Editing Neurosis (section)

=== Breuer, Freud and contemporaries (1880-1939) ===
[[File:Josef Breuer, 1897.jpg|thumb|[[Josef Breuer]] discovered the psychoanalytic technique of treating neurosis, and mentored Freud.]]
Austrian psychiatrist [[Josef Breuer]] first used [[psychoanalysis]] to treat hysteria in 1880–1882.<ref>{{cite book | vauthors = Freud S | title = Five Lectures on Psycho-Analysis | publisher = Penguin | date = 1995 | pages = 1–2, 10}}</ref> [[Bertha Pappenheim]] was treated for a variety of symptoms that began when her father suddenly fell seriously ill in mid-1880 during a family holiday in [[Ischl]]. His illness was a turning point in her life. While sitting up at night at his sickbed she was suddenly tormented by hallucinations and a state of anxiety.<ref>The details of her illness are taken from the case history published by Freud and Breuer in {{cite book | vauthors = Freud S, Breuer J | title = Studien über Hysterie | publisher = e-artnow | date = August 2020 | isbn = 978-80-268-2615-6 | url = https://books.google.com/books?id=dtlpBwAAQBAJ}}, as well as from her medical records found by Albrecht Hirschmüller in the papers of Bellevue Sanatorium and published in his {{cite book | vauthors = Hirschmüller A | chapter = Physiologie und Psychoanalvse im Leben und Werk Josef Breuers. | title = Jahrbuch der Psychoanalyse | location = Bern | publisher = Hans Huber | date = 1978}}</ref> At first the family did not react to these symptoms, but in November 1880, Breuer, a friend of the family, began to treat her. He encouraged her, sometimes under light hypnosis, to narrate stories, which led to partial improvement of the clinical picture, although her overall condition continued to deteriorate.

According to Breuer, the slow and laborious progress of her "remembering work" in which she recalled individual symptoms after they had occurred, thus "dissolving" them, came to a conclusion on 7 June 1882 after she had reconstructed the first night of hallucinations in Ischl. "She has fully recovered since that time" were the words with which Breuer concluded his case report.<ref>{{cite book | vauthors = Hirschmüller A | chapter = Physiologie und Psychoanalvse im Leben und Werk Josef Breuers. | title = Jahrbuch der Psychoanalyse | location = Bern | publisher = Hans Huber | date = 1978 | page = 35}}</ref> Accounts differ on the success of Pappenheim's treatment by Breuer. She did not speak about this episode in her later life, and vehemently opposed any attempts at psychoanalytic treatment of people in her care.<ref>{{cite book | vauthors = Edinger D | title = Bertha Pappenheim: Freud's Anna O. | publisher = Congregation Solel | date = 1968 | page = 15}}
</ref> Breuer was not quick to publish about this case.

(Subsequent research has suggested Pappenheim may have had one of a number of neurological illnesses. This includes [[temporal lobe epilepsy]],<ref name="Orr-Andrawes_1987">{{cite journal | vauthors = Orr-Andrawes A | title = The case of Anna O.: a neuropsychiatric perspective | journal = Journal of the American Psychoanalytic Association | volume = 35 | issue = 2 | pages = 387–419 | date = 1987 | pmid = 3294985 | doi = 10.1177/000306518703500205| s2cid = 32184483 }}</ref><ref name="Macmillan_1991">{{cite book | vauthors = Macmillan M |title=Freud Evaluated - The Completed Arc |date=1990 |publisher=Elsevier |isbn=978-0-08-086729-8 }}{{page needed|date=July 2023}}</ref><ref name="wrong">{{cite book | vauthors = Webster R |title=Why Freud Was Wrong: Sin, Science, And Psychoanalysis |date=1996 |publisher=Basic Books |isbn=978-0-465-09128-7 }}{{page needed|date=July 2023}}</ref> [[tuberculous meningitis]],<ref name="pmid15715742">{{cite journal | vauthors = Kaplan R | title = O Anna: being Bertha Pappenheim--historiography and biography | journal = Australasian Psychiatry | volume = 12 | issue = 1 | pages = 62–8 | date = March 2004 | pmid = 15715742 | doi = 10.1046/j.1039-8562.2003.02062.x | s2cid = 33384890 | url =}}</ref> and [[encephalitis]].<ref name="wrong" /> Whatever the nature of her condition, she went on to run an orphanage, and then found and lead the {{lang|de|[[League of Jewish Women (Germany)|Jüdischer Frauenbund]]}} for twenty years.)

