In medicine it is typical to single out three main classical forms of
neuroses: nervous breakdown, obsessive-compulsive disorder and hysteria. We
shall consider them in the order that they are generally discussed in special
Neurosthenia. This is considered to be the most frequent form of
neurosis. It was singled out in the 1880s as an individual nosological entity.
The American doctors Beard and Van Dusen, independently of each other, first
wrote about this neurosis in 1869. Since then the diagnostics of neurosthenia
have spread widely. Professor B.D. Karvasarsky offers a curious example: during
the First World War, a special program of learning was created in the British
army, upon completion of which the doctor received the title "Expert in
The given illness, as seen from its very name, is expressed by nervous
weakness right down to the deep exhaustion of a person’s living powers.
Sleeping hearths of infection become more acute, cholestitis, gastritis, ulcers
of the stomach or duodenum make themselves felt. The illness appears to be a
catalyst, highlighting the somatic pathology.
The portrait of a neurosthenic is typical — this is a person who is
quick-tempered, irritable, quickly wound up, "at the drop of a hat,"
in whom the nerves are clearly giving out (hypersthenic form of neurasthenia) or,
just the opposite, lethargic, whining, feeling tiredness and exhaustion in all
of his life powers (hyposthenic form). But it is interesting to note: the high
irritability and irascibility of the neurosthenic is not directed toward
himself, but towards others! Everybody and everything irritates him, he is
often capricious, is easily angered and enraged, but almost never rises to the
spiritual height of knowing his own imperfections, mistakes and sins. In this
way, neurasthenia is more or less an egotistical neurosis, nurtured by the
passion, which the holy fathers called pride or conceit.
Father Alexander Elchaninov wrote: "Nervousness and so on are
expressions of sin, and specifically, pride. The main neurasthenic is the
devil. Can one imagine a humble, kind, patient person as a neurosthenic?"
"Irritability comes from not knowing oneself, from pride, and also from
not realizing the depth of our nature’s damage, and from not knowing the meek
and humble Jesus." (Righteous St. John of Kronstadt). "No one should
justify irritability with some illness" (Elder Ambrose of Optina).
The Archbishop Arseniy (Zhadanovsky) wrote the following concerning the
reasons for irritability and loss of spiritual peace: "Sometimes an
irritable state comes upon you suddenly, discontent with people around you, an
oppressed state of the soul, melancholy, disappointment. The littlest thing —
and your mood is ruined. Why? Apparently, your spiritual ground was prepared
for this mood previously. Irritability, discontent are called out by envy,
hostility towards them…"
Thus, we can infer, that neurasthenia is more or less the consequence of
departing from Christ, falling into neo-heathenism. It is an expression of
passions. Neurasthenia can be considered in its way the opposite of meekness,
humility, patience and a peaceful structure of the spirit.
Priests of the Church paid particular attention to keeping peace of the soul
under any life circumstances. "I do not wish you riches, or fame, or
success, or even health, but only spiritual peace. This is the most important.
If you will have peace — you will be happy" (Ven. Alexis of Zosima). A
logical deduction follows: the best medicine for neurasthenia is deep
repentance, a Christian way of life, with patient and humble carrying of one’s
Obsessive-compulsive neurosis. Obsessions, that is, existing outside
the will and desires of a person, could be specific thoughts, memories, images,
doubts, as well as acts. Obsessive fears are also assigned to obsessive
neuroses. If a person experiences unaccountable fears of the unknown, it is
called a fear syndrome; if he fears something concrete, like darkness, heights,
sharp objects, close spaces, similar obsessive states are determined to be
phobias, specifying their particular fear by their names. For example,
cancerophobia — fear of cancer, claustrophobia — fear of small spaces,
hypsophobia — fear of heights, misophobia — fear of being dirty, pantophobia —
fear of everything around you.
Sometimes phobias appear only in appropriate circumstances: fear of
heights only when rising to heights, fear of mice only upon seeing one (Peter
the Great, for instance, panicked at the sight of cockroaches); but sometimes
they arise at the very thought of something.
Fear is inherent in fallen man’s nature ("Fear is absence of firm
hope," said St. John of Damascus) and deeply biological, because man
carries within himself an animal beginning, which instinctively fears threats
from without: darkness, attack and so on. In many instances, this acts as a
defensive mechanism, protecting us from all threats to our well-being. By
fearing, a person becomes more cautious, is able to protect himself, to save
himself from approaching threat. Fear is instituted by nature in the memory
from previous generations, as psychoanalysts say, in the "collective
unconscious" (Carl Young).
But neurotic fears are characteristically not based on any real threat, or
it is an illusory or unlikely threat. For example, one person suffers from
cardiophobic neurosis, that is, he fears that his heart will stop at any
moment. On one hand, theoretically that is possible, because sudden death
occurs even among young, apparently healthy people, but the objective
possibility of such a sudden heart stoppage in such a person is miniscule,
while it has a place as an artificial, imagined, fantasized threat to life,
conditional on false thoughts and unfounded fears.
Here is another example: a mother, fervently loving her child, all of a
sudden catches herself thinking that she might suffocate him. This thought horrifies
her, it does not correspond to her moral views, is not dictated by any real
external circumstances — just the opposite, it is absurd, without any real
reason. But, like a splinter, it becomes rooted in her consciousness, continues
to bring her pain that she is ashamed to acknowledge to anyone.
