WE WERE AS CONCERNED as anyone, perhaps more so, at last Sunday's announcement by the American Psychiatric Association that they are doing away with the terms "neurosis" and "neurotic," in favor of naming specific "disorders." Of course, we don't doubt that Dr. Robert L. Spitzer is right in contending that "the way the term neurosis has evolved over the last 100 years, it is no longer the most descriptive way of describing these problems." And when Dr. Arthur Shapiro says, "You can't identify neuroses reiably," that we need "more specific, measurable, documentable ways," who are we to object? Drs. Spitzer and Shapiro serve on the task force that is in the process of writing the APA's third edition of the "Diagnostic and Statistical Manual of Mental Disorders," so their word on these matters will be law. If the dictionary of mental disorders will no longer accept "neurotics," we laymen can only do the same.
But consider the cultural loss: Whenever someone is called "neurotic" or "a neurotic," it involves an implicit act of forgiveness and understanding. "Oh, So-and-so is just neurotic" means "Oh, So-and-so is excessively nervous. He didn't really want to toss the china at your head. It's just his way." Or: "So-and-so is just a neurotic" - meaning: "He can't help himself. He doesn't mean it every time he tosses china at your head." By calling someone neurotic we place the burden of adjustment not on the someone, but rather on ourselves. It's sort of a call to kindness, to a sense of social generosity.
Would the same be true if the "disordered" were tossing the china? We do not think so. To excuse So-and-so by citing his disorder - the specific category of his disorder, to boot - is like excusing a car for faulty brake-lining. Not only can the defect be repaired - it damn well ought to be, and quick. The burden of adjustment would sit squarely on the disorderee. No compassion would be asked of society at large, and naturally none would be forthcoming.
Think too of the self-esteem of the neurotic himself, who has long been comforted by the knowledge that he is "just a neurotic" - quite a few pegs safely below a psychotic, but quite a few above the common run of men. A neurotic is an eccentric touched by Freud. Society gives him an honorable, often a lovable place. Would the same niche be given the sufferers of "somatoform disorders" or "major depressive disorders" or "dissociative disorders"? Not bloody likely.
Then think of yourself, as the years go by, on your own slow, inexorable decline toward what was once neurosis and is now disorder. A neurosis has company: past, present and future. But a disorder? There is nothing to share with others. You become withdrawn, obsessive, hysterical, depressed - more disordered still.