Human personality and its pathology
I.
The most careful observation of what are known as mental diseases and defects justifies the conception of them as defects of personality in all its complexity. The behavior which is looked upon as abnormal and unusual indicates that the personality is disorganized, or out of harmony with its environing circumstances. The psychopathological behaviors of our everyday life represent peculiar slight failures to adapt ourselves to our surroundings in a usual or expected manner. This attitude concerning mental disease is a symptom of the development of a series of valuable scientific conceptions concerning human personality and human character. Human personality may now be looked upon as a phenomenon of science. It is an observable fact of our actual contact with concrete objects, and therefore subject to serviceable interpretation. The critical study of personality as a definite scientific phenomenon promises great value for the student of social and ethical facts; it will provide such students with data concerning human action and its motivation, whether moral or non-moral adjustments, or unusual maladjustments to the social, cultural, and physical surroundings.
II.
Personality may be analyzed for psychological descriptive purposes into two large component factors. One of these comprises the actions which represent the actual movements and behaviors of any particular person. In a broad way we have here the sum total of an individual's behavior or actions which are the direct visible signs of the individual's nature. Included here are all the acts of the moral, religious, esthetic, social, scientific, commercial and economic relations. The other major component is a series of more permanent action elements, which may be considered potential behaviors. We may best refer to these acts as dispositions or tendencies to action. When these dispositions or tendencies are actualizing themselves they influence the general direction which a response adjustment takes. In other words, whatever action an individual ever performs is determined by these dispositions which are cumulative responses centering around an original tendency. The original tendencies represent the inherited phases of personality which usually are modified by the actual experiences of the individual.
Both the actual behaviors and the dispositions may be further divided into predominately behavioristic or mentalistic factors. This analysis is proposed with a clear view as to its artificiality, but is undertaken in the interest of an understanding of the phenomena to be studied. The predominantly behavioristic behaviors, which are immediate-response acts, are analyzable into the series of reflexes, habits, and instincts. Between these acts and those which are predominantly mental there are such behaviors as emotions and voluntary acts, which, properly speaking, are on the border-line. The outstanding primarily mental acts are of course the perceptions, memories, and thought. It must be remembered that these functions are never isolated, but always factors or component functions of large complex adjustments in which these acts partake in various combinations. Further, these complex acts have no meaning unless considered in connection with the occasions under which they function, and this brings into relief the more permanent elements in personality, since every overt act is a product of the stimulating conditions, and the organic-response dispositions. The predominantly behavioristic dispositions include three types: namely, the muscular, glandular, and neural, which are capacities latent in the glandular, muscular and neural structures. These dispositions constitute the more permanent equipment of bodily functions necessary for adjustments to external conditions, and require only some definite stimulus-object to cause them to participate in a response act. It is clear then that the dispositions or tendencies to action are in a genuine way the personality,1 while the actual behaviors merely manifest this personality or its changes. It is obvious that what sort of person one is to be depends a great deal upon these latent powers and their development. All the qualities of strength, beauty, and grace center about these factors. We need only refer to the influence of the capacities of the pituitary, sexual, and other glands, to modify the quality of personality and its manifestations. 2
On the mentalistic side we must point out the innate capacities of attention, impulse, discrimination, affection and others. These are phases of conscious behavior which definitely stress the mental aspects of organic adjustments. These two sets of original tendencies, namely, the behavioristic and mentalistic, are of course absolutely inseparable phases of a unit individual, and act as unit responses to provoking stimuli. The two members of the series of incipient actions are variously organized as instinctive adjustments to environmental conditions and as such form the basis for all acts which the individual performs. The dispositions are therefore both native and acquired, each one being a complex accretion of either native or acquired tendencies or both around an innate core. At this point it may be well to observe that the personality is not in any sense a transcendent existence, but a concrete object developed from actual contact with surrounding objects and persons.
The development of human personality begins as process of organization of the original instinctive tendencies into instincts, which in contact with objects calling out some response result finally in the instinctive action. This process marks the first stage in the growth of character. The instincts are not uniformly developed action systems nor do they begin to function simultaneously. Another difference between them is that they vary widely in their urge to action, or in other words, they require stimuli of differing intensities. The instincts of feeding, flight, locomotion, and curiosity may be considered as appearing relatively early, while the instincts of gregariousness and sex among others may be looked upon as comparatively very powerful in function. The strength of some instincts, notably those of sex and gregariousness, have influenced various writers to make the entire complexity of human nature center around one or few instincts. When the individual begins to use this organized equipment he prepares himself to acquire various habits of response and many incipient responses. The entire equipment of native and acquired action systems marks the capacity of an individual to adapt himself to the various circumstances which the surroundings and their changes call out. The further development of personality is a process of constant acquisition of new forms of adaptations as the result of the modification of the original instinctive actions. This development parallels a concomitant development of complexity in the environment. The instinctive acts are genuinely modifiable elements of personality, a fact which is readily understood when we recognize that they are in great part dependent upon the occasion which makes them function. Attention must be directed to the fact that the instinctive action includes more than the innate tendency which actualizes itself as a simple random conative response; it comprises also more than mere instincts which are organized or directed random movements. Frequently instinctive actions are plentifully supplied with varying degrees of intelligence, and when modified by various influencing conditions become the intelligent acts which give value to personality. Similarly modified instinctive actions develop into the habits of thought, the complex emotional responses, and the voluntary behavior of highly adaptive persons.