The term ''psychoneurosis'' was coined by Scottish psychiatrist [[Thomas Clouston (psychiatrist)|Thomas Clouston]] for his 1883 book ''Clinical Lectures on Mental Diseases''.<ref>{{Cite book | vauthors = Clouston TS |url=https://books.google.com/books?id=pQFOAAAAYAAJ |title=Clinical Lectures on Mental Diseases |date=1897 |publisher=Lea Brothers |language=en}}{{page needed|date=July 2023}}{{primary source inline|date=July 2023}}</ref> He describes a condition that covers what is today considered the [[Schizophrenia spectrum|schizophrenia]] and [[Autism spectrum|autism]] spectrums (a combination of symptoms that would soon become better known as [[dementia praecox]]).
[[File:Charcot Jean-Martin Gallica Nadar.jpg|thumb|[[Jean-Martin Charcot]] believed some hysteria was caused by trauma, and mentored Freud.]]

French neurologist [[Jean-Martin Charcot]] came to believe that psychological trauma was a cause of some cases of [[hysteria]]. He wrote in his book ''Leçons sur les maladies du système nerveux'', (1885-1887) (and published in English as ''Clinical Lectures on the Diseases of the Nervous System):''<ref name="Charcot_1889">{{Cite book | vauthors = Charcot JM |url=http://archive.org/details/lecturesondisea03chargoog |title=Lectures on the Diseases of the Nervous System: Delivered at La Salpêtrière |date=1889 |publisher=The New Sydenham Society |others=unknown library |language=English}}</ref><blockquote>Quite recently male hysteria has been studied by Messrs. Putnam [1884] and Walton [1883]<ref>{{Cite journal | vauthors = Walton GL |date=1883 |title=Two Cases of Hysteria |url=https://archive.org/details/archivesofmedici9101unse/page/88/mode/2up |journal=Archives of Medicine |volume=10 |pages=88–95}}</ref> in America, principally as it occurs after injuries, and especially after railway accidents. They have recognised, like Mr. Page, [1885] who in England has also paid attention to this subject, that many of those nervous accidents described under the name of [[Railway spine|Railway-spine]], and which according to them would be better described as Railway-brain, are in fact, whether occurring in man or woman, simply manifestations of hysteria.<ref name="Charcot_1889" /></blockquote>Charcot documented around two dozen cases where psychological trauma appears to have caused hysteria.<ref name="White_1997">{{cite journal | vauthors = White MB | title = Jean-Martin Charcot's contributions to the interface between neurology and psychiatry | journal = The Canadian Journal of Neurological Sciences. Le Journal Canadien des Sciences Neurologiques | volume = 24 | issue = 3 | pages = 254–260 | date = August 1997 | pmid = 9276114 | doi = 10.1017/S0317167100021909 | s2cid = 7364585| doi-access = free }}</ref> In some cases, the results are described like the modern concept of PTSD.<ref name="White_1997" />

Austrian psychiatrist [[Sigmund Freud]] was a student of Charcot in 1885–6.<ref name="Odyssey">{{cite web |year=1998 |title=Jean-Martin Charcot |url=https://www.pbs.org/wgbh/aso/databank/entries/bhchar.html |access-date=13 October 2008 |work=A Science Odyssey: People and Discoveries |publisher=Public Broadcasting Service (PBS)}}</ref> In 1893 Freud credited Charcot with being the source of "all the modern advances made in the understanding and knowledge of hysteria."<ref>{{cite journal | vauthors = Breuer J, Freud S |title=On the Psychical Mechanism of Hysterical Phenomena (1893) |journal=The International Journal of Psycho-Analysis |volume=37 |date=1956 |pages=8–13 |url=https://pep-web.org/search/document/IJP.037.0008A |url-access=subscription }}</ref>

French psychiatrist [[Pierre Janet]] released his book ''L'automatisme psychologique'' (Psychological automatism) in 1889, its third chapter detailing his understanding of hypnosis and the unconscious. At this time, he claimed that the main aspect of psychological trauma is [[Dissociation (psychology)|dissociation]] (a disconnection of the conscious mind from reality).<ref>{{Cite web |last1=Hart |first1=Otto Van Der |last2=Horst |first2=Rutger |date=14 April 1989 |title=The Dissociation Theory of Pierre Janet |url=https://www.onnovdhart.nl/articles/dissociationtheory.pdf |access-date=23 August 2023}}</ref> (Freud would later claim Janet as a major influence.)<ref>{{cite book | vauthors = Freud S | series = Freud Library | volume = 11 | title = Metapsychology: The Theory Of Psychoanalysis |date=1984 |publisher=Penguin |location=UK |isbn=978-0-14-021740-7 | page = 52}}</ref>

