Tag: Sigmund Freud

What is Sublimation (in Psychology)?

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Introduction

In psychology, sublimation is a mature type of defence mechanism, in which socially unacceptable impulses or idealisations are transformed into socially acceptable actions or behaviour, possibly resulting in a long-term conversion of the initial impulse.

Sigmund Freud believed that sublimation was a sign of maturity and civilisation, allowing people to function normally in culturally acceptable ways. He defined sublimation as the process of deflecting sexual instincts into acts of higher social valuation, being “an especially conspicuous feature of cultural development; it is what makes it possible for higher psychical activities, scientific, artistic or ideological, to play such an ‘important’ part in civilized life.” Wade and Travis present a similar view, stating that sublimation occurs when displacement “serves a higher cultural or socially useful purpose, as in the creation of art or inventions.”

Nietzsche

In the opening section of Human, All Too Human entitled “Of first and last things”, Nietzsche wrote:

There is, strictly speaking, neither unselfish conduct, nor a wholly disinterested point of view. Both are simply sublimations in which the basic element seems almost evaporated and betrays its presence only to the keenest observation. All that we need and that could possibly be given us in the present state of development of the sciences, is a chemistry of the moral, religious, aesthetic conceptions and feeling, as well as of those emotions which we experience in the affairs, great and small, of society and civilization, and which we are sensible of even in solitude. But what if this chemistry established the fact that, even in its domain, the most magnificent results were attained with the basest and most despised ingredients? Would many feel disposed to continue such investigations? Mankind loves to put by the questions of its origin and beginning: must one not be almost inhuman in order to follow the opposite course?

Freud and Psychoanalytic Theory

In Freud’s psychoanalytical theory, erotic energy is allowed a limited amount of expression, owing to the constraints of human society and civilisation itself. It therefore requires other outlets, especially if an individual is to remain psychologically balanced. The ego must act as a mediator between the moral norms of the super-ego, the realistic expectations of reality, and the drives and impulses of the id. One method by which the ego lessens the stress that unacceptably strong urges or emotions can cause is through sublimation.

Sublimation (German: Sublimierung) is the process of transforming libido into “socially useful” achievements, including artistic, cultural, and intellectual pursuits. Freud considered this psychical operation to be fairly salutary compared to the others that he identified, such as repression, displacement, denial, reaction formation, intellectualisation, and projection. In The Ego and the Mechanisms of Defence (1936), his daughter, Anna, classed sublimation as one of the major ‘defence mechanisms’ of the psyche.

Freud got the idea of sublimation while reading The Harz Journey by Heinrich Heine. The story is about Johann Friedrich Dieffenbach who cut off the tails of dogs he encountered in childhood and later became a surgeon. Freud concluded that sublimation could be a conflict between the need for satisfaction and the need for security without perturbation of awareness. In an action performed many times throughout one’s life, which firstly appears sadistic, thought is ultimately refined into an activity which is of benefit to mankind.

Sexual Sublimation

Sexual sublimation was according to Freud a deflection of sexual instincts into non-sexual activity, based upon a principle akin to the conservation of energy in physics. There is a finite amount of activity, and it is converted, in a mechanistic fashion like a mechanical engine, from sexual activity to non-sexual. One such example is the case of Wolf Man, a case in which a young boy’s sexual attraction to his father was redirected towards Christianity and eventually led the boy to obsessional neurosis in the form of uncontrollable sacrilegious reverence. Freud travelled to Clark University to speak about instances of sexual sublimation, but he was not wholly convinced of his own theories. 20th century psychological thought by the likes of Melanie Klein has largely relegated the idea and replaced it with subtler ideas. One such idea is that the sexual desires are not made totally non-sexual, but rather transformed into a more appropriate desire.

Although superficially valid, with anecdotal examples from non-psychologists of civilizations at large and specific great achievers repressing sexual urges (e.g. Renoir “painting with his cock”, Wayland Young stating that “love’s loss is empire’s gain”, Lawrence Stone’s view that Western civilisation has achieved so much because of sublimation, and the claims by biographers of many people from Higgins on Rider Haggard to Sinclair on George Grey), it is ill-defined[11] and comes with the caveats that it rarely happens in practice, that many things attributed to it are actually the results of something else, and that it is most definitely not some quasi-physical transfer of some sort of “sexual energy” in the modern psychoanalytical view but rather an internal thought process.

Jung

C.G.Jung argued that Freud’s opinion:

…can only be based on the totally erroneous supposition that the unconscious is a monster. It is a view that springs from fear of nature and the realities of life. Freud invented the idea of sublimation to save us from the imaginary claws of the unconscious. But what is real, what actually exists, cannot be alchemically sublimated, and if anything is apparently sublimated it never was what a false interpretation took it to be.

In the same article, Jung went on to suggest that unconscious processes became dangerous only to the extent that people repress them. The more people come to assimilate and recognise the unconscious, the less of a danger it becomes. In this view sublimation requires not repression of drives through will, but acknowledgement of the creativity of unconscious processes and a learning of how to work with them.

This differs fundamentally from Freud’s view of the concept. For Freud, sublimation helped explain the plasticity of the sexual instincts (and their convertibility to non-sexual ends) – see libido. The concept also underpinned Freud’s psychoanalytical theories, which showed the human psyche at the mercy of conflicting impulses (such as the super-ego and the id). In his private letters, Jung criticised Freud for obscuring the alchemical origins of sublimation and for attempting instead to make the concept appear scientifically credible:

Sublimation is part of the royal art where the true gold is made. Of this Freud knows nothing; worse still, he barricades all the paths that could lead to true sublimation. This is just about the opposite of what Freud understands by sublimation. It is not a voluntary and forcible channeling of instinct into a spurious field of application, but an alchymical transformation for which fire and prima materia are needed. Sublimation is a great mystery. Freud has appropriated this concept and usurped it for the sphere of the will and the bourgeois, rationalistic ethos.

Lacan

Das Ding

The French psychoanalyst Jacques Lacan’s exposition of sublimation is framed within a discussion about the relationship of psychoanalysis and ethics within the seventh book of his seminars. Lacanian sublimation is defined with reference to the concept Das Ding (later in his career Lacan termed this objet petit a); Das Ding is German for “the thing” though Lacan conceives it as an abstract notion and one of the defining characteristics of the human condition. Broadly speaking it is the vacuum one experiences as a human being and which one endeavours to fill with differing human relationships, objects and experiences, all of which are used to plug a gap in one’s psychical needs. Unfortunately, all attempts to overcome the vacuity of Das Ding are insufficient in wholly satisfying the individual. For this reason, Lacan also considers Das Ding to be a non-Thing or vacuole.

