Karen Horney’s Magnus opus: Neurosis and Human Growth (1950) has to be one of the best writings produced by the psychoanalytic movement. It is the culmination of clinical observations made by Horney at age sixty five; it is a magnificent summation of everything that she had learned at that point in her illustrious psychoanalytic career. Two years after the publication of her tour du force she died (1952). As it were, she had given the world her best and moved on. What a heroic way to exit: give the world your all and then move on!

It is hard to add anything else to Horney’s description of neurosis and the neurotic process; she essentially said it all. However, what she left out and what she probably did not understand is the role of biology in the etiology of neurosis (and all mental disorders).

Horney’s approach to neurosis was essentially sociological and cultural. In her view, the nature of the culture children live in and how children are socialized is largely responsible for what kind of personality they develop. She is largely correct: culture plays a role in the genesis of personality, but biology plays a greater role.

While accepting Horney’s excellent description of neurosis, and accepting her description of the contribution of culture in the etiology of human personality in general, this paper adds the missing ingredient in the origin of neurosis (and personality in general), the human body. Until we factor in the role of the individual’s inherited body into the causal equation, we cannot fully understand the human personality, healthy or disordered.

Those that develop the neurotic personality that Horney described rather well are those born with certain biological deficits. Those deficits are not only deficient neurotransmitters, as contemporary reductive psychiatric would have us believe. Indeed, the deficient neurotransmitters that neuroscientists harp on may be secondary response to other biological disorders. For example, diseases that produce excessive pain for the individual also arouse his fear of death and fear is manifested as anxiety disorder and shown at the biochemical level as stimulation of the nervous system(less GABA and more adrenaline).

If a child inherits a body that is inordinately prone to pain, say, due to spondilolysis, he may develop the neurotic traits that Horney described. Given a weak and pained body, the child is not going to be able to successfully adapt to the physical challenges of our world. He would, in Alfred Adler’s (1999) terms, feel inferior. He would feel that as he is he is not good enough. He would feel his life threatened, as if he is about to be snuffed out of existence. He would feel greatly vulnerable.

Feeling very vulnerable the child whose life is threatened by inherited biological disorders would use his thinking and imagination to visualize an alternative ideal self that if he were him, he would meet the challenges of living on our impersonal earth, a place where the fittest survive and weakest die out.

Our physical world requires strength to adapt to it; our society is competitive; the physically challenged child may feel unable to meet these challenges. The physically challenged child uses his thinking and imagination to construct an idealized self image, a self he thinks is able to overcome the exigencies of living on this uncaring world.

In time his wished for ideal self image is confused with who he, in fact, should be. He comes to think that he should become his idealized self image and employs the various ego defenses (repression, suppression, denial, dissociation, displacement, rationalization, intellectualization, sublimation, reaction-formation, fantasy, avoidance, pride, guilt, shame, fear, acting out etc; see Anna Freud, The Ego and its Mechanism of Defense, 1980) to defend the imaginary idealized self image.

Once the idealized self image is constructed, usually before age six, the child’s personality and future development is now geared towards actualizing that imaginary but wished for ideal self. As Horney correctly pointed out, such a child is now neurotic in the sense that his pattern of growth is geared towards actualizing an imaginary ideal self, not realizing his innate potential, his real self (Maslow, 1970); indeed, he is now doing everything he could to alienate himself from his real self.

In a healthy pattern of growth, the child aims at actualizing his real self and his inherited potential; in a neurotic pattern of growth, the child wants to realize an imaginary ideal self. (The term neurotic is generic; it applies to all human beings, in degrees. No human being can exist on planet earth and escape some neurosis.)

Neurotic thinking and behavior patterns are predicated on realizing the individual’s idealized self concept.

The idealized self, generally rigid and inflexible, is pursued in a compulsive manner, for the false has to be defended for it to seem real. The real self is lived spontaneously, for it is the natural expression of nature in the individual. The ideal self is a false self, an artificial mental construct and for it to seem real must express itself in a pressured manner. The neurotic lives as if an inner force that he cannot disobey compels him to be the false ideal self he wants to become.

As it were, the neurotic has an inner slave master pushing him to become his idealized self or else he is punished; he feels that if he is not like the ideal self that he would die out from existence. As it were, his life now depends on him becoming the ideal self.