In 1891, Thomas Clouston published ''Neuroses of Development'',<ref>{{Cite book | vauthors = Clouston TS |url=https://books.google.com/books?id=5MoJAQAAIAAJ |title=The Neuroses of Development: Being the Morrison Lectures for 1890 | series=Morison lectures ;1890 |date=1891 |publisher=Oliver and Boyd |oclc=609217760 |hdl=2027/wu.89051300259 }}{{page needed|date=July 2023}}</ref> which covered a wide range of physical and mental developmental conditions.[[File:Sigmund Freud LIFE.jpg|thumb|[[Sigmund Freud]] established psychoanalysis as the dominant treatment for many mental conditions.]]Breuer came to mentor Freud. The pair released the paper "Ueber den psychischen Mechanismus hysterischer Phänomene. (Vorläufige Mittheilung.)" (known in English as "On the physical mechanism of hysterical phenomena: preliminary communication") in January 1893. It opens with:<blockquote>A chance observation has led us, over a number of years, to investigate a great variety of different forms and symptoms of hysteria, with a view to discovering their precipitating cause the event which provoked the first occurrence, often many years earlier, of the phenomenon in question. In the great majority of cases it is not possible to establish the point of origin by a simple interrogation of the patient, however thoroughly it may be carried out. This is in part because what is in question is often some experience which the patient dislikes discussing; but principally because he is genuinely unable to recollect it and often has no suspicion of the causal connection between the precipitating event and the pathological phenomenon. As a rule it is necessary to hypnotize the patient and to arouse his memories under hypnosis of the time at which the symptom made its first appearance; when this has been done, it becomes possible to demonstrate the connection in the clearest and most convincing fashion...

It is of course obvious that in cases of 'traumatic' hysteria what provokes the symptoms is the accident. The causal connection is equally evident in hysterical attacks when it is possible to gather from the patient's utterances that in each attack he is hallucinating the same event which provoked the first one. The situation is more obscure in the case of other phenomena.

Our experiences have shown us, however, that the most various symptoms, which are ostensibly spontaneous and, as one might say, idiopathic products of hysteria, are just as strictly related to the precipitating trauma as the phenomena to which we have just alluded and which exhibit the connection quite clearly.<ref>{{Cite book | vauthors = Breuer J, Freud S |url=http://archive.org/details/studiesonhysteri037649mbp |title=Studies On Hysteria |date= |publisher=Basic Books |others=Universal Digital Library}}</ref></blockquote>This paper was reprinted and supplemented with case studies in the pair's 1895 book ''[[Studien über Hysterie]]'' (Studies on Hysteria'').'' Of the book's five case studies, the most famous became that of Breuer's patient [[Bertha Pappenheim]] (given the pseudonym "Anna O."). This book established the field of [[psychoanalysis]].

French neurologist [[Paul Oulmont]] was mentored by Charcot. In his 1894 book ''Thérapeutique des névroses'' (Therapy of neuroses), he lists the neuroses as being [[hysteria]], [[neurasthenia]], [[exophthalmic goitre]], [[epilepsy]], [[migraine]], [[Sydenham's chorea]], [[Parkinson's disease]] and [[tetany]].<ref>{{Cite book | vauthors = Oulmont P, ((Royal College of Physicians of Edinburgh)) |url=http://archive.org/details/b21982454 |title=Thérapeutique des névroses |date=1894 |publisher=O. Doin|location=Paris}}</ref>

The fifth edition of German psychiatrist [[Emil Kraepelin]]'s popular psychiatry textbook in 1896 gave "neuroses" a well-accepted definition:<ref name="Knoff_1970" /><blockquote>In the following presentation we want to summarize a group of disease states as general neuroses, which are accompanied by more or less pronounced nervous dysfunctions. What is common to these manifestations of insanity is that we are constantly dealing with the morbid processing of vital stimuli; what they also have in common is the occurrence of more transitory, peculiar manifestations of illness, sometimes in the physical, sometimes in the psychic area. These attacks of fluctuations in mental balance are therefore not independent illnesses, but only the occasional increase in a persistent illness...

