Am I Neurotic Or Psychotic – How Do I Tell?

Am I Neurotic Or Psychotic – How Do I Tell?

by Dr Emma Gray - 10th January, 2014

download (4)There has long been confusion amongst individuals suffering with mental health problems as to whether they are neurotic or psychotic with many fearing that if they have a neurotic problem they will soon also develop a psychotic problem.


Neurotic problems are problems such as anxiety, depression, obsessive compulsive disorder (OCD), post traumatic stress disorder (PTSD), eating disorders (including bulimia disorder, anorexia nervosa, binge eating disorder and eating disorders not otherwise specified {EDNOS}). What these problems all have in common is that thoughts have become distorted resulting in beliefs that the individual is either inadequate in some way or at risk and lacks the necessary skills to deal with that risk. These thoughts then lead to often intolerable levels of distress and in turn self defeating behaviours which serve to perpetuate of self doubt, anxiety and ultimately the neurosis. However, at all times the individual is in touch with the reality of their situation and is able to discuss it rationally and with a certain degree of insight.

Psychotic problems involve symptoms such as visual and auditory hallucination, delusions and catatonia and are most commonly labelled as schizophrenia although this label is increasingly considered inaccurate and unhelpful by those working in the field of mental health. Unlike those with neurotic type problems individuals with psychotic problems have at best, a tenuous grip on reality.

The mechanisms of neurotic problems are increasingly well understood with therapies such as Cognitive Behavioural Therapy (CBT) spreading increasing light on the key developmental and maintaining factors involved. Psychotic problems are less well understood but what is clear from the research and treatment of mental health problem is that they are two unrelated problems and that there is no direct casual link between them, meaning that a vulnerability to one does not indicate a vulnerability to the other.

At The British CBT & Counselling Service a range of psychological therapies (including Cognitive Behavioural Therapy {CBT}) are offered for neurotic type problems. Delivered by specialist Clinical and Counselling Psychologists the rate of recovery once engaged in one of our programmes is over 75% with a further 14% of patients reporting that they felt ‘much better than before


If you are suffering with any of the issues discussed in this article and would like to seek professional help then you may find our page about Mental Health problems useful.

If you are suffering with any of the issues discussed in this article and would like to seek professional help then you may find our Problems Pages helpful.

Dr Emma Gray

Dr Emma Gray

I am often the first person with whom my patients share significant and intimate thoughts and memories; I never take that privileged position for granted nor the opportunity to help someone to feel better about themselves and discover a more fulfilling life. One of my colleagues once described me as a natural psychologist; I guess she was alluding to the fact that I feel at ease being a therapist, I can empathise with people’s distress and discomfort but don’t feel overwhelmed by it, I can understand their problem and know how to help, it has always just felt like what I should be doing.

Read more about my approach to counselling here...

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