« 上一頁繼續 »
THE NEUROTIC CHARACTER1
BY EDWARD GLOVER.
FROM time to time the psycho-analyst is called upon to treat certain individuals of both sexes whose illness cannot be classified under the usual categories. Indeed it may be difficult at first to understand exactly what urge has carried them to the point of undergoing a prolonged course of treatment. In some instances it is ostensibly a matter of matrimonial difficulties, in others an incapacity for social adaptation bringing with it a crop of emotionally tinged situations, in others again a tendency to 'breakdown' in phases of life requiring decisive action. Preliminary investigation does not bring much positive information: neurotic symptoms of a dramatic sort may be quite conspicuously absent, although leading questions in many cases uncover an obsessional disposition. Whatever symptomatic constructions are present have rather a larval character, for example a tendency to hypochondriacal preoccupation, mild forms of compulsive doubt, slight phobia constructions, lesser conversion or pathoneurotic symptoms or in some instances abnormal jealousy reactions together with indications that the patient's projective systems are being overworked, attitudes of exaggerated suspicion, a tendency to regard himself as the victim of conspiring circumstances. Some form or other of psycho-sexual inhibition is usually present although it may not have been regarded as such by the patient. Two facts however can usually be elicited without much difficulty, first that the individual is faced with a series of crises which recur constantly and seem to have a stereotyped form even although the environmental setting may vary: secondly, that the most acute of these crises are associated with changes in the libidinal milieu, separations from or losses amongst the family circle, problems of marriage or of marital life, changes in occupation or decisions regarding a fixed career, sudden variations in social conditions or sudden assumptions of responsibility.
Should the case proceed to analysis it is not long before some of the preliminary surmises are easily confirmed. The analytic situation with its potentialities for libidinal satisfaction is accepted with suspicious alacrity, and analysis often proceeds with that smoothness and intellectualistic avidity which indicates unconscious libido gratification and
1 Read before the Medical Section of the British Psychological Society, Nov. 25, 1925.
portends the most stubborn of affective resistances. Nevertheless from the mass of preconscious material which is produced, it becomes more and more certain that the situations of difficulty, doubt or emotional conflict have some patent resemblance. They may indeed be so identical as to merit the description 'repetitive,' but even where both stage setting and actors are widely different, the theme is worked out along identical lines, indicating an underlying mechanism common to all of the situations. Moreover it can be seen that the situations themselves although seemingly arising by chance are in fact unconsciously engineered to meet periodic stresses of instinctual tension.
The next point to be noted is the frequency with which everyday social contingencies are woven into an emotional climax and how the consequences also involve persons other than the patient. In short the latter stages two stock situations; in one of these, owing to a seemingly perverse and malignant environment, he is injured in some way or other; in the other, seemingly from no fault of his own and with the best of conscious intentions he brings unhappiness to certain significant persons in his environment. In many respects the situation is similar to that existing when, within the family circle, the neurotic is the victim of misunderstanding and at the same time inflicts considerable damage on his own capacities and on those of his family. In the latter instance however the area affected is a comparatively circumscribed one, whereas with the type we have mentioned the family circle has been widened to include the whole range of his acquaintance, indeed society as a whole represented through laws, customs, business conventions and so forth. Indeed the mechanism may be so obvious that the individual comes to be regarded by candid friends as a 'poor devil dogged by ill luck,' or as 'his own worst enemy,' or as a 'pest,' which latter category is quick to merge with that of the 'ne'er-do-well.'
By way of illustration, let us consider the following typical case. A male patient whose reasons for coming to treatment were ostensibly concerned with some hypochondriacal symptoms and some obsessive thoughts, soon indicated that what aroused most of his concern was a feeling of ineffectiveness in life and a considerable preoccupation with money affairs. In addition it was clear that, although married, his psycho-sexual life was very much inhibited. It gradually transpired that as well as occupying his attention, financial affairs constituted almost his sole activity. They seemed to be of two sorts, a concern with speculations which were intended to fulfil dreams of quickly amassed wealth but which in practice either failed in their purpose or ended in
sometimes substantial loss. In these matters he played a lone hand although the consequences sometimes involved others. But there was another group in which he acted as a kind of fairy godmother to other people, mostly men, and embarked on a series of ventures which again resulted most often in loss to himself although not to his protégé. A third situation was that of rescuing certain types in financial distress. The striking feature of the case was the persistent way in which, ignoring all previous experience, he would bring about precisely similar situations, entering anew on speculations, being drawn into new ventures and successfully sponged on by an always needy entourage. Even when his operations were successful he usually made it the occasion to transfer substantial sums to other members of the family, i.e. he was no longer in pocket. It was as if the amassing tendency was inevitably opposed by a tendency to rid himself of masses, which ultimately gained the upper hand and resulted in quite appreciable losses. With almost uncanny precision he would dally with speculative dreams until the moment for effective action was past and would then fling himself into the market to be left with a 'parcel' of stock, which he could only realize at a loss.
