and that are assumed to have existed before the onset of a mental disorder to be treated .

The term

The term neurosis disposition or neurotic disposition is not new in the psychoanalytic literature. Already in 1909 Alfred Adler published a treatise on neurotic disposition (see below: literature). In the 1960s, Horst-Eberhard Richter also spoke of the disposition for neuroses (see below: literature). In the 1970s, Jürg Willi (see below: literature) saw the respective neurotic dispositions of two partners in a couple relationship, such as the key and the matching lock, which together enter into a neurotic collusion .

The use of the term neurosis disposition as it is used in more recent psychodynamic literature, is derived from the concept of neuroses structure of Harald Schultz-Hencke from. At the time, Schultz-Hencke defined four neurotic structures (a schizoid, depressive, compulsive and a hysterical or histrionic neurotic structure, which later became popular with Fritz Riemann's book Basic Forms of Fear ). Udo Boessmann and Arno Remmers (see below: literature) have expanded Schultz-Hencke's concept of neurotic structures and distinguish ten (structural) neurosis dispositions in the psychodynamic diagnosis and treatment of individual personality styles. They are based on Lorna Smith Benjamin's structural analysis of interpersonal behavior (see literature) and on DSM IV . The term neurosis disposition is used in deep psychological and analytical psychotherapy, especially in the report to the expert in the context of the cash application. The therapist must write the report in order to prove the obligation of the statutory or private health insurance and, if applicable, the benefit agencies.

The disposition to neuroses says something about a person's personality and willingness to react. It describes characteristics of a person that persist over time, which are assumed to have existed before the onset of a mental disorder to be treated. The concept of the structural level according to OPD has in common with the concept of structural neurosis disposition that both mark an increased willingness (disposition) of the patient to react to certain, specific stresses and conflicts with mental or psychosomatic symptoms of illness.

The difference between the two terms is as follows: The structure level is - independent of specific unconscious conflict contents - an operationalizable measure for the maturity and performance of relatively well-describable formal self-control and interaction abilities of a patient (roughly what is also called ego functions) . The concept of neurosis dispositions, on the other hand, is based on psychodynamic theoretical constructs: it differentiates patients according to their characteristic constellation of unconscious motivations , drives and willingness to conflict as well as specific defense mechanisms and inhibitions and the specific relationship patterns caused by them.

Demarcation

The terms neurosis disposition and personality disorder are related, but they by no means mean the same thing: the personality disorder is a clinical picture, while the neurosis disposition is the willingness to be ill or to react

Personality disorders are chronic diseases. The personality structure of personality disorders is so dysfunctional, stressful or life-impairing that it is itself the problem that needs treatment. Personality disorders are usually the result of long development from childhood and adolescence. They do not show a clear beginning that could be correlated with a current stress or conflict situation causing illness. The treatment of interpersonal or intrapsychic conflicts often does not help the therapy - if the patients even get involved. The patient's introspection, transference and insight are significantly limited. A detective Psychotherapy - as Gerd Rudolf emphasized - be replaced by a structure-based psychotherapy. Often the social environment suffers more from the personality disorder than the patient himself. Sometimes the patient's motivation to change is so low or the burden on the therapeutic relationship so great that psychotherapy can hardly be carried out.

In contrast to personality disorders, predispositions to neuroses are not diseases, but only a willingness to be ill and to react and are consequently not taken into account in the ICD-10 . Symptoms requiring treatment are only triggered by additional factors, for example new requirements, development tasks, losses. Dispositions for neuroses that have not become a manifest neurotic disease are abilities to adapt and compensate and thus have no disease value of their own. The personality traits described in the DSM-5 and in the ICD-10, which appear in the personality disorders as manifest deviations from norms and gross dysfunctionalities, would only show up in the neurotic structures as tendencies and reaction options that only under special requirements, for example with new developmental tasks or be able to show abnormalities under new stresses in life.

Lower forms

The neurosis dispositions distinguished by Boessmann and Remmers are as follows:

  1. The altruistic-depressive disposition to neuroses
  2. The dependent or dependent neurosis disposition
  3. The fearful or avoidant-self-insecure disposition to neuroses
  4. The compulsive (anankastic) disposition to neuroses
  5. The histrionic or hysterical disposition to neuroses
  6. The emotionally unstable disposition to neuroses
  7. The paranoid disposition to neuroses
  8. The narcissistic disposition to neuroses
  9. The passive-aggressive or negativistic disposition to neuroses
  10. The pseudo-independent disposition to neuroses

literature

  • Alfred Adler : About neurotic disposition , Yearbook of Psychoanalysis 1909–1914, 1909
  • Horst E. Richter : Parents, Child and Neurosis. Psychoanalysis of the child's role , 3rd ed. 1972, Klett-Cotta
  • Jürg Willi : The two-way relationship. Causes of tension, disruption patterns, clarification processes, solution models , Rowohlt Verlag 1999, 1975, ISBN 3-499-60509-0
  • Lorna Smith Benjamin : The Interpersonal Diagnosis and Treatment of Personality Disorders , CIP Media, 2001
  • Wolfgang Tress (ed.). SASB. The structural analysis of social behavior . Munich: CIP, 2002.
  • Udo Boessmann, Arno Remmers : Treatment focus, Bonn: Deutscher Psychologen Verlag, 2008.
  • Udo Boessmann, Arno Remmers : The first interview, Bonn: Deutscher Psychologen Verlag, 2011.

Web links