Neurotic fears: what lies behind them

Neurotic disorders occupy a leading place in the structure of mental illnesses. The prevalence of psychogenic neurotic disorders necessitates constant improvement of their diagnosis, therapy and prevention. Often, patients with neurotic disorders seek specialized help from neurologists and general practitioners.

At the Yusupov Hospital, this category of patients is treated by experienced psychotherapists who have specialized in leading European clinics and are fluent in psychotherapeutic techniques, including cognitive behavioral therapy. Medical staff treats patients' problems with respect.

ICD 10 code

Stress-related and somatoform neurotic disorders in ICD 10 are classified in categories F40-F48. Neurosis is a disease with reversible mental disorders. The disease is caused by exposure to traumatic factors. Neurotic disorder is characterized by the presence of the following symptoms:

• disturbances of well-being, somato-vegetative, emotional functions;
• mental exhaustion;
• the patient’s awareness of the fact of his illness;
• absence of disruption of the reflection of the real world.

Psychiatrists distinguish the following clinical forms of neurotic conditions: asthenic neurosis (astheno-neurotic disorder or neurasthenia), obsessive-compulsive neurosis, hysterical neurosis, neurotic depression (depressive neurosis).

Causes

The formation of neurotic disorders is provoked by the influence of many factors. This may be a short-term reactor or chronic stress. Currently, there are two main causes of neuroses:

• insufficient functionality of the body's neurotransmitter and neurophysiological systems, which leads to a pronounced response to stress;
• mental characteristics, personality type and relationships with other people.
• The most common causes for the development of neurological disorders are:
• long-term illnesses, especially those accompanied by intoxication;
• addiction to drinking alcohol or smoking tobacco;
• chronic or acute stress: death or serious illness of a loved one, divorce, dismissal;
• mental overload;
• influence of family and others. Children adopt the habits and behavior of their parents; if the mother or father behaves aggressively, there is a high probability of neurotic disorders in the child.

Causes of neurotic disorders

Neurosis is always based on extreme stress caused by the inability to change an intolerable situation. However, the specific causes of the development of a neurotic disorder can vary significantly. In some cases, the impetus for the emergence of neurosis is an obvious acute stressful situation (for example, the breakdown of an important relationship or loss of a job). In others, internal tension increases slowly, unnoticed by others, and the person becomes ill, seemingly for no apparent reason, despite seeming complete or almost complete social and personal well-being.

Psychoanalysts believe that neurotic disorders arise as a result of a deep-seated psychological conflict that prevents the satisfaction of important needs or poses an insurmountable threat to the patient's future. The famous American psychologist and psychoanalyst Karen Horney viewed neurosis as a contradiction between various defense mechanisms designed to protect the patient from humiliation, neglect, aggression, total control and other influences that violate the natural fundamental rights of any person.

One way or another, all researchers of neuroses agree that the basis of the disease is an obvious or hidden internal conflict, a contradiction between various needs, feelings, desires and adaptive psychological mechanisms. Predisposing factors that increase the likelihood of developing neurotic disorders are considered to be certain characteristics of the patient’s character, personality and life history.

Neuroses more often occur in overly sensitive, emotional, impressionable patients with a rich imagination and well-developed imaginative thinking, or in psychologically rigid patients who are poorly aware of their feelings and have a hard time experiencing any life changes. Unfavorable conditions of upbringing are of great importance: neglect, rejection and inattention to the needs of the child, excessive guardianship, connivance, the tendency of parents to create an idol out of the child, contradictory upbringing, etc.

Biological factors have a certain influence on the development of neurotic disorders, in particular the individual level of neurotransmitters in the brain. The initially existing, mildly expressed anomaly turns out to be a “point of vulnerability” and under stress, along with other factors, provokes disturbances in the integrative activity of the brain. With the development of neurosis, neurotransmitter dysfunction increases, which causes further deterioration of the patient's condition.