It seems useful to me, for the time being, to distinguish between two main forms of general neuroses, [[Epilepsy|epileptic]] and [[Hysteria|hysterical]] insanity.<ref>{{Cite book | vauthors = Kraepelin E |url=http://archive.org/details/psychiatrieeinle02krae |title=Psychiatrie: ein Lehrbuch für Studirende und Aerzte |year=1976|orig-date=1899 |publisher=J. A. Barth |location=Leipzig|others=Lamar Soutter Library Univ. of Mass Medical School |isbn=978-0-405-07442-4}}</ref></blockquote>Pierre Janet published the two volume work ''Névroses et Idées Fixes'' (Neuroses and Fixations) in 1898.<ref name="Tremblay_2005">{{Cite web | vauthors = Tremblay JM |date=2005-02-02 |title=Pierre Janet, 1859-1947 philosophe devenu médecin et psychologue |url=http://classiques.uqac.ca/classiques/janet_pierre/janet_pierre.html |access-date=2023-04-13 |website=texte}}</ref><ref>{{Cite book | vauthors = Janet P |url=http://archive.org/details/nvrosesetide00jane |title=Névroses et idées fixes |date=1914 |publisher=Librairie Félix Alcan |location=Paris|others=University of Ottawa}}</ref> According to Janet, neuroses could be usefully divided into [[hysteria]]s and [[psychasthenia]]s. Hysterias induced such symptoms as anaesthesia, visual field narrowing, paralyses, and unconscious acts.<ref>{{cite journal | vauthors = Pitman RK | title = Janet's Obsessions and Psychasthenia: a synopsis | journal = The Psychiatric Quarterly | volume = 56 | issue = 4 | pages = 291–314 | date = 1984-12-01 | pmid = 6399751 | doi = 10.1007/BF01064475 | s2cid = 23032117}}</ref> Psychasthenias involved the ability to adjust to one's surroundings, similar to the later concepts of [[adjustment disorder]] and [[executive functions]].

Janet founded the French "Société de psychologie"<ref>{{Cite web |title=Accueil SFP |url=https://www.sfpsy.org/ |access-date=2023-07-08 |website=SFP |language=fr-FR}}</ref> in 1901. This later became the "Société française de psychologie", and continues today as France's main psychology body.<ref name="Isabelle">{{Cite web | vauthors = Isabelle S |title=Pierre Janet |url=https://francearchives.gouv.fr/fr/pages_histoire/38973 |access-date=2023-07-08 |website=FranceArchives |language=fr}}</ref>

[[Barbiturate]]s are a class of highly addictive [[sedative]] drugs. The first barbiturate, [[barbital]], was synthesized in 1902 by German chemists [[Emil Fischer]] and [[Joseph von Mering]] and was first marketed as "Veronal" in 1904.<ref>{{cite journal | vauthors = López-Muñoz F, Ucha-Udabe R, Alamo C | title = The history of barbiturates a century after their clinical introduction | journal = Neuropsychiatric Disease and Treatment | volume = 1 | issue = 4 | pages = 329–343 | date = December 2005 | pmid = 18568113 | pmc = 2424120}}</ref> The similar barbiturate [[phenobarbital]] was brought to market in 1912 under the name "Luminal". Barbiturates became popular drugs in many countries to reduce neurotic anxiety and displaced the use of bromides.

Janet published the book ''Les Obsessions et la Psychasthénie'' (The Obsessions and the Psychasthenias) in 1903.<ref name="Tremblay_2005" /> Janet followed this with the books ''The Major Symptoms of Hysteria'' in 1907,<ref>{{Cite book | vauthors = Janet P |url=http://archive.org/details/majorsymptomshy01janegoog |title=The Major Symptoms of Hysteria: Fifteen Lectures Given in the Medical School ... |date=1907 |publisher=The Macmillan company |others=University of California |language=English}}</ref> and ''Les Névroses'' (The Neuroses) in 1909.<ref name="Tremblay_2005" />

