Understanding Neuroticism: From Personality Trait to Psychoanalytic Concept

This podcast episode, hosted by Dr. Tracey Marks, delves into the multifaceted concept of neuroticism, primarily exploring it through two major psychological frameworks: the Five Factor Model of personality traits and historical psychoanalytic perspectives. Dr. Marks begins by introducing Lewis Goldberg's Five Factor Model (OCEAN), detailing each trait—Openness, Conscientiousness, Extroversion, Agreeableness, and Neuroticism—as measured on a spectrum. She emphasizes that neuroticism specifically quantifies an individual's vulnerability to negative emotions such as anxiety, depression, and anger, likening it to the delicate nature of fine china compared to stone, highlighting its inherent vulnerability but also potential value.

The discussion then shifts to the practical implications of high neuroticism, stressing the importance of prioritizing self-care and optimizing coping skills. Dr. Marks provides concrete examples of self-care activities, ranging from decluttering and digital detox to setting work limits and improving diet. She also mentions the Big Five Inventory as a tool for measuring these traits, listing specific items related to neuroticism, such as feeling depressed, being tense, worrying, and being easily upset or moody. This section underscores that personality traits exist on a continuum and can be influenced by circumstances, like a pandemic.

Dr. Marks then introduces the older, Freudian concept of "neurosis," which Sigmund Freud, a neurologist, considered a disorder of the nervous system characterized by behaviors used to manage unconscious anxiety. She notes that while "neurosis" was removed from the Diagnostic and Statistical Manual of Mental Disorders (DSM) in its third edition in 1980, it continues to be used internationally in the International Classification of Diseases (ICD) for describing mild mental conditions. This distinction highlights the evolution of diagnostic terminology in psychology and psychiatry.

Finally, the episode touches upon Otto Kernberg's psychoanalytic concept of personality organization, where "neurotic" represents the highest level of functioning, characterized by intact reality testing, mature defense mechanisms, and a stable self-concept. This is contrasted with borderline and psychotic levels of organization. Dr. Marks concludes by reiterating that while Kernberg's and Freud's terminologies are less common today, the Five Factor Model's definition of neuroticism as a proneness to negative emotions is widely accepted, though the term is often colloquially associated more with anxiety due to Freudian influence.

Neuroticism measures how vulnerable you are to negative emotions like anxiety, depression, and anger.

People who are highly neurotic are more prone to depression and anxiety disorders.

Think of it as being more vulnerable to stress, kind of like the difference between having a bowl that's made of delicate fine china versus one that's made of stone.

Similarly, being more emotionally reactive doesn't always have to be negative. There's value to being in touch with your emotions or having your emotions closer to the surface.

If you're highly neurotic, meaning very prone to negative emotional states, you have to prioritize yourself care and optimize your coping skills.

Sigmund Freud, a neurologist, considered a neurosis to be a disorder of the nervous system.

Under this construct, neurotic behaviors are things that you do to manage unconscious anxiety.

Neurosis was taken out of the DSM, or diagnostic and statistical manual with the third edition in 1980.

Neurotic was considered the highest level of functioning with intact reality testing, which means, you know what's real and what's not real, you have mature defense mechanisms, and you have a stable concept of yourself and others.

But I do think that people have come to associate the term neurotic more with anxiety than they do with depression. And that may be because of the Freudian influence.