Classification

The main types of neurosis include:

• Neurasthenia. Develops against the background of difficulties in interpersonal relationships. It is also called “irritable weakness”, such people show dissatisfaction with any reason, they are bothered by headaches and heart pain, tachycardia, heartburn and sleep disturbances;
• Hysteria or conversion neurosis. It is observed more often in females. Such people play along with the created image. Often this is the role of a seriously ill patient, simulating seizures or loss of vision. An attack of hysteria occurs spontaneously, usually after a provoking situation, in order to get what is what. However, the symptoms do not appear at the request of the patient and leave him tormented. Hysteria is observed in spoiled people and people with high self-esteem who are not accustomed to being denied anything;
• Obsessive-compulsive neurosis. The condition manifests itself through the emergence of fear and anxious thoughts even in the absence of a provoking agent. These include fear of society, fear of infection with some kind of disease. To alleviate their condition, patients may resort to special rituals that cause inconvenience and suffering. This group includes phobic neurosis and panic attacks;
• Somatoform disorders. This is the name given to the appearance of complaints that resemble a somatic disease, but no organ pathology is objectively detected.
• This group of neuroses is classified as general, in the clinic of which emotional disorders predominate.
• According to the duration of their course, neuroses are divided into:
• Spicy. They develop in response to short-term stimuli and can go away on their own, without specific therapy. This type of neurosis is also called situational;
• Chronic. They arise under the influence of a long-term stimulus, leading to disadaptation in society and changes in the psycho-emotional background.
• Other types of neurotic disorders:
• Bulimia is an eating disorder. It often occurs in teenage girls with complexes and lack of self-confidence. There are two forms of bulimic neurosis: with and without purging. In the first case, a person periodically overeats, then artificially induces vomiting so as not to gain weight. People suffering from bulimia without purging exhaust their bodies with strict diets and excessive exercise;
• Hypochondriacal neurosis is classified as a somatoform disorder. Such people concentrate their attention even on minor deteriorations in their well-being. They regard any symptoms as a sign of a dangerous disease. Such people usually come to the doctor with a stack of reports from other specialists and the results of many examinations. The diagnosis is made by excluding somatic pathology based on examination data, treatment is carried out by a psychotherapist;
• Autonomic neurotic disorder or VSD is a complex of symptoms caused by dysfunction of the sympathetic and parasympathetic nervous system. Depending on the predominance of the tone of the nervous system, VSD can occur as sympathicotonia or vagotonia. In the first case, symptoms of activation of the sympathetic nervous system (increased blood pressure, tachycardia, pallor) dominate, in the second - parasympathetic (low blood pressure, slow pulse, dizziness, redness of the skin). A separate category is vegetative crisis, which is characterized by increased symptoms and is accompanied by dizziness, weakness, sweating and decreased blood pressure. Against the background of an imbalance in the functioning of the nervous system, muscular or respiratory neurosis may occur;
• Noogenic neurosis has recently become increasingly widespread due to a sedentary lifestyle and the emergence of a virtual network. At the same time, a person loses his life values ​​and regards his existence as meaningless, he has no incentive to work, he is not satisfied with his life and is unable to overcome life’s difficulties;
• Neurogenic bladder syndrome is a neurosis characterized by a fear of voiding in a public place. Such a person takes a long time to adjust to urination, eventually avoids leaving the house, and tries to drink less liquid in a public place;
• Cardioneurosis or cardiac neurosis is a disorder of cardiac activity in response to a mental disorder. A person feels a “fading” heart, pain in the chest, attacks of palpitations or pulsations throughout the body. During an attack, a person is bothered by a feeling of fear and anxiety. After ruling out cardiac pathology, such patients are prescribed a consultation with a psychotherapist;
• Sexual neurosis is a mental disorder that affects a person’s sex life. Sexual disorders are manifested by either an increase or decrease in sexual desire. With increased desire, sexual desire is directed towards another object, and sexual perversion occurs. A decrease in desire leads to the fact that a person avoids sexual contacts, and sometimes even people of the opposite sex;
• Obsessive-compulsive disorder is characterized by the presence of intrusive thoughts (obsessions) and actions (compulsions).
• There is alcoholic neurosis, which occurs against the background of severe alcohol dependence and can become chronic. Symptoms of this condition vary and may include insomnia, fatigue, aggression or depression, headaches and heart pain. The main goal of treatment is to get rid of addiction.

Symptoms

In patients with neurosis, two groups of symptoms are distinguished:

• Somatic. They arise as a result of uncoordinated work of the sympathetic and parasympathetic nervous systems. In this case, the person has complaints about his health, but there is no pathology of the internal organs;
• Psychological symptoms are different for different types of neurosis.

