1977,41,763-776. @ Psychological Reports 1977
CONCEPT OF CHARACTER REVISITED: AN EGO-PSYCHOLOGICAL VIEW W I T H SOME THOUGHTS ON THE "DEPRESSIVE" CHARACTER NEAL DYE AND HAROLD J. FINE Oak Ridge Mental He& Center and University of Tennessee Summary.-The concept of character in the psychosnalytic literature is reviewed with reference to differentiation of character and its theoretical derivatives from thc concept of neurotic adaptation. Developments in psychoanalytic ego psychology and cognitive psychology are incorporated into a proposed framework for viewing character strucrure in light of socialization processes and the role of ego functions. This formulation of character more consonant with generalized life-styles is applied to an apparent "type" of character structure and organization at post-genital levels, labeled "depressive character." Some preliminary implications for tactical issues in the therapy process are noted.
Developments in psychoanalytic ego psychology and object relations have resulted in modification in the techniques of psychoanalysis and analytic psychotherapy. These changes have focused on the extension of treatment to more severe forms of psychopathology and more developmental primitive disorders (Giovacchini, 1975; Guntrip, 1969; Masterson, 1976; Kohut, 1971). These syndromes such as character disorders, borderline states, and narcissistic personality disorders were considered at one time to be beyond the scopes and limits of psychoanalytic treatment. Instead they have recently become the focus of major extension of treatment which has led to significant revisions and extensions of theory. This expansion of applicability of psychoanalytic ego psychology has been, however, rather exclusively focused on pregenital or pre-moral levels of development and (fixation). In this paper we propose an extension of theory and concomitant revisions of technique to incorporate psychopathology at levels advanced beyond genital-level development, i.e., an ontogenetic expansion to incorporate such factors as psychosocial issues and life-style dimensions within an ego-psychological framework. The implications of such an attempt are, of course, sweeping and profound. W e note here that such a proposal derives from experience in treatment of a group of patients whose presenting problems raised major questions in their lack of fit with widely accepted ego-analytic concepts and diagnostic criteria. In our search for a paradigm which would provide a sound theoretical as well as empirical explanation, we have traveled a circuitous and at times convoluted path. What that path has indicated to us is the importance of a re-examination of the concept of character in light of the last twenty years' developments in ego psychology. This we propose to do, as to present justification for post-genitallevel pathological adaptations and to relate to this the data derived from treatment of those patients whose status led us to re-examine our basic concepts.
Theoretical lssaes From an historical perspective the concept of life-style can be viewed as a partial reformulation of a theoretically "old" issue, having its origins in ego psychology and psychosocial developments in psychoanalytic theory. This area is perhaps best defined in the writings of Reich ( 1949) and Horney ( 1942, 1945), which emphasize the maladaptive life-styles or "neurotic character" in neurotic individuals. That is, character structure is seen as primary in leading to symptom formation, and yet symptoms as such may or may not be evident. As Horney viewed disordered behavior, every neurosis is a character neurosis, character referring to the organizations of thoughts, affects, perceptions, etc., a person has developed over the course of his life. Horney's criteria for neurotic character concern relatively invariable patterns of behavior which are overly generalized, occur indiscriminately, and are applied without variation and regard to situational appropriateness. Features of Horney's neurotic character which differentiate it from the "normal" are the apparent incongruities of the person's general functioning in contrast to his capabilities, background, and attributes. In other words, the neurotic character demonstrates inappropriate relationships between behaviors and the situations in which these occur, and as a style of living, with or without manifest symptomatic behaviors, there are always generalized difficulties in dealing with everyday life. Reich differentiates neurotics from neurotic characters on the basis of symptoms versus neurotic character traits, stating that the "basis of a symptom neurosis is always a neurotic character." A neurotic symptom is ". . . experienced as a foreign body . . . an illness;" a neurotic character trait is ". . . organically built into the personality." His widely accepted criteria for differentiating the symptom neurosis from the character neuroses include: (1) the "organic" inclusion versus "foreign