The Psychodynamic Perspective

According to Freud, human development proceeds through various psychosexual stages. In each, a particular area of the body becomes an erogenous zone, the focus of libidinal energy during that particular period. Sexuality was conceived as an instinctual force that naturally seeks discharge. For most people, progress through the psychosex-ual stages is largely unremarkable. Some individuals, however, experience either excessive frustration or excessive indulgence, resulting in the fixation of sexual energy on the concerns of a particular stage, thus coloring the total personality. During the oral stage, for example, sexual energy is focused on the mouth. Excessive gratification of oral needs was believed to lead to the development of an oral character, the psychodynamic equivalent of the contemporary dependent personality.

As children begin to move into toddlerhood, they leave the oral stage and enter a period of toilet training, the anal stage, beginning at about 18 months. As Freud (1908) noted, whereas the oral stage requires only suckling at the breast, an inborn reflex that comes naturally to all infants, the anal stage begins a period of anal eroticism that instead requires an inhibition of what is natural. In particular, the anal stage requires self-control, a delay of instinctual gratification that accompanies an immediate expulsion of feces. The pleasurable drive of the id thus runs directly into the desire of parents, so the anal stage plays an important role in the formation of the superego and the control of aggressive impulses.

The exact influence of the anal stage on personality development was believed to depend on the attitude taken by parents toward toilet training. A rigid, impatient, or demanding attitude could result in the formation of anal-retentive traits, the charac-terological counterpart of the compulsive personality. Essentially, the child reacts against the parents by holding back and refusing to perform, leading to adult traits such as stubbornness, stinginess, and hidden anger. Anal-retentive types were also believed to be punctual, orderly, conscientious, and preoccupied with cleanliness, the very traits that led their parents to demand that they perform on schedule, with everything in its place and with no mess. Alternatively, children might react to overcontrol by becoming an anal-expulsive type. Here, the child goes on the offensive; feces become a weapon. Whereas the anal-retentive strategy is simple refusal, now the strategy shifts to the active destruction of parental wishes, a desire to make others regret they had ever exerted any control at all. Naturally, adult traits are the opposite of the anal-retentive type and include destructiveness, disorderliness, and sadistic cruelty.

If we look at what the case studies say about Donald's and Holden's early childhood, we do find elements of parental overcontrol. Donald, in fact, struggled to do what he was told, remembering his mother and father as stern and intolerant of the horseplay that is part of the early life of most boys. Holden had a similar experience, being required to meet his parents' expectations and follow their rules, with "severe consequences" for misbehavior. Parental overcontrol is different from fixations of libidinal energy, but as these examples show, there is indeed some wisdom encapsulated in these old analytic conceptions.

As psychoanalysis began to develop into ego psychology and object relations, conceptions of the anal character broadened as well. W. Reich (1933) depicted the compulsive as preoccupied with a "pedantic sense of order," as living life according to preset patterns but also tending to worry and ruminate, characteristics seen especially in Holden. Perhaps more important, W. Reich (1949) regarded the compulsive as exceptionally reserved emotionally, not given to displays of love and affection, a characteristic he referred to as "affect-block." As we have seen, neither Donald nor Holden seems to have much room for fun in his life. We can't imagine either of them telling jokes "with the boys" or reacting to a serious situation with too much levity. Neither are they romantic.

A variety of theorists have made important contributions. Combining influences from economics, culture, and existentialism, Fromm (1947) described the hoarding orientation. Such persons build a protective wall around themselves to prevent anything new from entering. As if always expecting a famine or disaster, they hoard, save, and fortify themselves for lean times and, like the anal-retentive described previously, only rarely share anything with others. For them, orderliness signifies an existential victory over the ungovernable complexities of life, giving them a feeling of mastery and control over the world (see "Focus on History" box for more information on Fromm's scheme of character orientations). Like other theorists before and since, Rado (1959) described the compulsive as overly concerned with minutiae, details, and petty formalities. He also noted continuities between normality and pathology. Thus, the scrupulously honest person may give way to the hypocrite, and sensitivity to hurt may give way to destructive-ness, criticism, and vindictiveness. For Salzman (1985), the compulsive's unrelenting need to control internal and external forces provides an illusion of certainty and security in a threatening and uncertain world. To minimize the possibility of unanticipated misadventure, compulsives become cautious and meticulous, even phobic. There are other interpretations, but Donald's stomach pains could be seen as reaction to the feeling that too much about his life remains beyond his control, a feeling too threatening to be allowed into conscious awareness and thus channeled into his body.

