The Relationship Between the Individual, the Culture, and Psychopathology*

Karen Horney is generally considered to be a “culturalist” psychoanalyst. Indeed she was a pioneer in emphasizing the important role of sociocultural factors in shaping the personality and producing psychopathology. Yet once this point was made in her earlier work, she devoted the major stress in her later work to developing a psychological system of personality growth and structure. As a result, this concept of cultural influence remains one of the least clear and least precise aspects of Horney theory.

For many reasons, there is a need at present to redefine this relation between sociocultural conditions and individual psychopathology, not only as it applies to Horney theory but also in general. One reason is that the Horney concepts originally referred only to the neuroses; now they are being applied to other emotional conditions as well. To remain viable, these concepts must be shown relevant not only to these different emotional states but also to today's social conditions.

A second reason is that the forms of both neuroses and psychoses have been changing over the past fifty years. These changes demand an explanation if we are to understand and treat them effectively. Are these differences only superficial and symptomatic, or are they due to more basic etiological and dynamic factors? Are they primarily intrapsychic or are they primarily sociocultural, and to what social conditions are they related? A third reason is that previous definitions of mental illness are now being questioned. The line between mental health, or normality, and psychopathology requires clarification. Are neurotic symptoms simple and direct learned reactions to specific social situations, similar to conditioned reflexes, therefore requiring merely to be unlearned? Is schizophrenia an illness with an intrapsychic pathology, or is it simply a matter of social problems or deviancy from social norms? Is schizophrenia an illness at all, or is it society that really is schizophrenic? Is the pati