According to Janet, one cause of neurosis is when the mental force of a traumatic event is stronger than what someone can counter using their normal coping mechanisms.<ref>{{Cite web |date=2022-11-03 |title=Pierre Janet: French Neurologist and Psychologist |url=https://www.simplypsychology.org/pierre-janet.html |access-date=2023-04-21 |language=en-US}}</ref>
[[File:Поль-Шарль Дюбуа (Paul-Charles Dubois).jpg|thumb|[[Paul Charles Dubois]] developed "rational psychotherapy", an early form of cognitive behavioural therapy.]]
The Swiss psychiatrist [[Paul Charles Dubois]] published the book ''Les psychonévroses et leur traitement moral'' in 1904, which was translated into English as "Psychic Treatment of Nervous Disorders (The Psychoneuroses and Their Moral Treatment)" in 1905.<ref>{{Cite web |title=The psychic treatment of nervous disorders : (The psychoneuroses and their moral treatment) / by Paul Dubois ... ; translated and edited by Smith Ely Jelliffe ... |url=https://hdl.handle.net/2027/mdp.39015045682518?urlappend=%3Bseq=9 |access-date=2024-04-22 |website=HathiTrust | hdl=2027/mdp.39015045682518?urlappend=%3Bseq=9 |language=en}}</ref> Dubois believed that neurosis could be successfully treated by listening carefully to patients, and rationally convincing them of the truth — what he called "rational psychotherapy". This was a form of [[Cognitive behavioral therapy|cognitive behavioural therapy]]. He also followed [[Silas Weir Mitchell (physician)|Weir Mitchell]]'s rest cure, though with a broad fattening diet and other modifications.

Meanwhile, Freud developed a number of different theories of neurosis. The most impactful one was that it referred to mental disorders caused by the brain's defence against past psychological trauma.<ref name="Sletvold_2016">{{cite journal | vauthors = Sletvold J |title=Freud's Three Theories of Neurosis: Towards a Contemporary Theory of Trauma and Defense |journal=Psychoanalytic Dialogues |date=3 July 2016 |volume=26 |issue=4 |pages=460–475 |doi=10.1080/10481885.2016.1190611 |s2cid=151623430 }}</ref> This redefined the general understanding and use of the word. It came to replace the concept of "hysteria".

He held the First Congress for Freudian Psychology in [[Salzburg]] in April 1908. Subsequent Congresses continue today.

[[Progressive muscle relaxation]] (PMR) was first developed by American psychiatrist and physiologist [[Edmund Jacobson]].<ref name=":7">Jacobson, E. (1929). Progressive relaxation. Chicago: University of Chicago Press</ref> This began at Harvard University in 1908.<ref name=":7" /> PMR involves learning to relieve the tension in specific muscle groups by first tensing and then relaxing each muscle group.<ref name=":42">{{Cite book |last=Nathoo |first=Ayesha |title=The Restless Compendium |date=2016 |publisher=Palgrave Macmillan |isbn=978-3-319-45263-0 |pages=71–80 |language=en |chapter=From Therapeutic Relaxation to Mindfulness in the Twentieth Century |doi=10.1007/978-3-319-45264-7_9 |chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK453216/}}</ref> When the muscle tension is released, attention is directed towards the differences felt during tension and relaxation so that the patient learns to recognize the contrast between the states.<ref name=":5">Jacobson, E. (1938). Progressive relaxation. Chicago: University of Chicago Press</ref><ref name=":8">{{cite journal |last1=Ibáñez-Tarín |first1=C. |last2=Manzanera-Escartí |first2=R. |title=Técnicas cognitivo-conductuales de fácil aplicación en atención primaria (I) |trans-title=Easily implemented cognitive behaviour techniques in Primary Care (part 1) |language=es |journal=Semergen |date=September 2012 |volume=38 |issue=6 |pages=377–387 |doi=10.1016/j.semerg.2011.07.019 |pmid=22935834 }}</ref> This reduces anxiety and the effect of phobias.<ref name=":15">{{cite book |title=Encyclopedia & dictionary of medicine, nursing, & allied health. |date=2005 |publisher=Saunders |isbn=978-1-4160-2604-4 |editor-last1=O'Toole |editor-first1=Marie T. |edition=7th Revised |location=Philadelphia}}</ref>

Freud published the detailed case study "Bemerkungen über einen Fall von Zwangsneurose" (Notes Upon a Case of Obsessional Neurosis) in 1909, documenting his treatment of "[[Rat Man]]".

Freud established the [[International Psychoanalytical Association]] (IPA) in March 1910. He arranged for [[Carl Jung]] to be its first president. This organisation chose to only provide both psychoanalytic training and recognition to medical doctors.

The [[American Psychoanalytic Association]] was founded in 1911<ref>{{cite web |title=APsaA Mission & Vision {{!}} APsaA |url=http://www.apsa.org/content/apsaa-mission-vision |access-date=2018-10-01 |website=www.apsa.org |language=en |archive-date=2022-09-12 |archive-url=https://web.archive.org/web/20220912102821/https://apsa.org/content/apsaa-mission-vision |url-status=dead }}</ref> by Welsh neurologist [[Ernest Jones]], with the support of Freud. It followed the IPA's practice of only supporting psychoanalysis provided by medical doctors.

