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Play Smart with Smartphone Neurosis Revisited Damian B. Kim, M.D. ( 김 병석) SNUCMAAUSA June 2016
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Page 1: Play Smart with Smartphone - SNUCMAAsnucmaaus.org/wp-content/uploads/2016/08/Damian-Kim_Play...• Karen Horney discovered that ‘character neurosis’ seriously obstruct human psychic

PlaySmartwithSmartphoneNeurosisRevisitedDamianB.Kim,M.D.(김병석)

SNUCMAAUSAJune2016

Page 2: Play Smart with Smartphone - SNUCMAAsnucmaaus.org/wp-content/uploads/2016/08/Damian-Kim_Play...• Karen Horney discovered that ‘character neurosis’ seriously obstruct human psychic

DamianB.Kim,M.D.

• PsychoanalyticFellowofAmericanAcademyforPsychoanalysisandDynamicPsychiatry

• AssociateClinicalProfessorofSt.GeorgeUniversitySchoolofMedicine.

• AssistantClinicalProfessor,StateUniversityofNewYorkatDownstateMedicalSchool.

• Director,OutpatientDivisionofPsychiatryatConeyIslandHospital.

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DISCLOSURE

• Noconflictofinteresttodisclose.

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• IsthereNARCISSISM(자기도취증) Epidemic?

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Doyouseemoderndayyouthlikethis?– Highself-admiration.(자기칭찬에바쁘다)– Egocentric. (자기중심적이다)– Entitled. (무엇이던거저먹으려한다)– Outspoken– Disrespectful.– Arrogant.– Undisciplined.– Irritable.– Un-empathetic.– Materialistic.– Unethical.– Belittlesconventionalvalues.

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Introduction.

• Sure,theanswerisyes.Manyagreeitishappening.Butnonehasclearanswerastowhatreallyishappeningandwhyitishappeningandsothereisnoanswerwhattodoaboutit.Herearemytheories.

• ThosearethesymptomsofNarcissism.• NarcissismisonesymptomofCharacterNeurosis.(성격노이로제)• Butnarcissismalonecannotbedevelopedwithoutaccompanyingneuroticsymptoms.

• So,Itisimportanttounderstandneurosis.

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WhatisNeurosis?ADefinition.

• Amentaldisorder,createdbyintrapsychicdynamicprocesses.• Exhibitpsychologicalandfunctionalimpairment.• Interpersonalrelationshipisstrained.• Nodelusionorhallucinationasinpsychosis.• Nodisturbanceinthecapacitytograspreality.• Nodenialofrealitybutdistortionofreality.• Serioussymptomsbutarewithinsociallyacceptabletolerablerange.

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TheExistenceofNeurosis• ‘Neurosis’hasbeenanofficialnameofamentaldisease.• Theuseofthisterminologyhasbeendeclinedinmoderndaysamongmentalhealthprofessionalsandinthesociety.

• ThereasonforthisdeclineisduetotheremovalofthisterminologyfromDiagnosticStatisticalManual-IIIin1980.

• Thereasonforthisremovalisduetothereorientationofpsychiatrists‘viewingmentaldisordersfrometiologyorientedapproachtosymptomorientedapproach.

• Thereasonforthisreorientationistohavemorepsychiatristsagreewithsamediagnosis.

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TheExistenceofNeurosis-Continued

• Astheresult,thesymptomslistedunderneurosesarescatteredaroundasanxietydisorders,depressivedisorders,etc.

• InInternationalClassificationofDisease(ICD-10),thetermneurosisstillexists.

• ThisactionbyAmericanpsychiatriststochangeDSM-III,isabigmistake.

• Becausethischangepavedtheroyalroadtopsychopharmacologyandbehaviortherapydominationandincreaseofneuroses.

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TheExistenceofNeurosis-Continued

• HasneurosesdisappearedbecauseofthischangeinDSM?• Tothecontrary,Neurosesnotonlycontinuedtoexistbutthrivingandthenumberofpeopleafflictedwithneurosisareincreasingdrastically!

• Theproblemistheafflictedpeoplearenotawareoftheproblemuntiltheydevelopsometangiblesymptoms.

