Is Anyone Neurotic Out There?

breakdownThis is part two in my two-part series on ‘What happens in Psychotherapy’.

In my last article I distinguished between real suffering, which is imposed upon us by loss and fateful external events, and neurotic suffering which is ‘inauthentic suffering’, because we create it ourselves. The good news is, if we create our own suffering and are responsible for our neurotic symptoms of depression, anxiety, loneliness, obsessions etc., we can choose to undo them and heal.


Here’s an example. Many people were raised in a household of emotional chaos. At worst, their parents shamed them or intimidated them, overpowered and controlled them, or rejected and abandoned them, and so forth. In a subtler way, chaos also ensues in a family environment where father or mother were emotionally distant, involved only in their own self-centered universe or lost in frantic activity, which is the disease of our times. By the way, psychotherapy is not about parent bashing, but it is about having our patients make an accurate and realistic assessment of where they came from. Our parents were wounded too, and they just passed it on, most of the time without conscious intent.

The defense against Chaos is Control!

The child tries to control his or her limited universe as much as possible. This makes sense in childhood and is a healthy response to a crazy family situation, but using power and control over others in adulthood leads to neurosis and isolation. So how does the adult neurotic control? There are many ways… i.e. through tyrannical control over others at work or at home, through intimidation and more poisonously through giving guilt, malingering, passive-aggressiveness and other devious manipulations. At bottom, neurosis is an ethical and moral problem. I know, I’ve been there.

In order for the neurotic to heal, he has to cop to being either overtly or covertly tyrannical, to being manipulative and often ruthless. This is a Herculean task because the ‘neurotic tyrant’ often views himself to be a ‘nice guy’. For those brave souls, who can actually cop to their dark side and acknowledge that they’re not who they pretend to be, the rewards are awesome. Their neurotic symptoms of depression and anxiety will drop by the wayside. They regain freedom by finally taking responsibility for their lives and lose interest in controlling the lives of others. Our personal strength doesn’t come from what I call the ‘General Manager of the Universe Complex’ nor does our inner authority come from trying to control others and external events.

The brilliant bohemian psychologist Sheldon Kopp had this to say: “Neurosis is continuing to act as if we were coping with the problem of childhood. As grownups the world is not the same as in childhood…Neurosis is a way of behaving badly without feeling we are to blame.”

The art of psychotherapy comes in telling patients painful truths about themselves they don’t want to hear. This can only occur when there is trust and caring feelings between doctor and patient; without trust and love nothing happens. Intuition, the doctor sharing his own neurotic detours in life, as well as nighttime dreams can be very helpful. Sometimes only luck or the grace of God can intervene successfully. If we interpret our patient’s ‘controlling tyrant’ too early, they leave therapy pissed off because they are not ready. You can’t grow grass by pulling it. If we interpret too late, our patients leave because they don’t get better. The old cliché, ‘Timing is everything’ is especially true in psychotherapy.

Finally, there are two artists who have their own view of treating the neurotic condition. The first is Blues artist, Keb Mo: “If nobody loves you And you’re feeling like dust on an empty shelf,  just remember you can …. love yourself.”

The second one is the soulful German poet Johann Wolfgang von Goethe, “Whatever you want to do, or dream you can do…begin it! Boldness has genius, power and magic in it.”

Dr. Peter Milhado  © 2012

6 thoughts on “Is Anyone Neurotic Out There?”

  1. I came across your site by accident — actually just wanted to confirm a reference I am making to Lacan’s 2 classes of neurotics in a book I am finishing. Your description of the art of psychotherapy fits with a view of the good of good conversation that I am examining as a redemptive cultural practice. Your straight ahead clarity more sophisticated than less artful more tech. correct approaches can grant.

  2. I have stumbled across this webpage by the grace of my God. I am currently finishing up reading my favorite book to date for the second time around. If I had discovered this webpage three years ago, I wouldn’t have given it a second glance. I find your content refreshing. It allows me to travel down the less traveled road of my youth. As i sit in tears, I can only state my appreciation. Thank you.

  3. Cristina Duncan

    Thank you for making things (and writing them) simple. Two patients have canceled their appointments today and I’ve been able to finísh reading your posts. They’ re refreshing, wise and beautiful.

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