We have seen that compulsives, more than any other personality, intrinsically require order, detail, and perfectionism as a means of coping with what is unpredictable or unsure in the world around them. But that is not the limit of these requirements; compulsives demand the same sense of order and security from their internal world, as well. At any moment, a little self-examination shows that most of us are seething with conflicting feelings that pull us one way or another and prevent black-and-white assessments, even of simple situations. You take a class, for example, and although the instructor is superb, the workload gets in the way of other classes and causes you anger and regret. You take a class, and although the workload is easy, you definitely could be getting more substance for your tuition dollars. You love your mother, but she smothers you; then again, when she doesn't meddle at least a little, you wonder if she still loves you. The issues may be different, but everyone is caught in such conundrums. Most of us just acknowledge both sides of the coin and tolerate the complexity of life. Nothing is all good or all bad.

For compulsives, however, such contrary feelings and dispositions create intense feelings of anger, uncertainty, and insecurity that must be kept under tight rein. To do so, they make use of a whole host of defensive strategies, more than any other personality pattern. Research argues that the first, and perhaps most distinctive, is reaction formation (Berman & McCann, 1995). Here, compulsives reverse forbidden impulses of hostility and rebellion to conform to a highly rigid ego ideal. For example, when faced with circumstances that would cause dismay or irritability in most persons, compulsives pride themselves in displaying maturity and reasonableness, just as Donald does, when noting that even when his wife is griping and his pain is intense, he manages to keep things under control. In effect, compulsives symbolically purge themselves of unclean and shameful feelings by embracing what is diametrically opposite.

Second, compulsives often displace anger and insecurity by seeking out some position of power that allows them to become a socially sanctioned superego for others. Here, compulsives enact their anger by making others conform to precise standards that are unworkably detailed or strict. Holden is almost the incarnation of this pattern. Those who fall short either pay their dues by acknowledging the compulsive's superior authority and knowledge or fall victim to a swift judgment that conceals a sadistic and self-righteous joy behind a mask of maturity. Punishment becomes a duty; humanitarianism, a failing. Fiercely moralistic fathers and overcontrolling mothers provide examples of camouflaged hostility. Despite their efforts at control, research shows that compulsive traits are strongly related to impulsive aggression (Stein, Trestman, Mitropoulou, & Coccaro, 1996).

Although usually capable of exquisite self-control, compulsives sometimes transgress their own standards or incur the disapproval or disappointment of authority figures. When their ego defenses fail, they may become filled with feelings of guilt. Whereas hostility can be transformed or vented, guilt must be expiated or exorcised, a defense referred to as undoing. Compulsives go to great lengths to atone for their perceived sins. Such compensation seeks not only to repair the damage but also to put things back the way they were before and return them to a position of good standing in their own eyes and those of others. At the moment, for example, Holden is working so hard to organize and rememorize his old lecture notes that he's overloading himself and experiencing nightmares. We might expect, however, that when Holden returns to his teaching position in the history department, he may work harder than he ever has before to make up, at least in his own mind, for his previous rigid strictness. Paradoxically, he might even work hard at being merciful with the students in his new class.

Another defense mechanism used by compulsives, isolation of affect, connects the psychodynamic and cognitive domains, at least for these personalities. The same demand for order and perfection that compulsives demand of their environment, they demand of their own mental landscape. To keep oppositional feelings and impulses from affecting one another and to hold ambivalent images and contradictory attitudes from spilling over into conscious awareness, they organize their inner world into tight, rigid compartments. In effect, compulsives seek to suffocate instinct, passion, and emotion by deconstructing experiences into little bits that are easily classified and talked about rather than felt. For normal persons, memory is not just a mechanism of recall, but also is a means of rewinding and replaying episodes from our lives to recapture the fullness of the original experience, with all the emotions and sensations that accompany it. Although some are frightening and some are cherished, all of us have such memories that we return to many times.