body" dimension, ( 2 ) more thorough rationalization of the character trait versus the meaninglessness of the neurotic symptoms, ( 3 ) the simpler construction of the symptom and its relative closeness to the surface, and (4) the symptoms' correspondence to a single experience versus the character's correspondence to the specific individuality of the person. Reich's best known contribution to psychotherapy is in dealing with resistance, which he termed "character armoring." For Reich, character armor meant "a compact defense mechanism," a "protection from external reality and internal impulses," a generalized way of binding anxiety. Character resistance was seen as expressed in the formal aspects of general behavior, ". . . the how, not the what." If one were to accept the current view of character, it would seem that a "disorder of character" is a particularly primitive or pathological personality organization which is always severely disabling. This emphasis simplifies the concept of character disorder thereby justifying implicit assumptions regarding the types of relevant treatment and/or prognosis. Contrasted with the theme of character as a general life-style reflecting individualities of the organization of
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thoughts, affects, defenses and attributes this latter definition of character disorder can be seen as most restrictive. Beginning with Freud's observations regarding resistances and continuing through Reich's and Horney's emphasis on generalized maladaptations in "neurotics," one point seems recurrent. This is the emphasis on certain aspects of behavior as rather more resistant to therapeutic modification than others, these former behaviors representing deeply ingrained modes of adaptation and functioning which characterize the individual as an individual. Consistent with the contentions of Reich and Horney (and in addition, Freud), no individual develops a psychoneurotic symptom without first having developed a life-style conducive to such symptomatology, a life-style characterized by particular areas of inhibition or disinhibition, or by particular "security operations" or defense mechanisms. That school of thought which most thoroughly deals with the present emphasis on character is ego psychology (Fenichel, 1945). Viewed from the theoretical framework of ego psychology, character, as defined by Fenichel, represents:
. . . the habitual mode of bringing into harmony the tasks presented by internal demands and by the external world . . . necessarily a function of the constant organized and integrating part of the personality which is the ego (p. 467). This definition is somewhat expanded and restated by Prelinger and Zimet (1964) as: The particular way in which prominent instinctual demands are channeled and expressed, . . . but decisive is the overall, habitual dynamic organization in which the ego simultaneously deals with the multiple demands of the id, the superego, or external reality, and which is influenced by the ego's defensive and adaptive resources (p. 2 6 ) .
These authors suggest that character be viewed in terms of autonomous ego functions, emphasizing "styles and organizations" as "formal modes through which a person's ego structures its perceptual relations with the external world." Recent attempts to re-define and reformulate concepts in cognitive and psychoanalytic ego psychology can be viewed as expressing two common concerns. Holt ( 1965 ) , for example, has argued that many biological assumptions implicit in psychoanalytic theorizing are hardly consistent with current knowledge of the functioning of the human central nervous system. This view suggests that the "passive reflex model" of the central nervous system and its concomitant elaboration in closed system theories of personality may well have been a significant obstacle to the development of a theoretically and empirically systematic ego psychology. A second related area of concern has been the construction of alternatives to the "disease model" of human adaptive failure, which have generally emphasized stylistic features of individual adaptation. Shapiro (1965) has attempted to delineate styles of thinking, perception, and affective experience which characterize and differentiate hysterical, obses-
