For Freud, unlike psychosis, ‘in neurosis the ego suppresses part of the id out of allegiance to reality, whereas in psychosis it lets itself be carried away by the id and detached from a part of reality’ (1997, p. 207, emphasis added). Neuroses result from inadequately repressed internal impulses seeking expression, or from external traumatic events (e.g. sexual overwhelming or abuse, trauma); while most people live with neurotic conflicts, some have serious and debilitating symptoms that affect working, loving and leisure. Freud argued that the ego often seeks advantage through illness: the symptom, thus, enables the ego to avoid conflict between the ego and the id. The symptom, a substitute for the unacceptable impulse, reduces, displaces or distorts.
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