Karen horney theory of personality summary

This is the classroom book regarding Karen Horney

Cloninger, S. (2013). Theories of personality: Understanding persons. Upper Saddle River, NJ: Pearson.Constellation TM course digital materials (CDM) title.

Karen Horney’s theory is popular for its insights into gender. It confronted the male bias of the earlier generation of psychoanalysts. Asan icon of femininity in twentieth-century American popular culture, Marilyn Monroe portrays a person trapped in the gender role ofher time, and so she can be understood from the perspective of Horney’s interpersonal theory and of the subsequent relational theorythat further develops these ideas.

Although she has been dead since 1962, the movie actress Marilyn Monroe is a timeless embodiment of the image of femininity. Sheepitomizes sexual beauty; her picture on a nude calendar was admired by many men and envied by many women. She also had a tragicside, arousing sympathy for the helpless victim.

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Marilyn Monroe

Born in Los Angeles, California, in 1926, Norma Jeane Mortenson (her birth name) wasnot told the truth about her paternity, the product of an extramarital affair. She grewup without a father or mother. Mental illness ran in her family, and her mother andgrandmother were institutionalized (Steinem, 1986). After living in several fosterhomes and an orphanage and having no other stable home, Norma Jeane married atage 16 (a marriage that lasted 4 years). With her husband off to war, she worked in afactory until a photographer taking pictures to boost the troops’ morale discovered herthere. She quickly became a model, on her way to becoming a movie actress, under thename of Marilyn Monroe. Along the way, she posed as the first Playboy magazinecenterfold, married baseball star Joe DiMaggio (a union that lasted only 8 months), andthen married playwright Arthur Miller (for 4 years). She also was the lover ofPresident John F. Kennedy (among others). Marilyn Monroe had many lovers andthree, possibly four, husbands. As much as she sought love, her longest marriage lastedonly 4.5 years. She loved children but never raised her own. Many were conceived;reportedly she had over a dozen abortions. (She reported that she bore an illegitimatechild as a teenager, but it is unclear whether this is fact or imagination.) Whenmotherhood was acceptable, as Arthur Miller’s wife, she miscarried.

Throughout adulthood, Monroe took high doses of barbiturates and attempted suicideon several occasions. It is likely that her death was either an intentional suicide or anaccidental overdose. Theories of murder are favored by some, who argue that the FBI,the Kennedys, and the Mafia all had reasons to be involved in her death. Whatever thecircumstances, her death occurred on the fifth anniversary of her much-mournedmiscarriage.

DEVELOPMENT

Karen Horney’s theory emphasizes childhood parental love as essential for healthy development, whereas neglect produces afundamental conflict that endures. Conflict is between basic anxiety (fear of not being loved or lovable) and basic hostility (anger aboutthe lack of love).

Marilyn Monroe was neglected by her parents. She did not know her father. Her mother suffered serious depression and wasinstitutionalized when Monroe was 7 and for most of her life thereafter. Monroe then grew up in foster homes and an orphanage, neverexperiencing a stable, loving family that would help her establish healthy interpersonal relationships. This insecure beginning, accordingto Horney’s theory, would leave her with lifelong unconscious feelings of being unloved and angry.

DESCRIPTION

Horney’s interpersonal psychoanalysis and subsequent theories of object relations emphasize that the most important aspect ofpersonality is the relationships we have with other people. If they are not secure, then no amount of fame or success can replace them.Personality is described in terms of relationship styles. Some people have a style of an exaggerated need for love and acceptance(“moving toward” style). Others have exaggerated needs for competition or aggression (“moving against” style). A third style is anexaggerated need for isolation (“moving against” style).

Of these styles, Marilyn Monroe clearly had an exaggerated need for love. In her case, this need took the form of seeking sexual love andadmiration for her physical beauty. She had a childlike innocence in her physical appearance and also a childlike hunger for love withoutthe stabilizing anchor of mature self-esteem. Her childlike persona elicited love and protective impulses in others. Like many “movingtoward” women, she chose for her male partners powerful men (including baseball player Joe DiMaggio, playwright Arthur Miller, andPresident John Fitzgerald Kennedy). Gloria Steinem describes her as “the child-woman who offered pleasure without adult challenge; alover who neither judged nor asked anything in return” (1986, p. 22).

ADJUSTMENT

Mental health requires healthy interpersonal relationships, not immature relationships based on inadequate childhood experiences inobject relations theory, and not limited in Horney’s earlier theory to only one or two of the three interpersonal styles listed above. Apoorly adjusted person creates a defensive idealized self that resists awareness and does not permit flexibility. A person whose idealizedself demands always being loved will not be able to move against others by appropriate assertive behavior or to move away from themto be alone when that is needed. A variety of defense mechanisms maintain this style, defending against any unconscious impulses forthe repressed material to emerge—in this case, for repressed anger that could lead to competitiveness or assertiveness.

Physical beauty can be a way of ensuring love; it therefore takes on great value for those with a neurotic need for affection (Horney,1950, p. 138). Monroe’s exhibitionist tendencies trace back to childhood (Steinem, 1986). Horney (1937/1967d, pp. 256–257)suggested that a neurotic need for love can also be expressed as a series of sexual relationships, surely characteristic of Monroe, whosepromiscuity was legendary.

In people who have adopted this pattern of a neurotic, compulsive need for love, hostility is repressed, to avoid anxiety and the risk ofbeing unlovable. One anecdote strongly suggests how much suppressed hostility must have pervaded Monroe’s lovemaking. At a party,where a game required disclosing personal fantasies, “she said she imagined disguising herself in a black wig, meeting her father,seducing him, and then asking vindictively, ‘How do you feel now to have a daughter that you’ve made love to?’” (Steinem, 1986, p. 144).How clearly this says that she thought her father’s love could only be obtained by trickery, and she was mad about it. From an objectrelations theory point of view, this fantasy discloses an unhealthy pattern of relationships, and we would expect the fantasy to alsocontaminate her lovemaking.