Jung gave a speech explaining his understanding of Freud's work called ''Psychoanalysis and Neurosis'' in New York in 1912. It was published in 1916.<ref>{{cite book |doi=10.1515/9781400850938.243 |chapter=Psychoanalysis and Neurosis |title=Collected Works of C.G. Jung, Volume 4: Freud & Psychoanalysis |year=2014 |pages=243–251 |isbn=978-1-4008-5093-8 }}</ref>

The journal ''[[Internationale Zeitschrift für Psychoanalyse]]'' was established in 1913, and continued until 1941.

The battlefield stresses of [[World War I]] (1914–18) lead to many cases of strong short-term psychological symptoms, known today as "[[combat stress reaction]]" (CSR). Other terms for the condition include "combat fatigue", "battle fatigue", "battle neurosis", "shell shock" and "operational stress reaction". The general psychological term [[acute stress disorder]] was first used for this condition at this time.{{Citation needed|date=April 2023}}

The [[fight-or-flight response]] was first described by American physiologist [[Walter Bradford Cannon]] in 1915.<ref name="Walter Bradford Cannon 1915 211">{{Cite book | vauthors = [[Walter Bradford Cannon|Cannon WB]] |title=Bodily changes in pain, hunger, fear, and rage |publisher=[[Appleton-Century-Crofts]] |year=1915 |location=New York |pages=211}}</ref>

American military psychiatrist [[Thomas William Salmon|Thomas W. Salmon]] (the chief consultant in psychiatry in the [[American Expeditionary Forces|American Expeditionary Force]])<ref>{{cite journal | vauthors = Parry M | title = Thomas W. Salmon: advocate of mental hygiene | journal = American Journal of Public Health | volume = 96 | issue = 10 | pages = 1741 | date = October 2006 | pmid = 17008565 | pmc = 1586146 | doi = 10.2105/AJPH.2006.095794}}</ref> released the book ''The care and treatment of mental diseases and war neuroses ("shell shock") in the British army'' in 1917,<ref>{{Cite book | vauthors = Salmon TW |url=http://archive.org/details/caretreatmentofm00salmrich |title=The care and treatment of mental diseases and war neuroses ("shell shock") in the British army |date=1917 |publisher=War Work Committee of the National Committee for Mental Hygiene, Inc. |location=New York City |others=University of California Libraries}}</ref> dealing primarily with what was considered was the best treatment for hysteria. His recommendations were broadly adopted in the US armed forces.

Freud's most explanatory work on neurosis was his lectures later grouped together as "General Theory of the Neuroses" (1916–17), forming part 3 of the book ''Vorlesungen zur Einführung in die Psychoanalyse'' (1917), later published in English as ''[[Introduction to Psychoanalysis|A General Introduction to Psychoanalysis]]'' (1920).<ref name="Freud_1920">{{Cite book | vauthors = Freud S |url=http://archive.org/details/ageneralintrodu00freugoog |title=A General Introduction to Psychoanalysis |date=1920 |publisher=H. Liveright |others=Harvard University |language=English}}</ref>

In that work, Freud noted that:<blockquote>The meaning of neurotic symptoms was first discovered by J. Breuer in the study and felicitous cure of a case of hysteria which has since become famous (1880–82). It is true that P. Janet independently reached the same result...

The [neurotic] symptom develops as a substitution for something else that has remained suppressed. Certain psychological experiences should normally have become so far elaborated that consciousness would have attained knowledge of them. This did not take place, however, but out of these interrupted and disturbed processes, imprisoned in the unconscious, the symptom arose...

Our therapy does its work by means of changing the unconscious into the conscious, and is effective only in so far as it has the opportunity of bringing about this transformation...<ref name="Freud_1920" /></blockquote>Freud added to this with his paper "Aus der Geschichte einer infantilen Neurose" (From the History of an Infantile Neurosis) published in 1918, which is a detailed case study of his treatment of the "[[The Wolfman (Freud essay)|Wolfman]]".
[[The International Journal of Psychoanalysis]] was founded by Ernest Jones in 1920.

In response to stress injuries from World War I, the British government produced the ''[[Combat stress reaction|Report of the War Office Committee of Inquiry into "Shell-Shock"]]'', which was published in 1922.

