Advanced Psychopathology

Monday, March 06, 2006


that was hysterical!! (or was it compulsive?)

The obsessive-compulsive and hysterical characters seem to lie on opposite sides of a continuum, in terms of their cognitive and defensive styles. On one hand, the obsessive tends to overthink, overvaluing rational thought and intellectualization while the hysteric tends to be overly feeling, operating through pure emotion and sexualization, often regressing into childlike states. In a sense, one might argue that the two complement one another and could probably benefit from a mutual exchange of characteristic traits in order to achieve a better balance in their lives. In reading about these two personality styles, I could not help but think of two of my closest friends, whom I shall call Katie and Allison.

Katie was brought up in a Midwestern suburb, the younger of two. Her family is the picture of the “ideal” American family: her father is the head of a successful family business and her mother, a former homecoming queen, is a homemaker who maintains a perfect, immaculate home. She was raised to be a high achiever and to always present an outward appearance of perfection. While Katie is extremely personable and does not present with the typical isolative quality one might expect from an obsessive-compulsive, she is consumed with constant feelings of guilt at not doing enough, in spite of a highly successful record of professional achievement as a medical resident in dermatology (in addition to graduating first in her class from medical school) as well as having many close interpersonal relationships, including one with her husband of almost two years. Much of her daily life is characterized by an overarching need for control, manifested through her compulsive list-making, her intellectual dissection of problems, and many sleepless nights spent cleaning, cooking, or doing whatever she thinks it will take in order for things to be perfect. She tends to make decisions based upon what she thinks will please others, devaluing her own desires, yet often expresses feelings that somehow she has disappointed them regardless. During her adolescence, she suffered mildly from bulimia.

Allison, on the other hand, in spite of great intelligence and genuine concern for others, often comes across as being overly dramatic and insincere, as she tends to seek attention, looking for affirmation from others. Her parents are very doting; however, her mother is a rather helpless, anxious individual who has been further enfeebled by her father’s desire to take care of her. While her relationship with her father is very loving and seemingly nurturing, the implicit expectation for Allison has always been that she will rise above and be better than her mother. Unfortunately, although she is quite a capable individual, Allison often falls prey to feelings of being overwhelmed and unable to take care of herself. She frequently seeks out male companionship in order to feel good about herself and gain some sense of power, using seductive tactics to attract them to her. While she can certainly be manipulative at times, it is generally due to an intense anxiety that overcomes her, forcing her to act out in ways that appear to be self-serving and appear to quell her sometimes overly emotional state.

These two women, while perhaps not the most extreme examples of obsessive-compulsive and hysterical personalities, respectively, certainly exhibit strong degrees of each in their respective character organization.

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