In psychoanalysis, the combination of processes that determine which particular neurosis a patient develops. The notion that a patient in some sense chooses a neurosis was first mentioned by Sigmund Freud (1856–1939) in a letter to his friend, the German physician Wilhelm Fliess (1858–1928) in 1896 (Standard Edition, I, pp. 220–1) and was developed fully in 1913 in an article on ‘The Disposition to Obsessional Neurosis’ (Standard Edition, XII, pp. 317–26). See also compromise formation, return of the repressed, symptom formation.