Beyond Therapy: A Set of Essays
On Miscellaneous Topics in Psychology and Psychiatry (2001-2003)

III. On the Existence or the Non-Existence of the Neurotic Condition?
And the Possible Existence of a Stasic Condition??

0.   Introduction

	In the first essay of this series of psychological papers I was very critical of the psychoanalytical project as inaugurated and constructed by Sigmund Freud et al. In one area of his research, however, I do believe he may have made a significant contribution to an understanding of mental disorders, namely, his classification of neurosis. (1)

Today, this classification is not a fashionable condition in many psychiatric schema and numerous commentators have felt that it has disappeared from the acceptable list of conditions the same way as 'hysteria' has become a rare phenomenon. As a sign of this re-evaluation we have the expression 'neurosis' finding only a residual survival in such conditions as 'battlefield neurosis', 'war-neurosis', etc., although it continues to successfully survive in common parlance. (2)

	The reason for my re-appraisal is this. Over many years I have had the opportunity to observe the sleep, or lack of sleep, of patients suffering from a psychotic illness. Their sleep pattern is often disturbed - sleeping better one night and not sleeping well at all on the next. In more severe cases, this pattern spreading over three nights; with only one night in three demonstrating a relatively better sleep. It is almost as if the day for the psychotic patient was spread over the duration of two days or three. So, e.g., with one elderly depressed woman in mind, she would attempt to eat a few token meals one day and adamantly refuse to eat on every alternative day (and sometimes on two out of three days she would just pick at her food without tasting it). Similarly, she would sleep four to five hours one night and the next night, and sometimes the one after, only find two or three hours sleep if she were 'lucky'. Moreover the relative severity of her illness was directly reflected in the severity of overall behavioural disturbance spread over this two-day/three-day pattern, to the extent that this pattern was in evidence. A general pattern that I have witnessed on many occasions with numerous psychotic patients. On the other hand, it has been remarked that a 'neurotic' illness, or tendency, finds itself being expressed in the opposite manner, namely, the desire to sleep twice a day (with a nap after lunch) and the habit to eat six small meals (or in more extreme conditions to eat nine snacks a day with perhaps two or more periods of feeling drowsy in addition to their sleeping at night-time with variable degrees of reported/self-reported success). Assuming such a 'condition' does exist it would appear that the 'normal' circadian rhythm is now experienced in a converse manner to that of the psychotic person, namely, two or three days being expressed over the duration of one. (3)

	Armed with this tentative observation and its provisional interpretation as neurotic in complexion let me now examine this topic in more detail. I would also like to venture into the tentative formulation of unified theory of the personality using work outlined in these last two papers dealing with these topics of psychosis and neurosis. Moreover, in the process, I would like to provisionally propose a third general type of disorder, besides psychosis and neurosis, which I shall call stasis, wherein the individual who suffers from this type of condition is seen to demonstrate an inflexibility in beliefs and practices through an inability to be chaotically flexible in the intentional exercise of their decision-making faculties and who, instead, excessively indulges in patterns of repetitive performance while only generally impairing the ‘quality’ or ‘manner’ of their lifestyle and not the mere ‘fact’ or ‘survival’ of their existence. (4)

1.	A Provisional Phenomenological Interpretation of 'Neurosis'

I would like to argue that a neurotic condition, or in a less severe form, a neurotic complex, is the result of stress, or rather, a person's non-'normal', non-psychotic reaction to the same. In this provisional tripartite scheme of normal, psychotic and neurotic by 'non-normal' I do not mean that it is not normal to be psychotic or neurotic rather 'the normal range of psychic phenomena are bounded by a neurotic boundary on one side and a psychotic boundary on the other'. Moreover, I would like to more closely define the sense of the neurotic as 'an inadequate response to short-term/long-term stress, or, an appropriate response to relatively excessive short-term/long-term stress'. (5)

This should give us the artificial classification of four kinds of neurotic 'reaction'. Let me explore this possibility: (6)

				Short-Term Stress	         Long-Term Stress

							:
Inadequate Response			A		:		C
To Non-Excessive Stress		                	:
							:
………………………………………………………:…………………………							:
							:
Non-Inadequate Response		B		:		D
To Excessive Stress					:
								:

	In type A we have a short period of stress with an inadequate response to the same, namely, an inadequate response that is learnt, i.e., conditioned (and by definition, at least theoretically, a type of response that could be unlearnt [working on the principle that what is learnt can be unlearnt]). No doubt in this type of situation we have all the characteristics of what it means to be under stress complicated by the fact that, normally, under that amount of 'pressure' one should be able to cope [a state of self-reflection further complicated by the implications of a Sartrean 'look', etc., in so far as “one sees ‘one’s self being seen to not be coping’”, etc.]. (7)