COGNITION

As in other psychoanalytic theories, both object relations theories and Horney’s theory describe defense mechanisms that distortthinking and interfere with accurate self-perception. Some of these defense mechanisms (e.g., repression) are the same as thosedescribed in previous chapters, whereas others (e.g., blind spots and externalization) are first described by Horney.

Marilyn Monroe showed an exaggerated concern for the suffering of animals and even plants that can be interpreted as a defensemechanism (externalization) that distorted accurate self-perception. She externalized her own sense of being unloved and helplessnessin a hostile world, not realizing it was she herself who felt the need to be rescued. For example, when she found boys trapping pigeons tosell in New York City, she bought the birds every week and set them free. Another rather bizarre externalization occurred when she sawnasturtiums cut by a lawn mower. As her husband, Arthur Miller, tells it, “crying as if she were wounded,” Marilyn demanded that theystop the car as they drove past. “Then she rushed about picking up the fallen flowers, sticking the stalks back into the ground, to see ifthey might recover” (Summers, 1985, p. 200).

CULTURE

Horney’s most important contribution to psychoanalysis was her recognition that culture contributes significantly to mental healthproblems by encouraging certain neurotic tendencies. By relegating women into society’s accepted gender roles, culture producesunconscious conflict and neurosis. Early psychoanalysts did not recognize this, and so their supposed expertise had the unfortunateeffect of endorsing the unhealthy gender messages of society. Freud’s theory describes masochism as part of normal femininedevelopment, whereas Horney said this trait is a product of culture. It is not inevitably part of being a normal female, and it is nothealthy.

The particular style of femininity that Marilyn Monroe epitomized, the sex goddess of her age, was a product of her culture. MarilynMonroe paints, in bold strokes, themes that typify the feminine personality of her time, in her culture, suggests Gloria Steinem (1986).Her self-doubt and need to be loved, her inability to express anger appropriately, were widespread issues for women of that era. MarilynMonroe was treated by a Freudian analyst Ralph Greenson, a psychiatrist internationally known for his scholarly publications and aformer close friend of the Freud family. However, her therapist missed this opportunity to put her on a less dependent, healthier track(Steinem, 1986). Rather than challenging her need for love as neurotic, apparently he played along, at times even taking the patient intohis home. He also intervened in her movie roles and other extra-therapy aspects of her life, to an extent that violated even his ownteachings about proper therapy techniques (Kirsner, 2007). Of course, it is unfair to judge analysis from a distance; but if the therapy didnot get beneath the neurotic need for affection, it was not addressing the core neurosis and could not hope to achieve a personalityreconstruction. One suspects that Horney would even criticize the therapist for allowing “morbid dependency” in the doctor–patientrelationship (cf. Horney, 1950, p. 243). Cultural assumptions can blind even the experts.

BIOLOGY

Although Horney added a cultural component to psychoanalytic theory, she did not deny the underlying assumption that biologyprovides the energy for personality. Thus she suggested that physical as well as psychological symptoms can be produced by unresolvedunconscious conflict. She also realized that some people turn to physical substances to alleviate psychological suffering.

Marilyn Monroe tried to drown her hostility and anxiety with drugs. Horney (1950, p. 152) proposed that drug use stems from theunderlying problem of self-contempt. Even Monroe’s physical difficulties are consistent with Horney’s theory. Monroe suffered extrememenstrual pain. She was reportedly frigid, compulsively seeking intercourse but not experiencing orgasm. If Horney’s paper had notoriginally been published in 1926, we might have thought Horney had Marilyn Monroe in mind when she observed “that frigid womencan be even erotically responsive and sexually demanding, an observation that warns us against equating frigidity with the rejection ofsex” (Horney, 1926/1967c, p. 74). Horney reported that frigid women may convert their sexual functioning into a variety of menstrualdisorders, including pain and miscarriage.

FINAL THOUGHTS

It took a woman, Karen Horney, to see cultural bias in misunderstanding women in the psychoanalytic theory that she otherwiseadmired and practiced. Her insights help us understand the psychological flaws of Marilyn Monroe, not simply to admire or desire her.The core conflict, in Horney’s theory, stems from inadequate parental love. We may defend against that conflict in culturally driven ways,varying from one century to the next and from one subgroup within society to another, but our basic needs are the same.

6.2 INTERPERSONAL PSYCHOANALYSIS: HORNEY

The emphasis on society that Adler and Erikson contributed to psychoanalytic theory continued into the next generation of analysts,including Karen Horney. Like traditional Freudian psychoanalysts, Horney firmly believed that the unconscious is a powerful determinant ofpersonality and that childhood conflicts are important. However, she questioned Freud’s emphasis on sexual conflict. According to Horney,the most important conflicts are based on unresolved interpersonal issues. She argued that cultural forces must be considered and thepersonality differences between men and women are influenced more by society than by anatomy.

Table 6.1 Preview of Horney’s Theory and Object Relations Theory

IndividualDifferences

Individuals differ in the way they define themselves in relationships. Horney described a balance among threeinterpersonal orientations: moving toward, moving against, and moving away (from people). People have differentidealized selves and use different ways of adjusting to anxiety.

AdaptationandAdjustment

Healthy interpersonal relationships are a key to adjustment, and they are based on acceptance of the true self instead ofsome defensive idealized self. Horney provides full descriptions of neurotic trends. Therapy focuses more on the presenttime and on interpersonal relationships than on the past and libidinal conflict (contrasting with Freud’s theory).