Its recommended course of treatment included: <blockquote>While recognizing that each individual case of war neurosis must be treated on its merits, the Committee are of opinion that good results will be obtained in the majority by the simplest forms of psycho-therapy, i.e., explanation, persuasion and suggestion, aided by such physical methods as baths, electricity and massage. Rest of mind and body is essential in all cases. [The practices of [[Paul Charles Dubois]].]

The committee are of opinion that the production of deep hypnotic sleep, while beneficial as a means of conveying suggestions or eliciting forgotten experiences are useful in selected cases, but in the majority they are unnecessary and may even aggravate the symptoms for a time.

They do not recommend psycho-analysis in the Freudian sense.

In the state of convalescence, [[Occupational therapy|re-education and suitable occupation of an interesting nature]] are of great importance. If the patient is unfit for further military service, it is considered that every endeavor should be made to obtain for him suitable employment on his return to active life.</blockquote>''The common neuroses and their treatment by psychotherapy'' was a book released by British psychiatrist Thomas Arthur Ross<ref>{{Cite journal |date=1941-03-22 |title=OBITUARY |journal=British Medical Journal |volume=1 |issue=4185 |pages=463–464 |doi=10.1136/bmj.1.4185.463-a |pmc=2161727 }}</ref> in 1923, to instruct medical doctors in general.<ref>{{Cite book | vauthors = Ross TA |url=http://archive.org/details/commonneuroses029419mbp |title=The Common Neuroses |date=1949 |publisher=Edward Arnold And Company |edition=2nd}}</ref> (A second edition was published in 1937, which was subsequently reprinted many times). He also followed the practice of [[Paul Charles Dubois]], and believed "Freudian analysis" was only necessary for the most difficult cases. Ross would later write the books ''Introduction to analytical psychotherapy'' (1932) and ''An enquiry into prognosis in the neuroses'' (1936).

In April 1923 Freud published his monograph ''Das Ich und das Es'' (published in English as ''[[The Ego and the Id]]),''<ref name=":62">Freud, Sigmund. 1955 [1923]. "[[The Ego and the Id]]." In [[The Standard Edition of the Complete Psychological Works of Sigmund Freud|''Standard Edition'']] 19, edited by [[James Strachey|J. Strachey]]. London: [[Hogarth Press]]. Lay summaries via [https://www.simplypsychology.org/psyche.html Simply Psychology] and [https://daily.jstor.org/virtual-roundtable-on-the-ego-and-the-id/ JSTOR Daily Roundtable]. [https://www3.nd.edu/~dlapsle1/Lab/Articles%20&%20Chapters_files/Entry%20for%20Encyclopedia%20of%20Human%20Behavior%28finalized4%20Formatted%29.pdf Glossary] via University of Notre Dame.</ref> which included a revised theory of mental functioning, now considering that repression was only one of many defence mechanisms, and that it occurred to reduce anxiety. Hence, Freud characterised repression as both a cause and a result of anxiety.{{Citation needed|date=April 2023}}

Austrian literary theorist [[Otto Rank]] was a close ally of Freud. His book [[The Trauma of Birth|''The'' ''Trauma of Birth'']] (1924) focused more on people's choices, rather than Freud's focus on drives. He believed in the idea of psychotherapy as opposed to psychoanalysis — that understanding someone's neuroses wasn't sufficient for effective therapy.{{Citation needed|date=January 2024}}

Freud released his book ''Hemmung, Symptom und Angst'' (Inhibition, Symptom and Anxiety) in 1926, in reaction to Rank's book.<ref>{{Cite book |last1=Lieberman |first1=E. James |title=The letters of Sigmund Freud & Otto Rank: inside psychoanalysis |last2=Kramer |first2=Robert |date=2012 |publisher=Johns Hopkins university press |isbn=978-1-4214-0354-0 |location=Baltimore}}</ref> It detailed his further developed understanding of neurosis and anxiety. (The book was published in English as ''The Problem of Anxiety'' in 1936.) This book expressed his new view that anxiety created repression, rather than the other way around.<ref>{{Cite book |last=Freud |first=Sigmund |url=https://books.google.com/books?id=Aeq5S_TZflYC |title=Inhibitions, Symptoms and Anxiety |date=1977 |publisher=Norton |isbn=978-0-393-00874-6 |language=en}}</ref><!-- More here. --> 

Freud also published the book ''Die Frage der Laienanalyse'' ([[The Question of Lay Analysis]]) in 1926, in which he endorsed non-doctors performing psychoanalysis. 

