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Psychoanalysts of some experience often remark upon the change during recent decades in the patterns of neuroses. And younger analysts gain a similar impression from the discrepancy between the older descriptions of neuroses and the problems presented by the patients who come daily to their offices. The change is, of course, from symptom neuroses to character disorders and borderline states.
Several propositions may be advanced to account for this change. First, it may be more apparent than real. Neither symptom neurosis nor character disorder can exist in pure form. The one implies the other, the two categories being abstractions from either end of a continuum of neurotic patterns. The early analysts, being technically and theoretically unprepared to see character traits as fixed expressions of neurotic conflict, doubtless overlooked the character neuroses in many of their patients. The development of ego psychology during the past thirty years has so remedied this deficiency that we now are prepared to discover neurotic character problems in even those patients who seem at first to suffer only from ego-alien symptoms. To the extent that considerations of this kind apply, the change in question is in our point of view rather than in the nature of neurosis.
A second factor has to do with the increasing social acceptance of psychoanalysis and the increasing frequency with which troubled people turn to it for relief from the various burdens which oppress their lives. Normality has largely replaced morality as a standard