• Whathappenedwasthemodernmentalhealthworkersbecameignoranttoidentifythesepatients,failedtoprovideproperandefficienttreatmentandperpetuatingtheirsuffering.

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TheExistenceofNeurosis-Continued

• Mentaldiseasecanbedividedintotwomajorcategoriesbasedontheprecipitatingfactors.

First;biologicallyprecipitatedmentaldiseasesasschizophrenia,bipolardisorder,autism,etc.geneticalinoriginandendocrine,metabolic,organpathologicalinorigin.

Theprimarytreatmentforthesediseasesarebiologicaltreatmentssuchaspharmacotherapy,ECT,etc.

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TheExistenceofNeurosis-Continued

– Second;psychologicallyprecipitatedmentaldisordersasallanxietydisorders,depressivedisordersexceptbipolardepression,etc.

Theprimarytreatmentforthesediseasesshouldbepsychologicaltreatmentssuchaspsychotherapyesp.dynamicpsychotherapyandpsychoanalysis.

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TheExistenceofNeurosis-Continued

• Neurosisisapsychologicallyprecipitateddisease.

• Therefore,psychotherapyshouldbetheprimarytreatmentandmedicationandbehaviortherapyshouldbeanadjuncttopsychotherapy.

• Medicationwillnotchangehumanemotionsandthinkings.

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TheExistenceofNeurosis-Continued• From1950to1980,psychoanalyticpsychotherapydominatedpsychiatrictreatment.

• From1980topresent,psychopharmacologydominated.

• Mentalhealthworkersrealizedthatonetypeoftreatmentisnot‘fitforall’forallmentaldisease.

• It’stimetopicktheappropriateprimarytreatmentmodalitydependingonwhattriggeredtheproblem.

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Evidenceofneurosisincreasing• Thereisnoresearchorstatisticalreportofthisfactthatneurosishasincreasedbecausetheterm‘neurosis’isnotinclinicaluseanymore.

• Thereareclinicalevidenceofneuroticsymptomsincreasing.

• Thereareabundantreportsthatthereis‘Narcissism’epidemicinUSAandworldwide.

• Narcissismisoneofthesymptomsofcharacterneurosis.

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Evidenceofneurosisincreasing- cont.

• TwodifferenttypesofNarcissismaretobeconsidered.

• 1.PathologicalNarcissisticPersonalityDisorder.– Thisisararecondition,probablygeneticinorigin.

• 2.Narcissisticelementinnormalgeneralindividual.– Thisisthefocusofconcernbyprofessionalsaswellasbythepublicandthispresentation.

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Evidenceofneurosisincreasing-cont.A).Symptomsofneurosisareincreasing.

1.ThenumberofAnxietyDisordersisincreasing;Panicdisorder,Generalizedanxietydisorder,Phobias,OCD,etc.inclinicalpractice.2.ThenumberofDepressiveDisorderisincreasing;Dysthymia(Persistentdepressivedisorder),Majordepressivedisorder,etc.inclinicalpractice.

3.Theadditionof“Disruptivemooddysregulationdisorder”inDSM-5under DepressiveDisorder.Anoteworthyhappening.Thisisoneofthesymptomsof CharacterNeurosis.4.Narcissismisincreasingamongnormalindividuals.(Itisnotpathologicalnarcissisticpersonalitydisorderbutacharacterneurosissymptom.)

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Evidenceofneurosisincreasing-cont.B)Indirectevidencesofneurosisincreasing.

1.Thehoaxof“Selfitis”.Aproofofincreasedaddictiontocomputer,SNS(SocialNetworkSystem)andotherdigitalsystems.2.Thesuiciderateamongyouthandmiddleagedissteadilyincreasing.3.Thenumberofdrugandalcoholabuseisincreasing.4.Thenumberofautomobileaccidentanddeathfromitamongyouth isincreasing.(bydistractionandnarcissism).5.Disregardingconventionalvalueisincreasingamongyouths. (Insteadofrespectingtraditionalvalues,ratherworshipmoderndigitalculture.)6.MarkedincreaseofCosmeticSurgeries.7.Explosionofuniquenames.