The occasion of the modification of these instinctive acts are the various contacts with objects, other persons, groups and group-products such as customs, laws and other tangible and intangible institutions. Under these various molding influences the person becomes changed both by way of passive submission and active response. The latter point illustrates the give and take which takes place in the course of the development of a person. The individual not only is influenced by the group, but exerts a powerful influence upon other individuals and the group.
The acts of any particular person at any given time are represented by acquired dispositions in varying stages of development, coupled with original tendencies. This indicates the extreme complexity of the activities of a personality, which are always integrations of past activities perpetuated as action systems, complicated by persisting original tendencies, and adapted to currently existing adjustment conditions.
The products of the interaction of individuals and the groups in which they live are acquired dispositions to react in certain ways to surrounding objects and events. In their aggregate these dispositions upon which all action depends, constitute human character or human nature. Such dispositions or potential acts may be classified as interests, sentiments, ideals, convictions, and beliefs. Other traits of character such as desires, ambitions, fears, shames, reverences and jealousies, are also preparations for acts of various sorts. Some of these elements of personality are based upon accumulations of information through past experiences; others are more emotional in their nature, while still others are primarily impulsive in type, depending upon the specific character of their development.
III.
The normality of a person is a function of the harmony of his component action elements, and the efficiency of the person depends upon how well the particular combination of action systems fit in with the environmental conditions. Any serious misfit between the equipment of the personality and the surroundings may mean a disorganization of the action propensities, which may result in maladjustment to the environment. The defects of personality which may occur are of exceedingly various types, and can be roughly described as follow:
Pathological personalities may be due to imperfect development of the psycho-physical tendencies. In such case, the individual is not fitted with a series of organized action propensities, which enable him to adapt himself to his surroundings. We have here a predisposition to forego the ordinary experiences which human individuals enjoy, and this marks an original failure of the mental and behavioristic tendencies to so group themselves as to allow normal responses. Such a condition indicates not only a defect of immediate adjustment, but must result in a failure on the part of the individual to develop any considerable degree of intelligence. The variations of this type of defect are of course indefinite in number; the many degrees of uncoordination result in differing truncations of personality. This factor accounts for the varieties of morons, imbeciles, idiots and moral delinquents. the organization of certain specific mental tendencies with a corresponding lack of development of others, accounts for such capacities as are exhibited by "idiots savants." We observe frequently in what are otherwise usual individuals the presence of some type of action tendency in an exaggerated or insufficient degree. In most cases these inequalities of endowment or of organization are not observable because the disadvantages which they cause are overcome by various compensations, or by especially favorable environmental conditions. The typical case of uncoordination of original instinctive tendencies leaves the individual in an animal stage of development, and because he is born into a human environment we have that pitiful object, the idiot. The viewpoint here suggested indicates at once an advantage over the almost universally accepted doctrine which classifies the defects mentioned as cases of retarded mental development. If we take speech as an example of conscious behavior we see that the difficulty with the aments is that of a lack of organization of the whole set of native mental and bodily actions propensities. The development of speech and the capacity to use it are present in the higher grade of defectives and decreasingly absent in the lower one. Coordinate with this fact we find an undoubted progress in development of psychophysical organization from the idiots to the high grade morons. In the class of defectives known as aments we observe that the variation from the normal ranges from the idiots, who are confined to primitive behavior in response to physical surroundings, to the morons who have an added capacity to adapt themselves to simple social conditions. The complex behaviors involving thought and voluntary action are found here in degrees of undevelopment.
The next type of personality defect which we may consider is connected with a higher stage of human development. Here the original tendencies are entirely coordinated, but the resulting actions are not adapted to the needs of the individual, with respect to his environing circumstances. This is essentially a case of the development of unsuitable acquired tendencies, on a foundation coordinated and entirely functional original action systems. These defective personalities build up habits of thought and action which do not comport with the surroundings, thus preventing adequate maintenance and development. As occasions for adjustment we must consider here a very complex environment or series of environments. Unlike the previous sort of defect which failed to provide the proper mechanisms for adaptation to physical circumstances and simple social conditions we have here disharmonies of complex social and cultural surroundings. The defective persons included in this group are incompetent to meet the requirements of the moral and social environment which demands adjustment. The importance of the development of the proper dispositions for a given environment can not be overestimated because every action of an individual is a specific function of adaptation to a specific object or event. We can indicate for practical purposes four fairly distinct types of faulty development of dispositions, with a consequent production of abnormal individuals and actions.
