There are numerous definitions pertaining to the distinction between neurosis and psychosis; those which are more allopathic and medically based, through to more naturopathic, holistic interpretations. There is a large consensus however, about what constitutes one set of conditions and what constitutes the other. Below is a brief overview.
Neurosis involves distress and maladaptive coping mechanisms while maintaining contact with reality, whereas psychosis involves a loss of contact with reality, manifesting as hallucinations and delusions. So, the main difference is that there is a preserved sense of reality in neurosis, whereas with psychosis there is a significant break from reality.
Environmental factors can exacerbate both conditions; for instance, stress can be a trigger for psychotic episodes, especially in vulnerable individuals. Equally stress can lead to anxiety and panic disorders, which are classic characteristics of neurosis. Also, research shows that those who don’t have significant exposure to nature and are only ever exposed to high urban pollution have an increased risk of psychosis. These same conditions can increase the risk and rate of depression, especially for those who are suffering with a lack of meaning and purpose.
Neurosis
The neurotic individual remains connected to reality. Common symptoms of neurosis include overthinking, anxiety, distress and panic. Individuals’ perception of themselves and reality have altered in a way that they feel unable to cope with the demands and challenges of day to day life. In some cases there can be paranoia leading to false constructs (superimposing one’s perception onto others or particular situations).
Most cases of neurosis can be managed by offering the individual psychological strategies and coping mechanisms, which help them to change their inner narrative. CBT, MBSR (Mindfulness Based Stress Reduction), breathing techniques and solution focused therapies are popular strategies for addressing maladaptive thinking.
From a holistic perspective we know, based on our research and clinical experience, that helping clients develop a Story of Health plan, which equally meets the needs of mind, body, spirt and environment can lead to successful outcomes. This approach addresses the needs for hydration, precise nutrition, deep restorative sleep, decluttering one’s environment, developing healthy relationships, incorporating exercise and bodywork, and much more.
Psychosis
Psychosis often involves a significant loss of contact with reality, which is a key distinction from neurosis. This can manifest in a range of conditions such as schizophrenia, paranoid schizophrenia, bipolar disorder, dissociative disorders, Dissociative Identity Disorder (DID), Emotionally Unstable Personality Disorder (EUPD).
Common symptoms within this category are hallucinations (seeing or hearing things that aren’t there) and delusions (fixed and false beliefs). Although in the scientific literature it is stated that psychosis has a strong genetic basis, for balance it should be said that environmental factors are often crucial in the development of such conditions. For example, isolation, alienation and trauma can all trigger psychosis or psychotic episodes, where one loses touch with reality and believes that it’s everyone else who is seeing the picture incorrectly. This is often the point where one can cross over from neurosis into psychosis.
Psychosis can be successfully treated with patient, kind intervention that seeks to address underlying causes, recognising the complex interface between the genetic and environmental factors. It needs to be understood that the environment can act as a trigger for psychosis in those genetically predisposed to this condition. This includes noise pollution and what is described as urbanicity (densely populated areas with concrete jungles, creating a sense of dehumanisaton). There are some cases where medication will form part of a treatment protocol.
In summary
Neurosis is a struggle with distress where the individual, despite the challenges, remains in contact with reality. Psychosis on the other hand severs one’s connection with reality. As stated above, both conditions can be treated and at Reach we passionately advocate The Story of Health as the missing link, because it addresses the whole person and not just their symptoms. Very importantly it addresses the environmental factors that are often overlooked when treating such conditions.