Lacan considers Das Ding a lost object ever in the process of being recuperated by Man. Temporarily the individual will be duped by his or her own psyche into believing that this object, this person or this circumstance can be relied upon to satisfy his needs in a stable and enduring manner when in fact it is in its nature that the object as such is lost—and will never be found again. Something is there while one waits for something better, or worse, but which one wants, and again Das Ding “is to be found at most as something missed. One doesn’t find it, but only its pleasurable associations.” Human life unravels as a series of detours in the quest for the lost object or the absolute Other of the individual: “The pleasure principle governs the search for the object and imposes detours which maintain the distance to Das Ding in relation to its end.”

Lacanian Sublimation

Lacanian sublimation centres to a large part on the notion of Das Ding. His general formula for sublimation is that “it raises an object … to the dignity of The Thing.” Lacan considers these objects (whether human, aesthetic, credal, or philosophical) to be signifiers which are representative of Das Ding and that “the function of the pleasure principle is, in effect, to lead the subject from signifier to signifier, by generating as many signifiers as are required to maintain at as low a level as possible the tension that regulates the whole functioning of the psychic apparatus.” Furthermore, man is the “artisan of his support system”, in other words, he creates or finds the signifiers which delude him into believing he has overcome the emptiness of Das Ding.

Lacan also considers sublimation to be a process of creation ex nihilo (creating out of nothing), whereby an object, human or manufactured, comes to be defined in relation to the emptiness of Das Ding. Lacan’s prime example of this is the courtly love of the troubadours and Minnesänger who dedicated their poetic verse to a love-object which was not only unreachable (and therefore experienced as something missing) but whose existence and desirability also centred around a hole (the vagina). For Lacan such courtly love was “a paradigm of sublimation.” He affirms that the word ‘troubadour’ is etymologically linked to the Provençal verb trobar (like the French trouver), “to find”. If we consider again the definition of Das Ding, it is dependent precisely on the expectation of the subject to re-find the lost object in the mistaken belief that it will continue to satisfy him (or her).

Lacan maintains that creation ex nihilo operates in other noteworthy fields as well. In pottery for example vases are created around an empty space. They are primitive and even primordial artifacts which have benefited mankind not only in the capacity of utensils but also as metaphors of (cosmic) creation ex nihilo. Lacan cites Heidegger who situates the vase between the earthly (raising clay from the ground) and the ethereal (pointing upwards to receive). In architecture, Lacan asserts, buildings are designed around an empty space and in art paintings proceed from an empty canvas, and often depict empty spaces through perspective.

In myth, Pan pursues the nymph Syrinx who is transformed into hollow reeds in order to avoid the clutches of the god, who subsequently cuts the reeds down in anger and transforms them into what we today call panpipes (both reeds and panpipes rely on their hollowness for the production of sound).

Lacan briefly remarks that religion and science are also based around emptiness. In regard to religion, Lacan refers the reader to Freud, stating that much obsessional religious behaviour can be attributed to the avoidance of the primordial emptiness of Das Ding or in the respecting of it. As for the discourse of science this is based on the notion of Verwerfung (the German word for “dismissal”) which results in the dismissing, foreclosing or exclusion of the notion of Das Ding presumably because it defies empirical categorisation.

Empirical Research

A study by Kim, Zeppenfeld, and Cohen studied sublimation by empirical methods. These investigators view their research, published 2013 in the Journal of Personality and Social Psychology, as providing “possibly the first experimental evidence for sublimation and [suggesting] a cultural psychological approach to defense mechanisms.”

Religious and Spiritual Views

As espoused in the Tanya, Hasidic Jewish mysticism views sublimation of the animal soul as an essential task in life, wherein the goal is to transform animalistic and earthy cravings for physical pleasure into holy desires to connect with God.

Different schools of thought describe general sexual urges as carriers of spiritual essence, and have the varied names of vital energy, vital winds (prana), spiritual energy, ojas, shakti, tummo, or kundalini.

In Fiction

  • One of the best-known examples in Western literature is in Thomas Mann’s novella, Death in Venice, where the protagonist Gustav von Aschenbach, a famous writer, sublimates his desire for an adolescent boy into writing poetry.
  • In The Diamond Age by Neal Stephenson, sublimation is presented as the source of the Neo-Victorians’ dominance: “…it was precisely their emotional repression that made the Victorians the richest and most powerful people in the world. Their ability to submerge their feelings, far from pathological, was rather a kind of mystical art that gave them nearly magical power over Nature and over the more intuitive tribes. Such was also the strength of the Nipponese.”

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What is Neutrality (in Psychoanalysis)?

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Introduction

Neutrality is an essential part of the analyst’s attitude during treatment,  developed as part of the non-directive, evenly suspended listening which Freud used to complement the patient’s free association in the talking cure.

Refer to Psychoanalysis.

Early Development

In the Little Hans case study of 1909, Freud criticised the boy’s father (the prime ‘analyst’): “He asks too much and investigates in accord with his own presuppositions instead of letting the little boy express himself”.  In 1912 he laid down the mirror rule, that the analyst should not reciprocate the patient’s confidences, but only reflect back what they themselves contained.  In 1915 he introduced the term neutrality, warning especially against too great eagerness to cure; and in 1919 he wrote against offering guidance or counselling – synthesis as opposed to analysis – as to what form the patient’s cure should take.

Freud’s guidelines, especially with regard to the bracketing of ethical judgements, and personal disclosures, rapidly became accepted in the psychoanalytic mainstream,  as did the need to respect the patient’s speech and not impose preconceptions on it.

Transference

The principle of neutrality took on especial force as regards manifestations of transference, particularly given the strength of the emotions aroused thereby. Neutrality meant resisting the natural impulse to reciprocate affects, so as to remain in a position to analyse the transference, not respond to it.

Deviations and Criticisms

Freud’s analytic practice was noticeably less austere than the principles of neutrality he laid down: he would argue with, praise, and lend money to patients, and even records feeding the Rat Man on one occasion. However the first theoretical challenge to Freud’s concept came from Sándor Ferenczi, who saw the analyst’s attitude of non-disclosure in particular as part of the problem not the solution. Others would subsequently expand on Ferenczi’s points, Nina Coltart for example suspecting the “austere and benevolently neutral manner which we hold as our working ideal” and stressing that “we can do no harm to a patient by showing authentic affect”.

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What is the World Council for Psyhcotherapy?

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Introduction

The World Council for Psychotherapy is a non-governmental organisation (NGO) with consultative status at the Economic and Social Council of the United Nations.

It was founded in 1995, has its headquarters in Vienna, and holds a World Congress every three years with more than a thousand participants.

Objectives

The main objectives of the association are the promotion of psychotherapy on all continents (based on the principles in the Strasbourg Declaration on Psychotherapy in 1990), to improve the conditions of patients, to cooperate with national and international organisations to improve crisis management and peacekeeping, and to unify world training standards. Members are both psychotherapists and organisations. President of the WCP is Alfred Pritz.

The World Certificate for Psychotherapy (WCPC) is only awarded on the basis of recognised psychotherapy training and aims to encourage mobility within the profession. Each year, together with the city of Vienna, the Council awards the International Sigmund Freud Award for Psychotherapy.