A self that he himself constructed, a self, as George Kelly (1955) pointed out the child uses his biological and social variables to construct, has become the neurotic’s slave master. What creature human beings are; they invent false social selves and feel obligated to becoming them; they become slaves to their own constructs!

The idealized self invents ideal standards of behaviors, what should be, as opposed to what is. The neurotic feels compelled to live up to the standards of his idealized self and its idealized standards of behavior. The neurotic lives under the tyranny of how he should behave.

(Who said that the neurotic should behave thus? His idealized self said so. Of course, that idealized self’s impossibly perfect standard is constructed with society’s misguided perfectionist moral standards.)

The ideal self and its imaginary ideal, perfect standards are used to judge the real self and other peoples real selves. Nobody is ever found good enough relative to the idealized standards of morality.

Religion comes into the picture and reinforces the neurotic’s movement towards absolutes by giving him the impression that there are absolute standards of behavior that human beings must approximate to please religion’s imaginary gods.

(If gods existed how come they allowed the neurotic child to inherit a pained body?)

The neurotic child constructs an absolutistic, perfect moral system and believes that it is approved by his imaginary god and imaginary ideal society and uses that imaginary ideal standard to judge his every behavior, judge other peoples behaviors and judge everything in his world.

If you judge the imperfect real self and imperfect real world with idealized standards you would necessarily find them not good enough.

Finding other people not good enough, the neurotic, who has by now identified with his idealized self, feels superior to other people, for they do not live up to his idealized self for them.

Indeed, the idealized self feels superior to the neurotic’s real self, for his real self does not live up to the grandiose image of the ideal self.

The trap is set and complete: the neurotic is now living in tremendous psychological pain; he is now living in a world of inevitable frustrations for what he wants to become, ideal self, is not what he, in fact, is; what he wants other people to become, ideal selves, is not what they, in fact, are; the ideal social institutions he wants to see in place are, in fact, not what exists in the world; he despairs from not attaining his ideals.

The neurotic posits ideals for himself and for everything that exists in an imperfect form and attempts to approximate them and to get other people to approximate them and since no real human being living in flesh and blood could live up to his mentally constructed imaginary ideals, he is disappointed by reality. The neurotic wants reality, imperfection, to go away, so that his wish, perfection, would exist.

In Henry Thoreau’s words, the neurotic lives a life of quiet desperation, a life where nothing is ever quiet good enough for him.

Yet the neurotic struggles on, trying to become his idealized self, to get other people to become his idealized selves for them and to get the world to become his idealized image of it. Given the frustration and psychological pain that the neurotic experiences from not been able to realize his idealized self and world one would think that if he were reasonable that he would give them up? But he does not give them up. Indeed, even when psychotherapists urge the neurotic to give up his ideal goals he fights to keep them, to retain that which gives him nothing but pain, stress and mental illness. Why so?

NEUROTIC GOALS GIVE FALSE WORTH AND MEANING

The pursuit of his ideals gives the neurotic a sense of value and worth and gives his world purpose and meaning. (Sartre, 2003) This is false worth and meaning, of course.

The point, though, is that if the neurotic did not pursue his idealized self and idealized world he would suddenly feel that his life is meaningless and purposeless. He would confront reality, as it is, a reality he had wanted to escape from. (Camus, 2003)

Neurosis is largely an effort to deny reality and replace it with what the individual would like it to become.

The human reality is imperfect and the neurotic wants to replace it with a perfect reality. In reality we are always weak and vulnerable. We are born and will die. Our body is food for worms. In absolute terms, our bodies are valueless and worthless and life in body is meaningless and purposeless (except the pseudo meaning and purpose we give to it).

The neurotic to be child is generally a very sensitive and perceptive child and is acutely aware of the meaninglessness of being on planet earth and tries to replace it with a self constructed meaningful life.

Thus, as painful as the pursuit of his neurotic meaning is, the neurotic prefers it to the alternative: a meaningless world.

Karen Horney, of course, was not a philosopher and did not get to the point I am talking about here. She stopped at mere psychology, at description of neurotic process but did not explore the philosophical underpinning of neurosis. (Laing, 1960)

The neurotic is conscious of a meaningless self, his and other people’s, and a meaningless world and tries to use his imagination to come up with what seems to him a worthwhile self and a meaningful world.

As it were, neurosis is an individually invented religion; it is religion in the sense that the individual constructs it and uses it to give his life what religion gives mankind: worth and meaning.