CognitiveProcesses

Blind spots and other defense mechanisms limit insight, but courageous self-examination can lead to growth.Developmental and object relations theorists are studying specific cognitions, such as those related to emotion.

Culture

Culture is very important in shaping personality, especially through gender roles.

BiologicalInfluences

Biology is far less important than orthodox psychoanalysis claims.

Development

Love and nurturance are key to a child’s development. In Horney’s theory, basic anxiety and hostility are thefundamental emotions of childhood. Without adequate parental love, the child develops unhealthy interpersonal modesand a defensive sense of self. Few major changes in personality occur after childhood (except through therapy).

The interpersonal emphasis that Horney advocated has been the foundation of other psychoanalytic theories, as well. The relational approachdraws from many of these theoretical developments and has forged connections with advances in developmental and social psychology. Thisapproach, which has too many contributors to single out one “great name” with which to label it, is presented in this chapter.

BIOGRAPHY OF KAREN HORNEY

Karen Danielson was born near Hamburg, Germany, on September 15, 1885. She was the second child in an unhappy marriage of an often-absent Norwegian sea captain and his beautiful, somewhat higher-class wife. Danielson and her older brother Berndt were disciplined strictlyby their tyrannical Lutheran father when he was home from long sea voyages around Cape Horn to the Pacific coast of South and CentralAmerica. She retained a strongly independent character, regarded her father’s outspoken religious attitudes as hypocritical, and questionedthe fundamentalist teachings of her church.

This was a time of social change in Germany, opening opportunities for women. Young Danielson entered the University of Freiburg in 1906,in a class of 58 women and 2,292 men. There she studied medicine, was popular, and married one frequent companion, Oskar Horney, in1909. They moved to Berlin, where she continued her medical studies and he began a business career.

Karen Horney was a psychoanalytic patient of the Freudian analyst Karl Abraham. This was an avant-garde interest at that time. It wascharacteristic of her to explore new ideas, but she sought relief from personal problems as well: depression, fatigue, and dissatisfaction withher marriage. Her father died about this time, and she had ambivalent feelings toward him to sort out: anger because of the unhappiness ofher parents’ marriage, but also more fondness for him than she admitted. The demands of combining a medical education with family life,without much encouragement from her husband, also required coping.

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Karen Horney

After receiving her psychiatric degree in 1915, she dared to lecture on the controversialFreudian theory and to defend it against critics including, interestingly, Adler and Jung(Quinn, 1988, p. 151). Her own challenges to the theory were still brewing. Unlike manypsychoanalysts of this time, she did not visit Freud and so did not know him personally(Quinn, 1988). Freud did, however, chair a session in 1922 in which Horney presented apaper, “The Genesis of the Castration Complex in Women” (O’Connell, 1980).

Karen and Oskar Horney had three daughters. (One, Marianne Horney Eckardt, became aHorneyan analyst.) But the couple continued to have a troubled marriage and finallyseparated. Horney poured increasing energy into her career. She became one of thefounding members of the Berlin Psychoanalytic Institute in 1920 and published severalpapers on male and female development, relationships, and marriage. Her 14 papersbetween 1922 and 1935 outlined a theory of female psychology that was clearly critical ofFreud’s theory. Horney’s first suggestions were presented in a spirit of intellectual debatewithin classic Freudian theory, the sort of challenge that fosters the development of anyscience. The psychoanalytic community, however, dismissed her points and attacked hermotivations. Freud is reported to have said of her, “She is able but malicious—mean”(Quinn, 1988, p. 237). He accused her of an inadequate analysis, saying that she did notaccept her own penis envy (Symonds, 1991).

Given this hostile environment in Germany, it is no wonder that Horney accepted aninvitation to become associate director of a new Institute for Psychoanalysis in Chicago,under Franz Alexander, in 1932. Then, in 1934 she moved to New York. Ironically, the same sort of professional debates over theoreticalorthodoxy that had impelled her to leave Germany divided the New York Psychoanalytic Institute, which in 1941 voted to remove her fromher role as a teacher and clinical supervisor, demoting her to instructor.

Horney and her followers quickly formed a new organization, the Association for the Advancement of Psychoanalysis, and founded the American Journal of Psychoanalysis. The announcement of the new training institute contained a statement of commitment tononauthoritarian teaching:

Students are acknowledged to be intelligent and responsible adults.... It is the hope of the Institute that it will continue to avoid conceptualrigidities, and to respond to ideas, whatever the source, in a spirit of scientific and academic democracy. (cited in Quinn, 1988, p. 353)

It was not only the orthodox Freudians who were suspicious of her. The Federal Bureau of Investigation (FBI) kept a file on her because of heralleged communist sympathies, and she was for a while denied a passport (Quinn, 1988). She was ultimately granted the passport, and inJapan she stayed at several Zen monasteries (O’Connell, 1980). In Zen Buddhism, Horney found support for the idea of a striving, healthy realself within the individual that Freudian theory did not offer (Morvay, 1999). On December 4, 1952, within months of her return from Japan,she died of previously undiagnosed abdominal cancer.

As a person, Karen Horney seems to have had a capacity for enjoying life, despite the seriousness of her career and the disappointments ofher marriage. She liked fine dining, concerts, and parties. She enjoyed relationships with men and had several affairs (Quinn, 1988). DuringProhibition, she at least once spiked the punch by writing her own prescription for “medicinal” alcohol (Quinn, 1988).

Horney challenged Freud’s claim that he had discovered universal developmental conflicts. Instead, she argued that personality and itsdevelopment are influenced by culture and vary from one society to another. This energetic and nontraditional woman proposed newunderstandings of women, and of men, which today are more widely accepted than the classical Freudian theory she challenged. She ispraised as an important role model for women and her writings had a major influence on feminist theory (Gilman, 2001; O’Connell & Russo,1980).