World Congress for Psychotherapy

  • 1996 Vienna.
  • 1999 Vienna.
  • 2002 Vienna.
  • 2005 Buenos Aires.
  • 2008 Beijing.
  • 2011 Sydney.
  • 2014 Durban.
  • 2017 Paris.
  • 2020 Moscow.
  • 2022 Moscow.

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On This Day … 23 September [2022]

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People (Deaths)

  • 1939 – Sigmund Freud, Austrian neurologist and psychiatrist (b. 1856).

Sigmund Freud

Sigmund Freud (born Sigismund Schlomo Freud; 06 May 1856 to 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating pathologies in the psyche through dialogue between a patient and a psychoanalyst.

Freud was born to Galician Jewish parents in the Moravian town of Freiberg, in the Austrian Empire. He qualified as a doctor of medicine in 1881 at the University of Vienna. Upon completing his habilitation in 1885, he was appointed a docent in neuropathology and became an affiliated professor in 1902. Freud lived and worked in Vienna, having set up his clinical practice there in 1886. In 1938, Freud left Austria to escape Nazi persecution. He died in exile in the United Kingdom in 1939.

In founding psychoanalysis, Freud developed therapeutic techniques such as the use of free association and discovered transference, establishing its central role in the analytic process. Freud’s redefinition of sexuality to include its infantile forms led him to formulate the Oedipus complex as the central tenet of psychoanalytical theory. His analysis of dreams as wish-fulfilments provided him with models for the clinical analysis of symptom formation and the underlying mechanisms of repression. On this basis, Freud elaborated his theory of the unconscious and went on to develop a model of psychic structure comprising id, ego and super-ego. Freud postulated the existence of libido, sexualised energy with which mental processes and structures are invested and which generates erotic attachments, and a death drive, the source of compulsive repetition, hate, aggression, and neurotic guilt. In his later works, Freud developed a wide-ranging interpretation and critique of religion and culture.

Though in overall decline as a diagnostic and clinical practice, psychoanalysis remains influential within psychology, psychiatry, and psychotherapy, and across the humanities. It thus continues to generate extensive and highly contested debate concerning its therapeutic efficacy, its scientific status, and whether it advances or hinders the feminist cause. Nonetheless, Freud’s work has suffused contemporary Western thought and popular culture. W.H. Auden’s 1940 poetic tribute to Freud describes him as having created “a whole climate of opinion / under whom we conduct our different lives”.

What is Anal Retentiveness?

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Introduction

An anal retentive person is a person who pays such attention to detail that it becomes an obsession and may be an annoyance to others.

The term derives from Freudian psychoanalysis.

Origins

In Freudian psychology, the anal stage is said to follow the oral stage of infant or early-childhood development. This is a time when an infant’s attention moves from oral stimulation to anal stimulation (usually the bowels but occasionally the bladder), usually synchronous with learning to control its excretory functions – in other words, any form of child training and not specifically linked to toilet training. Freud posited that children who experience conflicts, in which libido energy is under-indulged during this period of time, and the child is perhaps too strongly chastised for toilet-training accidents, may develop “anal retentive” fixations or personality traits. These traits are associated with a child’s efforts at excretory control: orderliness, stubbornness, and compulsions for control. Conversely, those who are overindulged during this period may develop “anal-expulsive” personality types.

Influence and Refutation

Freud’s theories on early childhood have been influential on the psychological community; the phrase anal retentive and the term anal survive in common usage. The second edition of the Diagnostic and Statistical Manual (DSM-II) introduced obsessive-compulsive personality disorder (OCPD), with a definition based on Freud’s description of anal-retentive personality. But the association between OCPD and toilet training is largely regarded as unsupported “pop-psychology” and therefore discredited by the majority of psychologists of the late 20th and early 21st centuries. There is no conclusive research linking anal stage conflicts with “anal” personality types.

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Who was Emil Kraepelin?

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Introduction

Emil Wilhelm Georg Magnus Kraepelin (15 February 1856 to 7 October 1926) was a German psychiatrist.

H.J. Eysenck’s Encyclopaedia of Psychology identifies him as the founder of modern scientific psychiatry, psychopharmacology and psychiatric genetics.

Kraepelin believed the chief origin of psychiatric disease to be biological and genetic malfunction. His theories dominated psychiatry at the start of the 20th century and, despite the later psychodynamic influence of Sigmund Freud and his disciples, enjoyed a revival at century’s end. While he proclaimed his own high clinical standards of gathering information “by means of expert analysis of individual cases”, he also drew on reported observations of officials not trained in psychiatry.

His textbooks do not contain detailed case histories of individuals but mosaic-like compilations of typical statements and behaviours from patients with a specific diagnosis. He has been described as “a scientific manager” and “a political operator”, who developed “a large-scale, clinically oriented, epidemiological research programme”.

Emil Kraepelin in his later years.

Family and Early Life

Kraepelin, whose father, Karl Wilhelm, was a former opera singer, music teacher, and later successful story teller, was born in 1856 in Neustrelitz, in the Duchy of Mecklenburg-Strelitz in Germany. He was first introduced to biology by his brother Karl, 10 years older and, later, the director of the Zoological Museum of Hamburg.

Education and Career

Kraepelin began his medical studies in 1874 at the University of Leipzig and completed them at the University of Würzburg (1877-1878). At Leipzig, he studied neuropathology under Paul Flechsig and experimental psychology with Wilhelm Wundt. Kraepelin would be a disciple of Wundt and had a lifelong interest in experimental psychology based on his theories. While there, Kraepelin wrote a prize-winning essay, “The Influence of Acute Illness in the Causation of Mental Disorders”.

At Würzburg he completed his Rigorosum (roughly equivalent to an MBBS viva-voce examination) in March 1878, his Staatsexamen (licensing examination) in July 1878, and his Approbation (his license to practice medicine; roughly equivalent to an MBBS) on 09 August 1878. From August 1878 to 1882, he worked with Bernhard von Gudden at the University of Munich.

Returning to the University of Leipzig in February 1882,[1] he worked in Wilhelm Heinrich Erb’s neurology clinic and in Wundt’s psychopharmacology laboratory. He completed his habilitation thesis at Leipzig; it was entitled “The Place of Psychology in Psychiatry”. On 03 December 1883 he completed his umhabilitation (“rehabilitation” = habilitation recognition procedure) at Munich.

Kraepelin’s major work, Compendium der Psychiatrie: Zum Gebrauche für Studirende und Aerzte (Compendium of Psychiatry: For the Use of Students and Physicians), was first published in 1883 and was expanded in subsequent multivolume editions to Ein Lehrbuch der Psychiatrie (A Textbook: Foundations of Psychiatry and Neuroscience). In it, he argued that psychiatry was a branch of medical science and should be investigated by observation and experimentation like the other natural sciences. He called for research into the physical causes of mental illness, and started to establish the foundations of the modern classification system for mental disorders. Kraepelin proposed that by studying case histories and identifying specific disorders, the progression of mental illness could be predicted, after taking into account individual differences in personality and patient age at the onset of disease.