Human beings know that they would die and rot; they know not what happens when they die; they feel worthless and meaningless.

Religion, as Sigmund Freud (1996) point out in the Future of an Illusion, comes to their rescue and gives them worth and meaning via positing an imaginary after death existence and its imaginary gods.

Eric Fromm (1947) correctly understood that neurosis is a personal religion, whereas what we generally call religion is neurosis for the normal crowd.

For our present purposes, the salient point is that if the neurotic were to give up pursuit of his imaginary ideal self, ideal people, ideal social institutions and ideal world he would recognize what he was trying to run away from: the intolerable meaninglessness of being on planet earth. (Existential thinkers like Sartre, Camus, Jasper, Heidegger, and Kierkegaard have explored this matter.)

If the neurotic gave up pursuit of his false idealized goals, he would become existentially depressed. To avoid feeling depressed he clings to his imaginary ideals, just as the normal person avoids existential depression by clinging to the imaginary postulations of religion. (Meissner, 1994)

Not too many people can cope with existential meaninglessness without trying to escape from it.

In psychosis, the individual confronts his personal worthlessness and valuelessness, confronts the meaninglessness and purposeless of being and feels an urge to construct worth and meaning for him and believe in his imaginary worth. The psychotic uses his thinking and imagination to invent an imaginary self and imaginary world, a self and world that makes his existence seem important and actually believes in those fiction.

The neurotic wishes for his imaginary self and world to be real but knows that it is not real; the psychotic, on the other hand, believes that his imaginary self and world is real, hence has broken away from reality and is now living in a fantasy world.

The neurotic is aware of the fact that his idealized self and world are imaginary but compulsively seeks them; he has not yet lost the ability to test reality, as the psychotic has. The psychotic takes his fictions as true.

To heal neurosis, obviously, the individual has to embrace his worthless body and meaningless self, he has to accept existential nothingness and live with that reality. Life on earth is nothing; it has absolutely no worth and meaning; escaping into fictional worth and meanings is an illusion.

Neurosis and psychosis are attempts to replace unpalatable reality with ideal illusions of it.

Normalcy also replaces unpalatable reality with an illusion, but a shared social illusion (such as religion).

THE HUMAN PERSONALITY

The human personality, ordered or disordered is an adaptation to the realities of the individual’s body and society.

Body and society are contingent variables; they are changeable and not permanent. The individual could inherit a different body and could be born in a different society. If the individual has a different body and social experiences he would develop a different personality.

That is to say that personality is a contingent variable and not a permanent state. That, which is contingent on other variables, is changeable and not permanent and is fleeting and transitory, by definition, has no intrinsic value.

The human personality, the ego, the sense of separated self, is nothing important. Its lack of importance is demonstrated by the fact that nature treats it as such: tsunamis, earthquakes, floods, hurricanes, tornadoes, draughts, famine, diseases, germs etc snuff out the human body and personality, as they snuff out animals and trees.

If an individual decides to kill other people he does so and no god would stop him. Adolf Hitler and Joseph Stalin, two fiends, decided that they enjoyed killing people and killed millions of people and no god stopped them. (They were stopped by other human beings, those who wanted to avoid been killed.)

Simply stated, the human body and its personality are not special; whatever we think that they are, are imaginary mental and social constructs that are not validated by nature. Europeans wished to enslave Africans and did so and no god stopped them. (They rationalized their crime with all sorts of imaginary notions of their alleged superiority and African inferiority; one would think that if they were, in fact, superior, they would care for others, rather than exploit and kill them.)

Existentially, man is nothing special, and that is the gospel truth. Nevertheless, there seems an intelligent aspect to human existence. There is an intelligent element in the human life that employs the human body and social experience to construct the individual’s self concept, self image, and personality.

What is that intelligent force? Some say that it is spirit; others say that it is an epiphenomenal throw up of the biological processes of the human body. Whatever it is, what is self evident is that it is inventive, for it invents the human personality, the individual’s self concept and self image and uses them to operate in this world.

ONE SHOULD NEVER SUBSUME ONES IDIEAS IN OTHER PEOPLE’S IDEAS

Each human being is a unique manifestation of life in a human body. The configuration of his body and social experiences gives him a unique experience of life on earth and a different perception of phenomena. He cannot see the world as other people see it.