	In type B we have a short period of stress of an excessive intensity. Under such a situation it would be natural to be thoroughly stressed out, concerned about how long this excessive degree of suffering had to be endured, to wonder if we are going to be able to withstand this onslaught upon our sense of person, etc. Just like a person upon the field of battle. Physiological responses are going to take some time to return and reach a normal range of balance. But that, under normal circumstances, would be expected. People undergo harrowing times on the field of battle, e.g., but recover their composure in time given the opportunity to do so. (8)

	In type C we have the makings of a long term neurotic disorder. At this point we might like to consider the difference age might make in the manner of such a response [assuming that such traumatic stress in early childhood might predispose the person to behavioural problems later in life, such as certain forms of non-psychotic personality disorders? Adopting the presupposition that ‘the later in life this type of stress then the less socially disruptive the consequences this type of stress might have upon the individual’?] We might also like to include panic attacks in this category (on the grounds that conditioning has conditioned this state of affairs into a state of existence and/or inadequate physiological responses predispose the individual to suffer from the same). (9)

In type D we have the potential problem that excessive stress of an excessive kind might find a form of psychotic 'resolution'. On the other hand, this is not the necessary outcome of excessive stress over a long period of time as witnessed by certain individuals who have been tortured over a long period of prison confinement remaining psychological intact despite such unremitting terror. However, we do need to understand the nature of how some responses might include a phase-transition to a psychotic form of behaviour in those individuals more predisposed to such a 'breakdown' or 're-ordering' in their mental constitution. (10)

	In essence, I would like to argue that a neurotic illness is a certain type of response and reaction to the experience and perception of stress. Whether that stress is excessive or perceived as excessive, or, that response is appropriate or inappropriate, or, that reception of stress is physiologically normal or non-normal, or, that reception of stress is over a short time period or a long time period, or, reactions to the same are adaptive or maladaptive all neurotic like phenomena can be treated as arising form this close association with 'stress'. What implication does this 'fact' have for our understanding of this general condition? (11)

	It would appear that stress is one of the factors, if not the only factor, that is effecting the course of the circadian rhythms in this condition of the neurotic? I would conjecture that stress inhibits the progress of a normal circadian rhythm to reveal shorter wave-like phenomena such as the fractional splitting of the circadian rhythm? I.e., to divide it by a half or by three? Although, perhaps more correctly, merely inhibiting our daily circadian rhythm to reveal how that daily rhythm is made up out the resultant of a series of smaller wave-like phenomena that mirror, in miniature, the circadian rhythm; approximating how it would be spread out over the duration of a day; i.e., increasing/decreasing temperature, hunger, sleep-wakefulness, changes in skin resistance as a result of changes in the dryness or moistness of the skin, etc. (12)

	When working on nightshift I am aware of the persistence of an underlying circadian rhythm, albeit, a set of currents that diminish in intensity to the same extend one is able to turn night into day. Then, soon after finishing work, I retire. It is as if one can have one's cake and can eat it too! Although sleep is not as successful as it would have been if nightshift had not been entered into it is usually more than adequate. From experience and from the accounts of others who work a nightshift I find that there are those who should retire immediately, or at least soon after, on finishing work, and those who should retire later, later in the afternoon. It would appear that under the overall rhythm of a daily circadian rhythm miniature cycles mirror a daily rhythm, a set of cycles that must input into that of the daily cycle. (13)

	Now this complex view of the circadian rhythm accepted we must now ask ourselves what relationship does a neurotic condition bear to a normal one and vice versa, and, what relationship does a neurotic condition have with a psychotic state (and what relationship does a psychotic state have with a relatively normal state of affairs)? Then, we must ask ourselves what is the nature of the change in state, as a phase-change, that allows us to move form one condition to some other state of affairs? Envisaged would be some chaotic-type of phenomenological description where in a complex formula we might be able to adequately model the nature of these states and the nature of their transformation establishing in the process the boundary conditions that allow us to chaotically migrate from one phase (relative normality, neurosis, psychosis) to some other. As previously mentioned under extreme stress some individuals move from a neurotic complex to a psychotic one although it must be noted that the imposition of extreme forms of stress, as in torture, e.g., does not automatically shift the individual, through a change of state from a state of neurotic reaction under stress to a psychotic condition and its attendant loss of connected insight. (14)