Somatic symptoms Neurosis can be suspected if the following symptoms are present:

• increase or decrease in blood pressure;
• tinnitus, hand tremors;
• insomnia;
• decreased concentration, memory impairment;
• tachycardia or bradycardia;
• muscle pain, twitching, even cramps;
• nausea, vomiting;
• increased or decreased appetite;
• unsteadiness of gait;
• pain in the left side of the chest;
• difficulty urinating;
• increased sweating;
• tingling sensation, numbness in the limbs, changes in sensitivity in various parts of the body;
• gastrointestinal disorders: constipation, diarrhea;
• trembling in the body;
• headache;
• feeling of pulsation in various parts of the body;
• darkening of the eyes;
• stomach ache;
• decreased potency;
• pale or red skin;
• feeling of lack of air when breathing;
• skin rashes, scratching, burning.

When the first symptoms appear, patients go to the hospital and only after a long examination and consultations with various specialists do they see a psychiatrist.
Prolonged absence of diagnosis leads to increased severity of symptoms and the transition of the disease to a chronic form. The Yusupov Hospital employs specialists of the highest category with scientific degrees and extensive experience in treating neurotic disorders.

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Psychological The presence of psychological symptoms indicates that with neurosis there is a disorder of the psycho-emotional sphere. Signs of a neurotic disorder include:

• Decreased self-esteem. A person in a state of neurosis is indecisive in his actions, avoids crowds of people;
• Irritability. Any difficulties and situations provoke a violent reaction, anger, aggression, hysteria;
• Touchiness. A neurotic takes any criticism literally;
• Depression. The state of neurosis leads to a constantly depressed mood, lack of desires and drives, up to complete apathy and self-deprecation;
• Self-criticism. Neurotics treat even the slightest shortcomings strictly;
• Anxiety. Such people are constantly afraid of something, especially with regard to obsessive-compulsive disorder. Sometimes panic attacks can occur - an attack of anxiety and fear, accompanied by somatic symptoms;
• Instability of the emotional background is a change in mood, either for the good or for the bad, for no apparent reason. A bad mood can manifest itself as tearfulness and powerlessness for no reason;
• Difficulty communicating with other people. The state of neurosis provokes the emergence of internal conflict and alienation from the outside world.

Symptoms of neurosis in men and women Signs of a neurotic disorder in men may include disturbances in sexual desire and sexual function.
The stronger sex is more likely to experience depression due to lack of fulfillment and lack of work. Hysterical neuroses are more typical for women. This condition is often accompanied by severe somatic complaints. Typically, this condition occurs in people with a demonstrative personality type, when trying to attract attention.

Signs of other psychogenic neurotic disorders

Obsessive-compulsive neurosis actually includes obsessions (obsessions) and phobias (obsessive fears).
Obsessive disorders are represented by obsessive thoughts that are stereotypically repeated and extremely painful for the patient. Compulsions are repeated behaviors that purport to prevent harmful or dangerous events that are extremely unlikely to occur. The patient is formally critical of ritual actions, but cannot overcome them on his own. Phobic disorders include fear of certain situations. The patient is critical of his own phobic experiences, understands their alienness, strives to overcome them, but cannot free himself from them. The following obsessive fears are encountered:

• Agoraphobia is a persistent fear of being in crowds of people, fear of public places (workplaces, shops, streets, open squares, theaters, concert halls), and independent long trips on various types of transport;
• Claustrophobia – fear of closed spaces;
• Thanatophobia – fear of death;
• Cancerophobia – fear of cancer;
• Cardiophobia is the fear of severe heart disease.

Hysterical neurosis includes conditions that arise in patients with an obvious or objectively proven conflict situation (violation of interpersonal relationships, insoluble problems), even if the patient denies it.
More often, such conditions arise and stop suddenly. Some of them (anaesthesia and paralysis) gradually develop and persist for a long time. There is no connection between the mental disorder and neurological or physical disorders. The “benefits” for the patient and the clearly psychogenic nature of the disorders raise suspicions about attitudinal behavior. These specific psychopathological manifestations are disease states with specific pathogenetic mechanisms. Hysterical amnesia is manifested by impaired memory for recent stressful events, accompanied by depressive feelings. Memory loss is often partial. It is not caused by intoxication or organic brain damage.

Hysterical movement disorders reflect the patient’s subjective ideas about an alleged neurological disease, but the nature of the complaints does not correspond to real organic disorders. The presence of movement disorders allows the patient to avoid a difficult psychotraumatic situation. The intensity of the manifestation of disorders is closely related to the number of people who are present near the patient. Patients use the violations themselves to attract the attention of others.

