Obsessive neurosis: symptoms, causes and treatment

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

What is obsessive neurosis?

Freud described obsessive neurosis as a mental disorder in which those affected are constantly preoccupied with thoughts that do not interest them. The type of thoughts these patients suffer from is content that generates rejection in them, which can lead them to engage in unwanted behavior.

Much has been written about the difficult detection and treatment of obsessive-compulsive disorder because its symptoms may go unnoticed in many people with the condition. But how do people suffer from this condition? It is often said that they are perfectionists. Their thoughts can dominate their behaviors and mood, so they can adopt repetitive behaviors. and compulsive in trying to deal with his 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, however, a construct of great importance 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.

Concept history

French psychoanalyst Henri Ey conceptualizes obsessive neurosis as the inability to control the compulsiveness of feelings, Ideas or behaviors. This makes the affected person subject to the control of this type of neurosis.

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

In contemporary diagnostic textbooks, obsessive-compulsive disorder is included among anxiety disorders. Thus, the set of symptoms corresponds to OCD, or obsessive-compulsive disorder. OCD is a disorder in which there are compulsions and obsessive thoughts that the affected person recognizes as irrational and maladaptive. These symptoms cause noticeable agitation, and patients often engage in compulsive behaviors, rituals, etc.

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

main Features

The symptoms and characteristics of obsessive neurosis arise from the psychological and cognitive alterations from which the patient suffers. Obsessive thoughts flood the mind of the affected person.

Let’s see what kind of thoughts suffer from those affected by obsessive neurosis.

1. Obsessive cognitions

In the psyche of the affected person, obsessive phenomena are constantly occurring. This can materialize in uncontrollable feelings of guilt, checking out, obsession with order and cleanliness …

These recurring ideas are often a constant problem and concern for the patient.

2. Defense mechanisms

People with obsessive neurosis develop various defense mechanisms in an attempt to minimize their obsession.

However, these defense mechanisms also arise from obsessive thoughts and behaviors. Unlike obsessive cognitions, defense mechanisms can be consciously executed and the subject reproduces them in an attempt to reduce the discomfort of the former.

3. Other psychological and emotional disorders

This disorder is often accompanied by other emotional and affective disorders. Symptoms such as bullying, feelings of unreality, confusion, strangeness or bewilderment are very common characteristics in people affected by obsessive-compulsive disorder.


What are the most common symptoms of obsessive-compulsive disorder?

  • The affected person exhibits obsessive ideas that appear in their mind against their will. These are compulsive and uncontrollable thoughts.
  • The patient tends to adopt impulsive and aggressive behaviors, even if these are not the desired behaviors.
  • They perform repetitive behaviors of a symbolic nature. They are defined as rites of magical thinking.
  • Psychedenia appears, while the subject maintains a struggle to try to curb his obsessions.

the causes

Studies on obsessive-compulsive disorder have found it to be a multicausal psychopathology (That is, it can be due to different causes). There appear to be a number of factors which together can lead to the onset of the disorder.

Researchers have consistently categorized three types of causes of obsessive-compulsive disorder: physical, environmental, and genetic factors.

1. Physical factors

Symptoms associated with obsessive-compulsive disorder have been shown to be linked to various neurochemical imbalances.

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

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

2. Environmental factors

There can also be several environmental factors that can lead to the onset of this disorder. People who have been through situations that they could not control have a greater predisposition to obsessive-compulsive disorder.

For example, childhood trauma, being a victim of neglect or sexual abuse, living in an unstructured home, and being exposed to high levels of stress can also lead to the onset of this psychological illness.

3. Genetic factors

As with many mental disorders, obsessive-compulsive disorder has also been reported to have an important genetic component.

This has been seen as in some families it is easy to detect multiple members with this assignment. Additionally, having a family history of obsessive neurosis is a risk factor for developing the same disorder.


The usual symptoms of obsessive-compulsive disorder can be treated using two different (and often complementary) approaches: pharmacological treatment and psychological treatment.

In terms of pharmacotherapy, the most effective drugs are tricyclic antidepressants and selective serotonin reuptake inhibitors. This type of pharmacological intervention makes it possible to stabilize the clinical picture, even if they generally require psychotherapeutic support. In this regard, cognitive behavioral therapy is the most effective form of psychotherapy and generally the best complement to intervention with inhibitors.

Bibliographical references:

  • Freud, S. (1986). “About a case of obsessive neurosis (the ‘Rat Man’)”. Complete Works, Tom X. Amorrortu Editores.
  • Jarne, A. and Talarn, A. (2015). “Manual of Clinical Psychopathology”. Editorial Herder.
  • Indart, JC (2001), “The Obsessive Pyramid”. Editorial Tres Haches.
  • Lacan, J. (1984). “The seminar. Book XI: The four fundamental concepts of psychoanalysis.” Editorial Paidós.

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