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CausesofNeurosisIncreasing• Therearesixfactorsconsidered.1. Educationissues.Tooself-enhancingandpermissiveeducationwithout

accompanyingmoral/ethical/mannereducationanddisciplining.2. Parenting:Relinquishingtheirauthority,spoilingthemas‘youarethe

best’,overprotectiveofthem,toomuch‘freedom’and‘equality’withoutaccompanyingresponsibility.Encouragechildrentousedigitalsystem.

3. Mediacultureofenhancingnarcissisticelements,suchasshallow,blownuphighlightedcelebrityprograms.

4. Injudiciousexcessspendingduetoeasycredit.(toomuchdebts).5. Digitalinternetculture,especiallySocialNetworkSystem.6. Decreasingawarenessofmind,especiallyunconsciousmind.

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Causesofneurosisincreasing-cont.

• Inthispresentation,onlytwolastfactorswillbediscussed.

1. Digitalinternetculture,especiallySocialNetworkSystem.

2. Decreasingawarenessofmind,especiallyunconsciousmind.

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Causesofneurosisincreasing.SocialNetworkSystem

• ModernDigitalcivilizationmadehumanlifedrasticallyconvenientandcomfortable.Thepositivecontributionmayoutweighthenegatives,butthenegativeaspectsareoutofcontroltoignore.

• Itinstigatesnarcissisticelementsenhancementanddeprivespeopleoftimetolookattheirownmind.

• Peoplearetoobusytolookatthefaceofsmartphone,computerscreen,i-pad,readingFacebook,Linked-IN,Twitter,KakaoTalk,textingeachother,etc.andboastingthemselvesdirectlyandindirectly.

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TheExistenceofNeurosis• ‘Neurosis’hasbeenanofficialnameofamentaldisease.• Theuseofthisterminologyhasbeendeclinedinmoderndaysamongmental healthprofessionalsandinthecommunity.

• ThereasonforthisdeclineisduetotheremovalofthisterminologyfromDSM-IIIin1980.

• Thereasonforthisremovalisduetothereorientationofpsychiatrists‘viewingmentaldisordersfrometiologyorientedapproachtosymptomorientedapproach.

• Thereasonforthisreorientationistohavemorepsychiatristsagreewithsamediagnosis.

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Causesofneurosisincreasing.SocialNetworkSystem-cont.

• ThecontentsofFacebook,Twitter,Linked-in,Kakaoaremainlysomethingtobragaboutoneself,andseekingapprovalofothersabouthisthinkingandorhisactions,tryingtosatisfytheneedforpopularity.

• Someexamplesarethewebsitecalled“Invisibleboyfriend”,“SecondLife”.Recently,‘VirtualReality’gadget.(Goodmovietowatch;“Hur”).

• Thisindicatesthepostingpersonisstrugglingwithortoestablishhisidentity(개체성) orboosthisself-esteem.

• SNSprovidesthepersonwiththespacetoactoutallhisneuroticneeds.

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Causesofneurosisincreasing.SocialNetworkSystem-cont.

• ThismaycreateCharacterNeurosis,Expansivetype.(SimilartoNarcissisticpersonality.)Or,

• EnforceorElevatehisownexistingNarcissisticelement.Or,

• MobilizehisdormantNarcissisticelement.

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Causesofneurosisincreasing.SocialNetworkSystem-cont.

• Ontheotherhand,SNSwillincreaseInferiorityfeelingformanyotherpeople,whocompareselfwithothersandfeel‘whydon’tIhaveanythingtobragabout’,‘whycan’tIaffordthat?’,etc.

• Ifhispostingisrejectedorcriticized,hemaydeveloplowself-esteemorself-hate.

• Ifhebecomesacyber-bullyingtarget,hewillbecomedevastated.

• ThesewillleadthepersontoneuroticsymptomsofDepression,Anxiety,Jealousy,etc.andincreases SNSusetoaddictiveleveltorestorehisloweredself-esteemthroughSNSandbecomesmoreneurotic.

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Causesofneurosisincreasing.ComputerGame

• ComputerGameisanotherdigitalculturerapidlyspreading.• Itprovidestheopportunitytosatisfyhisunfilledneedsinimagination inthevirtualworld.

• ThiswillcontributetoboostinghisneuroticprideandNarcissisticelements.

• InDSM-5SectionIII,therenowisanewdiagnosticentitytobeconsideredandresearched,“InternetGameDisorder”.