	Having thought a lot about this type of problem, what is the nature of the relationship between psychosis and neurosis, I would like to outline my latest solution. Rather than sketch out the tortuous path along which I have travelled in order to reach this current opinion let me, instead, merely spell it out and see if it will survive the test of time. In the process, as a consequence, I believe, I will also have to place before your mind’s eye the possibility of a third general psychiatric condition which I will tentatively call stasis: a relatively milder condition wherein the person looses flexibility in the rhythms of their living in the world and that their circadian rhythms would also probably reflect this lose of chaotic freedom. Presuppositional to this outlook is the work done to date on the (tri-modal) concept of the hermeneutic circle as mentioned in many previous papers. (15)

2.	An Interpretation of ‘Self’ and its Fundamental Psychiatric Disorders
	
Two implications could be drawn from this exposition to date (among a number of others), namely, that a psychosis is in some manner or other a correlative pathological state to that of neurosis as re-defined in this paper, but, that these two states are also relatively independent of, or autonomous from, each other. If my previous observations about circadian rhythms are correct then, in some measure, they are the inverse of each other. At the same time, because excessive stress does not necessarily reverse a neurotic situation into a psychotic state then we must also assume that they are, in some sense, also pathologically distinctive, autonomous, discrete from each other, and, involve physiological foundations that may only impinge on structures and processes that involve similar mechanisms, such as circadian rhythms, etc. That in essence, fundamentally different, but interrelated, processes are involved and/or co-opted in the re-production of either disorder. This granted we might well ask ourselves if it possible to be both neurotic and psychotic at the same time? To answer this question I must tentatively assume that this is indeed possible which would lead me on to ask the following question – what would happen to our circadian rhythms if they were both doubled and halved at the same time? Would this not cancel out both parties from manifesting in this overall sense of self or person? On the other hand the circadian rhythms are complex and must include these harmonic resonances in their constitution, which being relatively autonomous, should not stop them from manifesting to some noticeable degree in a complex overt form? Surely a psychotic person is not immune from neurotically related forms of stress? So the conclusion I must draw is that it is possible for a person to be both psychotic and neurotic, but, all things not being equal, overt psychotic features will normally override overt forms of neurosis (indeed may eclipse them altogether). (16)

Because psychosis cannot be defined as merely the inversion of a neurotic condition, and vice versa, although to some degree also appearing to be implicated (on some more fundamental level of functioning), we must ask ourselves if a third psychiatric condition is also present against which the other two fundamental parties can be negatively co-defined just as in my expositions of the trimodal hermeneutic circle its three dialectical ‘moments’ collectively co-define each other negatively. E.g, like a triangle where angle ‘A’ is ‘not-B’ and ‘not-C’, etc., furthermore, in Euclidean geometry, the angles of all triangles add up to 180o which implies that if one knows any two angles of a triangle one can compute the third angle regardless of the type of triangle concerned. Adopting this archetypal trimodal structure immediately calls forth the need to find a third type of fundamental psychiatric disorder not necessarily the equal in pathological intensity to that of psychosis or neurosis (which themselves not being equal would imply that this third condition is most likely not equal to the aforementioned). But, first, using the model of the hermeneutic circle (and its moments of analysis, synthesis and suspension and other trimodal characterisations of the same in a gestalt frame of reference, noting species of repetition, harmonic theory, etc.) let me try to find polar resemblances between this theoretical work and that of our phenomenological understanding to date of psychosis and neurosis. (17)

For a start, I would like to propose that a neurotic type of disorder focuses the mind in a more analytical, reductive style of reference, whereas, on the other hand, the more fundamental disturbance of a psychotic condition would seem to implicate the background polarity of the synthetic moment. Indeed, the relatively more fundamental disturbance of a psychosis would seem to implicate a relatively more severe disturbance of the overall gestalt field, that, in its ongoing sense of totalisation, would seem to implicate this type of moment rather than the other two. (18)

So, if we are going to look for a third disorder in order to compare psychiatric pathologies of the person it would appear that we are going to need to concentrate on the moment of suspension (which being negatively co-defined by the other two moments would imply that the moment of suspension is both not the suspensions involved in reduction and reconstitution respectively). This moment has also been equated with a sense of self, processes of bare repetition (wherein pattern of repetitive performance are themselves repeated in order to reinforce intentional meaning  and its associated sense of meaningfulness to be found therein), spontaneity, the sense of the present, etc. (19)

With these types of argument and associations in mind let me now define what I would mean by a pathological stasic condition. (20)