BASIC ANXIETY AND BASIC HOSTILITY

Infants and young children are highly dependent on their parents for psychological security as well as physical survival. In the ideal case, theinfant senses that he or she is loved and protected by the parents and therefore is safe. Under less-than-ideal circumstances, the child feelsintensely vulnerable, experiencing basic anxiety, which Horney (1945, p. 41) described as “the feeling a child has of being isolated andhelpless in a potentially hostile world.”

basic anxiety

feeling of isolation and helplessness resulting from inadequate parenting in infancy

Parental neglect and rejection make the child angry, a condition Horney called basic hostility. However, expressing the hostility would resultin punishment or loss of love, so instead it is repressed, which increases anxiety. The neurotic, then, develops a basic conflict between“fundamentally contradictory attitudes he has acquired toward other persons” (Horney, 1945, pp. 40–41). On the one hand, the child needsthe parents and wants to approach them but, on the other hand, hates them and wants to punish them. This is the driving force behindneurosis: an interpersonal conflict, in contrast to Freud’s libidinal conflict between sexual desire and the restricting forces of society.

basic hostility

feeling of anger by the young child toward the parents, which must be repressed

THREE INTERPERSONAL ORIENTATIONS

What is the child to do? Three choices are available: accentuate dependency and move toward the parents, accentuate hostility and moveagainst them, or give up on the relationship and move away from them. The young child resolves the conflict with the parents by usingwhichever of these strategies seems best to fit his or her particular family environment. This choice becomes the person’s characteristicinterpersonal orientation.

Ideally, a healthy person should be able to moved toward people, move against them, or move away from them, flexibly choosing thestrategy that fits the particular circumstances. In contrast to healthy flexibility, neurotics are imbalanced in their interpersonal behavior.Some choices cause so much anxiety that they simply are not options. The young child who was never permitted to express any criticism ofthe parents, for example, is unlikely to be able to compete wholeheartedly against others in adulthood. The rejected child will continue tohave difficulty depending on people.

moving toward

interpersonal orientation emphasizing dependency

moving against

interpersonal orientation emphasizing hostility

moving away

interpersonal orientation emphasizing separateness from others

Horney said that neurotics who emphasize moving toward people adopt the self-effacing solution to neurotic conflict, seeking love andminimizing any apparently selfish needs that could interfere with being loved. Neurotics who emphasize moving against people adopt the expansive solution to neurotic conflict, seeking mastery even if it impedes close relationships with others. Finally, neurotics who emphasizemoving away from people adopt the resignation solution, seeking freedom even at the expense of relationships and achievement (see Table6.2).

self-effacing solution

attempting to solve neurotic conflict by seeking love; moving toward people

expansive solution

attempting to solve neurotic conflict by seeking mastery; moving against people

resignation solution

attempting to solve neurotic conflict by seeking freedom; moving away from people

A measure of Horney’s three interpersonal orientations, the Horney-Coolidge Type Indicator (HCTI; Coolidge et al., 2001) assesses threefacets of each orientation, based on factor analysis (see Table 6.3). In a study of normal adults (Coolidge et al., 2004), scores on a scalemeasuring personality disorders were correlated with HCTI scores. Those with higher Cluster A (eccentric) scores, comprising the paranoid,schizoid, and schizotypal personality disorder scales, scored higher on the Detachment scale and, to a lesser extent, the Aggression scale.Those with higher Cluster B (emotional) scores, comprising the antisocial, borderline, histrionic, and narcissistic personality disorder scales,scored higher on the Aggression scale. People with higher Cluster C (fearful) scores, reflecting avoidant, dependent, and obsessive-compulsivepersonality disorders, scored higher on the Detachment and Compliance scales. These results are consistent with Horney’s view thatimbalanced interpersonal orientations are maladaptive, although the research needs to be replicated among clinically diagnosed individuals.Interestingly, the Malevolence facet of the Aggression scale was positively correlated with all three clusters of personality disorders, which,according to the researchers, “captures the maladaptive relational aspect of the personality disorders and suggests that underlying thediffering relational postures of Horney’s theory is a basic belief that people hurt other people and cannot be trusted” (Coolidge et al., 2004, p.372). Other research using this questionnaire examines its relationships to biological factor models of personality (see Chapter 9), suggestingthat the Compliant scale is related to Eysenck’s Neuroticism measure, and the Aggressive and Detached scales to his Psychoticism (orantisocial) scale (Shatz, 2004).

Table 6.2 Horney’s Three Neurotic Solutions

1. Self-Effacing Solution: The Appeal of Love (“The Compliant Personality”)

“Moving toward” people

Morbid dependency: the need for a partner (friend, lover, or spouse)

“Poor little me”: feeling of being weak and helpless

Self-subordination: assumption that others are superior

Martyrdom: sacrifice and suffering for others

Need for love: desire to find self-worth in a relationship

2. Expansive Solution: The Appeal of Mastery (“The Aggressive Personality”)

“Moving against” people

Narcissistic: in love with idealized self-image

Perfectionistic: high standards

Arrogant-vindictive: pride and strength

Need to be right: to win a fight or competition

Need for recognition: to be admired

3. Resignation: The Appeal of Freedom (“The Detached Personality”)

“Moving away from” people

Persistent resignation and lack of striving: the aversion to effort and change

Rebellious against constraints or influences: the desire for freedom

Shallow living: an onlooker at self and life, detached from emotional experiences and wishes

Self-sufficient and independent: uninvolved with people

Need for privacy: keeping others outside the magic circle of the self

Source: Adapted from Horney, 1945, 1950.