Another case showed a somewhat similar reaction, with this difference, that he could allow himself to be effective to an appreciable extent but after these periods of success would bring himself to the verge of actual ruin. Again and again he would exhibit great skill in building up a business; this would be followed by periods of foreboding and ultimately by disaster which in the retrospect was seen to have been avoidable. He would then start all over again with a fresh venture. In both cases described the actual steps taken were however at the time based on seemingly unassailable rationalizations. This repetitive play with means of subsistence can be enacted with every possible variation. It is seen too, although in less dramatic form, with persons who turn from one occupation to another, always abandoning one activity when a certain degree of efficiency or futility has been demonstrated. An artist becomes an actor, takes up singing, dabbles in lecturing, turns to teaching and ends in so-called nervous breakdown. We might include here too individuals such as those described by Stekel1 and Abraham2, who spend their lives in dramatic representation of some quality or other which is suggested by their own surname, or who unconsciously model
1 Stekel, "Die Verpflichtung des Namens," Zeitschrift für Psychotherapie und medizinische Psychologie, Bd. ш, Ht. 2, 1911.
2 Abraham, "Über die determinierende Kraft des Namens," Klinische Beiträge zur Psychoanalyse, 1921.
their behaviour on the pattern of some famous personage whose name or surname they happen to share.
Other common types are those who, although not necessarily unsuccessful in business affairs, expend much energy and ingenuity in getting into stereotyped emotional situations. Their lives seem to be a running series of clashes with authority, successfully engineered rebellions and superfluous martyrdoms. Others again involve themselves in a series of social situations where they deem themselves to be slighted, passed over or wronged; they bring themselves periodically to states of emotional misery and inflict not a little suffering on the involuntary actors in their dramas. Their reactions resemble very closely the reactions of a large group of seemingly normal persons whose love-life is made up of a series of repetitive affairs with different love-objects, the ultimate end of which is disappointment on one or both sides and a compulsive drive towards the next entanglement. In this connection Freud has shrewdly remarked how unhappy marriages, loss of money or bodily infirmity may resolve an otherwise refractory neurosis1. Postponing for the moment analytical consideration of the mechanisms operative in the above types, we may say that they have a sufficiently pathological stamp to distinguish them from ordinary character reactions. On the other hand, although usually associated with some mild form of typical neurotic symptom, their general reactions do not conform to the accustomed modes of neurotic symptom formation. In fact from both descriptive and psycho-genetic points of view, it has been found convenient to distinguish the conditions with the special designation of 'neurotic character.' Needless to say, it does not follow that the cases described are the only ones which justify this diagnosis; as we shall see, there are other character abnormalities of a more glaring and compulsive nature which would seem to indicate the necessity for subdivision of the neurotic character or for a separate category or again for inclusion in a possible psychotic character grouping. The types illustrated have three features in common, first that the character reaction is pathological, secondly that it is diffused throughout everyday life, and thirdly that it is supported by a framework of cast-iron rationalizations, which on many occasions satisfy the onlooker as well as the patient.
Now it might well be argued by those familiar with the handling of neurotic patients that this so-called neurotic character is a matter of everyday analytical experience, hence that there is no need to isolate it
1 Freud, "The Economic Problem of Masochism," Collected Papers, vol. II, International Psycho-Analytical Library, 1924.
as a distinct pathological state or to consider it as more than a sort of neurotic 'aura.' This would seem to be borne out by the frequency with which repetitive situations occur in the love-life of the neurotic and by the fact that in particular neuroses there is a notable accentuation of certain character traits, e.g. in obsessional neurosis an accentuation of anal character traits which are repetitive in type and exploited under varying conditions. Against this we have to put the facts that many pathological character changes do exist without symptom formations and particularly that treatment of character changes can give rise to a temporary exacerbation of larval neurotic symptoms. Perhaps the most satisfactory method of approaching the matter however is to consider the historical stages leading to the isolation of the neurotic character.
It is scarcely necessary to recall here the pioneer work in psychoanalytic characterology carried out by Freud1, Jones2 and Abraham3. Freud's original classification of orderliness, obstinacy and avarice as anal character traits was abundantly confirmed and amplified in numerous respects by all three writers. Almost simultaneously urethral character changes, ambition, envy and impatience were described, some of which were later traced back to a primary character-stamp affixed during the oral stage of libido development4. During the same period much individual work had been done on more general character peculiarities and psycho-analytic literature is replete with descriptions and interpretations of such conditions. Unfortunately these are as a rule sandwiched between material dealing with pure symptom constructions, but in some instances we can find evidence of more elaborate study of general character changes. Freud5 for example, in his description of the obsessive disposition, calls attention to the remarkable character changes occurring at the climacteric, how the sweet maiden, loving woman and tender mother may deteriorate into the 'old termagant,' becoming quarrelsome, peevish, argumentative, petty and miserly. The observation was not in itself original but Freud's explanation was both original and illuminating, 1 Freud, "Character and Anal Erotism," Collected Papers, vol. II, International Psycho-Analytical Library, 1924.
2 Jones, "Anal-erotic Character Traits," Papers on Psycho-Analysis, 1923.
Abraham, "Contributions to the Theory of Anal Character," International Journal of Psycho-Analysis, vol. IV, 4, 1923.
Abraham, "The Influence of Oral Erotism on Character Formation," International Journal of Psycho-Analysis, vol. VI, 3, 1925. Edward Glover, "Notes on Oral Character Formation," ibid. vol. VI, 2, 1925.
Freud, "The Predisposition to Obsessional Neurosis," Collected Papers, vol. II, International Psycho-Analytical Library, 1924.