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Variant, v. 1, issue 2, whole no. 2, May 1947
Page 9
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May 1947 VARIANT Page 9 This is the second in that series of articles on psychiatry and kindred subjects, by Helen Cloukey. NEUROSIS AND PSYCHOSIS by Helen Cloukey NEUROSES: A group of behavior disorders representing suboptimal adaptations to biodynamic stress and conflict. Neurosis are characterized symptomatically by 1. anxiety 2. various and pervasive defenses such as phobias, obsessions, or compulsions, or by 3. psychosomatic dysfunctions. PSYCHOSES: A group of grave disorders of behavior most of which satisfy the legal criteria of insanity in that the person is unable to care for himself and/or constitutes a danger to others. The psychiatric criteria: 1. loss of contact with, or marked distortion of socially accepted interpretations of reality. 2. severe and persistent disorders of affect (emotion) 3. marked regressions with retreat from or perversion of social relationships. 4. personality disintegration 5. acute derangement of "intellectual" capabilities or their deterioration. These two definitions are from Jules H. Masserman's recent book, Principles of Dynamic Psychiatry, and they make clear the difference between two categories of behavior disorder. Examination of the definition of psychosis will provoke some thought, however. We suffer psychosis in our midst to an amazing extent, and think little of it. Even in its more colorful manifestations of hallucination, it is common, as recent PSFS discussions of the "lunatic fringe", and derology will illustrate. Many, many people have a clearly developed psychosis which society will tolerate until it threatens injury to its bearer or others. "Harmless," yes. but most of us bear the scars of some encounter with a person technically insane, though socially tolerable. As Alvarez puts it, a person must be indeed aberrant in his behavior to gain more than the reputation of "queer," "a suspicious old duck," or an "unsociable devil". Certainly, each of us have known at least one person who is convinced that every gesture or word directed to him has some secretly spiteful intention. These are the persons who fight with waitresses, yell "discrimination" all of the time, and lose their friends by believing that they are out to harm them for some supposed gain. Then, each of us have struggled to communicate with the ones who do not have two connected thoughts. They do not pay attention. They cannot give a pertinent answer to a question. One must speak twice to gain their attention, then repeat one's message twice. They apparently ignore everything, signs, street-lights, other people. Their behavior is vague and irresponsible, and their friends get into the habit of writing down their notes for them, having learned that it is useless to expect them to remember engagements, addresses, letters to be written, or other data. Of much the same breed, but far worse, are those who do not care, about anything, about anyone. These frequently, as Alvarez puts it, "crave a love that they will not or cannot earn or keep." Their only reaction is indifference, and their behavior frequently reflects a degree of selfishness and callousness that is extreme. They cannot be influenced, and, if honest, may make responsible and valuable citizens. Many of us have not known people who "heard voices" or "saw things" but apparently Richard Shaver has known some. If we add to these, the infinite hosts of people who have "one crazy idea", that the prescient is responsible for all the trouble in the country, or that all Jews are pyromaniacs, or that all negroes are eyphilitic, or all partakers of alcohol are children of the devil, we gather quite a crew together. So what? Why spend so much time hanging a label on people, especially such a damning one as "psychotic"? As I hear the howls of laughter that arise from discerning souls who will think that my sentiments are those of the old Quaker lady, "All the world is queer but me and thee and
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May 1947 VARIANT Page 9 This is the second in that series of articles on psychiatry and kindred subjects, by Helen Cloukey. NEUROSIS AND PSYCHOSIS by Helen Cloukey NEUROSES: A group of behavior disorders representing suboptimal adaptations to biodynamic stress and conflict. Neurosis are characterized symptomatically by 1. anxiety 2. various and pervasive defenses such as phobias, obsessions, or compulsions, or by 3. psychosomatic dysfunctions. PSYCHOSES: A group of grave disorders of behavior most of which satisfy the legal criteria of insanity in that the person is unable to care for himself and/or constitutes a danger to others. The psychiatric criteria: 1. loss of contact with, or marked distortion of socially accepted interpretations of reality. 2. severe and persistent disorders of affect (emotion) 3. marked regressions with retreat from or perversion of social relationships. 4. personality disintegration 5. acute derangement of "intellectual" capabilities or their deterioration. These two definitions are from Jules H. Masserman's recent book, Principles of Dynamic Psychiatry, and they make clear the difference between two categories of behavior disorder. Examination of the definition of psychosis will provoke some thought, however. We suffer psychosis in our midst to an amazing extent, and think little of it. Even in its more colorful manifestations of hallucination, it is common, as recent PSFS discussions of the "lunatic fringe", and derology will illustrate. Many, many people have a clearly developed psychosis which society will tolerate until it threatens injury to its bearer or others. "Harmless," yes. but most of us bear the scars of some encounter with a person technically insane, though socially tolerable. As Alvarez puts it, a person must be indeed aberrant in his behavior to gain more than the reputation of "queer," "a suspicious old duck," or an "unsociable devil". Certainly, each of us have known at least one person who is convinced that every gesture or word directed to him has some secretly spiteful intention. These are the persons who fight with waitresses, yell "discrimination" all of the time, and lose their friends by believing that they are out to harm them for some supposed gain. Then, each of us have struggled to communicate with the ones who do not have two connected thoughts. They do not pay attention. They cannot give a pertinent answer to a question. One must speak twice to gain their attention, then repeat one's message twice. They apparently ignore everything, signs, street-lights, other people. Their behavior is vague and irresponsible, and their friends get into the habit of writing down their notes for them, having learned that it is useless to expect them to remember engagements, addresses, letters to be written, or other data. Of much the same breed, but far worse, are those who do not care, about anything, about anyone. These frequently, as Alvarez puts it, "crave a love that they will not or cannot earn or keep." Their only reaction is indifference, and their behavior frequently reflects a degree of selfishness and callousness that is extreme. They cannot be influenced, and, if honest, may make responsible and valuable citizens. Many of us have not known people who "heard voices" or "saw things" but apparently Richard Shaver has known some. If we add to these, the infinite hosts of people who have "one crazy idea", that the prescient is responsible for all the trouble in the country, or that all Jews are pyromaniacs, or that all negroes are eyphilitic, or all partakers of alcohol are children of the devil, we gather quite a crew together. So what? Why spend so much time hanging a label on people, especially such a damning one as "psychotic"? As I hear the howls of laughter that arise from discerning souls who will think that my sentiments are those of the old Quaker lady, "All the world is queer but me and thee and
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