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sive-compulsive, paranoid, and impulsive types. A similar approach was taken by Phillips ( 1968) in a research program directed towards the establishment of systematic relationships among symptom clusters and styles of life. Shapiro defines styles as ". . . a form or mode of functioning . . . that is identifiable, in an individual, through a range of his specific acts." Phillips contends that ". . . the clinician implicicly makes use of behavioral style constructs in arriving at the diagnosis of a specific mental illness." While neither of these systems is proposed as absolute or comprehensive, they do seem to offer alternatives to the disease model, and to the current classification systems which have well-known inadequacies. They conclude that the theory of character has led to the inclusion of characteristic individual forms of a variety of adaptive and defensive functions, of enduring intrapsychic structures and "of the unique ways in which all these structures, functions and contents become organized and come into play as an integrated unit." These various points of view seem to possess a core of similarity in their emphasis on ego functions (or peripheral aspects) in character structure. Rather than being viewed exclusively as the behavioral derivations of psychosexual fixations, with the consequent centrality of erogenous zones and their typical modes of adaptation, character structure becomes defined by a unique clustering of responses of the individual to the demands of living, responses which because of their adaptive ability become strengthened and therefore integral features of the individual's adaptation. Moreover, ego psychology has increasingly challenged libidinal theory because of its well-known inadequacies. Guntrip ( 1969), for example, argues for a reformulation of libidinal drive to a "life force" concept, which would include psychosexual features but simplify the metapsychology of psychoanalysis considerably. A typology of character thus expanded from a strictly psychosexual framework allows for a variety of different types, theoretically as diverse as humans have methods of adapting to their internal promptings and environments. Different character structures are not then necessarily "episexual" at core and may be conceived of in a psychosocial context. Practically speaking, however, western man in western culture has a limited number of adaptive styles, which are generally agreed upon in clinical practice. An additional aspect of the current conceptualization of character is its allowance for the acquisition and entrenchment of stylistic features at more advanced developmental levels, with the implication of greater complexity and more socially relevant "meaning" than the general modes of relating associated with psychosexual stages alone. Following Erickson's stages, these might be labeled "psychosocial" fixations, with varying degrees of crippling or inhibiting consequences for adult adaptation. In this respect the assessment of character structure would automatically include both assets and liabilities of life-style, specifying strengths a s well as weaknesses viewed within a framework of developmental phases or sequences extending throughout the maturation process.
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When applied to the previously discussed "neurotic character" or "character neurosis," this conception of character allows for the inclusion of a greater variety of functions. The critical emphasis of this analysis lies in the differentiation of ego functions as developed by the on-going "school" of ego psychology and beginning with Hartmann's (1958) delineation of the synthetic, adaptive, and integrative functions, and the conflict-free ego sphere, generally referred to as "executive functioning" (Turner & Cumming, 1967). In defining the conflict-free sphere as ". . . that ensemble of functions which (ordinarily) at any given time exert their effects outside the region of mental conflicts." Hartmann implies that the synthetic, adaptive, and integrative functions are primarily concerned with defense mechanisms and the individual's psycho-social conflicts. On the other hand, executive functions concern skills or complex sequences of motor and/or symbolic behaviors essentially independent of the "synthetic" functions. As elaborated by Turner and Cumming, the conventional assumption that effective executive functioning is necessarily an end-product of intact synthetic functions may be inaccurate. If executive and synthetic spheres are regarded as having degrees of independence and interdependence, therapeutic attention could conceivably be directed to either set of functions and thus the variety of behaviors associated with the clinical conception of general functioning and adaptation expanded. From this point of view it can be easily seen that "symptoms" of ego failure or dysfunction can be delineated in many areas of individual-environment transactions. As clearly stated by Turner and Curnming, this orientation suggests that one approach to the therapeutic modification of disordered behavior might be:
. . . to recognize social "symptoms"
of ego failure and to work directly on enhancing executive functioning, rather than to continue in the belief that if we could just learn to uncover and remove the pathogenic sources of symptoms, the individual would become a more effective, instrumentally competent human being. It may even be reasonable to hypothesize that enhancement of executive functioning may affect synthetic processes, producing a reduction in symptomatology (p. 53).
