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Obsessive neurosis: symptoms, causes and treatment

Obsessive neurosis: symptoms, causes and treatment

September 28, 2023

We speak of obsessive neurosis to refer to a mental disorder linked to nervous type tensions and psychic problems of a different nature. It was Sigmund Freud, the famous Viennese psychoanalyst, who described him for the first time.

What is obsessional neurosis?

Freud described obsessional neurosis as a psychic disorder whose sufferers are constantly preoccupied with thoughts that do not interest them. The type of thoughts suffered by these patients are of a content that generates rejection, which can lead them to have unwanted behaviors.

Much has been written about the difficult detection and treatment of obsessive neurosis, since its symptoms may go unnoticed in many affected. But, how are the people who suffer from this condition? It is often said that they are perfectionists. Your thoughts can dominate your behaviors and your mood, so you can perform repetitive behaviors and compulsive to try to manage their discomfort.

It is a term that is no longer used in modern clinical psychology. It does not appear in the DSM or in the CIE. Obsessive neurosis is, nevertheless, a construct of great relevance in the history of psychopathology.

In this article we will know the definition of this disorder, in addition to its symptoms, causes and possible psychological treatments.

History of the concept

French psychoanalyst Henri Ey conceptualizes obsessional neurosis as the inability to control the compulsivity of feelings , of ideas or behaviors. This causes the affected person to be subjected to the control of this type of neurosis.

Although the DSM-IV does not consider obsessional neurosis as an independent psychopathological entity, the different characteristics of the disorder have been treated, although with nuances very different from those proposed by Freud or those previously described by Henri Ey.

In contemporary diagnostic manuals, obsessive neurosis is integrated among anxiety disorders. In this way, the set of symptoms corresponds to OCD, or obsessive-compulsive disorder. OCD is an alteration in which there are compulsions and obsessive thoughts that the affected person recognizes as irrational and not very adaptive. These symptoms generate a remarkable restlessness and the patients usually present compulsive behaviors, rituals, etcetera.

As we can see, there are significant differences between the disorder initially described by psychoanalysis with the term of obsessive neurosis and the psychopathology that is currently described in the manuals, under the name of OCD (obsessive compulsive disorder).

Main characteristics

The symptoms and characteristics of the obsessive neurosis derive from the psychological and cognitive alterations suffered by the patient. Obsessive thoughts flood the affected person's mind.

Let's see what types of thoughts suffer those affected by obsessive neurosis.

1. Obsessive cognitions

Obsessive phenomena arise continuously in the psyche of the affected person . This can be expressed in uncontrollable feelings of guilt, of verification, obsession with order and cleanliness ...

These recurring ideas usually represent a problem and a constant concern for the patient.

2. Defense mechanisms

People with obsessive neurosis develop various defense mechanisms to try to minimize their obsession.

However, these defense mechanisms also start from obsessive behaviors and thoughts. Unlike obsessive cognitions, defense mechanisms can be performed consciously and the subject reproduces them to try to reduce the discomfort of the former.

3. Other psychological and affective alterations

This disorder is often accompanied by other emotional and affective affectations . Symptoms such as abulia, the feeling of unreality, confusion, strangeness or perplexity are very common characteristics among those affected by obsessive neurosis.


What are the most common symptoms of obsessive neurosis?

  • The affected person presents obsessive ideas that appear in his mind against his will. They are compulsive and not controllable thoughts.
  • The patient has a tendency to perform impulsive and aggressive behaviors, despite not being desired behaviors.
  • They perform repetitive behaviors of a symbolic nature. They are defined as rites of magical thinking.
  • Psicastenia appears, since the subject maintains a struggle to try to curb his obsessions.


Studies on obsessive neurosis have revealed that it is a multicausal psychopathology (That is, it may be due to different causes). It seems that there are a series of factors that, together, can lead to the appearance of the disorder.

Typically, scholars have classified three types of causes of obsessional neurosis: physical, environmental, and genetic factors.

1. Physical factors

It has been shown that the symptoms associated with obsessive neurosis are related to several neurochemical imbalances.

It seems that dysfunction in the orbito-fronto-caudate circuit could be a common factor in the onset of the disorder.

Another hypothesis proposes that certain anomalies in the striatum and the facilitation of serotonin transmission in the orbito-frontal region may also be risk factors.

2. Environmental factors

There may also be several environmental factors that can cause the emergence of this disorder. Individuals who have experienced situations that they could not control have a greater predisposition to suffer from obsessive neurosis.

For example, a childhood trauma, having been a victim of abandonment or sexual abuse, living in a broken home and being exposed to high levels of stress can also lead to the emergence of this psychological illness.

3. Genetic factors

As with many mental disorders, it has also been reported that obsessive neurosis has a large genetic component.

This has been seen since in some families it is easy to detect several members with this affectation. Also, having a family history of obsessive neurosis is a risk factor for developing the same disorder.


The usual symptoms of obsessive neurosis can be treated from two different approaches (and complementary in many cases): pharmacological and psychological treatment.

As for pharmacological therapy, the most effective drugs are tricyclic antidepressants and selective inhibitors of the reuptake of the hormone serotonin. This type of pharmacological intervention allows to stabilize the clinical picture, although they usually require psychotherapeutic support. In this respect, cognitive-behavioral therapy is the most effective form of psychotherapy and the one that usually complements better with intervention with inhibitors.

Bibliographic references:

  • Freud, S. (1986). "About a case of Obsessive Neurosis (the" Man of the Rats ")." Complete works, Volume X. Amorrortu Editores.
  • Jarne, A. and Talarn, A. (2015). "Manual of Clinical Psychopathology". Editorial Herder.
  • Indart, J.C. (2001), "The obsessive pyramid". Editorial Tres Haches.
  • Lacan, J. (1984). "The Seminar. Book XI: The four fundamental concepts of psychoanalysis. " Editorial Paidós.

Obsessive compulsive disorder (OCD) - causes, symptoms & pathology (September 2023).

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