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Psychoanalysis arose from the need for a nineteenth-century medical approach to neurosis, that baffling state of the self-identified patient whose medical-seeming symptoms revealed no apparent organic cause, often appeared somehow unwittingly self-induced, impressed many observers as less painful than meaningful, and seemed to mean, in particular, something about sex—earning such conditions since ancient times the cognomen “hysteria.”
What has become of neurosis? In our day it has all but vanished from popular as well as professional discourse. Psychic suffering has taken on a new mantle of medical meaning, now more frankly psychological in its presentation but still cloaked in the medical “in-valid-ation” that serves in some measure to protect its sufferers from appearing either to have brought it upon themselves, or to mean anything by it. Instead of neurosis we now have Disorders. In place of hysteria, neurasthenia, and obsessional neurosis we now encounter Depressive Disorder, Obsessive-Compulsive Disorder, Post-Traumatic Stress Disorder, Attention-Deficit Disorder, etc., all very scientifically categorized to five significant figures and supported by scientific data popularly taken to prove that the sufferer's brain is doing it all to him—as many Disorders, an alien or merely cynical observer might say, as there are ways to lose the capacity to tolerate one's passions, to lose or even abdicate agency over them, or to make sense of them, as the now-unfashionable psychoanalytic psychiatry once tried to do. Today, instead of exploring symptoms to find their meaning, we classify them. Instead of explaining them, we try to undo them with drugs. If thine eye offend thee, pluck it out! When we do explain symptoms—and by “we” I mean primarily contemporary psychiatrists and those who share their general perspective on these matters—we follow the psychoanalyst's lead by imputing those symptoms to unconscious processes; but we go further than the anal