Advanced Psychopathology

Monday, March 06, 2006


Obsessive Compulsive v. Hysterical Styles

Obsessive compulsive people are characterized by rigid thinking, tense activity, and loss of reality. The first trait may be observed by a stiff body posture, overly formal social behaviors, and unyielding, unrealistic perseverance. Cognitively, it can manifest in inattentiveness to new facts or different perspectives. This is related to a general inability to easily direct their attention from one task to another. While their attention to detail is sometimes adaptive, they can be so intent upon capturing fine points that they miss the whole picture. Their tense activity is evidenced in continuous involvement with some type of routine or technical work. The motivation behind their intense efforts is usually related to thoughts of “I should do…” (out of propriety, obligation, supervisor expectations, cultural moors, etc). Their loss of reality is associated with an exceptionally harsh and insufficiently integrated superego. They commonly defend against this punishing superego using regression, reaction formation, isolation of affect, and undoing. Unfortunately, these defenses disconnect them from their true desires, resulting in great difficulty making decisions.

Hysterical individuals can be characterized by a relative absence of active concentration, vulnerability to transitory influences, and existence within a relatively nonfactual, subjective world. The first trait results in an inability to capture fine detail. They respond to stimuli by identifying the most impressive, striking, or obvious attribute. Actual facts and consequences of events are noticed only vaguely, peripherally. Consequently, they lack a sense of themselves as factual beings with solid convictions and consciousness of the objective world. Furthermore, since their attention is always fleeting, they are highly distractible, highly suggestible, and easily surprised. These traits are all related to their hallmark defense - repression. Through repression they construct wistful and idealized memories of important figures and a sentimental view of the present. This results in an internal and external reality that is vibrant, colorful, and emotionally charged.

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