Compulsives, however, are different. Their mental contents resemble highly regimented repositories of shriveled or dehydrated facts, each of which is carefully indexed but kept separate from the others. In effect, their goal is the opposite of poetry. Whereas poetry embellishes experience by providing symbolic and metaphorical links to related experiences, compulsives seek to contain each aspect of experience in its own little compartment. They database their memories and make only intellectual associations among them. By preventing their interaction, compulsives ensure that no single facet of experience is able to catalyze any other to produce an unanticipated emotion or drive of significant depth. Consequently, most compulsives view self-exploration as a waste of time. Psychotherapy may be seen as too much of a soft science to warrant their time or attention. For the compulsive, isolation of affect and mental structure protectively reinforce each other. We don't see Donald or Holden breaking forth in laughter or tears because some aspect of their immediate environment took them back to an old memory.

Modern conceptions of the compulsive personality are put forward from an object-relations framework. As noted previously, the psychodynamic development of the compulsive personality is linked closely to the anal stage. Freud emphasized frustration and the resulting fixation of psychosexual energy. Later psychodynamic thinkers reinterpreted the psychosexual stages in object-relations terms, making central the role of caretakers, not the fixation of psychic energy. The essential conflict is between the parent's desire to interfere and control and the child's growing sense of autonomy. Toilet training is then only a small part of the total interaction between parent and child, and it is out of this total interaction that personality grows. We don't need to know how Donald or Holden were toilet-trained to see the continuity between their parents' treatment of them and their adult characteristics.

In addition to overcontrol, contemporary psychodynamic accounts also emphasize expectations of perfection by caretakers. As noted in Gabbard (1994), compulsives internalize a harsh superego and search for flawlessness as a means of regaining lost parental approval (for further discussion of childhood expression of these symptoms, see "Focus on Childhood" box). From the beginning, they are taught to feel a deep sense of responsibility and a deep guilt whenever their responsibilities are not met. Frequently, they are moralized to by others to inhibit any impulse toward frivolous play and are instilled with a sense of shame whenever their sense of responsibility sags. When Donald's parents refused to let him play with other children because they disapproved, at first he probably conformed simply to do as they said. Eventually, however, Donald incorporated their moral sense of superiority into himself. Now, he disapproves of others for any number of reasons, seemingly as part of the substance of what he is.

By the time they reach adolescence, future compulsives have fully incorporated the strictures and regulations of their elders. By now, they are equipped with an inner gauge that ruthlessly evaluates and controls them, relentlessly intruding to make them

Focus on Childhood

Overanxious Disorder in Children Pathways to Adult Personality Patterns

Developmental psychopathology is one of the most rapidly evolving areas in diagnostic knowledge. Accordingly, a variety of childhood disorders included in the DSM-III, published in 1980, are no longer listed in the DSM-IV, published in 1994. One of these, overanxious disorder in children, includes features related to the compulsive personality. According to the DSM-III, such children often seem "hyper-mature with their precocious concerns." They take on responsibilities or attitudes that go far beyond their developmental level. Also noted were traits such as perfectionistic tendency, obsessional self-doubt, excessive conformity, excessive approval-seeking, overconcern about competence, a preoccupation with the appropriateness of their behavior, excessive need for reassurance, somatic complaints, and marked feelings of tension or an inability to relax. Overly trained and disciplined youngsters have little opportunity to shape their own destinies. Such children learn to control their feelings and focus their thoughts on becoming a model of parental orderliness and propriety. Although adults may be comforted by their good manners, many are uptight and agitated. Some will act out later in life when parental disapproval and discipline are no longer a force in their lives.

doubt and hesitate before acting. External sources of restraint have been supplanted with the inescapable controls of internal self-reproach. Compulsives are now their own persecutor and judge, ready to condemn themselves not only for overt acts but for thoughts of transgression as well. By promoting a sense of guilt, the child acquires a self-critical inner voice ready with rebuke even when caretakers are physically absent or even dead. Religious elements often play an important role. Some are told the terrifying consequences of mischief and sin; others are told how troubled or embarrassed their parents will be if they deviate from the "righteous path." Sometimes, they turn their sense of morality into a sense of moral superiority and use this to fuel an indignation that excuses the expression of anger and focuses it toward a suitable target, as Holden often did by using bureaucracy as a weapon.

Eliminating Stress and Anxiety From Your Life

Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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