Table 6.3 Horney-Coolidge Measure of Interpersonal Orientations: Facets and Sample Items

1. Compliance Scale

Altruism

“I like to help others.”

Need for Relationships

“I feel better when I’m in a relationship.”

Self-Abasement

“I am self-sacrificing.”

2. Aggression Scale

Malevolence

“Beggars make me angry.”

Power

“I like to be in command.”

Strength

“I test myself in fearful situations to make myself stronger.”

3. Detachment Scale

Need for Aloneness

“I prefer to be alone.”

Avoidance

“I avoid questions about my personal life.”

Self-Sufficiency

“I don’t really need people.”

Source: Prepared from information in Coolidge et al., 2001; and Coolidge et al., 2004.

Moving toward People: The Self-Effacing Solution

Some people turn to others for the love and protection lacking in their early life and must be careful to do nothing to alienate others. Horney(1945) referred to these as compliant types. Some are dominated by a need for affection, living as though their motto were, “If you love me,you will not hurt me” (Horney, 1937, p. 96). Others are characterized by their submissive attitude, as though they felt, “If I give in, I shall notbe hurt” (p. 97).

To be lovable, a person will do things to endear others: becoming sensitive to their needs; seeking their approval; and acting in unselfishways, generous to a fault. The need for love may be expressed in an exaggerated need to be “in love” or involved in sexual relationships inwhich the partner takes control.

The compliant type of person makes few demands on others, instead playing a “poor me” role that emphasizes helplessness andsubordination. This produces low self-esteem. Such a person “takes it for granted that everyone is superior to him, that they are moreattractive, more intelligent, better educated, more worthwhile than he” (Horney, 1945, pp. 53–54).

Moving against People: The Expansive Solution

A second strategy for resolving the conflict over unmet early needs is to emphasize the mastery of tasks and power over others, which seemto offer protection from the vulnerability of being helpless. Horney (1945) refers to those who adopt this strategy as aggressive types, whoseem to live by the motto, “If I have power, no one can hurt me” (Horney, 1937, p. 98). Less subtle domination over others, or more subtlepower through competitive mastery, both achieve the desired protection against humiliation.

Career competitiveness and perfectionism tap this trend. In politics, the expansive solution can lead to vigorous campaigning or it can makemilitary action seem more appealing (Swansbrough, 1994). From her clinical experience, Horney noted that patients of this type seem to haveparticular difficulty when they begin to come close to other people in love or friendship.

Moving away from People: The Resignation Solution

A third strategy for resolving childhood conflicts is epitomized by the fox in Aesop’s fable who could not reach the grapes hanging over hishead. After all attempts to reach them failed, the fox finally gave up, avoiding disappointment by telling himself that the grapes were probablysour anyway. In Horney’s theory, some people try to do without other people, having given up on solving the problem of basic anxiety throughlove or power. Horney (1945) refers to these as detached personality types and says they seem to live by the motto, “If I withdraw, nothing canhurt me” (Horney, 1937, p. 99). In the effort to be self-sufficient, detached types may develop considerable resourcefulness andindependence; Horney cites the example of Robinson Crusoe. Or they may restrict their needs and protect their privacy. Creative people areoften detached types.

Healthy versus Neurotic Use of Interpersonal Orientations

Harmonious interpersonal relationships are an important source of life satisfaction cross-culturally, although to a greater extent in somecultures than others (Kwan, Bond, & Singelis, 1997). How do we achieve this? The healthy person adopts, when appropriate, any of the threeorientations toward people because each is adaptive in certain situations. The neurotic individual is limited in using these orientations.Consider aggression. Although it is pathological to be aggressive toward everyone, the healthy person must be capable of “adequateaggressiveness,” by “taking initiative; making efforts; carrying things through to completion; attaining success: insisting on one’s rights;defending oneself when attacked; forming and expressing autonomous views; recognizing one’s goals and being able to plan one’s lifeaccording to them” (Horney, 1935/1967e, p. 228). The current term would be assertiveness rather than aggressiveness. Similarly, althoughexcessive dependency (moving toward) is neurotic, the inability to ask for appropriate help (a deficit in the moving-toward orientation) isalso maladaptive (cf. Bornstein, 1992).

Interpersonal orientations also influence physical health. Horney reported that repressed hostility may cause physical symptoms, such asheadaches and stomach problems (1945, p. 58). Research confirms that high levels of hostility (“moving against” orientation) contribute tocoronary heart disease (Miller et al., 1996; Roemer, 1987). Excessive dependency, too, puts people at increased risk for many physicaldiseases, including ulcers, asthma, epilepsy, and heart disease—perhaps in part because unmet dependency needs arouse anxiety, whichimpairs the immune system (Bornstein, 1998, 2000). If these relationships were found only after people became ill, we might dismiss them asonly indicating that sick people become dependent. The fact that the relationships are also found in prospective studies (i.e., that earlierdependency predicts later illness) indicates that the dependency–illness relationship is not simply an artifact of the sick role. On the positiveside, Robert Bornstein (2000) points out that dependency can have a protective effect, too, when it stimulates people to seek early treatmentand to comply with medical instructions.

FOUR MAJOR ADJUSTMENTS TO BASIC ANXIETY

To solve conflicts over basic anxiety, an individual adopts defense mechanisms, including many of the defense mechanisms that previousanalysts had described, such as repression, and Horney’s expanded list of defensive maneuvers. All neurotics use some combination of fourmajor strategies for resolving the basic conflict between helplessness and hostility. These strategies do not solve the conflict or lead togrowth, but they may allow a person to adapt sufficiently to cope with daily life.

