Sources of Anxiety
in the Personality
By: Henry Kellerman and
Anthony Burry
The role of anxiety in personality functioning is considered here
from the
point of view of the patient’s experience of distress, interference with
cognitive and intellectual abilities, and the ways in which anxiety is managed.
Several characteristic methods of handling anxiety are
discussed and related to diagnostic states. The conscious experience of
anxiety, acting-out, and somatization are considered as major means of
coping with anxiety.
Reporting of anxiety in the personality.
Management of anxiety in personality functioning affects:– Operation of cognitive controls
– Achievement of potential levels of intellectual functioning
– Symptom formation
– Subjective distress
A report should indicate how anxiety is manifested in the individual’s functioning:
– Does the anxiety disturb the patient?
– Does the anxiety generate failure in performance?
– Does the anxiety reduce capacity to deal with frustration?
If
anxiety impedes performance, then the patient may show self-defeating behavior,
such as:
– Withdrawing from tasks
– Becoming noncommunicative or uncooperative
– Becoming discouraged or depressed
– Engaging in impulsive behavior
– Withdrawing from tasks
– Becoming noncommunicative or uncooperative
– Becoming discouraged or depressed
– Engaging in impulsive behavior
If
anxiety is not regulated or managed adaptively, then problems may emerge,
including:
– Depression, withdrawal, or inhibition of effort
– School failure or job loss
– Irritability and aggression
– Passivity or dependency
– Depression, withdrawal, or inhibition of effort
– School failure or job loss
– Irritability and aggression
– Passivity or dependency
Is
the anxiety consciously experienced, acted-out, somatized, or understood?
– If consciously experienced, what is the subjective level of distress?
– Does the anxiety generate fantasy, reinforce passivity, or stimulate activity?
– Are phobias or panic states developed?
– Are obsessions developed to generalized anxiety feelings?
– If consciously experienced, what is the subjective level of distress?
– Does the anxiety generate fantasy, reinforce passivity, or stimulate activity?
– Are phobias or panic states developed?
– Are obsessions developed to generalized anxiety feelings?
A
report should describe how anxiety affects the conflict between impulse and
control. For example:
– If anxiety is acted-out, the resulting behavior may be ego-syntonic.
– The person may find it difficult to tolerate frustration even though the experience of anxiety is reduced.
– Acting-out also reduces attention span and, therefore, learning capacity.
– When impulsivity increases, an overall action orientation in the subject is seen.
– If anxiety is acted-out, the resulting behavior may be ego-syntonic.
– The person may find it difficult to tolerate frustration even though the experience of anxiety is reduced.
– Acting-out also reduces attention span and, therefore, learning capacity.
– When impulsivity increases, an overall action orientation in the subject is seen.
A
diagnosis of antisocial personality can be made if
qualities of immaturity, underdeveloped superego, and magical thinking are
prominent. Other character or personality diagnoses that avoid anxiety include obsessive-compulsive
and borderline personalities:
– Schizoid individuals offer few responses
– Passive-aggressive persons express negativism and withholding
– Obsessive-compulsives overfocus on details and offer excessive verbalizations
– Borderline individuals may express angry reactions even to minor frustrations
– Narcissistic persons may express extreme dissatisfaction to frustration of expected entitlements
– Schizoid individuals offer few responses
– Passive-aggressive persons express negativism and withholding
– Obsessive-compulsives overfocus on details and offer excessive verbalizations
– Borderline individuals may express angry reactions even to minor frustrations
– Narcissistic persons may express extreme dissatisfaction to frustration of expected entitlements
When anxiety is somatized: – Actual conversion of psychosomatic symptoms may appear as acting-in
– Acting-in frequently relates to anger, hostility, or sexuality
The
prevalence of ego-syntonic (comfortable) traits suggests a characterological
diagnosis (personality disorder). In contrast, the presence of ego-alien
(uncomfortable) symptoms and anxiety experienced in relation to such symptoms
suggests a diagnosis in the neurotic range. It is likely that underlying the
anxiety is a store of anger.
References
Henry
Kellerman and Anthony Burry, Handbook of Psychodiagnostic Testing, Fourth
Edition, 2007, Springer ScienceBusiness Media, LLC.
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