Hysterical neurosis can be manifested by the following motor disorders:

• convulsive seizures;
• paralysis (complete and partial);
• hyperkinesis (excessive violent motor acts that occur against the patient’s will);
• contractures (stiffness of joints);
• mutism (a condition when the patient does not answer questions and does not even make it clear that he hears them);
• hysterical stupor (depressed mental state, manifested in silence, inhibition, inactivity).

The patient may experience convulsions similar to epileptic seizures.
All these disorders are not caused by organic damage to the organ or other disease. There are no signs such as tongue biting, involuntary urination, consequences of sudden falls, or loss of consciousness. Sensory disturbances during hysteria are manifested by a variety of sensitivity disorders:

• anesthesia (loss of sensitivity to pain);
• hyposthesia (decreased pain sensitivity);
• hyperesthesia (increased pain sensitivity);
• paresthesia (sensation of itching, burning, crawling).

Sensory disturbances often correspond to areas of innervation.
Patients experience bright, unusual hysterical pains. There is loss of hearing and vision. Depressive neurosis is a condition that is determined by the depressive triad: decreased mood, mental and motor retardation. Symptoms of the disease are moderately expressed, affect the patient’s behavior, but allow the individual to maintain social adaptation. Patients' ability to concentrate and self-esteem decreases. Night sleep disturbances and anxiety are typical.

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Symptoms of neurotic disorders

All neuroses are accompanied by emotional, psychological and autonomic disorders. Autonomic symptoms include lightheadedness, dizziness, a feeling of unsteadiness, trembling limbs, muscle twitching, muscle cramps, increased heart rate, pain and discomfort in the chest, increased or decreased blood pressure, feelings of cold or heat, sensations of suffocation, lack of air or incompleteness. inhalation, yawning, appetite disturbances, various dyspeptic disorders, frequent urination, pain, itching and discomfort in the perineum, sweating, chills and a slight causeless increase in temperature. Characteristic features of autonomic disorders are their instability and polysystemic nature.

In all neurotic disorders, sleep disturbances are observed: difficulty falling asleep due to thoughts associated with a traumatic situation, or due to an overly acute perception of any external signals (ticking clocks, street noise, sounds of neighbors' footsteps), frequent awakenings, shallow sleep, vivid or nightmare dreams, feeling weak and exhausted after a night's sleep. Often the patient suffers from drowsiness during the day and from insomnia at night.

Another obligate sign of neuroses is asthenia. Patients do not tolerate stress well and quickly become exhausted. Neurotic disorders are accompanied by mood instability, irritability and decreased performance of varying degrees. The sexual side of the patients’ lives also suffers - sexual desire disappears or decreases, the duration of sexual intercourse decreases, sexual contacts do not bring the same satisfaction, various disorders arise (potency disorders, premature ejaculation).

In neurotic disorders, affective disorders are observed. The general background of mood decreases, patients feel sadness, melancholy and hopelessness. Habitual pleasures (delicious food, hobbies, communication with friends and family), which previously brought joy, become indifferent. The range of interests narrows, patients become less sociable and begin to avoid contact with other people. Depression or subdepression often develops. The level of anxiety increases. Patients see the future as unfavorable and unfavorable. They live in anticipation of an uncertain catastrophe and tend to overly concentrate on negative scenarios.

In contrast to the above manifestations of neurosis, obsessions and phobias do not occur in all patients. These two signs are closely related, but in the clinical picture, as a rule, one of the two symptoms predominates. Obsessions are involuntary, intrusive thoughts, urges, fears, or memories. To get rid of obsessions, patients perform compulsive actions, often taking the form of complex rituals.

Phobias are obsessive fears of objects or situations that currently do not pose a real danger to the patient. There are three types of phobias: simple phobias (isolated fears of spiders, flying, birds, clowns, etc.), agoraphobia (fear of open spaces, places that cannot be left unnoticed, and situations in which you can be left without help) and social phobia (fear of situations , in which the patient is the center of attention of others).

Diagnostics

Only a highly qualified specialist can diagnose neurosis, since the symptoms are very nonspecific. This may require consultation with doctors of various specialties:

• therapist;
• endocrinologist;
• gastroenterologist;
• cardiologist;
• neurologist.

Before scheduling a consultation with a psychiatrist, the patient is prescribed an examination. Taking into account the complaints, the doctor selects the necessary studies:

• MRI, CT;
• Ultrasound of the thyroid gland, genital organs;
• ECG;
• Echocardiography;
• Fibrogastroduodenoscopy.