The similarity between this orientation and that of the behavior therapies is obvious, but more important here is the idea that both synthetic and executive ego functions can be the focus of the therapeutic process. With respect to the present conceptualization of character structure, this differentiation of synthetic and executive functions is considered to be an approach to the for& aspects of behavior expressed in the deeply ingrained or stylistic aspects of behavior and to an explication of some ways in which a disordering of character may occur, i.e., via the contamination of executive functions by impaired synthetic-integrative-adaptive functions and the consequences of such a contamination for the synthetic functions. It is interesting to note that Hartmann ( 1958) referred to Reich's concepts of automatic reactions in the genesis
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of character neuroses. H e further noted that "automatized" functions indude motoric, perceptual and cognitive behavior or what he termed "apparatus formation," not nece~smilyof a pathological natwe. In fact, Hartmann further states that ". . . automatization is a characteristic example of those relatively stable forms of adaptedness which are the lasting effects of adaptation processes." The major extension of this thought to the concept of disordered character is in the notion that automatic ego functions in such cases may be too inflexible, and therefore inappropriate, and may act as impediments to healthy synthetic functioning. Again, Hartmann states that: Healthy people too obey "musts." They are not mollusks; they have "characteristics: and these are simply relatively stable reaction forms which are not reconsidered at every occasion . . . the ego must not be equated with one of its functions, [i.e.] flexible thinking and action; . . . the healthy ego chinks and acts flexible, but nor exclusively s o . . . (pp. 94-95).
In summary, what we have proposed is a reconsideration of character structure which gives primary consideration to ego functions and particularly to those which become more or less automatized over time. Our emphasis in the assessment of disordered character is directed towards specification of these functions as they are manifested in the formal or qualitative aspects of behavior and in the reciprocal relationship postulated between executive and synthetic-adaptive ego functions as stylistic or characteristic aspects of an individual's general behavior. Thus we are speaking of the development of types of adaptation which result in a deficit in either synthetic functioning or executive functioning, or both. It is dearly implied that these styles are subject to individual variations within the class and further that their relative inflexibility may be maladaptive in the sense that the life-style provides a receptive matrix for symptom formation and even further that some styles may in themselves be considered maladaptive, with or without conventional symptomatology.
Clinical Data At this point the conceptualization of character outlined in Part I can be more clearly defined by referring to actual cases. The particular type of patient to be discussed is one which to us expresses in concrete fashion the differences between character neurosis and psychoneurosis or symptom neurosis. W e have chosen the label "depressive" character type, which obviously concerns a lifestyle based upon deeply rooted convictions of hopelessness and despair. The similarity of these individuals is striking and suggests the hypothesis that such a disorder of character is the outcome of the interaction of a particular set of psychosocial conditions and a particular type of character organization. The patients reported here are all women, married and in the third decade of life. Their application for psychotherapy follows the development of the usual symptomatology seen in the psychoneurotic depressive reaction. Historical data indicate the absence of disorder or symptomatology at any point in the
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past. Indeed, until the appearance of the depression they appear to have lived rather well-adjusted lives although in each case there has been a fair degree of underachievement. The initial diagnostic assessment raises several paradoxical aspects. First, a rather well-integrated personality with prominent intellectual resources and emotional maturity emerges. There seems to be a fair degree of genital maturity, which from a conventional diagnostic framework is quite inconsistent. While such usual depressive liabilities as introjected hostility, somewhat excessive guilt, and denied dependency needs are apparent, these seem effectively counterbalanced by a demonstrated capacity for intimacy, and a reasonable development of synthetic and executive functions of the ego. In short, these are not "sick characters, but women who seem closer to self-actualizing activity than to mere homeostatic balance. They may also reflect some of the findings of Horney ( 1945 ) such as the avoidance of success, albeit in a clinical sense (Hornet, 1968a, 1972 ). The therapist's initial reaction is quite often