Obsessive thoughts often begin with the question "What if?" Later
it becomes automatic, becomes rooted in the consciousness, and, repeated often,
create real difficulties in life. And the more a person battles with them, the
stronger they take hold.
The main reason for the development and the very existence of neurotic fears
is the overblown sensual imagination, which is usually by-passed by the special
literature devoted to this subject. A person, for example, does not simply fear
falling from heights, but "ignites" the imaginary situation,
imagining his funeral, seeing himself lying in the coffin and so on.
Besides this, in similar states, there is weakness of mental defenses
(censorship) due to the natural individualities of the given personality or as
the result of a sinful state. It is common knowledge that alcoholics are more
susceptible to suggestions. Debauchery substantially weakens spiritual
strength. The lack of continual internal effort of self-control, spiritual
sobriety and conscious administration of one’s thoughts is manifested (these
efforts are described in the literature of the holy fathers).
It must also be admitted that some thoughts are in reality foreign to a
given person, therefore demonic. Unfortunately, a person is often unable to
determine the true source of his thoughts, and the demonic suggestion easily
enters into his soul. Only experienced monks and holy people already purified
by prayerful tasks and fasting, are able to reveal the approach of dark
spirits. The souls of usual people, enveloped by sinful darkness, often do not
sense or see this, because it is hard to see what is dark in the dark.
St. Ignatius (Brianchaninov) explains: "The spirits of hate conduct war
against humans so cleverly, that thoughts and ideas suggested by them appear to
be the person’s own."
Bishop Varnava (Beliaev) writes: "The mistake of modern persons is,
they think that only they suffer "from thoughts," while in actuality
they suffer even more from demons… Then, when they try to defeat thought with
thought, they see that opposing thoughts — are not simply thoughts, but
"obsessive" thoughts, that are impossible to deal with and before
which a person is helpless, which have no logical connection and are foreign to
him, extraneous and hateful… But if a person does not recognize the Church,
grace, holy mysteries and the value of virtues, how can he defend himself? Of
course he can’t. And then, since the heart is empty of humility and other
virtues, demons come and do whatever they want with the mind and body of the
person" (Matt. 12:43-45).
These words of Bishop Varnava are fully confirmed clinically. Obsessive
neuroses are harder to treat than any other neurotic type. Often they do not
submit to any therapy, exhausting their victims with the most severe
sufferings. In stubborn obsessions a person is steadfastly deprived of his
ability to work and simply becomes an invalid. "Fear causes great harm, —
writes the Elder Macarius of Optina, — the body is weakened by the decline of
the spirit and the absence of tranquility, and illness comes without
illness." Experience shows that true recovery can come only with the grace
The fear of God (reverence before their Creator) is necessary for every
person, but this great gift is often distorted and replaced by animal
cowardice. The fear of God has several levels, the first of which is fear of
violating God’s laws — sinning, doing something vile, unworthy, and offensive,
in the eyes of God. The second level applies to more accomplished pious
ascetics and consists of the fear of falling away from God, losing His grace,
holy peace, for this departure would mean spiritual death.
"Behold, the fear of the Lord, that is wisdom," — say the
Holy Scriptures (Job 28:28). "By living without the fear of God, one
cannot accomplish anything noble or amazing," writes the universal teacher
of the Church St. John Chrysostom.
On the basis of the literature of the holy fathers, we can conclude that it
is precisely the fear of God that is capable of healing a person of his
neuroses: when a person gains this spiritual gift, then this noble fear drowns
out the other small, day-to-day living fears. Just as a large wave on the ocean
absorbs the small ripples, so does the true fear of God consume neurotic fears
And finally, the last aspect related to the reason for the rise of fear,
which is also not discussed in scientific literature. We see it pointed out in
the Holy Scriptures: "There is no fear in love; but perfect love
casteth out fear: because fear hath torment" (1 John 4:18). It turns
out, that the presence of fear in the soul and heart of a person means the
absence or lack of love for God.
Let us now briefly discuss obsessive (compulsive) actions.
Their character may be very different. They often take the form of some
habitual ritual and are repeated contrary to logic and necessity. For instance,
the obsessive washing of hands; rituals while dressing and undressing;
senseless moving of furniture; counting money constantly; tapping, rocking;
avoidance of specific objects; repetition of specific words and actions upon
contact with some seeming evil. A feeling of relief upon performing the
obsessive action is characteristic. But this relief is temporary and soon the
need to repeat the given ritual arises again.
An important moment for clarifying the nature of obsessive actions is their
aforementioned alien nature and their compulsion to performing senseless acts.
This is what Bishop Varnava (Beliaev) writes about this: "What is the source
of this coercion, if a person with all the strength of his soul rejects and
doesn’t want it, considers it an element alien and abnormal? Clearly, from
another spiritual essence — evil and unclean. Then one understands the illogic
of thought, this tyranny, of which scholars themselves speak, one understands
the relief after completing the act… (that is, the devil departs, glad, that he
forced a person to do something against his will), one understands the
agonizing discontent with oneself, because the person’s conscience tortures the
person for listening to the devil."
In particularly difficult cases a person cannot control himself and becomes
a sort of "biorobot." Remember, for example, the ritual murder of the
three monks in the Optina Monastery, performed by a criminal who later
admitted, that some strange power forced him to perform this crime and he could
not resist it. Other criminals often mention a similar force that overpowers
the will and consciousness. This, by the way, does not lead to their release
from legal responsibility. Drug addicts and alcoholics also mention a strange
forcible irresistible desire. The power that stands behind all this, I think,
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