In 1929, Austrian psychiatrist [[Alfred Adler]] published the book ''Problems of Neurosis: A Book of Case-Histories'', furthering the school of [[individual psychology]] he had established in 1912.<!-- More here. -->

1929 also saw [[Edmund Jacobson]] publishing of the professional instruction book ''Progressive Relaxation''.<ref>{{Cite book |last=Jacobson |first=Edmund |url=http://archive.org/details/progressiverelax0000jaco |title=Progressive relaxation; a physiological and clinical investigation of muscular states and their significance in psychology and medical practice |date=1974 |publisher=Chicago [Ill.] University of Chicago Press |others=Internet Archive |isbn=978-0-226-39059-8}}</ref> It explained the benefits of relaxation for addressing neuroses and other mental conditions.<ref>{{Cite news |date=2015-11-04 |title=The man who invented relaxation |language=en-GB |work=BBC News |url=https://www.bbc.com/news/magazine-34714591 |access-date=2023-12-16}}</ref> He followed this with the more publicly-oriented ''You Must Relax''<ref>{{Cite book |last=Jacobson |first=Edmund |url=http://archive.org/details/youmustrelax0000jaco |title=You must relax |date=1976 |publisher=New York : McGraw-Hill |others=Internet Archive |isbn=978-0-07-032182-3}}</ref> in 1934.

[[Walter Bradford Cannon]]'s 1932 book ''The Wisdom of the Body<ref name="wisdom">{{cite book |title=The Wisdom of the Body |vauthors=Cannon WB |date=1932 |publisher=W. W. Norton and Company |place=New York |pages=177–201}}</ref>'' popularised the concept of fight-or-flight.

The [[American Medical Association]] released its ''Standard Classified Nomenclature of Diseases'' in 1933, the first widely accepted such nomenclature in the United States. By the second edition of 1935, its category of "psychoneuroses" included:

* Hysteria
** [[Anxiety disorder|Anxiety hysteria]]
** [[Conversion hysteria]]
*** Anesthenic type
*** Paralytic type
*** Hyperkinetic type
*** Paresthetic type
*** Autonomic type
*** Amnesic type
** Mixed hysterical psychoneurosis
* Psychasthenia or compulsive states
** [[Obsessive–compulsive disorder|Obsession]]
** [[Tourette syndrome|Compulsive tics or spasms]]
** [[Phobia]]
** Mixed compulsive states
* [[Neurasthenia]]
* [[Hypochondriasis]]
* [[Reactive depression]]
* [[Anxiety state]]
* Mixed psychoneurosis<ref>{{Cite book | vauthors = Logie HB |url=https://catalog.hathitrust.org/Record/010176111 |title=Standard classified nomenclature of disease |date=1938 |publisher=American Medical Association |location=Chicago}}</ref>

[[File:Portrait Hans Selye.jpg|thumb|[[Hans Selye|Hans Seyle]] devised the general adaptation syndrome to describe stress.]]
The [[General Adaptation Syndrome|general adaptation syndrome]] (GAS) theory of stress was developed by Austro-Hungarian physiologist [[Hans Selye]] in 1936.<ref>{{cite book | vauthors = Taylor S, Sirois F |title=Health Psychology |date=2012 |publisher=McGraw-Hill Ryerson |isbn=978-0-07-031979-0 |edition=2nd Canadian}}</ref>

In 1937, Austrian-American psychiatrist [[Adolph Stern]] proposed that there were many people with conditions that fitted between the definitions of psychoneurosis and psychosis, and called them the "border line group of neuroses".<ref>{{cite journal | vauthors = Stern A |title=Psychoanalytic Investigation of and Therapy in the Border Line Group of Neuroses |journal=The Psychoanalytic Quarterly |date=October 1938 |volume=7 |issue=4 |pages=467–489 |doi=10.1080/21674086.1938.11925367 }}</ref> This group would later become known as [[borderline personality disorder]].

By 1937, the concept of "occupational neuroses" was known by many American health practitioners. It referred to neuroses caused by any aspect of someone's employment.<ref>{{cite journal | vauthors = Harms E |title=The Social Background of Occupational Neuroses |journal=The Journal of Nervous and Mental Disease |date=June 1937 |volume=85 |issue=6 |pages=689–695 |doi=10.1097/00005053-193706000-00004 }}</ref>