Commentary on "Neurosis and the Historic Quest for Security"

Jeff Mitchell’s article tackles the very important task of developing a psychosocial conception of mental problems by focusing on the interweaving of social roles and personal identity. We hope that this important task will be pursued further despite the challenges it imposes on anyone who is so ambitious to undertake it. We have serious reservations about the success of Mitchell’s particular approach, however, in spite of our admiration for the interesting use he makes of Rose Laub Coser’s fine book, In Defense of Modernity: Role Complexity and Individual Autonomy. It would have been nice to see Coser’s work supplemented by Peter L. Berger and Thomas Luckmann’s pithy study, Modernity, Pluralism and the Crisis of Meaning: The Orientation of Modern Man (1995).

We shall focus our reservations regarding Mitchell’s approach on three topics: (1) the usefulness of the term neurosis; (2) the limitations of Karen Horney’s ideas; and (3) the explanatory connection between cultural values and neurosis.

The Usefulness of the Term “Neurosis”

In order to refer to a broad range of mental difficulties Mitchell employs the word neurosis. We, however, find ourselves among those “readers who would prefer we abandon” the term because of its “motley past.” Mitchell, while conceding that problems plague the concept, opts for retaining it for a variety of reasons. We think that the reasons Mitchell cites for retaining neurosis are, on the contrary, better reasons for avoiding it. He writes, “Due to its popularization by psychoanalysis, the word has long since passed into common parlance, and so is now part of a cultural heritage that far exceeds the limits of professional psychology and psychiatry.” But its use in common parlance is extremely vague, and such vagueness is precisely what is not needed in an essay like Mitchell’s. His essay cuts such a broad theoretical swath that the reader has difficulty seeing just how his approach really helps the psychiatrist. Given this need to see his position’s real applicability, Mitchell’s terms would profit from a more exact meaning, not a less. Mitchell is explicitly aware of the “ambiguity” of the word neurosis, as he is of the “fairly large net” his theory casts. But surely then the individual lines of his large net need to be closely tied if both big and little fish are not to escape through it. Rather than employing a term whose vagueness obscures so many important distinctions, we think that Mitchell should have focused on particular mental disorders that most psychiatrists would today concede to be realities.

The Limitations of Karen Horney’s Ideas

We think that Mitchell takes a decisively wrong turn when he adopts Karen Horney’s conception of neurosis. Horney’s position unequivocally pinpoints a single social institution, the family, as the site of neurotogenesis. As Mitchell summarizes Horney’s view,

Under favorable conditions—a familial atmosphere of warmth, good will and caring restraint—children are able to grow according to their “individual needs and possibilities.” . . . A great variety of adverse conditions can warp the course of a child’s personal evolution—parents may be too authoritarian, overindulgent, erratic, play favorites among siblings, etc. Although the sources of psychological stress on the infant are multifarious, they all originate from the same fundamental shortcoming: The rearing adults are too involved with their own neurotic problems to be able to give the child thoroughness, love, and accompanying insight it needs to flourish

(italics added).

If a person is neurotic, it is because of his or her “rearing adults.” Similarly, if a person is mentally healthy, i.e., has grown according to his or her “individual needs and possibilities,” it is because of the family, with its atmosphere of warmth, goodwill, and caring restraint. By adopting Horney’s position, Mitchell abandons what the reader had been led to believe was a major part of his thesis: the structure of the larger society, with its manifold institutions, functions in the origin of neurosis.

The mistakes here are not merely theoretical, however. Much real personal misery results from the confusion of patients...