NEUROSIS AND TREATMENT: A HOLISTIC THEORY

ANDRAS ANGYAL

 

Edited by Eugina Hanfmann and Richard M. Jones

 

FOREWARD BY ABRAHAM H. MASLOW

 

 

Authors Preface:

This book is an outgrowth of the holistic theory of personality, which I put forward many years ago, and of my subsequent therapeutic work with neuroses.  In my earlier book,* starting from the premise that personality is a dynamic whole, I dealt with it in terms of concepts that are psychophysically neutral and adapted to the description of biospheric processes resulting from an interplay of organismic and environmental forces.  The usefulness of my theory in formulating specific problems and interpreting data remained to be tested by empirical methods of inquiry.  A few years after the appearance of Foundations I went into private practice, and my next fifteen years were devoted to therapeutic work with neurotic problems.  In following my patients through the mazes of neurotic entanglements and trying, together with them, to make sense of seemingly inconsistent patterns, I found the general concepts I had developed earlier to be useful guides.  They gave me fresh insights into the origins of neurotic phenomena, into the complex structure of the fully developed neurosis, and into the reasons for its stubborn retention by the patient; these concepts also supplied a rationale for the factors and sequences that did facilitate change.

 

From the multitude of individual patterns observed and traced, certain general features eventually emerged, which provided the basis for the theory of neuroses and their treatment, which is the topic of this book.  In some of its aspects this theory is not novel and could not possibly be: the study of neuroses has been an increasingly active field since Freuds ground-breaking work.  My formulations take previous achievements into account; on some points they largely agree with those of other theorists, on others they differ.  What I believe is distinctive about my work is my having consistently placed the findings, old and new, within the holistic framework.  It was through the application of my ideas about the nature and action of systems to the problem of neurosis that I was led to formulate the theory of universal ambiguity, which is the central theoretical part of my contribution.

 


The basic tenet of the holistic approach is that personality is an organized whole and not a mere aggregate of discrete parts.  Its functioning does not derive from the functioning of its parts; rather the parts must be viewed in the light of the organizational principles governing the whole.  In my reading this implies that concepts referring to broad trends, under which many manifestations of human life can be subsumed, are preferable to concepts based on specific partial functions.  One can, of course, make valid generalizations about human nature at any points of the specificity-generality continuum, and references to the most specific functions may have the appeal of obviousness: all human being undoubtedly have to breathe, eat, and so forth.  However, any attempt to view the total human life as deriving from these fixed physiological features is bound to lead to a good many forced constructions.  The approach from above, from general patterns and trends, enables us to keep the perspective on the whole and offers a comprehensive framework for the understanding of the specific.  The generality of this framework permits us to remain unbiased and alert to the many individual patterns the general trends can form; a theory of this kind is not likely to violate concrete reality.

 

In terms of this conception the early personal manifestations, important as they may be in shaping the persons future, are not more real or basic than the later ones.  Both express the same human trends-through the medium of functions that are available or prominent at a given developmental level; this accounts for the similarity of their patterning.  Normal development can be viewed as a process of successive approximation of the state of complete realization of the basic human trends.  The meaning of the early primitive expressions of a trend is clarified by our knowledge of its later mature expressions: to understand an embryo we must know the structure of the mature organism.

 

To illustrate my point of view, let us take the concept of castration anxiety, a concept centered on a specific psychic content but commonly applied to anxiety about any vital injury or loss.  If this use of the term implies that the actual fear of losing the penis is the origin and nucleus of all other homologous fears, which are merely its derivatives or disguises, I cannot agree with this usage.  I should consider the issue involved to be a broad one, that of response to a severe threat to one's safety and integrity.  Fear of the loss of penis is a very common reaction to such a threat, because this extremely plastic and concrete image is a good vehicle for emotional ideas formed at an early level of development.  Since at that stage the childs experience is not differentiated and not organized conceptually, these images are equated with that which they represent.  Thus the idea of castration becomes a central symbolic concretization of the general threat of which it is a striking expression but not the only expression; in the case of a girl, it can become an explanation of the already experienced rejection resulting in a feeling of worthlessness.

 

All this may sound like undue insistence on mere terminological precision or like metaphysical speculation about the nature of ultimate reality.  It seems obvious to me, however, that the type of concepts we choose has definite implications for the outcome of our efforts to form an adequate conception of personality.  If we work downward from the broad pattern to the specific, we minimize the risk of being left with a collection of fragments difficult, if not impossible, to combine into a unified whole.

 

In presenting my approach to neuroses and their treatment, I wish to share with others who are professionally or personally interested in this field the ways of viewing the problem that have proved clarifying to me and to my patients.  I hope that I may have helped to demonstrate the fruitfulness of the holistic approach by having applied it to a sector of life that, far from being small and isolated, reflects in its very distortions the crucial issues of human existence.

 

                                                                                                                           ANDRAS ANGYAL

 



*A. Angyal, Foundations for a Science of Personality.  The Commonwealth Fund, New York, 1941.


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