Eclipsing the Conflict: Moving toward or against Others

First, the neurotic may “eclipse part of the conflict [between helplessness and hostility] and raise its opposite to predominance” (Horney,1945, p. 16). Some eclipse hostility and emphasize helplessness, seeking nonconflictful interactions and moving toward others. This stylerequires low self-esteem in order to avoid the distress that would otherwise result from holding back one’s self-assertion (Robinson &Wilkowski, 2006). Others eclipse helplessness and emphasize hostility against other people. These constitute two of the basic interpersonalorientations: moving toward and moving against people.

Detachment: Moving away from Others

A second major adjustment strategy is to become detached from others. Because the conflicts are inherently interpersonal, simply movingaway from people reduces the experience of conflict. If this tendency is much stronger than eclipsing, it leads to Horney’s third interpersonalorientation, moving away from people.

The Idealized Self: Moving away from the Real Self

The third major neurotic adjustment strategy is to turn away from the real self toward some seemingly better (less helpless, less angry) idealized self. The real self is “the alive, unique, personal center of ourselves” (Horney, 1950, p. 155) and is involved in healthy psychologicalgrowth. It is the self that would have developed if we had been nurtured properly as we were developing or that we may become once weovercome our neurosis (Paris, 1999).

idealized self

an image of what a person wishes to be

real self

the vital, unique center of the self which has growth potential

A healthy adult who is neglected or rejected can turn to other relationships, confident in his or her own self-worth, but the young child doesnot have the resources to do so. Consequently, the sense of self, which is just in the process of developing, emerges already wounded. Thechild develops a low self-esteem. The person may feel like a counterfeit, having “lost touch with essential aspects of self,” that is, alienatedfrom the true self (Ingram, 2001). Instead, the neurotic turns to an imagined idealized self, which would not be despised. The idealized selfvaries depending on the interpersonal orientation of the individual. “Perhaps if I am very, very good and kind, I will be lovable,” thinks onechild. “Or,” imagines another, “if I impress people with my achievements and power, they will not be able to hurt me, and they may evenadmire me.” “Or,” muses a third, “maybe I don’t need people after all; I can manage alone.”

The profoundly disturbing consequences of turning from the real to the idealized self are suggested by the comparison Horney (1950) makes.The process corresponds to “the devil’s pact...the selling of one’s soul” (p. 155). The healthier choice is to turn away from false pride andinstead to accept the “ordinariness” of one’s real self (Horner, 1994).

However, neurotics try instead to strengthen the idealized self and avoid painful confrontation with the repressed real self. “I should be kindto everyone” or “I should not have to depend on other people.” Horney called these sorts of demands the tyranny of the shoulds. They urgeus ever closer to the idealized self but at the expense of increased alienation from the real self. Perfectionism can produce the sort of highperformance that many jobs reward, but the cost is great, including emotional disorders and an elevated risk of suicide (Bieling et al., 2004; Blatt, 1995; Chang, 1998; Flett et al., 1998; Hewitt, Flett, & Ediger, 1996; Hewitt et al., 1997; Minarik & Ahrens, 1996; Orbach, 1997; Shafran &Mansell, 2001). Even if they succeed, perfectionists may feel like “impostors” (Henning, Ey, & Shaw, 1998). Bernard Paris (1999, p. 165)conveys wise advice: “Horney recognized that the absolute best is the enemy of the good, that we must not disregard our accomplishmentsbecause we have failed to attain perfection.”

tyranny of the shoulds

inner demands to live up to the idealized self

Externalization: Projection of Inner Conflict

In the fourth major adjustment strategy, the neurotic projects inner conflicts onto the outside world, a process Horney called externalization. Externalization refers to “the tendency to experience internal processes as if they occurred outside oneself and, as a rule, tohold these external factors responsible for one’s difficulties” (Horney, 1945, p. 115). It includes the defense mechanism of projection, astraditional psychoanalysis understands it, in which our own unacceptable tendencies (such as anger or sometimes ambition) are perceived ascharacteristic of other people but not ourselves. In one case study, for example, a woman was interpreted to have selected her ambitious butnarcissistic husband because she could externalize onto him “power, competence, and a capacity for success” that she could not see in herself(Horwitz, 2001). This defensive choice by the self-effacing wife, combined with the husband’s own expansive and narcissistic solution toconflict, led to considerable marital discord.

externalization

defense mechanism in which conflicts are projected outside

Externalization can also include our unrecognized feelings. Horney cited the example of a man unaware of his own feeling of oppression, who,through externalization, was “profoundly disturbed by the oppression of small countries” (1945, p. 116). Neurotics often externalize feelingsof self-contempt, either by thinking that others despise them (projection of the impulse) or by despising others (displacement of the object ofcontempt). Compliant types (those who move toward others) are likely to externalize in the first way, and aggressive types (those who moveagainst others) in the second way. In either case, the neurotic is unaware of deep self-contempt.

These four attempts at solution occur in all neuroses, although not with equal strength. The neurotic attempts only to “create an artificialharmony” (Horney, 1945, p. 16) rather than actually resolving the problem.

SECONDARY ADJUSTMENT TECHNIQUES

In addition to the major defensive strategies (eclipsing, detachment, the idealized self, and externalization), there are many auxiliarystrategies for reducing anxiety. Horney believed these secondary adjustment techniques, like the major adjustment techniques, do not reallysolve the neurotic problem in any lasting way, as she made clear in the title by which she introduced the concepts: “Auxiliary Approaches toArtificial Harmony” (1945, p. 131).