Unfortunately, society has a need for unification of perception. Apparently, to get all people to see the world in a similar manner makes for social cohesion. Thus, most societies socialize their children to ignore their unique experiences and perceptions and conform to whatever is the accepted socially constructed reality.

Whereas conformity to accepted social constructs makes for social stability, it is the greatest mistakes human beings have made in their sojourn on planet earth. It retards human progress, it destroys knowledge. (Schopenhauer, 1818)

The individual should never subsume his perception of reality, his ideas, in other people’s perception. If the individual negates his perceptions, his personal reality, he has negated his uniqueness and has become a thing, and is no longer a being.

Education, religion, psychology, philosophy, science etc all attempt to get the human child to conform his perception and thinking to how the dominate figures of his society wants them to be. The typical child, especially the so-called normal child, easily slides into the social norm.

In encouraging children to conform to its dictates, society stifled creativity. Knowledge grows when each human being articulates his understanding of phenomena and, hopefully, tests it in a scientific manner and accepts only demonstrably realistic ones. (Popper, 1963)

Psychoanalysis, as posited by Sigmund Freud (1961), persecuted any one who did not conform to Freud’s largely false views of phenomena (such as the persecution of Adler and Horney; both were expelled from the psychoanalytic movement for stating the truth as they saw it).

Behaviorism (Skinner, 2002) came along and reduced complex phenomena, particularly human beings, to an aspect of it. Human beings do learn; extrapolating from that fact, behaviorism concludes that human beings are nothing but what they learn.

The fact that man thinks and imagines things is ignored for we cannot test those variables. Well, the fact is that human begins are thinking animals and do think about themselves and their world. Their personalities are a compendium of their thinking and behaviors, not an either or.

Now we are in the age of neuroscience. Behavior is now reduced to the dance of neurotransmitters. If you are anxious (neurotic) there is excess excitatory neurotransmitters (say norepinephrine) and deficit of inhibitory neurotransmitter (say GABA) in your brain. You are given medications (anxiolytics, such as Xanax, Valium etc) and they calm your anxiety down and addict you to the medications and produce terrible side effects for you.

If you are depressed you have shortage of serotonin and you are given serotonin boasters. If you are schizophrenic you have too much dopamine and you are given medications to reduce that neurotransmitter in your brain. If you are manic you are given medications to reduce excitatory neurotransmitters in your central nervous system.

Most physiological disorders impact the workings of the brain; thus the brain disorders observed by neuroscientist may be secondary systemic response to other biological disorders. In this light, it seems that Psychiatry has placed the horse before the cart and now treats brain chemical imbalances rather than the medical disorders that may have produced those imbalances.

In neurosis (Shapiro, 1999) the child inherited biological disorders that upon encounter with the environment make him feel pained and weak. His mind goes to work and assesses environmental reality correctly. In our impersonal world, if you are not strong the chances are that you would die. Nature selects for the survival of the fittest, the weak die.

The human child recognizes that he is weak and could die. He does not want to die, so he uses his thinking and imagination to invent an imaginary idealized self, a self that fictionally conquers the exigencies of his world.

Once the human child creates the idealized self he strives to actualize it. In trying to actualize the imaginary ideal, perfect self, he is now neurotic; he experiences secondary psychological pain from not being able to realize his idealized self concept and its image. He is caught in a no win situation, for no matter what he does he could never become his idealized self. Yet he desires that idealized self for it is a self that enables him seem to cope with the implacable exigencies of this world, a self that seems to make his life meaningful. To give up pursuit of his idealized self is to accept that which he was trying to escape from, his weak, pained and vulnerable self.

The neurotic is caught in a vicious cycle. He must strive after his neurotic goals, his desire for superiority and ideals yet in doing so he guarantees his personal suffering.

REALISTIC PSYCHOTHERAPY

The function of psychotherapy is to help the neurotic, all human beings, to give up the pursuit of illusions and accept reality, as it is, imperfect. Accept your real self, accept other people’s real selves, and accept the world as it is, all imperfect, all meaningless and purposeless. In accepting this imperfect and meaningless reality and not hoping for perfect illusions to replace them, the individual feels relaxed, peaceful and happy. A heavy weight has been lifted off his shoulders; the pursuit of the imaginary ideal is taken away from him. Reality is terrible but it can be lived with.