Early diagnosis makes it possible to treat neurotic disorders in the early stages.
The Yusupov Hospital has its own diagnostic center with modern equipment of European quality. Doctors at our clinic regularly attend conferences, receive scientific titles and master new treatment methods. When diagnosing neurosis, differential diagnosis is carried out with other diseases:

• enteritis, gastritis;
• psychopathy;
• angina pectoris;
• hypothyroidism;
• adrenal tumor.

The main difference between neurotic disorders and somatic pathology is that as a result of examinations of internal organs, no deviations from the norm are observed. To confirm neurosis, special psychological tests are carried out: anxiety, the Zung and Beck depression test, the K. Leonhard questionnaire.

Treatment

Treatment of neurosis has two main directions:

• medicinal;
• psychotherapeutic.

Usually, for complete recovery, only psychotherapy is sufficient, but if this method is ineffective, drug treatment is required. Psychotherapy For neurosis, psychotherapy makes it possible to find the cause of the disorder and choose the most effective method of therapy. The following areas of psychotherapy are used to treat neurosis:

• Cognitive behavioral therapy allows you to learn to identify and manage negative thoughts, discover and change beliefs that cause maladjustment in the environment;
• Art therapy is aimed at the patient mastering various types of art: dancing, drawing, modeling, music. In the process of training, a person masters new possibilities, and this also allows him to throw out his emotions and negativity. This allows you to relax and take your mind off problems and get rid of complexes. With the help of art, a person gets to know himself, discovers new abilities, which is very important in the treatment of neurotic disorders. Art therapy is also used to diagnose mental disorders. In the process of sculpting or drawing, a person involuntarily projects his thoughts and emotions, which helps to identify hidden aggression and a depressive state;
• Psychoanalysis is a treatment method in which, based on associations, fantasies and dreams, the doctor can determine the presence of an internal conflict. With its help, the instinctive behavior of a person, drives and desires at the level of consciousness and the unconscious are studied;
• With the help of Gestalt therapy, a person acquires the ability to make decisions independently and control their behavior.
• Psychotherapy improves the patient’s general condition and normalizes the emotional background. Getting rid of anxiety, depression, fears and phobias in most cases is only possible with the help of treatment from a psychiatrist. Explanation of behavior and identification of the provoking agent is the basis of therapy for psychoneurosis. In addition to a psychiatrist, sessions with a psychologist can help. At your appointment, you will be able to learn relaxation techniques that will help you overcome stress.

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Drug treatment Despite the high effectiveness of psychotherapy, it does not always allow you to completely get rid of neurosis. Drug treatment of neurotic disorders involves normalizing the function of the nervous system and enhancing the effect of treatment by a psychotherapist. In pharmacotherapy, the following groups of drugs are used:

• Sedatives are used as a remedy for mild neurosis. They have a calming effect and reduce emotional stress. They practically do not cause side effects and addiction;
• Tranquilizers have an anti-anxiety effect and a strong sedative effect. They reduce fear, anxiety, eliminate obsessive thoughts and actions;
• Antidepressants normalize the levels of serotonin, dopamine and norepinephrine. They improve mood, have virtually no side effects and are highly effective, especially in people with hypothymia;
• General strengthening treatment is achieved by taking vitamins B, A, D, E and antioxidants.

Other commonly used treatments include:

• Massage for neurosis can be acupressure or individual segments. It increases blood circulation, improves skin nutrition, relieves muscle spasms;
• Physiotherapeutic procedures such as inductothermy, electrophoresis, galvanization and electrosleep help improve overall well-being and normalize mood.

Neurotic fears: what lies behind them

It makes you feel hot, presses in your chest, and gives you goosebumps all over your body. Just thinking about what could happen makes my head spin. I’m scared, I understand that it’s very scary to endure this life, take the next steps, meet the new, frightening and unknown... Fear is one of the regulators of human behavior, as well as a feeling that allows us to take care of our safety. And this is a good and necessary feeling when it fulfills its regulatory function - that is, we do not cross the road at a red light and do not eat something that is inedible and will cause harm.

When fear is more an enemy than a protector

But often fear is something more than just regulating behavior; it is a kind of panic state, or a state of severe anxiety, which fetters your arms and legs and rather interferes with your life. We encounter it when we make choices in favor of something new. Advertising Neurotic fear is always in the future, it is in our fantasy.
The key point about neurotic fear is that it is always directed to the future, it is always some model of reality in our head. What if I die? Or will I get sick? Won't they help me? Will I be alone? These questions emerge in the mind and are turned into a reality that does not yet exist, which has not yet arrived.