3.	Stasis

One dictionary defines stasis in a pathological context as a stagnation in the normal flow of bodily fluids, such as the blood or urine, and in a literary context, as a state or condition in which there is no action or progress, a static condition, hence, dramatic stasis. From this definition I wish to borrow from that type of connotation, namely, blockage, standing still, being locked in, not changing, being inflexible, preferring an absolute routinization of personal/institutional existence, etc. (21)

	In the course of our living in the world with other people we all come across instances of others being relatively more inflexible to some extent or other, appearing not able to change in certain aspects of their lives, etc. That this tendency also inhabits the very territory of our own self. Indeed, life is made easier for us by doing what we have done before. But deep-seated patterns of response are not always going to be appropriate in every situation however similar that situation might appear on a superficial inspection. It is when this tendency takes over and a marked inflexibility, rigidity comes to the fore that I would consider this pathological condition of stasis to be coming to a state of prominence in the presentation of an overall sense of self. (22)

	I have a scientific, and medical, analogy in mind. It is an observed fact that when the heart ceases to respond in a chaotic fashion that it becomes, as a result or as an indicator, increasingly open to a severe disturbance of its function if not its complete disruption and therein that person’s death. In other words, although the heart, in its functioning, might appear to be regular it is its complete regularity that indicates its current pathological nature, so much so that it cannot respond appropriately in a time of cardiac stress with fatal consequences. So, just as an irregular heart-beat is indicative of a pathological cardiac condition so too a perfectly regular heart-beat can also be indicative of a cardiac pathology. The reasoning being, as stated, that the inability to chaotically respond to fluctuations in our cardiac functioning will lead inevitably to an inability to adequately respond to changing cardiac conditions with an eventual disruption in the effectiveness of cardiac function with the increased possibility of an imminent death. (23)

	In a parallel manner I envisage the psychopathological condition of stasis to manifest itself in a form relatively milder than that of a psychosis and possible even less marked than that of an overt neurosis? That characteristic of such a state is a tendency to be non-flexible, rigid in beliefs and practices, relatively non-adaptive to changing situations, etc., with the addition of a tendency to view the world in rather narrow ideal, perfectionist terms of reference. Their hierarchy of immediate needs, as indicated verbally or in practice, overlooking what should be more obvious and more pressing concerns than those adopted concerns that seem to preoccupy and dominate their time and attention in an attempt to re-order the visible world around them and reduce its apparent semblance of discomfiting discomfit. A condition that seems to have some resemblance with that of an obsessive-compulsive complex but which should be differentiated by virtue of the fundamental psychotic nature of the latter. At the same time a neurotic fussiness with details could be differentiated as forms of displacement activity adopted to divert the neurotically predisposed individual from concentrating on more overt manifestations of their neurosis (like a nervous cat licking its paws when it cannot make up it mind as to what to do in an ambiguous and complex situation of stress). (24)

	Although this pathological condition might not be too pathological for those concerned(?)  (and those around such people?) our awareness and self-awareness of such a condition might be helpful in our being able to help them adopt a more flexible, chaotically in tune form of a response (that might too be assisted by forms of ‘insight counselling’ and appropriate use of medication?). Moreover, we need not insist that this tentatively proposed condition always, or ever, manifests itself in a pure form, that, quite possibly, in the general disruption of the effectiveness of the psyche this tendency might too present itself with or without other forms of disruption. That, in effect, in the non-normal disruption of the effectiveness of psychic functioning we should differentiate the co-presence of psychotic, neurotic and stasic features as they appear or not appear to manifest themselves in the disturbed individual (and the not so disturbed or normal individual). (25)

	Now, assuming circadian rhythms are effected in states of psychosis and neurosis, what hypothetical implications can we speculate upon as possibly occurring in this tentatively proposed state of stasis? (26)

	As I envisage the third moment of the hermeneutic circle to be implicated in this condition of stasis, I would propose by analogy with the medical analogy proffered that this state of stasis is, essentially, a chaotically inflexible one through being locked in a super-suspension of reductive suspensions and re-constitutive suspensions. Without wishing to repeat previous work in this field let me simply say that in a suspension we have a balance of two correlative states of affairs. This by itself would lead to a state of psychic paralysis that theoretically, could only be resolved in turn by ‘suspending the suspension itself’. Just as in the zen-like koan of ‘how to get the goose out of a bottle?’ one might answer, “there, it is out”, so too an act of suspending the suspension releases us (the silly goose) from a state of suspension where we would have been left, otherwise, in a state of grid-lock between competing processes in a perfect state of balance, etc. The other states of psychosis and neurosis can also be ‘explained’ by invoking ‘the imposition of non-suspended types of suspension’ (namely, respectively, those of a re-constitutive nature and reductive nature). (27)

