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Psychoanalysis first developed as a method of therapy in the strict medical sense. Freud had discovered that certain circumscribed disorders that have no discernible organic basis—such as hysterical convulsions, phobias, depressions, drug addictions, functional stomach upsets—can be cured by uncovering the unconscious factors that underlie them. In the course of time disturbances of this kind were summarily called neurotic.
After a while—within the last thirty years—psychiatrists realized that neurotic people not only suffer from these manifest symptoms but also are considerably disturbed in all their dealings with life. And they also recognized the fact that many people have personality disorders without showing any of the definite symptoms that had previously been regarded as characteristic of neuroses. In other words, it gradually became more apparent that in neuroses symptoms may or may not be present but personality difficulties are never lacking. The conclusion was thus inevitable that these less specific difficulties constitute the essential core of neuroses.
The recognition of this fact was exceedingly constructive in the development of psychoanalytical science, not only increasing its efficacy but also enlarging its scope