In 1884, he became senior physician in the Prussian provincial town of Leubus, Silesia Province, and the following year he was appointed director of the Treatment and Nursing Institute in Dresden. On 01 July 1886, at the age of 30, Kraepelin was named Professor of Psychiatry at the University of Dorpat (today the University of Tartu) in what is today Estonia (see Burgmair et al., vol. IV). Four years later, on 05 December 1890, he became department head at the University of Heidelberg, where he remained until 1904. While at Dorpat he became the director of the 80-bed University Clinic. There he began to study and record many clinical histories in detail and “was led to consider the importance of the course of the illness with regard to the classification of mental disorders”.

In 1903, Kraepelin moved to Munich to become Professor of Clinical Psychiatry at the University of Munich.

In 1908, he was elected a member of the Royal Swedish Academy of Sciences.

In 1912, at the request of the DVP (Deutscher Verein für Psychiatrie; German Association for Psychiatry), of which he was the head from 1906-1920, he began plans to establish a centre for research. Following a large donation from the Jewish German-American banker James Loeb, who had at one time been a patient, and promises of support from “patrons of science”, the German Institute for Psychiatric Research was founded in 1917 in Munich. Initially housed in existing hospital buildings, it was maintained by further donations from Loeb and his relatives. In 1924 it came under the auspices of the Kaiser Wilhelm Society for the Advancement of Science. The German-American Rockefeller family’s Rockefeller Foundation made a large donation enabling the development of a new dedicated building for the institute along Kraepelin’s guidelines, which was officially opened in 1928.

Kraepelin spoke out against the barbarous treatment that was prevalent in the psychiatric asylums of the time, and crusaded against alcohol, capital punishment and the imprisonment rather than treatment of the insane. For the sedation of agitated patients Kraepelin recommended potassium bromide. He rejected psychoanalytical theories that posited innate or early sexuality as the cause of mental illness, and he rejected philosophical speculation as unscientific. He focused on collecting clinical data and was particularly interested in neuropathology (e.g. diseased tissue).

In the later period of his career, as a convinced champion of social Darwinism, he actively promoted a policy and research agenda in racial hygiene and eugenics.

Kraepelin retired from teaching at the age of 66, spending his remaining years establishing the institute. The ninth and final edition of his Textbook was published in 1927, shortly after his death. It comprised four volumes and was ten times larger than the first edition of 1883.

In the last years of his life, Kraepelin was preoccupied with Buddhist teachings and was planning to visit Buddhist shrines at the time of his death, according to his daughter, Antonie Schmidt-Kraepelin.

Theories and Classification Schemes

Kraepelin announced that he had found a new way of looking at mental illness, referring to the traditional view as “symptomatic” and to his view as “clinical”. This turned out to be his paradigm-setting synthesis of the hundreds of mental disorders classified by the 19th century, grouping diseases together based on classification of syndrome – common patterns of symptoms over time – rather than by simple similarity of major symptoms in the manner of his predecessors.

Kraepelin described his work in the 5th edition of his textbook as a:

“decisive step from a symptomatic to a clinical view of insanity. . . . The importance of external clinical signs has . . . been subordinated to consideration of the conditions of origin, the course, and the terminus which result from individual disorders. Thus, all purely symptomatic categories have disappeared from the nosology”.

Psychosis and Mood

Kraepelin is specifically credited with the classification of what was previously considered to be a unitary concept of psychosis, into two distinct forms (known as the Kraepelinian dichotomy):

Drawing on his long-term research, and using the criteria of course, outcome and prognosis, he developed the concept of dementia praecox, which he defined as the “sub-acute development of a peculiar simple condition of mental weakness occurring at a youthful age”. When he first introduced this concept as a diagnostic entity in the fourth German edition of his Lehrbuch der Psychiatrie in 1893, it was placed among the degenerative disorders alongside, but separate from, catatonia and dementia paranoides. At that time, the concept corresponded by and large with Ewald Hecker’s hebephrenia. In the sixth edition of the Lehrbuch in 1899 all three of these clinical types are treated as different expressions of one disease, dementia praecox.

One of the cardinal principles of his method was the recognition that any given symptom may appear in virtually any one of these disorders; e.g. there is almost no single symptom occurring in dementia praecox which cannot sometimes be found in manic depression. What distinguishes each disease symptomatically (as opposed to the underlying pathology) is not any particular (pathognomonic) symptom or symptoms, but a specific pattern of symptoms. In the absence of a direct physiological or genetic test or marker for each disease, it is only possible to distinguish them by their specific pattern of symptoms. Thus, Kraepelin’s system is a method for pattern recognition, not grouping by common symptoms.

It has been claimed that Kraepelin also demonstrated specific patterns in the genetics of these disorders and patterns in their course and outcome, but no specific biomarkers have yet been identified. Generally speaking, there tend to be more schizophrenics among the relatives of schizophrenic patients than in the general population, while manic depression is more frequent in the relatives of manic depressives. Though, of course, this does not demonstrate genetic linkage, as this might be a socio-environmental factor as well.

He also reported a pattern to the course and outcome of these conditions. Kraepelin believed that schizophrenia had a deteriorating course in which mental function continuously (although perhaps erratically) declines, while manic-depressive patients experienced a course of illness which was intermittent, where patients were relatively symptom-free during the intervals which separate acute episodes. This led Kraepelin to name what we now know as schizophrenia, dementia praecox (the dementia part signifying the irreversible mental decline). It later became clear that dementia praecox did not necessarily lead to mental decline and was thus renamed schizophrenia by Eugen Bleuler to correct Kraepelin’s misnomer.

In addition, as Kraepelin accepted in 1920, “It is becoming increasingly obvious that we cannot satisfactorily distinguish these two diseases”; however, he maintained that “On the one hand we find those patients with irreversible dementia and severe cortical lesions. On the other are those patients whose personality remains intact”. Nevertheless, overlap between the diagnoses and neurological abnormalities (when found) have continued, and in fact a diagnostic category of schizoaffective disorder would be brought in to cover the intermediate cases.

Kraepelin devoted very few pages to his speculations about the aetiology of his two major insanities, dementia praecox and manic-depressive insanity. However, from 1896 to his death in 1926 he held to the speculation that these insanities (particularly dementia praecox) would one day probably be found to be caused by a gradual systemic or “whole body” disease process, probably metabolic, which affected many of the organs and nerves in the body but affected the brain in a final, decisive cascade.

Psychopathic Personalities

In the first through sixth edition of Kraepelin’s influential psychiatry textbook, there was a section on moral insanity, which meant then a disorder of the emotions or moral sense without apparent delusions or hallucinations, and which Kraepelin defined as “lack or weakness of those sentiments which counter the ruthless satisfaction of egotism”. He attributed this mainly to degeneration. This has been described as a psychiatric redefinition of Cesare Lombroso’s theories of the “born criminal”, conceptualised as a “moral defect”, though Kraepelin stressed it was not yet possible to recognise them by physical characteristics.