Fear is meant to prevent something from happening.

And this something may have already happened to us. Once upon a time, in the past. If you ask yourself what I’m afraid of, then I’m not afraid of the present, I’m afraid of something in the future - or rather, a repetition of a situation that happened in the past (or part of it, an element). It is this condition, this pain that I experienced in the past, that I am afraid to experience again.

I cannot be afraid of what I have never seen or known. This is simply not in my experience. I can only fear what I have already experienced.

But what about fantasies about serious illness and death, you ask? After all, we have never experienced this before!

Yes, definitely. But it’s not death itself that we’re afraid of. We are afraid of dying, afraid of the torment we might end up in. We are essentially afraid of experiencing pain.

And once upon a time we already found ourselves in torment. Perhaps it was such torment that could be compared with the torment of a dying person. Once upon a time, in childhood, in the most vulnerable childhood, where we could do very little for ourselves and relied on the protection of adults.

It was then that we could feel the real, genuine fear and horror of the impending end and incessant torment. The kind that last forever. Because it’s unclear when mom will come and stop them. It is completely unknown what will happen next, will they hear, will they help, will they support, will my pain be taken away?..

We could be afraid of the torment that we don’t know when it will end. This is the worst thing - not knowing when the pain will stop.

Then we could be completely powerless. They may have been tied up in diapers, or perhaps left in the hospital. Alone, with unknown doctors who climb into the body, who are not interested in how we are doing all this, whether it’s scary...

And the worst thing is when there is no mother. Or the one who is “for us”. The one who stands behind us and always makes sure that nothing bad is done to us. And he asks us, is interested in us, notices.

And when there is no obvious strong danger for us at the moment, but we are faced with the experience of wild fear and horror in adulthood, it is always about the past. It's always about that little girl or that little boy. It's always about powerlessness and horror of the inevitable. It's always about a lack of protection and support. Self-defense and self-support.

It is often about giving the environment and people around you strong power over yourself and your life. This is about the fact that one’s own will is not enough, one’s own power over oneself is not enough. It’s always about a request: notice, support, reassure, help...

Neurotic fear: how to deal with it

In fact, everything described above is a neurotic fear, that is, one for which there are no obvious specific reasons in the here and now (a house is not falling, a comet is not flying, a weapon is not being fired, etc.). Neurotic fear is a fantasy. And usually, what do we do with them? We can freeze and think, fantasize. And then switch to something else, out of unbearability of being alone with a frightening fantasy.

In fact, we ourselves do not develop our imagination, we do not detail it. For example, the fear of getting cancer. We can imagine some terrible image, a picture, perhaps even blurry and unclear, and become very frightened, run to do an analysis, or, conversely, hide somewhere under the blanket.

But we just need to detail our imagination... How will it all be, how will we do research, how will we find out that we are sick, what kind of tumor will we have? Where will it be located and how. Detailing, we can notice that our overwhelming fear changes a little, perhaps some other experiences appear.

After all, we begin to understand that everything we think may not be so, and even in what we fantasize we can live and there are many options for the development of events. Fear begins to take on some visible forms, becoming not blurry and limitless, but, on the contrary, targeted and understandable. Ideas and ways to protect yourself and what measures to take begin to emerge.

On the other hand, it is important to think about what exactly leads to this fantasy?

For example, there are no objective reasons to get cancer. No diagnosis, no real disease. But in my head, it’s as if it already exists. Where does it come from? Why cancer and not AIDS, for example...

And here you can explore those “roots” from which fears grow. It's always some kind of past experience that we have. What is he like? Someone was sick and died in their arms? And then we can be “merged” with this person and for some reason now “must” also suffer.

Or perhaps something similar has already happened to you? Have you already experienced some element of a “cancer” disease?.. For example, you could have something removed, cut out, you could lose some organ.

And also - this kind of fear, illness, some kind of evil directed at oneself - this is a very auto-aggressive action. That is, in my fantasy I realize a lot of aggression and anger (and maybe even hatred) directed at myself. That is, for some reason I want to torture myself, kill myself, mock myself. What is this about in my life?

Why should my organs be burdened with a malignant tumor. Why can't they be healthy?