a sense of bewilderment about the real basis for the depression. Here are bright, generally responsive women, in the prime of life, with no apparent serious liabilities, who appear capable of attaining any reasonable goal for which they might strive, yet they are depressed. Their depression seems to be the only aspect of their behavior which marks them as having psychological difficulties. Otherwise they are characterized by generally mature functioning. And further, neither they nor the therapist initially are able to specify a source for the depression which reasonably matches its intensity. Through the extensive investigation of treatment, some characterological features become evident as the basis of depression. It quickly becomes clear that the "neurotic" depressive symptoms are associated with a "fate neurosis," a lack of meaning in their lives expressed as a pervasive feeling that "something is missing" but exactly what they do not know. Historically, there is an undercurrent of a desertion theme running throughout their interpersonal relationships, particularly in the heterosexual sphere. The derivative of this theme in the patient's awareness is seen in deeply ingrained hopelessness, and their sensitivity serves to reinforce this hopelessness. One patient who fits this typology came from a family where the father deserted when she was seven. Subsequent relations with paternal surrogates and later male peers always took on the aspect of re-enactment of this desertion, and many times this seems to have been masochistically motivated. There is the demonstrated capacity for meaningful and intense love relationships, particularly at their inception, however, particularly with love relationships, there is great difficulty in sustaining and maintaining these, and they invariably become exceedingly ambivalent. Another feature of the character structure is an intense longing, a kind of cognitive and affective hunger and yearning which seemingly can never be fully
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invested or resolved; this too strengthens the experiential depression, sometimes to the point of suicidal ideation. There is thus a shift of emphasis to "coping" with the present situation as a paramount concern accomplished through efficient obsessive-compulsive occupation with daily routines and social commitments of an admittedly unsatisfactory nature. Hence there appears the opposition to two very intense and deeply rooted characteristics. The great need for involvement and investment in self-obscuring activity, and the conflicting conviction of the hopelessness of such activity uniformly and invariably result in despair. By the time treatment is sought they have developed an ambivalence between these two directions which has become a major obstacle to even daily routine. Yet the underlying hopelessness leads to concern that the treatment too, will also be pointless, often expressed as a somewhat humorous statement, that even the treatment must at some time end, and without regard to the actual gains that might be achieved. As treatment progresses, the neurotic depressive symptoms abate yet the depressive cycle remains. The dilemma they pose for the therapist, as a characterological tactic, centers around their being treated by the therapist as either dependent or autonomous. Neither can be tolerated for very long, despite concrete evidence of each in themselves, weighing more heavily in the direction of autonomy. It further becomes apparent that this dilemma typifies their other relationships, and a s a tactic it frequently leads to "desertion," if only psychologically, which only serves to intensify the hopelessness and despair. One cannot avoid, it would seem, the acknowledgement that this is in many respects the dilemma of the bright, responsive, and mature women in our contemporary culture. Despite the ostensible investment with this quality in most women of these outstanding attributes, its greater intensity in the depressive character-type poses therapeutic problems. While many sectors of the treatment will concern modifications of minor or mildly self-diminishing traits such as facilitating expression of affect, lessening of guilt and introjection of hostility, any modification of the hopelessness and despair cycle and its resultant withholding of egeinvestment in genuine activity does not necessarily follow. I n terms of treatment objectives and methods the present conceptualization of character structure and character neurosis offers several hypotheses. First, it should be remembered that the focus of treatment quiddy shifts from "neurotic" symptomatology to the character or life-style which has led to the development of such symptoms. The depressive character-type, with its cycle of despair, can be seen as demonstrating a contamination of both synthetic-adaptive and executive functions, and a consequent reduction of the conflict-free ego sphere. Therefore, one aspect of the treatment program would appear to be directed at the reestablishment of effective executive functions, and a withdrawal of synthetic functions from their position of prominence in the conflict-free ego sphere.