HORNEY’S DEFINITION OF NEUROSIS

At the outset, one should point out that what Horney called neurosis, indeed, what psychoanalysts called neurosis, has been broken down to many nosological categories.

In 1952, the year that Horney died, the American Psychiatric Association came up with the first edition of its Diagnostic and Statistical Manual. Many editions of that manual have been drawn up. What psychoanalysts used to call neurosis can now be found in the various personality disorders. (DSM, 1994)

Horney had talked about three basic patterns of responding to the exigencies of life: moving towards people, moving against people and withdrawing from people. We can pretty much divide the ten personality disorders into these three categories. Schizoid, avoidant and obsessive compulsive personality disorders can be considered moving away from people.

Paranoid, antisocial and passive aggressive personality disorders can be considered moving against people.

Narcissistic, histrionic, borderline and dependent personality disorders can be considered moving towards people.

The avoidant personality posits an idealized self and that false ideal self is afraid of other people’s rejection and experiences anxiety at the prospect of rejection and to avoid rejection and anxiety keeps way from other people; in social withdrawal the avoidant personality retains his grandiose false ideal self.

The obsessive-compulsive personality posits a grandiose perfect self and experiences anxiety because he cannot attain that ideal self; he avoids people in an effort to maintain that false ideal self.

The schizoid personality avoids other people and in social isolation maintains the fiction of having a self sufficient ideal self.

The paranoid personality posits a grandiose self and imagines that other people do not acknowledge that self and is fighting with them for not validating his false ideal self.

The antisocial personality is angry at people for not taking care of all his needs and affirming his grandiose self and does bad things to them out of that anger.

The passive aggressive personality feels angry at people for making him deny his true self and live a mask of a pleasing self and gets back at people by obstructing their goal attainments.

The narcissistic personality moves towards people by always seeking their approval and admiration; he presents a false ideal self for them to approve.

The histrionic personality pretty much does what the narcissistic person does, presents an idealized self based on a pretty body for the people to approve.

The borderline personality wants every person to accept and care for her or else she harms herself to make other people feel guilty and out of guilt take care of her.

The dependent personality says that she is so weak that other people ought to lead her.

The salient point is that what psychiatry now calls personality disorders (as well as other disease categories) can be subsumed under Horney’s conception of neurosis.

Horney talked about the various aspects of neurosis: the neurotic search for glory (the desire to become as important as the ideal self), the neurotic claim of specialness, the neurotic should (I should be perfect, I should be special, I should be ideal), the neurotic tyranny of should makes the neurotic a miserable person, for he never lives up to his should. Neurotic pride system (the neurotic takes pride in being his idealized self and wants other people to validate that special self, the elevated important self and easily feels slighted if the imaginary ideal self is not affirmed by other people). The neurotic self hatred and contempt for the real self (the neurotic hates his real self and admires his ideal self; he has contempt for the real human being and wants to kill it off and replace it with an imaginary ideal self). The neurotic alienation from the real self (the neurotic denies his real self and tries to live as if he is his imaginary ideal self and acts as if he is that alternative self that he is not).

The neurotic employs the various ego defenses to protect and defend his imaginary ideal self and to the extent that he seems to be like the ideal self he appears functioning well but he does so at the expense of his mental health. No one can be mentally healthy who has attacked and tried to kill off his real self.

The pursuit of the idealized self disturbs the individual’s interpersonal relationships; the neurotic is almost always fighting with those other people who do not seem to validate his ideal self. The paranoid neurotic, for example, wants to seem a grand self and is angry at those who do not seem to affirm his imaginary important self; he could kill you if he thinks that you are treating him as a nothing special. (Swanson et al 1970)

At home the neurotic is always disturbing his relationship with his family members, his wife and children, because he wants them to see him as the ideal person he wants to be but is not, and, thus, forces every person in the family to be playing games with him, to wear masks. He feels angry and flies off the handle if he thinks that his imaginary self is not respected by members of the family. His family environment is always tense and lacks peace.

The neurotic has disturbed work relationships. The person who wants to be ideal and all important obviously is going to have problems respecting his work boss and will end up having difficulties with the boss and his coworkers. Generally, the neurotic does not have a harmonious relationship with his coworkers.

All in all, the neurotic has a problematic social life.

Horney’s idea of therapy for the neurotic is very simple: the neurotic must let go of his identification with the false ideal self. He should not try to be who he is not.