In fact from 1904 Kraepelin changed the section heading to “The born criminal”, moving it from under “Congenital feeble-mindedness” to a new chapter on “Psychopathic personalities”. They were treated under a theory of degeneration. Four types were distinguished: born criminals (inborn delinquents), pathological liars, querulous persons, and Triebmenschen (persons driven by a basic compulsion, including vagabonds, spendthrifts, and dipsomaniacs).

The concept of “psychopathic inferiorities” had been recently popularised in Germany by Julius Ludwig August Koch, who proposed congenital and acquired types. Kraepelin had no evidence or explanation suggesting a congenital cause, and his assumption therefore appears to have been simple “biologism”. Others, such as Gustav Aschaffenburg, argued for a varying combination of causes. Kraepelin’s assumption of a moral defect rather than a positive drive towards crime has also been questioned, as it implies that the moral sense is somehow inborn and unvarying, yet it was known to vary by time and place, and Kraepelin never considered that the moral sense might just be different.

Kurt Schneider criticised Kraepelin’s nosology on topics such as Haltlose for appearing to be a list of behaviours that he considered undesirable, rather than medical conditions, though Schneider’s alternative version has also been criticised on the same basis. Nevertheless, many essentials of these diagnostic systems were introduced into the diagnostic systems, and remarkable similarities remain in the DSM-V and ICD-10. The issues would today mainly be considered under the category of personality disorders, or in terms of Kraepelin’s focus on psychopathy.

Kraepelin had referred to psychopathic conditions (or “states”) in his 1896 edition, including compulsive insanity, impulsive insanity, homosexuality, and mood disturbances. From 1904, however, he instead termed those “original disease conditions, and introduced the new alternative category of psychopathic personalities. In the eighth edition from 1909 that category would include, in addition to a separate “dissocial” type, the excitable, the unstable, the Triebmenschen driven persons, eccentrics, the liars and swindlers, and the quarrelsome. It has been described as remarkable that Kraepelin now considered mood disturbances to be not part of the same category, but only attenuated (more mild) phases of manic depressive illness; this corresponds to current classification schemes.

Alzheimer’s Disease

Kraepelin postulated that there is a specific brain or other biological pathology underlying each of the major psychiatric disorders. As a colleague of Alois Alzheimer, he was a co-discoverer of Alzheimer’s disease, and his laboratory discovered its pathological basis. Kraepelin was confident that it would someday be possible to identify the pathological basis of each of the major psychiatric disorders.

Eugenics

Upon moving to become Professor of Clinical Psychiatry at the University of Munich in 1903, Kraepelin increasingly wrote on social policy issues. He was a strong and influential proponent of eugenics and racial hygiene. His publications included a focus on alcoholism, crime, degeneration and hysteria.

Kraepelin was convinced that such institutions as the education system and the welfare state, because of their trend to break the processes of natural selection, undermined the Germans’ biological “struggle for survival”. He was concerned to preserve and enhance the German people, the Volk, in the sense of nation or race. He appears to have held Lamarckian concepts of evolution, such that cultural deterioration could be inherited. He was a strong ally and promoter of the work of fellow psychiatrist (and pupil and later successor as director of the clinic) Ernst Rüdin to clarify the mechanisms of genetic inheritance as to make a so-called “empirical genetic prognosis”.

Martin Brune has pointed out that Kraepelin and Rüdin also appear to have been ardent advocates of a self-domestication theory, a version of social Darwinism which held that modern culture was not allowing people to be weeded out, resulting in more mental disorder and deterioration of the gene pool. Kraepelin saw a number of “symptoms” of this, such as “weakening of viability and resistance, decreasing fertility, proletarianisation, and moral damage due to “penning up people” [Zusammenpferchung]. He also wrote that “the number of idiots, epileptics, psychopaths, criminals, prostitutes, and tramps who descend from alcoholic and syphilitic parents, and who transfer their inferiority to their offspring, is incalculable”. He felt that “the well-known example of the Jews, with their strong disposition towards nervous and mental disorders, teaches us that their extraordinarily advanced domestication may eventually imprint clear marks on the race”. Brune states that Kraepelin’s nosological system “was, to a great deal, built on the degeneration paradigm”.

Influence

Kraepelin’s great contribution in classifying schizophrenia and manic depression remains relatively unknown to the general public, and his work, which had neither the literary quality nor paradigmatic power of Freud’s, is little read outside scholarly circles. Kraepelin’s contributions were also to a large extent marginalized throughout a good part of the 20th century during the success of Freudian etiological theories. However, his views now dominate many quarters of psychiatric research and academic psychiatry. His fundamental theories on the diagnosis of psychiatric disorders form the basis of the major diagnostic systems in use today, especially the American Psychiatric Association’s DSM-IV and the World Health Organization’s ICD system, based on the Research Diagnostic Criteria and earlier Feighner Criteria developed by espoused “neo-Kraepelinians”, though Robert Spitzer and others in the DSM committees were keen not to include assumptions about causation as Kraepelin had.

Kraepelin has been described as a “scientific manager” and political operator, who developed a large-scale, clinically oriented, epidemiological research programme. In this role he took in clinical information from a wide range of sources and networks. Despite proclaiming high clinical standards for himself to gather information “by means of expert analysis of individual cases”, he would also draw on the reported observations of officials not trained in psychiatry. The various editions of his textbooks do not contain detailed case histories of individuals, however, but mosaiclike compilations of typical statements and behaviours from patients with a specific diagnosis. In broader terms, he has been described as a bourgeois or reactionary citizen.

Kraepelin wrote in a knapp und klar (concise and clear) style that made his books useful tools for physicians. Abridged and clumsy English translations of the sixth and seventh editions of his textbook in 1902 and 1907 (respectively) by Allan Ross Diefendorf (1871-1943), an assistant physician at the Connecticut Hospital for the Insane at Middletown, inadequately conveyed the literary quality of his writings that made them so valuable to practitioners.

Among the doctors trained by Alois Alzheimer and Emil Kraepelin at Munich at the beginning of the 20th century were the Spanish neuropathologists and neuropsychiatres Nicolás Achúcarro and Gonzalo Rodríguez Lafora, two distinguished disciples of Santiago Ramón y Cajal and members of the Spanish Neurological School.

Dreaming for Psychiatry’s Sake

In the Heidelberg and early Munich years he edited Psychologische Arbeiten, a journal on experimental psychology. One of his own famous contributions to this journal also appeared in the form of a monograph (p.105) entitled Über Sprachstörungen im Traume (On Language Disturbances in Dreams). Kraepelin, on the basis of the dream-psychosis analogy, studied for more than 20 years language disorder in dreams in order to study indirectly schizophasia. The dreams Kraepelin collected are mainly his own. They lack extensive comment by the dreamer. In order to study them the full range of biographical knowledge available today on Kraepelin is necessary.