CHARACTER: EGO-PSYCHOLOGICAL VIEW Case History
The following representative case illustrates several aspects of the depressive Life-style and the possible effect of therapeutic intervention. Specifically these aspects include the differentiation of psychoneurotic "symptoms" from the life-style and manifestations of the life-style in thought and affective processes. Mrs. G., a 39-yr.-old, white, married mother of five children, applied for treaunent because'she was extremely depressed, had been crying frequently and at "awkward" moments, and generally felt that she was "coming unglued." A short, slightly heavy but rather attractive woman, she describedher. depression as having gradually and insidiously increased over a period of several years. Her depression exacerbated following the cancellation of her plans to return to college for graduate study, a change apparently dictated by financial concerns. What particularly upset her was the fact that she had long planned and anticipared this change as a "way out" of what had become an intolerable family situation. Her husband had been frequently absent from the home on business throughout their 17 yr. of marriage. She found herself being forced to "cope" with increasingly inadequate financial, moral and physical support. In short, she was bitterly disappointed at the disruption of her plans. She felt that she was "trapped" in the role of a housewife and she felt that this latest upset had confumed what she had long "half-believed," i.e., that she never should have gotten married. She saw this latter confirmed as the basis for her inability- to -perform routine tasks around the house, and she resented the demands made upon her because she felt so totally responsible for the family. Somewhat paradoxically she stated that she had no desire for her husband to change jobs or for any other readjustments of the family situation. Her sole desire in seeking treatment was to learn to "cope" with the existing situation. Routine ps~chologicalassessment performed at the time indicated that she was exerting a great deal of control over herself and her feelings, a control which resulted in an avoidance of any decisionmaking or confrontation with her difficulties beyond her subjective distress. ~ o w e v e i the , examiner noted that ". . . she does not approach life with the feeling of total despair. . . ." In taking one objective test she informed the examiner that she had answered the items as she would when she felt "more like herself." For the purpose of this paper only those aspects of the treatment of the patient's behavior having relevance to character neurosis and the nature of her ego impairment are presented. The patient was the oldest of four children in the family of a minister and missionary of a fundamentalist religion. Her early years were spent in a small town in the Far East where the father was assigned. A very strict, almost fanatically religious man, her father devoted his energies almost entirely to his missionary work, and demanded rigid adherence to rather, stringent disciplinary standards for his children. Mrs. G., the oldest child and only daughter, was,
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however, his favorite, and he spent a great deal of his time at home with her. The parents' relationship was evidently based more on custom and convenience than on any warm or meaningful feelings, and the patient's mother was constantly preoccupied with church affairs or the rituals of homemaking. The father directed all his tender feelings toward the patient, who by adolescence felt that she had "taken her mother's place" as companion and confidant to her father. The mother was apparently an extremely embittered and highly passive individual who required constant reassurance and support but was unable to give of her own feelings. Since the patient's brothers were considerably younger than she, her relationships with them were somewhat distant, but she was rather awed by their intelligence and ability, and evidently they responded to her as a "typical sister." During her mid-adolescence the family returned to the U.S., the father having accepted a pastorate in a small Southern town. By this time the patient was a "model" child, very devoted to her parents, yet at the same time very angry and distressed by their overprotectiveness. She was quite tom-boyish throughout adolescence and did not really become aware of her sexuality until she left home to attend a small denominational college in another part of the state. Apparently she was "awakened" as a woman by her eventual husband. She quickly became deeply enamored of him but without sexual involvement for several years until immediately prior to their marriage after graduation. The husband is described as an unusually handsome and "magnetic" personality, and Mrs. G . could never really understand his attraction for her. Yet their marriage was satisfactory for the first 5 yr., and the patient experienced reasonably mature genital sexual response. During these early years the husband's occupation necessitated numerous changes of location. As her children were born, however, a compromise was affected, although the husband accepted a job which required his frequent absence from home, Mrs. G. and her children set up a permanent household in a Southeastern city. Because of the husband's frequent absences, the brunt of responsibility for managing the home, children, and family finances fell to Mrs. G., who initially eagerly accepted this. As time passed their