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Causesofneurosisincreasing.Inattentiontomind

• AccordingtoFreud’sThreeFundamentalPsychoanalyticTheories,minddeterminesallhumanthinking,feeling,andbehavior (Psychicdeterminism.壹體唯心造).

• TheUnconsciousmotivationdeterminesmostofconsciousthinking,feelingandbehaviors.

• Theunconsciousmotivationsdrivingusareemotionalforces.• Therealityofmindweareconsciousislikethetipoficeberg.• Littletimetolookatownmind,orcommunicatewithrealpersontograspandcorrecthisthinking,feeling,andbehaviorbecauseofSocialNetworkSystemandComputerGames.

• ThisdepriveshimoftheopportunitytopreventthedevelopmentofNeurosis.

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ClassificationofNeuroses.

• NeurosisislargelyDividedintotwo:

- SymptomNeurosis.(증상노이로제)

- CharacterNeurosis.(성격노이로제)

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SymptomNeuroses

I. AnxietyDisorders:- GeneralizedAnxietydisorder.- PanicDisorder.- Phobias.- PostTraumaticStressDisorder.- ObsessiveCompulsiveDisorder.

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SymptomNeuroses-cont.II. DepressiveDisorders:

- MajorDepressiveDisorders.

- Dysthymia.(PersistentDepressiveDisorder)

-DisruptiveMoodDysregulationDisorder.(NewadditiontoDSM-V)

III Behindtheseneuroticsymptoms,therealwaysareCharacterNeuroses.

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CharacterNeurosis.

• Apsychiatricdisorderthatdoesnotexhibitanysymptomsbutexhibitscharactertraits(성격특성) asifthosearehisspecificpersonalitymake-up(성격구조) andthereforeisnotperceivedasadiseaseandissociallytoleratedandaccepted.

• Examplesare;beingperfectionistic,aggressive,irritable,compliant,ingratiating,indifferent,self-sufficient,etc.

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CharacterNeurosis-cont.

• Characterneurosisisdifferentfrompersonalitydisorder.

• Personalitydisorderisafixedstyleofreactiontotheenvironmentandinterpersonalrelationship,andthereisnointrapsychicpsycho-dynamicprocess initsgeneration.Probablygeneticinorigin.

• Characterneurosisisthecreationandmanifestationofintrapsychicpsycho-dynamicprocess.

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CharacterNeurosis-cont.

• Theterm‘CharacterNeurosis’ispresentedbyFranzAlexandertodesignateneurosiswithoutsymptoms.

• KarenHorneyadoptedthistermtodifferentiateherneurosistypefromsymptomneurosis,thatis‘characterneurosis’.

• KarenHorneyemphasizesthatthepresenceorabsenceofsymptomshouldnotbethecriteriatodifferentiateneuroses.

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CharacterNeurosis-cont.

• KarenHorneydiscoveredthat‘characterneurosis’seriouslyobstructhumanpsychicgrowthandinducefunctionaldisturbance.

• Presentedhertheoryof‘characterneurosis’,itsdevelopmentandwaystoovercome‘characterneurosis’.

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Characteristicsofcharacterneurosis.• Thereactiontoeverydaylifematterisdeviatedfromgenerallyknownnorm.

• Compulsive.

• Self-centered.

• Theachievementisusuallylowerthanhispotential.

• Theresolutionofpsychologicalconflictisunsatisfactoryincomparisontonon-neuroticpersonandtheprocessisverystressful.

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Thedevelopmentofcharacterneuroses-cont.

• KarenHorneydivided“self”intothree.

• First:RealSelf.

• Second:ActualSelf.

• Third:IdealizedSelf.

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Thedevelopmentofcharacterneuroses-cont.

• Actualself:Theall-inclusiveselfasoneis,atapointoftime,healthyorneurotic.

• Idealizedself:Theselfcreatedbyone’sownirrationalimaginationandbyinflated(orneurotic)pridethatdictateshowoneshouldbe.(ThisiswhatgoesoninNarcissism)

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Thedevelopmentofcharacterneuroses

• InordertounderstandthedevelopmentofKarenHorney’stheoryofcharacterneurosis,itisessentialtounderstandtheconceptof‘RealSelf’.