Bibliography

  • Kraepelin, E. (1906). Über Sprachstörungen im Traume. Leipzig: Engelmann. ([1] Online.)
  • Kraepelin, E. (1987). Memoirs. Berlin, Heidelberg, New York: Springer-Verlag. ISBN 978-3-642-71926-4.

Collected Works

  • Burgmair, Wolfgang & Eric J. Engstrom & Matthias Weber et al., eds. Emil Kraepelin. 9 vols. Munich: belleville, 2000–2019.
  • Vol. I: Persönliches, Selbstzeugnisse (2000), ISBN 3-933510-90-2
  • Vol. II: Kriminologische und forensische Schriften: Werke und Briefe (2001), ISBN 3-933510-91-0
  • Vol. III: Briefe I, 1868–1886 (2002), ISBN 3-933510-92-9
  • Vol. IV: Kraepelin in Dorpat, 1886–1891 (2003), ISBN 3-933510-93-7
  • Vol. V: Kraepelin in Heidelberg, 1891–1903 (2005), ISBN 3-933510-94-5
  • Vol. VI: Kraepelin in München I: 1903–1914 (2006), ISBN 3-933510-95-3
  • Vol. VII: Kraepelin in München II: 1914–1920 (2009), ISBN 978-3-933510-96-9
  • Vol. VIII: Kraepelin in München III: 1921–1926 (2013), ISBN 978-3-943157-22-2
  • Vol. IX: Briefe und Dokumente II: 1876-1926 (2019), ISBN 978-3-946875-28-4

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On This Day … 06 May [2022]

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Events

  • 1757 – English poet Christopher Smart is admitted into St Luke’s Hospital for Lunatics in London, beginning his six-year confinement to mental asylums.

People (Births)

  • 1856 – Sigmund Freud, Austrian neurologist and psychoanalyst (d. 1939).
  • 1922 – Camille Laurin, Canadian psychiatrist and politician, 7th Deputy Premier of Quebec (d. 1999).

People (Deaths)

  • 2012 – Jean Laplanche, French psychoanalyst and author (b. 1924).

Christopher Smart

Christopher Smart (11 April 1722 to 21 May 1771) was an English poet. He was a major contributor to two popular magazines, The Midwife and The Student, and a friend to influential cultural icons like Samuel Johnson and Henry Fielding. Smart, a high church Anglican, was widely known throughout London.

Smart was infamous as the pseudonymous midwife “Mrs. Mary Midnight” and for widespread accounts of his father-in-law, John Newbery, locking him away in a mental asylum for many years over Smart’s supposed religious “mania”. Even after Smart’s eventual release, a negative reputation continued to pursue him as he was known for incurring more debt than he could repay; this ultimately led to his confinement in debtors’ prison until his death.

St Luke’s Hospital for Lunatics

St Luke’s Hospital for Lunatics was founded in London in 1751 for the treatment of incurable pauper lunatics by a group of philanthropic apothecaries and others. It was the second public institution in London created to look after mentally ill people, after the Hospital of St. Mary of Bethlem (Bedlam), founded in 1246.

Sigmund Freud

Sigmund Freud (born Sigismund Schlomo Freud; 06 May 1856 to 23 September 1939) was an Austrian neurologist and the founder of psychoanalysis, a clinical method for evaluating and treating pathologies in the psyche through dialogue between a patient and a psychoanalyst.

In founding psychoanalysis, Freud developed therapeutic techniques such as the use of free association and discovered transference, establishing its central role in the analytic process. Freud’s redefinition of sexuality to include its infantile forms led him to formulate the Oedipus complex as the central tenet of psychoanalytical theory. His analysis of dreams as wish-fulfilments provided him with models for the clinical analysis of symptom formation and the underlying mechanisms of repression. On this basis, Freud elaborated his theory of the unconscious and went on to develop a model of psychic structure comprising id, ego and super-ego. Freud postulated the existence of libido, sexualised energy with which mental processes and structures are invested and which generates erotic attachments, and a death drive, the source of compulsive repetition, hate, aggression, and neurotic guilt. In his later works, Freud developed a wide-ranging interpretation and critique of religion and culture.

Camille Laurin

Camille Laurin (06 May 1922 to 11 March 1999) was a psychiatrist and Parti Québécois (PQ) politician in the Canadian province of Quebec. A MNA member for the riding of Bourget, he is considered the father of Quebec’s language law known informally as “Bill 101”.

Jean Laplanche

Jean Laplanche (21 June 1924 to 06 May 2012) was a French author, psychoanalyst and winemaker. Laplanche is best known for his work on psychosexual development and Sigmund Freud’s seduction theory, and wrote more than a dozen books on psychoanalytic theory. The journal Radical Philosophy described him as “the most original and philosophically informed psychoanalytic theorist of his day.”

From 1988 to his death, Laplanche was the scientific director of the German to French translation of Freud’s complete works (Oeuvres Complètes de Freud / Psychanalyse – OCF.P) in the Presses Universitaires de France, in association with André Bourguignon, Pierre Cotet and François Robert.

What is the British Psychoanalytical Society?

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Introduction

The British Psychoanalytical Society was founded by the British neurologist Ernest Jones as the London Psychoanalytical Society on 30 October 1913.

It is one of two organisations in Britain training psychoanalysts, the other being the British Psychoanalytic Association.

The society has been home to a number of important Psychoanalysts, including Wilfred Bion, Donald Winnicott, Anna Freud and Melanie Klein. Today it has over 400 members and is a member organisation of the International Psychoanalytical Association.

Establishment and Name

Psychoanalysis was founded by Sigmund Freud, and much of the early work on Psychoanalysis was carried out in Freud’s home city of Vienna and in central Europe. However, in the early 1900’s Freud began to spread his theories throughout the English speaking world. Around this time he established a relationship with Ernest Jones, a British neurosurgeon who had read his work in German and met Freud at the inaugural Psychoanalytical Congress in Salzburg. Jones went on to take up a teaching post at the University of Toronto, in which capacity he established the American Psychoanalytic Association.

When Jones returned to London, he established the society in 1913, as the London Psychoanalytical Society. The society had 9 founding members including William Mackenzie, Maurice Nicoll and David Eder. Almost immediately, the society was caught up in the international controversy between Carl Jung and Sigmund Freud. Many of the society’s membership were followers of Jung’s theories, although Jones himself enjoyed a close relationship with Freud and wished for the society to be unambiguously Freudian. Jones had joined Freud’s Inner circle in 1912, and helped to oust Jung from the International Psychoanalytical Association.

However, the outbreak of World War One in 1914 meant that the nascent society, which depended heavily on correspondence with psychoanalysts in Vienna, then part of Austria-Hungary, had to be suspended. There were a few informal meetings during the war, but these became less and less frequent as the war went on.

