fei75766_ch06_179-205.indd 202  02/06/20 11:32 AM
Part II    Psychodynamic Theories202
ofFriedman’s “healthy neuroticism:” apersonality–inflammation link.Apparently, 
combining thevigilance andworry characteristic ofneuroticism withmore respon -
sible, conscientious health behaviors results inlower inflammation, andthiswassup-
ported bythestudy’s finding thatthose whowerebothhighly neurotic andhighly 
conscientious alsohadfewer chronic health conditions andlower BMIscores.
Generally speaking, itmaynotbeapositive thing tobeneurotic andconstantly 
obsessed withavoiding negative outcomes, butthere isonlysomuch about ourperson -
alitythatisinourcontrol. Neurotic people cannot simply wake uponedayandstop
being neurotic. Neurotic trends andrelated defenses outlined byHorney arestable 
anddurable aspects ofindividuals’ personalities thatarenotlikely tochange sud-
denly. Therefore, itisimportant torealize that,though much research shows thedark
sideofneuroticism, itisnotallbadnews. Many neurotic people arequite skilled 
atavoiding negative outcomes, andtheavoidance ofthese outcomes doesindeed 
make them feelbetter onadaily basis. Furthermore, ifneurotic individuals canhar-
nesstheworry andvigilance thattheyoften experience anddirect itconscientiously 
toward cooperating withmedical regimens andavoiding unhealthy behaviors intimes 
ofstress andchallenge, theymayenjoy better health outcomes.
Critique of Horney
Horney’s social psychoanalytic theory provides interesting perspectives onthenature 
ofhumanity, butitsuffers from lackofcurrent research thatmight support hersuppo -
sitions. Thestrength ofHorney’s theory isherlucid portrayal oftheneurotic person -
ality. Noother personality theorist haswritten sowell(orsomuch) about neuroses. 
Hercomprehensive descriptions ofneurotic personalities provide anexcellent frame -
work forunderstanding unhealthy people. However, hernearly exclusive concern 
withneurotics isaserious limitation tohertheory. Herreferences tothenormal or
healthy personality aregeneral andnotwellexplicated. Shebelieved thatpeople by
theirverynature willstrive toward self-realization, butshesuggested noclear picture 
ofwhat self-realization would be.
Horney’s theory fallsshort onitspower bothtogenerate research andtosubmit 
tothecriterion offalsifiability .Speculations from thetheory donoteasily yield test-
ablehypotheses andtherefore lackbothverifiability andfalsifiability. Horney’s theory 
wasbased largely onclinical experiences thatputherincontact mostly withneurotic 
individuals. Tohercredit, shewasreluctant tomake specific assumptions about psy-
chologically healthy individuals. Because hertheory deals mostly withneurotics, itis
rated highonitsability toorganize knowledge ofneurotics butverylowonitscapacity 
toexplain what isknown about people ingeneral.
Asaguide to action, Horney’s theory fares somewhat better. Teachers, thera -
pists, andespecially parents canuseherassumptions concerning thedevelopment 
ofneurotic trends toprovide awarm, safe,andaccepting environment fortheirstu-
dents, patients, orchildren. Beyond these provisions, however, thetheory isnotspe-
cificenough togivethepractitioner aclear anddetailed course ofaction. Onthis
criterion, thetheory receives alowrating.
IsHorney’s theory internally consistent, withclearly defined terms useduni-
formly? InHorney’s book Neurosis and Human Growth (1950), herconcepts andFinal PDF to printer