One should not try to actualize an idealized self that one cannot become no matter what one does, any way. Let go of the ideal ego and be yourself.

The healthy person, as Horney sees him, is a person who embraces his real self.

Horney provided us with a theory of the human personality. This theory holds that human beings have real selves and that the exigencies of living in a society that insists on accepting them only when they are ideal makes them pursue ideal selves and in doing so become neurotic. For people to become mentally healthy and incidentally physically relaxed they have to give up the pursuit of the ideal self and live as their real selves.

Horney really did not tell us what constitutes the real self other than say that it is the authentic individual that lives spontaneously and not compulsively.

WHAT IS THE REAL SELF?

Towards the end of her life, Horney dabbled in Zen Buddhism and, like Eric Fromm, took trips to Japan and explored Zen with the Zen master Suzuki. It would have been interesting if she lived longer and practiced Zen Buddhism long enough to experience (in meditation) what Zen calls Satori (and Buddhism, in general, calls Nirvana, Hinduism calls Samadhi and Christian mysticism calls unified experience). (Underhill, Mysticism, 1911, Schucman, A Course in miracles, 1976)

Horney was operating under the paradigm of science. That paradigm does not speculate on what cannot be verified in the empirical world of here and now. Such ideas as God, spirit, life after death etc are not verifiable through the scientific method, so psychoanalysis and science in general avoid talking about them.

Yet we know that the religions of mankind postulate what they call God and a spiritual world. Hinduism talks about a unified state that is not in form, is spirit. To Hinduism and Buddhism the real self is unified self, a self that are simultaneously one and infinite in numbers (See the Gospel of Ramakrishna by M.). That one self cannot be understood by the categories of our separated ego world.

THE FAILURE OF EMPIRICAL PSYCHOTHERAPY

The reason we need to focus on the non-empirical is that it seems that Western psychology, alone, does not heal any one. Western psychology is descriptive of mental disorders but so far does not know how to heal them.

Generally, neurotics find healing when they let go of their pursuit of ideal selves and submerge themselves in the world of religion. Those who submerge themselves in what religions call God, accept that God created them and that they did not create themselves, let go of the idealized selves they invented to replace their real self (spirit) and generally do what the various religions ask them to do: love God (love the whole) and love people (love the parts) tend to heal their neurosis. The neurotic is alienated from the human group and from the world. When alone feeling neurotics join religious groups, they obtain a sense of belonging to a large whole, and to the world. Human beings tend to feel secure in groups and insecure outside groups. As Fromm pointed out in Escape from Freedom, human beings who feel alienated from other people and from nature often extinguish their nascent individuality in political and religious organizations that give them a sense of belonging.

Clearly religion has a better track record of healing neurosis than psychotherapy. This is not to say that religion and what it teaches is true; but just to say that psychoanalysis, behaviorism, neuroscience and other aspects of Western psychology do not improve the lives of neurotics (and psychotics). Something must give, an alternative must be found to help people feel healed from their neurotic anxiety.

In other writings, I explored the nature of that alternative approach to psychotherapy. While accepting science, I sought to explore the possibility of life existing outside our bodies. I called that approach a combination of secular and spiritual psychologies. This is not the place to explore spiritual psychology. Suffice it to say that I believe that the real self is not merely epiphenomenal, that it is independent of matter though when it operates in matter, in our bodies, is limited by matter, space and time, as in our limited psychological selves, our imperfect personalities.

CONCLUSION

The exigencies of human life on earth makes all of us feel that our real selves, whatever those are, are not adaptive and or good enough. Most of us wish that we had alternative ideal selves that if we were them would enable us successfully navigate our lives on earth. Unfortunately, life is not art, though it imitates art. No matter how much we wish to be god-like and perfect we remain inadequate and imperfect creatures, creatures limited by matter, space and time. We cannot even lift our hands if the wind pressure is strong enough. Simply stated, to be a human being is to be weak, inadequate and imperfect. This reality not withstanding, human beings strive to be powerful and perfect. They use their thinking and imaginations to invent powerful, superior and ideal selves and want to become them.

The normal person has an ideal self that approximants his real self more than it deviates from it. Those who inherited more problematic bodies tend to reject their bodies and invent totally idealistic selves that are not related to their weak bodies and want to become those ideal selves. These behave as if they are their ideal selves and generally act as if they are their imaginary ideal selves. The neurotic wishes to be ideal but, fortunately, knows that he is not ideal. The neurotic is unable to accept his weak imperfect self or completely identify with his imaginary ideal self; the result is that he lives in terrible conflict, to be real or to be ideal?