In 1919, Ernest Jones re-founded the society as the British Psychoanalytical Society, and served as its President. He took the opportunity to define the society as Freudian in nature, and removed most of the Jungian members. With the help of John Rickman, the society established a clinic and a training arm, known as the Institute of Psychoanalysis.

Interwar Years

In the 1920s, Ernest Jones and the society grew increasingly under the influence of Melanie Klein. Jones was inspired by her writings to develop several of his own psychoanalytical concepts. In 1925, Klein delivered a series of talks at the society on her theories. Klein’s work was well received in London, but it attracted increasing controversy on the continent, where the majority of psychoanalysts were still based. Realising that her ideas were not warmly received at the Berlin Psychoanalytic Institute, where Klein was based, Jones invited her to move to London, which she did later in 1925.

The rise of the Nazi Party in Germany and later in Austria, led to increasing numbers of German and Austrian Psychoanalysts fleeing to London, where they joined the burgeoning society. By 1937, 13 out of 71 members were refugees from Europe. Ernest Jones personally intervened to bring Sigmund Freud and his daughter, Anna Freud, to London. In 1938, Sigmund Freud wrote to Jones:

“The events of recent years have made London the principal site and center of the psychoanalytical movement. May the society carry out the functions thus falling to it in the most brilliant manner.”

By the start of the second world war, 34 out of 90 members were emigres from the continent.

However, the assimilation of so many prominent Psychoanalysts from continental Europe created tensions. The huge difference in the approaches of Anna Freud and Melanie Klein led to the development of several factions. Increasingly, presentations of papers at the society became thinly veiled attacks on opposing factions theories. For example, in March 1937 Melitta Schmideberg (Klein’s daughter) presented her paper: “After the Analysis – Some Phantasies of Patients”, which viciously attacked almost all of Klein’s ideas, though it did not mention her by name.

The views of the different Psychoanalysts: Kleinian, Freudian, and those who were not affiliated with either, led to increasing dysfunction, and things became so bad that a specific committee had to be established to deal with the problem.

The ‘Controversial Discussions’

By 1942, relations between the factions within the society had become so heated that a committee had to be convened to facilitate monthly discussions on the scientific nature of the society. The committee was chaired by three members of the society, each representing one of the major factions:

  • James Strachey: A member of the British Independent Group.
  • Marjorie Brierley: An ally of Melanie Klein.
  • Edward Glover: Who identified as ‘pure Freudian’, in opposition to Melanie Klein. Glover resigned from the society in 1944, along with several other Freudian psychoanalysts.

After heated debate, the committee resolved to a “gentleman’s agreement” – which ensured that each faction would have equal representation within all committees within the society. It was also agreed that training of future psychoanalysts at the institute would be organised into two pathways: one Kleinian, and one Freudian.

After World War Two

With the resolution of the controversial discussions, the society became dominated by independent psychoanalysts such as Donald Winnicott, Michael Balint or Wilfred Bion.

The Society Today

Through its related bodies, the Institute of Psychoanalysis and the London Clinic of Psychoanalysis, it is involved in the teaching, development, and practice of psychoanalysis at its headquarters at Byron House, west London. It is a constituent organisation of the International Psychoanalytical Association and a member institution of the British Psychoanalytic Council.

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What is a Narcissistic Parent?

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Introduction

A narcissistic parent is a parent affected by narcissism or narcissistic personality disorder.

Typically, narcissistic parents are exclusively and possessively close to their children and are threatened by their children’s growing independence. This results in a pattern of narcissistic attachment, with the parent considering that the child exists solely to fulfil the parent’s needs and wishes. A narcissistic parent will often try to control their children with threats and emotional abuse. Narcissistic parenting adversely affects the psychological development of children, affecting their reasoning and their emotional, ethical, and societal behaviours and attitudes. Personal boundaries are often disregarded with the goal of moulding and manipulating the child to satisfy the parent’s expectations.

Narcissistic people have low self-esteem and feel the need to control how others regard them, fearing that otherwise they will be blamed or rejected and their personal inadequacies will be exposed. Narcissistic parents are self-absorbed, often to the point of grandiosity. They also tend to be inflexible, and lack the empathy necessary for child raising.

Characteristics

The term narcissism, as used in Sigmund Freud’s clinical study, includes behaviours such as self-aggrandisement, self-esteem, vulnerability, fear of losing the affection of people and of failure, reliance on defence mechanisms, perfectionism, and interpersonal conflict.

To maintain their self-esteem and protect their vulnerable true selves, narcissists seek to control the behaviour of others, particularly that of their children whom they view as extensions of themselves. Thus, narcissistic parents may speak of “carrying the torch”, maintaining the family image, or making the mother or father proud. They may reproach their children for exhibiting weakness, being too dramatic, being selfish, or not meeting expectations. Children of narcissists learn to play their part and to show off their special skill(s), especially in public or for others. They typically do not have many memories of having felt loved or appreciated for being themselves. Instead, they associate their experience of love and appreciation with conforming to the demands of the narcissistic parent.

Destructive narcissistic parents have a pattern of consistently needing to be the focus of attention, exaggerating, seeking compliments, and putting their children down. Punishment in the form of blame, criticism or emotional blackmail, and attempts to induce guilt may be used to ensure compliance with the parent’s wishes and their need for narcissistic supply.

Children of Narcissists

Narcissism tends to play out intergenerationally, with narcissistic parents producing either narcissistic or co-dependent children in turn. While a self-confident parent, or good-enough parent, can allow a child his or her autonomous development, the narcissistic parent may instead use the child to promote his or her own image. A parent concerned with self-enhancement, or with being mirrored and admired by their child, may leave the child feeling like a puppet to the parent’s emotional/intellectual demands.

Children of a narcissistic parent may not be supportive of others in the home. Observing the behaviour of the parent, the child learns that manipulation and guilt are effective strategies for getting what he or she wants. The child may also develop a false self and use aggression and intimidation to get their way. Instead, they may invest in the opposite behaviours if they have observed them among friends and other families. When the child of a narcissistic parent experiences safe, real love or sees the example played out in other families, they may identify and act on the differences between their life and that of a child in a healthy family. For example, the lack of empathy and volatility at home may increase the child’s own empathy and desire to be respectful. Similarly, intense emotional control and disrespect for boundaries at home may increase the child’s value for emotional expression and their desire to extend respect to others. Although the child observes the parent’s behaviour, they are often on the receiving end of the same behaviour. When an alternative to the pain and distress caused at home presents itself, the child may choose to focus on more comforting, safety-inducing behaviours.

Some common issues in narcissistic parenting result from a lack of appropriate, responsible nurturing. This may lead to a child feeling empty, insecure in loving relationships, developing imagined fears, mistrusting others, experiencing identity conflict, and suffering an inability to develop a distinct existence from that of the parent.