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Thedevelopmentofcharacterneuroses-cont.RealSelf.

• ThebeginningandthecenterofKarenHorney’stheoryisReal-Self.

• DefinitionofReal-Self:Everyoneisbornwithit,butuniquetotheindividual,andtheoriginalforceofgrowthandfulfillmentandconstructivecreativity.

• Thisisthepartwhenwesay‘Self-discovery’.

• The‘realself’ispossibletoattainbut‘idealizedself’isimpossibletoattain.

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Thedevelopmentofcharacterneuroses-cont.AlienatingFactorsfromRealself

• BasicAnxiety.Itisthefeelingofprofoundinsecurityandvagueapprehensioncausedbythefeelingofbeingisolated andhelplessintheworldperceivedaspotentiallyhostile.

• Thisfeelingiscausedbythewayhisparentswhothemselvesareneuroticraisehim.

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Thedevelopmentofcharacterneuroses-cont.AlienatingFactorsfromRealself

• Theneedsforthefeelingofself-confidence andsafety,urgentlycallsfortheneedtoestablish

– Self-identitythattellsyouwhoyouareandmakeyourselfmeaningfultoyourself,givesyouafeelingofpowerandsignificance.

– Theneedtolifthimselfaboveothers.

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Thedevelopmentofcharacterneuroses-cont.AlienatingFactorsfromRealself

• Inordertofulfillalltheseneeds,thepersonwillusehisbesttool,thatis,hisimaginationtocreateinhismindanidealizedimageofhimself.

• Thisprocessiscalledself-idealization.– Satisfyfeelingofsafety.– ProvidewithSelf-confidence.– ProvidewithFeelingofsuperiority.

ThissameprocesshappensinNarcissismbuildup.

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Thedevelopmentofcharacterneuroses-cont.

• Bythisselfidealization,hisshortcomingsandflawsaredimmedorglorified.

• Throughtheprocessofidentification,idealizedimagebecomesidealized-self.

• Hefeelstheidealized-selfmorerealthanhisreal-self becauseitfulfillsallhisneeds.

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Thedevelopmentofcharacterneuroses-cont.• Howaneuroticpersonwouldhandleasituationheisfacedwithandhehastomakeadecision,woulddependonhowlifeisreflectedonhim.

• Thisviewwilldeterminethetypeofcharacterneurosis.

• Therearethreereflectedviewoflifeinneurosis.– Islifeanythingtoconquer?– Islifeanythingtofillwithlove?– Islifeanythingtoseekforfreedom?

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Typesofcharacterneurosis

1. EXPANSIVETYPE.

2. SELF-EFFACINGTYPE.

3. RESIGNEDTYPE.

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Typesofcharacterneurosis-cont.

• Everyonecarriesallthesethreeelementsofneuroticcharacter.

• Thetypeofcharacterneurosisisdeterminedbywhichmovementisexaggeratedandcompulsive.

• Healthypersonwilluseallthesethreeelementsflexiblydependingonthesituation.Neuroticpersoncompulsively.

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Expansivetype• Thisisthetypeselectedbythepersonwhoviewlifeassomethingtoconquer.

• IdentifieswithhisinnerShoulds.

• Believeshecandoanythingwell.

• Makeseffortsdependingonthedegreeofhisimagination.

• ContainsmanysimilarelementsofNarcissisticPersonalityDisorder.

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Self-effacingtype

• Thisisthetypeselectedbythepersonwhoviewlifeassomethingtofillwithlove.

• Emphasizeshisinnershoulds neverbecomeanissue.• Tryingtohidehisownexistence.• Alwaysbehaveforothers’sakeandtryingtobecomealovingperson.

• Alwayscriticalofhimselfandlamentshehasnotreachedhisexpectation.

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Resignedtype

• Thisisthetypeselectedbythepersonwhoviewslifeassomethingtosecurefreedom.

• Rebelsvehementlyagainsthisowninnerdictatesorshoulds.

• Exhibitsextremereactionagainstanyoneperceivedastryingtointerferewithhisopinion,feeling,andbehavior;thatishisfreedom.

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Summary.• Thereisnodoubtthatnarcissismisincreasing.

• ItisnotjustnarcissismbutitisCharacterNeurosisthatisincreasing.

