Being markedly egocentric and suspicious, he builds up in his delusion a private world or pseudo-world, which replaces the normal world that others inhabit.
A woman may develop the delusion, for example, that others are trying to poison her or to control her thoughts by special waves from another world.
A man or a woman may see himself as a new religious savior and his viewpoint may color all his attitudes towards his associates.
Since the patient shows little additional mental deterioration he often develops clear and logical plans for warding off the persecutions or affronts of others.
Such a plan may even involve a decision to kill his “enemy” which indicates the danger of such delusions. Neuroses are the classification of neuroses in the general form today including six and many forms listed above.
Anxiety Reaction
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The person with an anxiety reaction describes himself as continually uneasy or heinous and there may be secondary complaints usually insomnia, inability to concentrate, and various autonomic nervous system signs of disturbances.
Some disturbances once classified separately but presently regarded, as a variant of an anxiety reaction are hypochondrias and neurasthenics.
Hypochondriacal and Neurasthenics Reactions
In hypochondria and neurasthenia, the individual is excessively preoccupied with his physical condition – the way he feels. In hypochondria, he feels sick, and in neurasthenia, he feels tired.
The complaints of a hypochondriac run the whole gamut of man’s ills – indigestion, stomach aches, heart or lung trouble, glandular ailments, urinary disturbances, sore muscles, and others in almost endless variety.
He spends much of his spare time in doctor’s offices or poring over popular medical books and journals looking for remedies. Many seem to “enjoy poor health” and like to tell others about their symptoms, their operations, their tribulations, and their expenses in trying to find relief.
Often they become the unwary dupes of quacks. The chief symptom of neurasthenia is an exaggerated feeling of fatigue, which explains why neurasthenia is often called fatigue neurosis.
A neurasthenic complains of exhaustion and a feeling of general weakness. He feels mentally and physically inadequate and often complains that he cannot concentrate. Difficulties that appear small to others may upset him completely.
He is very irritable and this irritability may give way to emotional exhaustion, accompanied by feelings of depression.
Sometimes, without any specific organic basis, he may develop specific physiological symptoms, such as headaches, backaches, and numbness in various parts of the body.
Often the neurasthenic will lose all sexual vigor, becoming virtually impotent. Neurasthenic is often difficult to diagnose because many of its symptoms may have their origin in some temporary or chronic physical condition.
Physical condition, however, serves mainly as a “psychological excuse” to develop the other symptoms found in the neurasthenic picture.
Case studies of neurasthenics reveal that the symptoms of pronounced fatigue rarely arise from overworking or from other forms of strenuous mental or physical work.
Rather, the fatigue seems to be of an emotional or mental variety, arising from a person’s inability to resolve a long series of emotional difficulties. Neurasthenic symptoms, like other symptoms in neuroses, serve an important function for the person.
They may be a form of ego protection against the admission of inadequacy, or failure, in many different areas.
The main difference between the neurasthenic and the hypochondriac is that the former complains of bodily fatigue, disorder, and “all over” discomfort, to focus his complaints upon a specific organ or function of his body.
Instead of being tried all over, he has a heart that doesn’t work right or a kidney that won’t let him function adequately.
Both, however, share the characteristics of abnormal concern about their well-being. “Poor health” serves important psychological functions for both of them.
Dissociative Reactions
The remarkable group of neurotic disturbances called dissociative reactions includes:
- Amnesia (s)
- Fugue
- Multiple Personalities
- Somnambulism’s
Amnesia(s)
In Amnesias a person cannot recall certain past experiences of one’s life. Some Amnesia is based on brain damage (Organic Amnesia). But functional amnesia involved no such injury.
For instance, the shock of seeing a fatal accident blots out all traces of the events from one’s memory. The forgotten materials remain inaccessible to the patient for a day or week or may persist for years, although they can often be restored after a time or with treatment.
Fugue
The fugue is quite similar in certain respects to an attack of amnesia. The fugue victim forgets his identity and runs away from familiar surroundings “coming to” later in some distant place, dazed, confused, and unable to remember how he got there.
His memory lapse may continue for several days, weeks, or even months, during which time he will be unable to recall his past. When he recovers, he will recall the past, but the period of fugue however may remain a blank.
There have been cases of individuals who have lived away from their original homes, for ten or more years starting a new occupation, and building a family only to reawaking later of missing their old forgotten place of origin.
Thus, this is an unusual condition in which a person has no memory of his actions over some time. The fugue state may last for several minutes or months. It is a period of loss of memory when the individual disappears from his usual haunts.
Multiple Personalities
Multiple personalities are relatively rare. Ordinarily, every one of us plays several different roles, during the day. A man may assume the role of husband, father, employer, philanthropist, or sportsman, all in a day and act quite differently in each role.
But he recognizes himself as a unified, integrated personality no matter how diverse the roles may be. In the case of multiple personalities, however, this integration is missing.
The individual is unable to reconcile the character traits of one personality, of one role he assumes, with another and frequently is unable to recall or to recall only dimly – the acts and thoughts of other personalities. Tersely, the person is shifting abruptly from one personality to another.
Somnambulism
The sufferer rises from the bed during sleep and carries out some acts which sometimes can be rather complex.
As in amnesias, there is usually no memory during the waking state e.g. wake, iron a shirt or two and go back to sleep and not remember what has happened or wake, take his car’s key, kick and drive to a kilo and forgot when he wakes, or he wakes up, say few things and go back to sleep but forget what he has said.
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