Sensitive, guilt-ridden children in the family may learn to meet the parent’s needs for gratification and seek love by accommodating the wishes of the parent. The child’s normal feelings are ignored, denied and eventually repressed in attempts to gain the parent’s “love”. Guilt and shame keep the child locked in a developmental arrest. Aggressive impulses and rage may become split off and not integrated with normal development. Some children develop a false self as a defence mechanism and become co-dependent in relationships. The child’s unconscious denial of their true self may perpetuate a cycle of self-hatred, fearing any reminder of their authentic self.

Narcissistic parenting may also lead to children being either victimised or bullies, having a poor or overly inflated body image, tendency to use and/or abuse drugs or alcohol, and acting out (in a potentially harmful manner) for attention.

Short-Term and Long-Term Effects

Due to their vulnerability, children are extremely affected by the behaviour of a narcissistic parent. A narcissistic parent will often abuse the normal parental role of guiding their children and being the primary decision maker in the child’s life, becoming overly possessive and controlling. This possessiveness and excessive control disempowers the child; the parent sees the child simply as an extension of themselves. This may affect the child’s imagination and level of curiosity, and they often develop an extrinsic style of motivation. This heightened level of control may be due to the need of the narcissistic parent to maintain the child’s dependence on them.

Narcissistic parents are quick to anger, putting their children at risk for physical and emotional abuse. To avoid anger and punishment, children of abusive parents often resort to complying with their parent’s every demand. This affects both the child’s well-being and their ability to make logical decisions on their own, and as adults they often lack self-confidence and the ability to gain control over their life. Identity crisis, loneliness, and struggle with self expression are also commonly seen in children raised by a narcissistic parent. The struggle to discover one’s self as an adult stems from the substantial amount of projective identification that the now adult experienced as a child. Because of excessive identification with the parent, the child may never get the opportunity to experience their own identity.

Mental Health Effects

Studies have found that children of narcissistic parents have significantly higher rates of depression and lower self-esteem during adulthood than those who did not perceive their caregivers as narcissistic. The parent’s lack of empathy towards their child contributes to this, as the child’s desires are often denied, their feelings restrained, and their overall emotional well-being ignored.

Children of narcissistic parents are taught to submit and conform, causing them to lose touch of themselves as individuals. This can lead to the child possessing very few memories of feeling appreciated or loved by their parents for being themselves, as they instead associate the love and appreciation with conformity. Children may benefit with distance from the narcissistic parent. Some children of narcissistic parents resort to leaving home during adolescence if they grow to view the relationship with their parent(s) as toxic.

What is Narcissistic Withdrawal?

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Introduction

In children, narcissistic withdrawal may be described as ‘a form of omnipotent narcissism characterised by the turning away from parental figures and by the fantasy that essential needs can be satisfied by the individual alone’.

For adults, ‘in the contemporary literature the term narcissistic withdrawal is instead reserved for an ego defence in pathological personalities’. Such narcissists may feel obliged to withdraw from any relationship that threatens to be more than short-term.

Psychoanalysis

Freud used the term ‘to describe the turning back of the individual’s libido from the object onto themselves….as the equivalent of narcissistic regression’. On Narcissism saw him explore the idea through an examination of such everyday events as illness or sleep: ‘the condition of sleep, too, resembles illness in implying a narcissistic withdrawal of the positions of the libido on to the subject’s own self’. A few years later, in ‘”Mourning and Melancholia”…Freud’s most profound contribution to object relations theory’, he examined how ‘a withdrawal of the libido…on a narcissistic basis’ in depression could allow both a freezing and a preservation of affection: ‘by taking flight into the ego love escapes extinction’.

Otto Fenichel would extend his analysis to borderline conditions, demonstrating how ‘in a reactive withdrawal of libido…a regression to narcissism is also a regression to the primal narcissistic omnipotence which makes its reappearance in the form of megalomania’.

For Melanie Klein, however, a more positive element came to the fore: ‘frustration, which stimulates narcissistic withdrawal, is also…a fundamental factor in adaptation to reality’. Similarly, ‘Winnicott points out that there is an aspect of withdrawal that is healthy’, considering that it might be ‘”helpful to think of withdrawal as a condition in which the person concerned (child or adult) holds a regressed part of the self and nurses it, at the expense of external relationships”‘.

However, from the mid-20th century onwards, attention has increasingly focused on

‘the case in which the subject appeals to narcissistic withdrawal as a defensive solution…a precarious refuge that comes into being as a defense against a disappointing or untrustworthy object. This is found in studies of narcissistic personalities or borderline pathologies by authors such as Heinz Kohut or Otto Kernberg’.

Kohut considered that ‘the narcissistically vulnerable individual responds to actual (or anticipated) narcissistic injury either with shamefaced withdrawal or with narcissistic rage’. Kernberg saw the difference between normal narcissism and ‘ pathological narcissism…[as] withdrawal into “splendid isolation”‘ in the latter instance; while Herbert Rosenfeld was concerned with ‘states of withdrawal commonly seen in narcissistic patients in which death is idealised as superior to life’, as well as with ‘the alternation of states of narcissistic withdrawal and ego disintegration’.

Schizoid Withdrawal

Closely related to narcissistic withdrawal is ‘schizoid withdrawal: the escape from too great pressure by abolishing emotional relationships altogether’. All such ‘fantastic refuges from need are forms of emotional starvation, megalomanias and distortions of reality born of fear’.

Sociology

‘Narcissists will isolate themselves, leave their families, ignore others, do anything to preserve a special…sense of self’ Arguably, however, all such ‘narcissistic withdrawal is haunted by its alter ego: the ghost of a full social presence’ – with people living their lives ‘along a continuum which ranges from the maximal degree of social commitment…to a maximal degree of social withdrawal’.

If ‘of all modes of narcissistic withdrawal, depression is the most crippling’, a contributing factor may be that ‘depressed persons come to appreciate consciously how much social effort is in fact required in the normal course of keeping one’s usual place in undertakings’.

Therapy

Object relations theory would see the process of therapy as one whereby the therapist enabled his or her patient to have ‘resituated the object from the purely schizoid usage to the shared schizoid usage (initially) until eventually…the object relation – discussing, arguing, idealizing, hating, etc. – emerged’.

Fenichel considered that in patients where ‘their narcissistic regression is a reaction to narcissistic injuries; if they are shown this fact and given time to face the real injuries and to develop other types of reaction, they may be helped enormously’ Neville Symington however estimated that ‘often a kind of war develops between analyst and patient, with the analyst trying to haul the patient out of the cocoon…his narcissistic envelope…and the patient pulling for all his worth in the other direction’.

Cultural Analogues

  • In I Never Promised You a Rose Garden, the therapist of the protagonist wonders ‘”if there is a pattern….You give up a secret to our view and then you get so scared that you run for cover into your panic or into your secret world. To live there.”‘.
  • More generally, the 1920s have been described as a time of ‘changes in which women were channelled toward narcissistic withdrawal rather than developing strong egos’.