ABSTRACT
Within clinical psychiatry a distinction is often made between ‘neurosis’ and ‘psychosis’. A neurosis is deemed to be a mental disorder without any organic basis, where the ‘patient’ does not lose touch with external reality, in other words the person does not experience confusion in distinguishing between
fantasies and false beliefs that are subjective and a product of illness, and objective, external reality. Accordingly, the conditions discussed in Chapter 5 such as depression and anxiety are judged to be neuroses because the individual retains ‘insight’ that their distress is produced by a mental health problem. This is contrasted with the psychoses, which are characterised as more severe disorders where there is an inability on the part of the person
to distinguish between external reality and phenomena that are mentally produced as a result of the mental disorder. The most common psychosis is schizophrenia, though there are others such as persistent delusional disorder, induced delusional disorder and schizoaffective disorder. Conventionally, a distinction is made between the kinds of psychotic experiences that a person reports, and it is helpful for social workers to understand the basic terminology that is used in describing psychotic phenomena:
A delusion is a fixed and unshakeable belief that is held despite any evidence produced to the contrary, and that is not explicable in terms of the person’s social milieu; for instance, it is not derived from and explicable in terms of their cultural or religious background. This is not to say that delusions do not reflect the preoccupations of someone’s culture. For example, in developed countries they may have a flavour of science fiction, perhaps the unshakeable belief that a partner or child is really an alien or robot.