relationship was maintained by their lack of long-term contact, more or less keeping the relationship on the level of a protracted affair. Mrs. G. joined a variety of social and church-related organizations, although she had long before "lost" her religious convictions, despite the burden which these additional commitments posed for her. In addition, she quidtly and consistently sought responsibility in these activities, until she became generally recognized as a "doer." At the time she sought treatment the responsibilities had become more than she could effectively tolerate. The therapist's suggestion that she might reconsider her social commitments led to a rapid cut-back in this area. Further, the suggestion that she attempt to seek another form of involvement outside the home led to her immediate enrollment in a training program for auxiliary personnel in the mental health field. The therapist comments that she seemed to
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be "coping" quite adequately under the new circumstances, and within a 6-wk. period her symptomatic depression had markedly ameliorated. There were, however, several aspects of her behavior which seemed highly consistent and pervasive, and further, which were clearly characterological. First, her rather over-controlled manner seemed primarily related to her inability to consider any expression of hostility or dissatisfaction with her husband or his employment. It became clear that she equated such behavior with courting disaster, or more appropriately desertion, as she had learned in her development through the gradual withdrawal of her father's affection because of her expressions of dissent with his view of life. When she was confronted with this aspect of her behavior she immediately questioned the value of continuing her treatment, saying that since the therapist was in a training facility she did not see the point of involving herself in an activity which might be prematurely terminated. A further aspect of her behavior concerned the continued maintenance of a tearful state always bordering on crying, long after her depression had cleared. Initially she described the basis for this as her compartmentalizing all of her unhappiness and distress into her weekly therapy hour. When it was suggested that this was perhaps the first relationship in her experience where this kind of emotional expression was accepted, she seemed quite surprised and became visibly anxious. She went on to her perception of the therapist as entirely impersonal, a sort of "computer" who was invariably correct in his interpretations and not subject to the usual kinds of "emotional hangups" she had found in her relations with other men. Upon the therapist's interpretation of this as a rather impersonal and, to him, hostile and self-depriving approach to interpersonal relations, the patient cried intensely and launched into a stream of self-derogatory evaluations. When it was further suggested to her that the basis for this perception was her marked inability to express negative feelings, she again became rather agitated and quite hostile, in an extremely indirect and subtle fashion. The attempt to achieve a direct expression of hostile feelings became a continuing source of difficulty in the treatment, but one which eventually led to a confrontation of her husband, making known her feelings of desertion and marked despair. Following this, she became aware for the first time of her intense hostility for her husband, and, in fact, men in general. A result of this awareness, however, was her bombardment of her husband with her feelings, which led to his emotional and physical withdrawal in the form of longer periods away from home. Subsequently she demanded that he take a more active role in family life and spend more time with her, a demand to which, to her surprise, he readily acquiesced. At this point, realizing the extent of her control, she withdrew from him sexually, but only for a short time, since the therapist pointed out the hos-' tility in this action and its similarity to other forms of immaturely expressed emotion. This trend seemed to bring forth an additional feature of her character-style,
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i.e., her pervasive but obscure feeling of the hopelessness and despair of pursuing those aspects of herself and her relationships of which she had recently become aware. Her attitude seemed to be an expression of "so what?" "What's the point of all this?" This soon became clarified as a generalized feeling that any positive steps she might take would only result in further disappointment. Because of the effort involved in continuing self-examination and her proximity to a state of positive adaptation, she felt that any disappointment would be even more bitter for her. Indirectly revealed here was another characterological feature, her longing for meaningful activity had always led to her rapid involvement and then the disenchantment with her "mission," finding it more a burdensome than a pleasureful activity. Her involvement in the training program had quickly become intense. She was enthralled by the prospects she saw for making improvements in the lives of others and yet underlying this was the feeling that "there's so much to be done, it seems hopeless," "what's the point?" Her lifespace had been modified significantly both in terms of her family and marital situation and her involvement in personally satisfying interests. Confronted with her obvious achievements both