People are often unaware of aspects of their behavior that are blatantly incompatible with their idealized self-image. Horney (1945) cited theexample of a patient who “had all the characteristics of the compliant type and thought of himself as Christlike” but who blindly failed torecognize the aggression expressed by his symbolic murders of co-workers. “At staff meetings he would often shoot one colleague afteranother with a little flick of his thumb” (p. 132). Such blind spots prevent conscious awareness of the conflict between the behavior and ourself-image.

blind spots

secondary adjustment technique in which aperson is unaware of behavior inconsistent with the idealized self-image

Another way to prevent the recognition of conflict is by compartmentalization, allowing the incompatible behaviors to be consciouslyrecognized but not at the same time. Each is allowed to be experienced in a separate “compartment” of life: family or outsiders, friends orenemies, work or personal life, and so forth. For example, a person may be loving within the family but a ruthless business competitor outsidethe family.

compartmentalization

secondary adjustment technique in which incompatible behaviors are not simultaneously recognized

Horney (1945, p. 135) called rationalization “self-deception by reasoning.” We explain our behaviors so they seem consistent with what issocially acceptable and with our idealized self-image. Horney provided these examples: A compliant type who is helpful will rationalize thisaction as due to feelings of sympathy (ignoring a tendency to dominate, which may also be present); an aggressive type will explain his or herhelpfulness as expedient behavior.

rationalization

secondary adjustment technique in which aperson explains behaviors in socially acceptable ways

Excessive self-control prevents people from being overwhelmed by a variety of emotions, including “enthusiasm, sexual excitement, self-pity, or rage” (Horney, 1945, p. 136). When emotions threaten to break through, people may fear they are going crazy. Rage is particularlydangerous and is most actively controlled. People using this defense mechanism typically avoid alcohol because it would be disinhibiting, andthey have difficulty with free association in psychotherapy.

excessive self-control

secondary adjustment technique in which emotions are avoided

Arbitrary rightness “constitutes an attempt to settle conflicts once and for all by declaring arbitrarily and dogmatically that one is invariablyright” (Horney, 1945, p. 138). Inner doubts are denied, and external challenges are discredited. The rigidity of these people makes them avoidpsychoanalysis, which challenges a person’s core defensive beliefs.

arbitrary rightness

secondary adjustment technique in which a person rigidly declares that his or her own view is correct

Elusiveness is quite the opposite of arbitrary rightness. These people do not commit themselves to any opinion or action because they “haveestablished no definite idealized image” (Horney, 1945, p. 139) to avoid the experience of conflict. The person who is elusive does not stickwith a conflict long enough to really work at resolution. “You can never pin them down to any statement; they deny having said it or assureyou they did not mean it that way. They have a bewildering capacity to becloud issues” (p. 138). They are reminiscent of the joke about theneighbor who, asked to return a borrowed bucket, says he did not borrow it, and besides it was leaking when he borrowed it, and besides healready returned it.

elusiveness

secondary adjustment technique in which aperson avoids commitment to any opinion or action

Cynicism avoids conflict by “denying and deriding... moral values” (Horney, 1945, p. 139). A Machiavellian-type person is consciously cynical,seeking to achieve his or her goals without moral qualms. Others use cynicism unconsciously; they consciously accept society’s values but donot live by them.

cynicism

secondary adjustment technique in which the moral values of society are rejected

CULTURAL DETERMINANTS OF DEVELOPMENT

Horney stressed cultural determinants of personality and neurosis, in addition to orthodox Freudian biological forces. Specific familyexperiences, such as having domineering or self-sacrificing mothers, only occur under particular cultural conditions (1937, p. viii). ForHorney, even the Oedipal complex is not universal. Psychoanalysts have noted that family ties are closer and more central to the patients’sense of self in Asian countries influenced by Confucian values, including China, Japan, Korea, and Vietnam (Slote, 1992).

Horney (1937, p. 62) argued that sexual conflict was becoming less important as a source of anxiety at the time she wrote than in Freud’ssomewhat earlier era, and the conflict between competitiveness and love was becoming more important. “In our culture,” she wrote, “themost important neurotic conflict is between a compulsive and indiscriminate desire to be the first under all circumstances and thesimultaneous need to be loved by everybody” (1937/1967d, p. 258). This conflict is exacerbated by the feminine role. Because cultures canchange, Horney’s emphasis on culture appeals to feminists and others who advocate change.

Gender Roles

Whereas biology determines sex (male or female), it is culture that defines the accepted traits and behaviors for men and women. Torecognize that we are discussing cultural rather than biological phenomena, it is customary to use the terms masculine and feminine insteadof male and female and the term gender instead of sex. According to social role theory, cultures define what is masculine and what is feminine(Eagly, 1987; Eagly & Wood, 1991). For example, contrast the traditional value of machismo to the masculine identity of Chicano men (Segura& Pierce, 1993) with the high levels of dependency among males in China (Dien, 1992).

ACHIEVEMENT

Horney’s description of gender roles concerning achievement stimulated later research. Women, she claimed, are especially likely to becomecompliant types who do not risk achievement because “our cultural situation... stamps success a man’s sphere” (1937, p. 204). In her time,Horney (1939, p. 181) noted that a woman who sacrificed her own career for her husband’s career was considered “normal,” even if the wifewas more gifted. Women may even develop a “fear of success” (pp. 210–214) that comes from a conflict between competition and the needfor affection, leading her to believe that if she succeeds, she will lose her friends. Fear of success is measured for research purposes by aprojective test (Horner, 1972), which has been used in many studies.

SOCIAL DOMINANCE

Traditionally, gender roles prescribe dominance or power for males and submissiveness or nurturance for females. This is true to such anextent that the short form of the Bem Sex-Role Inventory “masculine” scale is virtually identical to a scale derived by factor analysis calledInterpersonal Potency, and the Bem “feminine” scale is virtually identical to an Interpersonal Sensitivity scale (Brems & Johnson, 1990).

Gender roles profoundly influence the development of social power or dominance. Masochism (the enjoyment of pain and suffering) was abiological characteristic of females, according to Freud. Horney disagreed, suggesting that “masochistic phenomena represent the attempt togain safety and satisfaction in life through inconspicuousness and dependency” (1939, p. 113).