We may take as our first case the personality of the moral delinquent. Students of behavior constantly meet with certain individuals who apparently can not meet the requirements of their moral surroundings. This is of course a problem of social harmony and approval. These individuals have built up action systems which are entirely incompatible with the environing society. Typical examples of these persons are the pathological liars and swindlers.3 Another type of abnormal person is the exhibitionist and other sexual male-factors. The abnormality concerned is a failure to check the development of unsocial action tendencies by the development of suitable habits of self restraint. These individuals permit their original propensities to organize themselves and to develop without due regard for social requirements and demands. Such individuals may be very well adapted to care for themselves in the natural world, and in certain social surroundings, but there are phases of the social milieu which seem completely to overwhelm them.
The second type of defective personality which is accounted for by wrong development is the paranoiac. This type of person form his early years builds up habits of shunning others, is suspicious, and bears a general attitude of isolation and persecution. This attitude may also take the form of exaggerated self-regard and expand into a highly developed stage of grandeur-delusion. The individual creates for himself a world far removed from actual contact with natural events, and other individuals. This attitude of removal and isolation may finally culminate in a situation extremely harmful to the individual himself and the persons with whom he comes into contact. There is always great danger in the systematic organization of the behaviors and ideas of persecution and of grandeur, because they inevitably result in a situation inimical to society. One of the worst manifestations of these paranoiac behaviors is that which reaches the querulous form. Those persons developing the habits of seeking recourse to the law for all their ills, real and imaginary, may clog up the local judicial system and involve hundreds of people. In all these cases there is at the basis of the difficulty a separation of the individual from his immediate surroundings; a condition which breeds great mischief for the individuals with whom the paranoiac is associated. The paranoiac type of personality defect may be distinguished from some of the other types by the fact that it is a slowly developing system of acquired reactions which are out of harmony with the requirements of the group in which the individual finds himself.
We must consider next the great class of individuals who are grouped under the heading of psychoneurotics. Here are individuals whose original action tendencies group themselves into habits and volitions which unfit them to maintain their expected place in society. They develop such reactions to their surroundings as to create great inconsistencies in their experiences. Consequently the individual's responses are so out of tune with each other that he loses control over his environment. An English soldier says of his obsessions, "I know I'm a damned fool and it's rot, but there it is; I can not help myself."4 The psychasthenics develop obsessions, impulsions, and fixed ideas all of which are incipient tendencies of action which are extremely detrimental to the individual and his group. We find individuals exhibiting abnormal reactions of fear, and performing acts which are described as the pyromanias, arithmomanias and others. In this same class are the persons who look with suspicion and doubt upon all the world and its objects. Such types are the so-called metaphysicians who can not go through a day without experiencing the most violent anguish because they can not explain how the world was created or whether a God exists.
The neurasthenics establish as elements of their personalities various inhibitions, or action habits which interfere with the ordinary activities of normal persons. These individuals are irritable, constantly fatigued, and in other ways incapacitated to carry on their usual activities. The neurasthenics cultivate idleness in all its forms, and make themselves passive, helpless persons.
In the various manifestations of the hysterical individuals we find evidence of the building of peculiar reaction habits. We discover the most varied truncations of personality along every line of conscious behavior. The hysterical person responds so differently to ordinary objects as to be branded as abnormal. The peculiar reactions are often acquired as protective devices to meet particular needs, such as to shield one from extraordinary circumstances, or normal conditions which appear difficult to these particular individuals. Hysterical reactions involving the ignoring of various sensorial and memorial experiences indicate the acquisition of response tendencies which are substitutions for adjustments to unusual environmental conditions. The individuals frequently lose their self-control and become entirely helpless.
The building up of unserviceable reaction habits and tendencies finds its mechanism to a considerable extent in suggestion. There is always in these cases either a condition of being greatly overwhelmed by external conditions, or the individual starts out with an unstable personality. By an unstable personality is meant the condition of organization of innate action tendencies which allows for useless and ineffective responses. We find then action systems built up which make for paralyses of various kinds; anesthesias, tactual, visual, and auditory defects aboulias and amnesias. The hysterias of war, which are referred to as war and shell shock, show all types of acquisition of abnormal reaction systems for protective purposes against unendurable external circumstances.5 In a general way we might look upon the development of hysterical individuals as persons whose instinctive tendencies can not harmonize and develop coordinately in the particular environment in which they are thrown. The secret of the value in Freudism lies in the fact that the Freudians worked out fairly well the conflicts and confusions which center about one of the important bases of human nature. When psychologists work out as well the mechanisms of development for the other equally important foundation stones of human personality we shall have reached an important stage in understanding personality and its pathological states.