• Itisaffectingindividualsandentiresociety.

• Digitalcultureanddecreasedintrospectionarebigcontributingfactors.

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DISCUSSION

1. TherearemanyarticlesabouttheuseofSocialNetworkSystemandmentalhealthissues.

2. Mostofthemaretryingtounderstandwhatdrivespeopletodoit.– ReasonsbehindtheseuseareSeekingforgratification.

• Self-presentation.• Relationshipbuilding.• Relationshipmaintenance.• Gainasenseofcommunity.• Informationseeking.• Diversion;eg.Entertainment,pleasure.

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DISCUSSION-cont.

3.Thedrivingforcebehindare,– Needforpopularity.– Buildingupself-esteem.– Needtobelong.– Entitlement.– Narcissism.

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DISCUSSION-cont.PsychodynamicUnderstanding

• MostofSocialNetworkSystembehaviorscanbeviewedasSELF-IDENTITY(자아의식) issues;– identityformation,– identityconfirmation,– identitybuildup,– identitymaintenance,– identitymodification.

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DISCUSSION-cont.

• Functionofself-identityisadouble-edgedsward.

• positivefunction.

– Tellsyouwhoyouare.

– Makeyourselfmeaningfultoyourself.

–Givesyouafeelingofpowerandsignificance.

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DISCUSSION-cont.

– Negativefunctionofself-identity.

• Tryingtomaintainestablishedidentitybyallmeans.

• Createsconflicts.

• CasesofArtificialIntelligence.Thedoomsdayiscoming.

• Buddha’sessentialteachingis,‘extinctself’(연기법).

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DISCUSSION-cont.

• HowcanArtificialIntelligencebringondoomsday?• StephenHawkingjustsaidiffullhumanintelligenceisgiven.• But,theanswerisbygivingittheabilitytodevelop‘Selfawarenessandself-identity’.

• Theopposingviewstates,unlesshumanconsciousness,feelingandemotionscanbebuiltin,doomsdayisnotpossible.

• Iwouldliketoaddhere,‘unconsciousmind’.• IfunethicalneuroticpersonbuildtheAI,doomsdayispossible.(Thatis,‘HumanIntelligence’orHIcaninducedoomsday)

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DISCUSSION-cont.Impactonhumancharacter

• Mostofall,SocialNetworkSystemtapsontheexpansiveelementthathasnarcissisticelements.

• Astheresult,SNSelevatestheexpansiveornarcissisticelementsintheperson.

• Mayhelpdevelopexpansivetypeofpersonalityoractivateexpansiveelementsmoretothesurface.

• MaycontributetodevelopSelf-effacingandResignedtypeaswell.

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DISCUSSION-cont.Impactonhumancharacter

• TherearethreeelementsinExpansiveTypeofcharacterneurosis;

• thosearesameelementsinNarcissism.

– narcissistic,

– perfectionistic,

– arrogant-vindictiveelements.

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DISCUSSION-cont.Impactonhumancharacter

• DSM-5descriptionofNarcissisticpersonalitydisorder.– Hasagrandiosesenseofself-importance.– Ispreoccupiedwithfantasiesofunlimitedsuccess,power,brilliance,beauty.– Believesthatheisspecialandunique.– Requiresexcessiveadmiration.– Hasasenseofentitlement.– Isinterpersonallyexploitative.– Lacksempathy.– Isoftenenviousofothersorbelievesothersareenviousofhim.– Showsarrogant,haughtybehaviorsorattitudes.

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DISCUSSION-cont.Impactonhumancharacter

• Thecharacteristicsof‘Moderndigitalgeneration’.SimilartoKarenHorney’sExpansivetypeandNarcissisticPersonalityDisorder.– Egotistic.(narcissistic).Self-admiration,self-respect.– Egocentric.– Entitled.– Outspoken– Disrespectful.– Arrogant.– Undisciplined.– Irritable.– Un-empathetic.– Materialistic.– Unethical.– Belittlesconventionalvalues.

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DISCUSSION

• Remediesfortheotherfactors(educationbyschoolandparents,media,easycredit)arebeyondmentalhealthworkers;weneedaleaderwhohasinsightintothesesocialissuesandhasvision abouthowtoremedythesedestructiveissues.Allocatingbigfundsfordigitalengineeringeducationshowsthefailureofgraspingtherealityofthisproblemandsenseofpriority.

