Neurosis is a result of a child's difficulty in dealing with a potentially hostile world. Horney's describes 10 neurotic needs that she placed into 3 categories. These needs cause individuals to:

1. Go towards others (These are the compliant types. Their needs are connected with moving towards people. They have a neurotic need for affection and approval, for a partner to control their lives, and for a life within restricted borders).

2. Go against others (These are the aggressive types. These people have a neurotic need for power and are associated with moving against people. They believe others are hostile and untrustworthy. They are highly competitive, and they are driven to demonstrate continually that they are the strongest or the smartest. The main reason for having people in their lives is to enhance their own prestige, wealth, or power).

3. Go away from others (These are the detached types. They have neurotic needs for self-sufficiency and perfection. Their needs are associated with moving away from people. They tend to operate in total secrecy. They are very reluctant to reveal even the most basic and trivial details of their lives. Most of their activities are solitary).

Karen Horney, (pronounced Horn-eye), was pushed into a state of depression early in life. She was trying to finish her medical studies while juggling the responsibilities of motherhood when her mother died and she begin to experience difficulties in her marriage. As a result, Karen entered therapy. She became very disappointed with the whole process and the basic principles of psychoanalysis. Horney became very active and outspoken against the primary canons of psychoanalysis. This is where she came out against Freud and what he labeled as "penis envy".

According to Freud, many of the abnormalities seen in women can be directly related to their frustrated wishes to become men. He further stated that the most disturbing aspect for women in their development is when they discover that boys have penises and they do not. The Freudian view of development leads to the unequivocal conclusion that women are inferior to men. This inferiority complex is an expression of contempt for their womanhood because of their lack of having a penis. In short, Horney rejected Freud's concepts on the Oedipal conflict and Penis Envy as being responsible for the development of female character and his theory of female masochism. She did go on to state that penis envy did derive to a degree from anatomical differences between man and woman, but a more important
and accurate reason for this is cultural and social forces in this patriarchal society that indoctrinates male superiority and female inferiority.

Anatomy is not necessarily destiny, but it plays an important role according to Horney. She further maintained that women must realize that their inferiority complex is based on unconscious acceptance of the belief of male superiority. This complex that women feel can only be changed when the society as a whole becomes more democratic and egalitarian. Out of her departure from Freudian psychoanalysis, Horney came up with an outline and description of 10 neurotic needs: the need for affection and approval, the need for a partner who will take over one's life, the need to restrict one's life within narrow borders, the need for power, the need to exploit others, the need for social recognition and prestige, the need for personal admiration, the ambition for personal achievement, the need for self-sufficiency and independence, and the need for perfection and unassailability.