Neurotics are very different from individuals with a character disorder on the dimension of anxiety. Anxiety is that primal emotion (i.e. fear response) that we get when we feel threatened in some way. When our fear is attached to a specific, identifiable circumstance, such as being in a room filled with a lot of people, having to take a test, or coming face to face with a snake, we call it a phobia. When our apprehension does not appear connected to a specific thing or circumstance, is unidentifiable, unknown, or unconscious, we call it anxiety. Experiencing too much anxiety, especially with regard to urges or issues that shouldn’t normally evoke high levels of anxiety is the number one way to know if someone is neurotic as opposed to character disordered. Neurotics can suffer several a host of maladies that are either directly caused or exacerbated by their anxiety such as stress-related ulcers, tension headaches, fear-based avoidance of crowds or open places (i.e. agoraphobia), obsessive worry, fear of abandonment, etc.
Character disordered individuals are notoriously nonchalant about the things that most others get upset about. They don’t experience enough anxiety when it would be normal or even beneficial to do so. The disturbed character doesn’t get apprehensive enough about his conduct. He is too indifferent and unshaken when problems arise as the result of the way he does things, and he remains too unnerved and unperturbed in the face of conflict. The disordered character doesn’t do the dysfunctional things he does because some past trauma has him too hung-up to do otherwise. He does what he does because unlike the neurotic, he lacks the capacity to get hung-up enough to think twice about his behavior and inhibit himself and restrain his conduct. A little of the neurotic’s typical apprehension would go a long way toward helping the disturbed character be more cautious or hesitant when it comes to doing the things he does that frequently cause problems.
For several reasons that I have never fully understood, traditionally-oriented therapists and relatively neurotic individuals seem to insist upon ascribing fears and insecurities to disordered characters that simply don’t exist. They will frequently misinterpret the behavior and motivations of character-disordered individuals and frame things inappropriately. For example, some disordered characters have such a passion for novelty and such a craving for excitement that they constantly seek shallow, intense, and short-lived high-risk sexual involvements or other interpersonal entanglements. But this thrill-seeking behavior is sometimes framed as a “fear” of intimacy or commitment. I think this mistake is often made because it’s difficult for neurotic individuals to imagine why a person wouldn’t necessarily prefer a stable intimate relationship over multiple risky encounters unless they were in some way afraid of a deeper relationship. This kind of thinking also reflects a long-held but unproven tenet of classical psychology theories that everyone will naturally gravitate toward the healthiest life choices unless they are hung-up by unconscious fears born of early trauma. The disordered character is very different from the neurotic on this key criterion. For the most part, neurotics experience too much anxiety. Disturbed characters don’t experience enough anxiety, especially at times when some gut level apprehension would serve them and the rest of society well.