Actual neurosis and psychoneurosis

A comprehensive and unitary psychoanalytic approach must acknowledge the importance of the so-called 'contentless mental state' of mounting psychic tensions. These states, once called the actual neuroses, are probably always further elaborated in fantasy. Once these states are endowed with meaning through free association and the joint constructive efforts of analyst and analysand, they may also be drawn into the orbit of neurotic conflict, if they have not already been drawn in by the patient alone, and then they may be dealt with analytically in connexion with the components of compromise formations which have interpretable meaning. Any person may be subject to traumatic states. Such states do not necessarily comprise a separate nosological category. What we are dealing with is a quantitative dimension of human existance that cuts across all conditions. Along with severe early traumata, weakness of the biologically determined stimulus barrier may predispose to later and life-long susceptibilities to traumatic states. If we substitute the notion of actual neurotic states for the older 'actual neuroses', we come closer to a fully integrated psychoanalytic approach, to understanding and treatment of actual- and psychoneurotic conditions.