On the other hand, some unfortunate human beings somehow come to believe that they are their imaginary ideal self concepts and self images. These reject that they are, in fact, and now think that they are the selves they want to become. Thus, we see psychotics claiming to be Jesus Christ, Napoleon and any other personage what they and society associates with power and perfection.

As long as people pursue ideal selves they live in psychological pain. The solution to this problem is for people to give up their mentally construed ideal selves and accept who they are, in fact: limited, imperfect selves and live as such.

Alas, society keeps giving people the feedback that as they are is not good enough. In our competitive society, we are told that we have to live up to certain socially approved images before we are accepted. Society contributes to our neurosis and psychosis.

As Carl Rogers (1951) pointed out, we need to change society so that it accepts all people in an unconditionally positive manner. However, this is easier said than done. There are certain behaviors that society would never approve, not if it wants to remain in tact. No society, for example, would approve murderers, rapists and thieves.

In the real world, there must always be some conditional acceptance of people. What this means is that some children would always grow up rejecting aspects of them. Neurosis will always be part of the human make up.

I accept Karen Horney’s psychological constructions. However, she ignored the biological dimension to the etiology of neurosis. I know from practical experience that children who tend to have more self rejection and pursue exaggerated ideal selves tend to be sensitive children, children who inherited problematic bodies that made them feel weak, pained and or are easily somatically aroused (some are quicker to fear response, to stress response etc). Biology plays a role in the genesis of neurosis; there is no doubt about that.

It is necessary to emphasize the contribution of biology in the genesis of neurosis lest neurotics think that merely listening to talk psychotherapists that they are going to become like normal persons. No, their bodies played a role in their neurosis and they need to accept that fact.

Another dimension to neurosis and all mental disorder is existential meaninglessness. Acute observation of the human condition leads to the awareness that life is meaningless and purposeless. Our bodies are valueless and worthless. Folks try to hide these ugly facts from their immediate awareness by positing false ideal self concepts and self images and pursuing those.

Nobody wants to think of his worthlessness and meaninglessness. To think about this ugly aspect of reality as it is depressing.

To avert depression and possible suicide, folks run into neurosis. Consider the paranoid person who thinks that he is an important person. Actually, deep down, he feels like he is inadequate. His grandiose persona is a mask over his underlying sense of inadequacy. If he removes his mask of greatness he experiences his underlying depression.

What to do? Leave people to wear their masks of importance and idealism. But for those who can handle it, let them know that we are nothing and for us to have the courage to live with that fact.

We do not need false masks to cover our existential reality; we do not need the sop of religion or neurosis to live, we can live as we are, nothing; we can have the courage to accept our nothingness and in it be at peace and joy.

Clearly, no human being is going to be perfectly healthy (health is conceptual and not a fact) but the neurotic who has understood the nature of neurosis and stopped trying to become an ideal self and simply lives through his real self tends to live a happy, peaceful and productive existence; he tends to have harmonious relationships with other people. He is no longer devoting enormous psyche energy defending a false ideal self and is now more able to produce goods and services that serve society’s welfare.

The psychotherapist, such as Horney, who helps people to remove the obstacles to their living more productive lives, serves a useful social function. Horney’s work has made human living more peaceful, joyous and productive. For her contribution to human psychological well being one says thank you.

Ozodi Thomas Osuji

February 20, 2007

FOR FURTHER READING

Adler, Alfred (1999) The Neurotic Constitution. New York: International Library of Psychology, Routledge.

Allport, Gordon (1961) Pattern and Growth in Personality. New York: Harcourt College Publishers.

(1975) The Nature of Prejudice. Westport, CN: Greenwood Press.

American Psychiatric Association, Diagnostic and Statistical Manual, (1994) Washington, DC. American Psychiatric Press.

Ansbacher, Henz .L. and Ansbacher, Rowena, R. (1964) The Individual Psychology of Alfred Adler. New York: Harper Torchbooks.

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# 1 Karen Horney’s Magnus opus: Neurosis and Human Growth (1950) has to be one of...Read the full article. Posted by Robot| 20.02.2007 17:00