And if these organs are responsible for some area of ​​our life - for example, the reproductive system - for the area of ​​sexuality, childbirth, respiratory organs - for the area of ​​breathing as a manifestation of life, the right to life in this world, the opportunity to breathe this air, to have one’s place , claim it. The digestive system is for the ability to use us, “absorb”, digest what we need and get rid of, reject what is unnecessary.

Isn’t such an aggressive fantasy about illness a manifestation of self-sacrifice, hatred of oneself or of some specific organ or system that for some reason should not live?.. Why shouldn’t my lungs live? Why shouldn’t I breathe?.. Is there a place for me in this world?.. Do I give myself the right to this life? Why shouldn’t my reproductive system live? Do I allow myself to be sexy, to realize my arousal? Do I allow myself to get pregnant and have children?..

Can I absorb what is in this world - food, information, care, relax, take advantage of all this, appropriate something for myself? Digest, reject? Should you throw something away completely? Perhaps I don't have the right to do this? Or did I not deserve it, I didn’t do enough to “eat”? Or maybe I swallowed something and I can’t refuse it anymore, I can’t spit it out? How much and what will I owe for being “fed”?..

To begin to contact neurotic fear, to begin to deal with it, it is important to “unpack” it. Those “layers” of it that the psyche hides from us, giving only a vague and terrible image of “something”, one or two pictures.

Neurotic fear deprives us of freedom to contact our needs. After all, behind this horror there may be many complex experiences - for example, guilt or shame, pain, humiliation, from which you want to isolate yourself.

But if they already exist, if they “sit” somewhere, stopped and “packed”, then they will make themselves felt all the time - with such horror and such fantasies and phobias.

In psychotherapy, during individual and group psychotherapeutic work, there is an opportunity to come into contact with what you cannot see and touch on your own. There is an opportunity, next to another, or a group of others, to “feel” your fear and horror and what lies behind it, to consider all the “layers of the pie,” to explore their nature, their roots, where, how and when they originated.

And ultimately make fear more real, which means focused, targeted, and conscious. Make it your resource and real protection.

Prognosis and prevention

Many people wonder how to live with neurosis.
The prognosis depends on the stage of development, type of disorder, timely detection and initiation of treatment. A significant improvement in the condition is observed with an integrated approach and a combination of medication and psychological assistance. Timely identification of the disorder guarantees the success of treatment, therefore, if you have symptoms of neurosis, you should immediately consult a doctor. Preventive measures to prevent neuroses and their relapses include:

• proper nutrition with sufficient fruits and vegetables will cover the body’s need for vitamins and minerals;
• a favorable atmosphere in the team and at home helps to improve vitality and strengthen the nervous system;
• getting rid of bad habits;
• healthy sleep and rest;
• regular walks in the fresh air;
• playing sports is one of the main ways to combat depression.

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Diagnosis and treatment of neurotic disorders

The diagnosis of neuroses is complicated by the small number of objective symptoms that make it possible to unambiguously judge the presence or absence of a disorder. The patient's complaints and medical history are of primary importance in making a diagnosis. In addition, the doctor conducts psychological testing using special standardized questionnaires (BVNK-300 in Bakirova’s adaptation, Cattell’s 16-factor questionnaire, etc.). During the diagnostic process, organic pathology is excluded that could provoke the appearance of psychological and somatovegetative disorders. If necessary, the patient is referred for consultation to a neurologist, therapist, cardiologist, gastroenterologist, endocrinologist and other specialists, and MRI of the brain, EEG, ECG and other studies are prescribed.

The main method of treating neurotic disorders is psychotherapy. They use psychoanalysis, cognitive behavioral therapy, Ericksonian hypnosis, integrative transpersonal therapy, psychodynamic therapy and other techniques. The goal of therapy is to identify conscious and unconscious adaptation mechanisms and their subsequent correction. If necessary, psychotherapy is carried out against the background of medication support. Depending on the symptoms, tranquilizers, antidepressants and antipsychotics are used.

General strengthening treatment is prescribed, which includes physical therapy, massage, taking vitamins and microelements. Changing your lifestyle is of great importance: maintaining a work and rest schedule, moderate physical activity, spending time in the fresh air, a balanced diet, giving up bad habits. Sometimes a change of activity is required. With timely initiation of treatment, the prognosis is favorable. Symptoms disappear, patients return to normal life, but relapses are possible under severe stress. With late treatment and non-compliance with doctor’s recommendations, there is a tendency for a protracted course.