ENERGY
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GAIN ENERGY
APPRENTICE
LEVEL1
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THE
ENERGY BLOCKAGE REMOVAL
PROCESS
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THE
KARMA CLEARING
PROCESS
APPRENTICE
LEVEL3
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MASTERY
OF RELATIONSHIPS
TANTRA
APPRENTICE
LEVEL4
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2005 AND 2006 |
PsychopathTHE MASK OF SANITYSection 3: Cataloging the MaterialPart 2: A comparison with other disorders32. The psychoneurotic
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32. The psychoneurotic People who suffer from personality disorders which cause them to be anxious, restless, unhappy, and obsessed with thoughts they themselves recognize as absurd but who are, in the lay sense, altogether sane have for years been classed as psychoneurotic. They recognize reason in general, often admit that their symptoms arise from emotional conflicts, and are free from delusions and hallucinations. Sometimes their complaints are chiefly physical, of fatigue, of numbness, of indigestion, even of paralysis. Often they will not admit that this numbness or indigestion or paralysis could possibly be related to emotional difficulty and indeed they themselves may be unaware of conflict. They are often resistant to reasoning but more in the sense of a person with strong prejudices than of one with delusions or with intellectual dilapidation. Sometimes they feel strong fears that they may carry out acts which they dread and which would indeed be tragic or criminal, but they recognize the nature of these acts and do not carry them out. Other acts, all patently senseless but relatively harmless, they do carry out, recognizing CATALOGING THE MATERIAL 257 the absurdity of feeling that they must do so but becoming anxious if they resist the impulse. In general, psychoneurotic people recognize objective reality and try to adapt themselves like most others to the ways of society. Patients with traditional psychoneurosis are not characterized by antisocial activity or by striking inability to pursue ordinary goals. Their symptoms handicap them often, but in a way we readily understand. Anxiety, for instance, can make special difficulties for a salesman or obsessive manifestations can handicap a banker, a scholar, or a housewife. These patients as a group are sharply characterized by anxiety and by the various symptomatic schemes that apparently arise from the anxiety and that look as if they were measures employed in reaction to the anxiety and in efforts to relieve it, it is true that many patients with conversion symptoms do not show what is ordinarily conveyed by the word anxiety or by tension, fear, distress, and similar terms. Many psychiatrists believe that in such instances the paralysis (or the blindness) may be a substitute for conscious anxiety and probably a defense against it, a means of preventing it or controlling it. The rather remarkable calmness shown by such patients has often been pointed out. Not a few psychopathologists maintain that there is an "unconscious anxiety" or what might be thought of as something embryonic, underlying, or incipient that would be anxiety if not converted into the physical manifestation. Certainly it may be said about psychoneurosis, as the term is officially used and most widely accepted, that patients with this kind of disorder usually find their symptoms unpleasant, consciously suffer from them, and complain. On the contrary, those called psychopaths are very sharply characterized by the lack of anxiety (remorse, uneasy anticipation, apprehensive scrupulousness, the sense of being under stress or strain) and, less than the average person, show what is widely regarded as basic in the neurotic. It is very true that Alexander9,11 and others79,209 who use his terminology and accept his interpretations refer to behavior disorders as character neuroses. Karpman164 feels that most (but not all) patients who are classed as psychopaths should be grouped with the neurotic or the psychotic group. So far as its implication of causal factors is concerned, the term neurotic has undeniably valuable applications for those who feel that they have discovered such causes; but its tendency otherwise to identify the psychopath with hysteria, anxiety reactions, or ordinary obsessive-compulsive disorders is likely to cause confusion and make for practical difficulties. If the psychopath really has a neurosis, it is a neurosis that is manifested in a fundamentally different life-pattern from classic neurosis, manifested, 258 THE MASK OF SANITY one might say, in a pattern that is not only different but opposite. Alexander and others have made this quite clear, and the interpretation of the psychopath's behavior as symptomatic "acting out" against his surroundings, in contrast with the development of anxiety or headache or obsession is, it seems to me, an interesting formulation. It is of obvious importance to respect this polar difference between how the psychopath is going to behave socially and what can be expected of patients with somatization conversion. I do not believe that psychopaths should be identified with the psychoneurotic group, for this would imply that they possess full social and legal competency, that they are capable of handling adequately their own affairs, and that they are earnestly seeking relief from unpleasant symptoms. There are disorders in which the two diverse types of reaction (developing subjectively unpleasant symptoms versus callously carrying out socially destructive acts) seem to exist in the same symptom. The so-called pyromaniac (and kleptomaniac) often seems motivated by forces similar to the classic obsessive-compulsive patient who corrects the alignment of objects on the bureau forty times a day and who is painfully and overscrupulously preoccupied with fears that he may harm his child. Such a patient detests the acts he carries out as a sort of ritual to mitigate his subjective distress and is by no means likely to harm the child. He is, in fact, horrified by these thoughts (fears) and is nearly always conscientious to an excessive degree. On the other hand, as Fenichel has pointed out, the patient abnormally impelled to commit arson or theft (or sex murder) is not committing an act in which scrupulous feelings play a direct or major role and (despite possible ambivalence) gains excitement and consciously satisfies strong drives. The distinction emphasized by Fenichel between ego-syntonic and ego-alien motivations (compulsive acts of caution versus so-called "compulsive" antisocial acts) is a fundamental point and brings out a distinction not merely of degree but of quality. Behavior that Fenichel classifies as impulse neurosis seems to lie in an area where the unlike (and, as a rule, mutually exclusive) manifestations of the psychopath and the classic obsessive-compulsive patient both play a part together, the two customary opposites approaching and perhaps merging, paradoxically, in the antisocial act.79,254 This particular mingling of influences (or merging of pictures) ordinarily quite different (and mutually exclusive) is not unique in psychiatry. Is there any one who has not seen patients manifesting genuine manic and genuine catatonic features? Has any psychiatrist failed to note obsessive relations that are colored with genuine delusion? Despite any confusions that arise in arguments about psychopathology CATALOGING THE MATERIAL 259 (dynamic or descriptive) in regard to the psychopath, all, I believe, will agree that his clinical manifestations are easily distinguished from the syndromes now classified as psychoneurosis. It is doubtful if in the whole of medicine any other two reactions stand out in clearer contrast. The true psychopaths personally observed have usually been free, or as free as the general run of humanity, from real symptoms of psychoneurosis. The psychoneurotic patient, furthermore, is usually anxious to get over his symptoms, while the psychopath does not show sincere evidence of regretting his conduct or of intending to change it. Caldwell has effectively set down outstanding differences between these two clinical pictures in a brief tabulation. Our point can be clarified by quoting it:39
Feeling Thinking Acting
1, Ego-enhancement (psychopathic) Hedonistic Callous Emotionally immature Irresponsible Rationalistic Antisocial Impulsive Defiant Explosive 2. Ego,depreciation (neurotic) Apprehensive Anxious Fearful Depressed Helpless Inferior Jealous Stereotyped in fantasies Preoccupied with moral and religious ideas Obsessive Antisocial Asocial Shy, sensitive Hesitant Indecisive Suggestible Overly protective Sexually conditioned Timorous Passive Some observers believe that the presence of what has long been known as psychoneurosis is sufficient reason for questioning the diagnosis of psychopathic personality. In the study just referred to, Caldwell reports neurotic manifestations in patients whose chief features were plainly those of the psychopath. I believe that the two types of reaction are not characteristically seen together but perhaps there are no two pathologic syndromes in psychiatry, however distinct, that may not sometimes overlap. |
Energy Enhancement Enlightened Texts Psychopath The Mask Of Sanity
Section 3, Part 2
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