In dementia praecox we find another pathological condition of personality which is the result of the acquisition of unsuitable action systems. In a genuine sense also, the praecox individual is one in whom the innate action tendencies fail to harmonize, and therefore seriously conflict. The result of this is the serious inhibition of the complex integration of the original simple acts, and a consequent incapacity to make correct adjustments. Typical examples of these unfortunate individuals are fond in what Hoch has termed the "shut in" personality. Such persons develop response acts which tend to seclude them and cut them off from other individuals. They can not get into touch with the realities of life, and are abnormally prudish and religious. They do not at all fit into the social milieu in which they are doomed to spend their days.
There are three classes of defects of personality which may be grouped under the general caption of disorganizations or disintegrations. These three cases show various kinds of dissociation of the original and acquired tendencies after they are organized and developed. In all these cases we have the breakup of the psychophysical organism with its mass of acquisitions resulting in a greater or lesser prominence of the bodily components of the individual. In some cases the disintegration takes place as an atavistic return to a more primitive condition of reaction. We find the manic-depressive individuals dropping off the acquired action tendencies, and responding to their experiences as children do, or as primitive people. These disintegrated persons are lacking in their restraining influences which are generated by interaction with social beings and institutions. In the main these individuals become free and frank, and not only carry their hearts upon their sleeves, but persist in drawing attention to their display. These individuals openly confess their desires whatever they may be, offer all the information they may have about themselves, and in general give themselves whole-heartedly to those whom normal individuals would call strangers. In their display of emotional reactions and flightiness of ideas, they exhibit in a marked way the reactions of children. In the involutional cases there is a clear dropping off of the developed phases of personality and a return to a primitive condition.
The type of disintegration just discussed may be considered as a transverse splitting off of the acquired action tendencies, and thus different from the next type, which marks a longitudinal dissociation of the components of personality. In the various kinds of double and multiple personalities we have individuals whose original reaction systems fail to be harmonized by their experiences and thus can be split of from each other together with the acquisitions built upon them. It is thus possible to find within a single individual several personalities capable of separation under various circumstances. These individuals differ from normal persons who of course always comprise numerous selves, in that the latter have their experiences unified and harmonious. The various selves represent responses to varying surrounding conditions, all of which are threads of a common fabrics in what my be called a single piece of cloth.
Finally, we must consider the confusional disintegration of personality in which there is a general dismemberment of the innate and acquired action systems in no definite order. In the various types of paresis we have examples of the complete degeneration of personality with concomitant deteriorations of its anatomical supports to the stage of total extinction. The paretics show us cases in which there is a rapid disintegration of the acquired action systems with undue and unlicensed exercise of the instinctive action tendencies. In these cases we find a progressive severance of the individual from his normal surroundings and occupations with a striking sense of confusion in the entire procedure. When the elemental action tendencies are released from the accretion of socially molded tendencies, they have no survival functions and the individual becomes soon a hopeless and helpless wreck, a depersonalized mass of plastic clay.
IV.
The facts of pathological personalities offer numerous warnings against considering them as definite fixed kinds of defects. Any of the types may be affected in several different ways. The classifications of defects which have been made are approximations to actual conditions and serve to illustrate the fundamental hypothesis concerning the nature of human disintegrations, which have been known as mental diseases. We might describe any specific defect as predominantly of one type or other, although it may at the same time take on any of the other forms. Human personality is a dynamic object of extreme complexity, and can not be assumed to function in an inflexible and constant manner. The disintregrations of personality can not be reduced to rigidity, because personality can not in any sense be said to develop in a regular and orderly way but rather in a complex hit and miss interaction of psychophysical organisms, under extremely variable conditions of external circumstances.
The study of human personality and its defects also indicates in a decisive way that the dispositions to actions as components of personality are not metaphysical entities. They are not existing potential acts, but represent such modifications in the mental and bodily aspects of individual organization as to result in a specific act under certain definite conditions of stimulation. This is a point which unfortunately has been overlooked by otherwise successful students of human behavior.
Footnotes
1 So far as behavior is concerned.
2 "It is coming to be believed that one of the important factors of the involution period is the atrophy of certain of the ductless glands"-- "and that certain of the disturbances of this period of life are dependent upon an unbalanced relationship brought about between these glands." White, Outlines of Psychiatry, 1918, p. 172.
3 Cf. Healey, Pathological Lying: Accusation and Swindling, 1915.
4 Eder, War Shock, 1917, p. 109.
5 Cf. Donald, E. Gore, Lancet, March 9, 1918, p. 365.