Neurosis vs. Character Disorder: Levels of Internal Discomfort

Neurotics are generally uncomfortable with the “symptoms” of their illness and seek help on their own. While others may be upset with signs and symptoms of their disturbance, disordered characters like who they are and how they operate and rarely get into therapy unless pressured to do so.

I’ve posted earlier on how neurotics and disordered characters differ with respect to their levels of awareness (“Neurosis vs. Character Disorder: Levels of Awareness”) and their contrasting needs in therapy (“Neurosis vs. Character Disorder: Contrasting Needs in Therapy”). But as an important footnote, neurotics are also different from character disorders on another very key dimension. In large measure, the signs and symptoms of neurosis are usually experienced by the individual as unpleasant and unwanted. Perhaps a person has been worrying to the point that he’s developed an ulcer. Perhaps the constant pain has slowed him down at work, making him less productive. Clinicians say that it is ego-dystonic (unpalatable to his image of himself) for him to feel that he is not performing at his best. What’s more, he doesn’t like his “symptoms” (i.e., the ulcer and its pain) either. As a result, he might easily take the initiative to get help.

Disturbed characters also display telltale signs and “symptoms” of their disorder. Lying, conning, manipulating, defaulting on social obligations, etc. are several of the disordered character’s defining features. The negative attitudes they hold, the distorted way they tend to think, and the irresponsible ways they tend to behave are likely to be greatly upsetting to others. But these things are, as clinicians describe them, ego-syntonic (i.e. compatible with his self-image) to the disordered character. The disordered character doesn’t see anything wrong with those characteristics and is not upset by the kind of person he has become as a result. Others may complain and experience frustration over his manner, but he likes who he is and how he operates. Disturbed characters are rarely in the kind of inner distress that might prompt them to seek guidance or counseling on their own. Others might try to force the issue, but generally with little success.

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