4.	Conclusion

With these speculative arguments as presented what is one entitled to conclude? Although insisting on the provisional nature of this research (as the phenomenological nature of all research) let me provisionally argue for the following ‘observations’. (28)

	First, in the formulation of a general theory of the person, a theory an overall sense of self, one would need to take into account these organisational hierarchies of emergent epistemological/psychological activity as outline in my Scheme (or Schema) as presented in my second paper on psychosis and in earlier papers. (29)

	Second, one would in the light of this research argue for three basic types of pathological disturbance in this schematisation of the psyche, namely, psychotic, neurotic and stasic. (30)

	Third, conjoining this research as indicated in points one and two we should propose that a thorough schematisation of the ‘disturbed’, and the not so disturbed psyche or ‘normal’ psyche, we would need to note any aspects in this schematisation of the psyche that appears to demonstrate an overt sense of disturbance (or relative improvement, etc.). It also being essential that a popper and appropriate prioritization also be invoked in our assessment of this information (for a similar set of reasons as noted in the last paper). (31)

	Four, disturbed behaviour of a learnt nature should more likely be treated as neurotic in complexion and treated appropriately in the light of that type of schematisation (e.g., through counselling, behavioural re-conditioning, etc.). On the other hand disturbed behaviour of a psychotic nature should not be treated to processes of counselling except as an indirect adjunct in the treatment of that individual (in so far as life-skills, problems in relationships need to be attended to, etc). Lastly, the treatment of pathological conditions and disturbed aspects of a stasic nature need to be totally rethought - a task which has not been attempted in this paper. (32)

	Fifth, this research needs to investigate how these three fields of the psychotic, the neurotic and the stasic overlap and influence each other (in theory, and, through processes of recognised forms of treatment in so far as these disorders negatively co-define each other, and, in the process, apply to the totality of the (non-pathological/pathological) psyche as previously schematised). (33)

	Sixth, we also need to investigate and formulate the nature of the interactions and phase changes that take place within and between these relatively normal non-disturbed polar states and their states of psychosis, neurosis and stasis both individually and collectively. (34)

	Last we need to re-thematise our concepts of normality in the light of this research in order to understand how these four phases interact with each other as noted in the last two points. (35)

	To finally conclude (and that is not my real objective here other than to end this essay) we can tentatively note, I hope, with some degree of accuracy, that the concept of psychosis has been accurately sketched out if only in a rough format, that the concept of neurosis has been rehabilitated, and, that we need to take into account a third general pathological condition of stasis, even if it proves to be milder than neurosis, but, as introduced in this paper, a potentially more insidious condition by virtue of its relative non-severity and lack of recognition! (36)

A Later End-Note: Some Tentative Definitions of Psychosis, Neurosis and Stasis

	I would like here to supply some provisional definitions.

Psychosis is the same distinctively defective, repetitively patterned mode(s) of behaviour in both periods of that person’s perception of relative stress and non-stress.

Neurosis is the same distinctively defective, repetitively patterned mode(s) of behaviour in periods of that person’s perception of relative stress.

Stasis is the same distinctively defective, repetitively patterned mode(s) of behaviour regardless of periods of that person’s perception of relative stress and non-stress, indeed, stress more often than not arising through an inability to adhere to their daily rituals involved in their living of their daily life.

By same and distinctive is meant the presence of a certain phenomenon, e.g., a psychosis. By defective is meant a general inability to adapt to changing situations and environmental change (within a situation). By repetitively patterned is meant the persistence of the phenomenon in question. By person’s perception of stress is meant what is perceived and regarded as stressful by that person concerned.

Some Observations

1.	Battlefield neurosis should be regarded and treated as a psychosis.
2.	Under stress the psychotic person may actually regain a greater degree of temporary overall integration and reality-based integration with their environment. E.g., a schizophrenic patient in a hospital may be rambling most of the day about CIA operatives, etc., etc., but in the stress of needing their next cigarette can suddenly be ‘with it’ and ask their nurse for one (even though they have previously referred to them as CIA operatives out to poison them, kill them, etc.).
3.	Stress for the stasic person is more likely to take the form of not being able to adhere to their daily rituals for the living of their life. An ability shown by a person to not be stressed by changes in routines ruling out that type of diagnosis. 							    (Noël Tointon, 31.1.04)