professionally and personally, she repeatedly minimized these. She knew that this was not enough, that "something was missing," but what it was or how she might proceed in discovering it she could not say. She was unable to accept her concrete achievements as meaningful, despite considerable evidence chat through her own efforts she had succeeded in modifying many aspects of herself and her lifespace. She had become a warmer, more sensitive person, capable of deriving enjoyment from mature relations with others, had become more genitally mature, and yet she was still dissatisfied. Pursuit of this point of dissatisfaction led directly into several aspects of transference in therapy which had taken on many of the features of her struggle with her outside adaptation, namely, an increasing discomfort in the patienttherapist relationship and again the feeling that something was missing. She revealed that almost since the beginning of treatment she had harbored a vague feeling of distaste for the idea of being in therapy, because it indicated to her chat she was not in control of her life and that in therapy she was confronted with the task of facing issues squarely, of having to deal with the "gloomy" side of her life. While her further comments suggested that much of her discomfort was a result of her eroticizing the relationship, she denied this repeatedly. One incident expressed her feelings and attitudes clearly. She entered the therapy office in a breathlessly excited manner, stating that she had experienced a "flashback" which seemed to "put things in perspective" for her, a recovered memory concerning her relationship with her brothers when she was an adolescent. As she began relating this her mood of happiness rapidly became tearful and sad. The memory in brief concerned her feelings about her brothers, l.e., that "they would stop to help her," but she never felt that she was "on their level, an equal." At this point the treatment was interrupted because of the death of her
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father, coincidentally following a discussion of the problerr~sone faces as one's parents age and grow ill. Her ability to "cope" with this siruation seemed to present her with the first acceptable evidence of her growth and improvement. It appeared to her that the critical factor was her own performance when faced with a situation both cognitively and affectively challenging. For the first time, she seemed able to accept the possibility and necessity of maintaining multiple perspectives of herself, of accepting some of the despair of living without depression or hopelessness. She also gained from this experience insight into several of her characterological features, i.e., her over-eagerness to seek excessive responsibility and later feel resentful toward those who allowed her to do this. Also she accepted uncertainty in the future without despair including the possibility of her mother's eventual infirmity. At this point her treatment continues, seemingly near to successful termination. The affective hunger she previously held seems to be directed more fully to her relationship with her husband and her professional work. Apparently she had faced an ultimate desertion in her father's death through which she had gained the ability to see the prospect of hope in her future. The cycle of hopelessness had not been broken, but perhaps a small port of entry had been found. W e have attempted to point out one aspect of human behavior that has received little attention in the therapy literature over the past 10 to 15 years, namely, characterological elements which contribute to symptomatology. Empirical considerations of character problems could lead to a paradoxical clearingup and simultaneous confounding of the treatment process. REFERENCES BREGER, L. I.
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Englewood Cliffs: Prentice-Hall, 1969. FENICHEL,0 . T h e psychoanalytic theory o f neurosis. New York: Norton, 1945. FORD, D. H., & URBAN.H. B. Systems of psychotherapy: a comparative study. New York: Wiley. 1963. G I O V A ~ ~ H P. I N IPrychoanalyris , o f character disorders. New York: Jason Aaronson. 1975. GREENFIELD, N. S., & LEWIS, W. C. (Eds.) Psychoanalysis and current biological thought. Madison: Univer. of Wisconsin Press, 1965. GUNTRIP, H. T h e schizoid phenomena: object relations and the self. New York: International Univer. Press, 1969. HARTMANN, H. D. Ego psychology atzd the problems of adaptation. New York: International Univer. Press, 1958. HOLT.R. R. A review of some of Freud's biological assumptions and their influence on his theories. In N. S. Greenfield & W . C. Lewis (Eds.), Psychoanalysir and cursen1 biological thought. Madison: Univer. of Wisconsin Press, 1965. Pp. 93-124. HORNER, M. S. A psychological barrier to achievement in women-the motive to avoid success. Symposium presentation at the Midwestern Psychological Association, Chicago, May, 1968. HORNER, M. S. Sex differences in achievement motivation and performance in competitive and noncompetitive situations. Unpublished doctoral dissertation. Univer. of Michigan, 1968. HORNER, M. S. Fail: bright women. Psychology Today, 1972, 3 ( 6 ) , 36-38.
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HORNBY,K. Self-analysis. New York: Norton, 1942. HORNBY,K. Our inner conflicts. New York: Norton, 1945. KOHUT,H. T h e analysis o f the self. New York: International Univer. Press, 1971. MASTERSON, J. M. [email protected]
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