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DISCUSSION-cont.Proposedremedialapproach.

• Asaphysician,keep inmindthatthereareabundantbutneglectedmentaldisordernamedneurosis,esp.characterneurosis.

• Whenevertreatingpatientswhopresentssymptomsofneurosis,suchasanxietydisorderanddepression(exceptbipolardepression),lookforthetriggers,suchasinjuredNarcissisticpride.

• AskabouttheuseofSocialNetworkSystem.• ExplaintheimpactofoveruseofSNSandtamingtheoverusewheneverpossible.

• KeepinmindthatthedifficultyindealingwithCharacterNeurosisisthefactthatthesymptomsareinsociallyacceptableandtolerablerange andsodifficulttomakediagnosisandthepatientdoesnotfeeltheneedforhelp.

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DISCUSSION-cont.Proposedremedialapproach.

• Helppatientsbuildahabitoflookingattheirinnermind.

• Atanopportunetime,dealwithself-identityissuesifapplicable.

• Providepsychodynamicpsychotherapyforthesepopulationinadditiontomedicationand/orbehaviortherapy.Or,refertoapsychoanalyst/psychiatrist.

• RecommendMindfulnessMeditation.

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FutureOutlook• CharacterNeurosisandnarcissisticelementswillcontinuetogrow.– Becauselittleattentionispaidforthisphenomena.– BecauseNeuroticparentswillcreateneuroticchildrenandtherealreadyareplentyofneuroticparentsandthosetobe.

ØWillseeincreasingnumberofpeoplewhoareanxious,irritable,depressed,abusedrugs,commitsuicide,andsoon.

ØManysocialproblemswillgrow,suchasdrugs,crimes,violence,bankrupsy,etc.

ØMentalHealthClinicwillbebooming.(NYCmayorstartedtopayunprecedentedattentiontomentalhealthissues)

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AProposal

• RestoretheDiagnosticentityof“Neurosis”inDSM.

• Thiswillhelpprovidetreatmentaccordingtotheetiologyofthementalproblemandthatismoreappropriateandeffectivetreatmentapproach.

• Otherwise,treatmentwillbejustsymptomorientedlikedrugsandbehaviortherapyregardlesswhatcausedthesymptom.

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References

• Itisallaboutbeingpopular:TheEffectsofNeedforPopularityandSocialNetworkSiteUse.SonjaUtz,Ph.D.etals.Cyberpsychology,Behavior,andSocialNetworking.Volume15,number1,2012

• ProblematicuseofSocialNetworkSites:TheInteractiveRelationshipBetweenGratificationsSoughtandPrivacyConcerns.Hsuan-TingChen,PhD,Yongwhan Kim,PhD.Cyberpsychology,BehaviorsandSocialNetworking,Vol16,Number11,2013.

• OnlineSocialNetworkingandMentalHealth.ByIgorPantic,M.D.Cyberpsychology,Behavior,andSocialNetworking.Vol.17,number10,2014

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References-cont.

• CompulsiveUseofSocialNetworkingSitesinBelgium:Prevalence,Profile,andtheRoleofAttitudeTowardWorkandSchool.Rozane DeCock,PhDandetal.Cyberpsychology,BehaviorandSocialNetworking,volume17number3,2014.

• OnlineSocialNetworkingSitesandMentalHealthResearch.FrontiersinPsychiatry.March12,2015.

• OnlineSocialNetworkingandAddiction-AReviewofthePsychologicalLiterature.DariaJ.Kuss andMarkD.Griffiths.Int.JournalofEnvironment2011.

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References-cont.

• “OnlineSocialNetworkingandAddiction”,byDariaJ.Kuss andMarkD.Griffiths.

• “TheNarcissisticEpidemic”byJeanM.Twenge,PH.D.andW.KeithCambell,PH.D.publishedbyAtria,March2013.

• “NeurosisandHumanGrowth”byKarenHorney,1950publishedbyNortonBooks.

• “카렌호나이의 분석정신”김병석저 2015년 4월하나의학사출판

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• Anyquestions• and

• Comments?

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