Abnormal Psychology

The History of Abnormal Psychology 19

Neurosis

According to psychoanalytic theory, a pattern of

thoughts, feelings, or behaviors that expresses

an unresolved confl ict between the ego and the

id or between the ego and the superego.

Defense mechanisms

Unconscious processes that work to

transform psychological confl ict so as to

prevent unacceptable thoughts and feelings

from reaching consciousness.

According to Freud, a child who fails to satisfy the needs of a psychosexual

stage will develop a fi xation, a tendency for thoughts, feelings, and behaviors

to relate to that particular stage of psychosexual development, even as the child

passes to the next stage. Under stress, a person with a fi xation might regress to

the thoughts, feelings, and behaviors of the earlier stage. For example, accord-

ing to Freud (1905/1955), people with a fi xation at the oral stage use food or

alcohol to alleviate anxiety.

Mental Illness, According to Freud

Freud proposed two general categories of mental illness: neuroses and psycho-

ses. A neurosis is a pattern of thoughts, feelings, or behaviors that expresses

an unresolved confl ict between the ego and the id or be-

tween the ego and the superego. One type of neurosis—

what Freud called an anxiety neurosis—involves extreme

“free-fl oating fear” that latches onto different objects or

possibilities; people with anxiety neuroses may “interpret

every coincidence as an evil omen, and ascribe a dreadful

meaning to all uncertainty” (Freud, 1920, p. 344).

Freud (1938) defi ned psychosis as a break from reality

characterized by confl ict between the ego’s view of reality

and reality itself. (Note that this is not the defi nition of psy-

chosis provided earlier in this chapter; that will be the one

employed throughout the rest of this book.) According to the

psychoanalytic view, then, schizophrenia involves a psycho-

sis because it is an escape from reality into one’s own inter-

nal world (Dorcus & Shaffer, 1945).

Freud was also revolutionary in proposing that

parents’ interactions with their child are central in the for-

mation of personality. For instance, parents who are too

strict about toilet training their toddler may inadvertently

cause their child to become fi xated at the anal stage. A per-

son who has such a fi xation may develop obsessional thoughts and compulsions

about being clean and orderly, as in obsessive-compulsive disorder, which is

marked by persistent and repetitive thoughts and behaviors (American Psychiat-

ric Association, 2000).

Defense Mechanisms

In addition to proposing an explanation for how internal psychological con-

flict arises, Freud, along with his daughter, the noted psychoanalyst Anna

Freud (1895–1982), suggested how such conflicts are resolved: The ego fre-

quently employs unconscious defense mechanisms, which work to transform

the conflicts in a way that prevents unacceptable thoughts and feelings from

reaching consciousness. If successful, defense mechanisms can decrease anxi-

ety (see Table 1.3). Freud proposed several defense mechanisms, and Anna

Freud extended this work. Conflicts and threats do not necessarily cause psy-

chological disorders, but they may do so when a particular defense mechanism

is relied on too heavily.

Psychoanalytic Theory Beyond Freud

Psychoanalytic theory has been modifi ed by Freud’s followers; these variations fall

under the term psychodynamic theory and have attracted many adherents. Psycho-

dynamic theorists have focused on areas that Freud did not develop fully:

• normal versus abnormal development of the self (Kohut, 1971);


• the contribution of additional sources of motivation, such as feelings of inferiority

(Ansbacher & Ansbacher, 1956);

• the development and work of the ego (Hartmann, 1939);

In Freud’s view, mental illness is caused by

unconscious confl icts that express themselves as

psychological symptoms. He revolutionized treat-

ment of psychological disorders by listening to

what patients had to say.

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