An empirical study of couples provides evidence that social power determines interpersonal behavior. The strategies people use to influencetheir intimate partners were found to vary with the person’s structural strength or weakness in the relationship, as indicated by income,education, and age. The more powerful member of a couple was more likely to use bullying and autocratic tactics to influence the partner,whereas the weaker partner was more likely to use supplication and manipulation. This association held for both heterosexual andhomosexual couples. In the former, the more powerful partner was usually the man, but it was power, rather than sex, that best predictedbehavior (Howard, Blumstein, & Schwartz, 1986).

VALUING THE FEMININE ROLE

Horney rejected Freud’s assertion that women reject their bodies as inferior. She argued that culture, rather than anatomy, is the importantforce behind the “penis envy” Freud had postulated. Women envy the power and privilege that humans with penises have, rather than theorgan itself (Horney, 1926/1967a, 1923/1967b; Siegel, 1982). She countered, “Is not the tremendous strength in men of the impulse tocreative work in every field precisely due to their feeling of playing a relatively small part in the creation of living beings, which constantlyimpels them to an overcompensation in achievement?” (quoted in Gilman, 2001). This argument, well known by the catchy term womb envy ,questions the assumption that men have the enviable position.

womb envy

men’s envy of women’s reproductive capacity (the complement of Freud’s penis envy)

Other supporters of women’s roles emphasize the value of interpersonal connectedness and relationship-oriented values like nurturance andempathy (Gilligan, 1982; Lang-Takac & Osterweil, 1992; Miller, 1976; Symonds, 1991). This argument has not gone unchallenged. MarciaWestkott contends that women’s valuing of relationships often takes the form of an idealized self, and that feminist theory and therapy, byaffirming relationship values, unwittingly confirm a neurotic idealized self and perpetuate a cultural expectation that women should take careof men (Westkott, 1986a, 1986b, 1989). For example, when feminine nurturant values are emphasized, family members of alcoholics mayinadvertently enable the alcoholic to continue drinking by taking care of the problems that the addiction creates, which is unhealthy for boththe alcoholic and the codependent family member (Haaken, 1993).

MENTAL HEALTH AND GENDER ROLES

In the past, the prevailing view among psychologists was that women who work and have professions suffer personality disturbances(labeled “penis envy” or otherwise) and that traditionally feminine women were psychologically healthier. Research does not support thisview (Helson & Picano, 1990; Yogev, 1983). Psychological “masculinity” (as measured on sex-typing instruments such as the Bern Sex-RoleInventory), which reflects such qualities as assertiveness, is associated with better mental health in both men and women. Calling suchhealthy traits “masculine” reflects a cultural viewpoint.

Traditional gender roles bring a price. In women, they discourage assertiveness and individual development. People who overemphasizeother people’s needs compared to their own, in a pattern called unmitigated communion, are prone to later psychological maladjustment,such as depression (Aubé, 2008). The finding applies to both women and men, though gender roles make this style more common amongwomen. In men, traditional gender roles contribute to defense mechanisms such as restrictions in emotionality (Mahalik et al., 1998) and togender-related problems, including violence, fear of homosexuals, detached fathering, and neglect of health needs (Levant, 1996).

Cross-Cultural Differences

The emphasis on individual achievement is, as Horney hinted, particularly characteristic of Western culture. Harry Triandis and hiscolleagues have studied cultural differences in individualism, a value that emphasizes individual accomplishments and privileges. TheUnited States and Britain are particularly high in individualism (Triandis, McCusker, & Hui, 1990). In contrast, countries that are less affluent,in which people depend on cooperation to share resources, are characterized by collectivism, which values the relationships between peopleand their shared goals and mutual responsibilities (Triandis, 1996). Collectivist cultures, like those in Africa, Asia, and Latin America,emphasize conformity, social harmony, group tasks, and family obligations.

individualism

values, predominant in many Western cultures, of individual goals and achievement (in contrast to shared groupgoals and cooperation)

collectivism

values, predominant in some cultures, of social cooperation and group goals

The assumption that the self is separate rather than connected to others pervades Western thought and psychological theory and treatment,reflecting the individualistic values of its cultural founders. Having harmonious relationships with other people is less important as a sourceof life satisfaction in the United States, an individualistic culture, than in (for example) Hong Kong (Kwan, Bond, & Singelis, 1997).Individualistic cultures encourage Horney’s moving-against orientation, emphasizing achievement and accepting aggressive behavior.Collectivist cultures are more supportive of a mov-ing-toward orientation. For therapists dealing with clients from other cultures, it isimportant to not misperceive people whose behavior may reflect their different cultural values, rather than individual problems. Fortheorists, it’s important to realize that our assumptions about what is healthy may be limited by our cultural vision, and that other culturesmay provide correctives to cultural myopia.

HORNEY’S APPROACH TO THERAPY

In criticizing Freud’s patriarchal biases, Horney set a model for later clinicians to question whether therapists could also fail to understandpatients because of their own limited experience of race, sexual orientation, or other factors. Horney opened the door for realizing that thetherapist, too, is influenced by culture, bringing perhaps biased assumptions to the understanding of the client (Miletic, 2002).

Although orthodox in her acceptance of the importance of childhood experience in developing personality, Horney did not believe allpsychoanalytic treatment required delving into childhood recollections. Horney criticized the Freudian overemphasis on the exploration ofchildhood origins of neurosis, although she would doubtless agree that interpersonal relationships based on faulty parent–child interactingcan be mended in therapy (Morgan, 1997). Horney advised the therapist to keep bringing the patient back to the present, seeing how neurotictrends influence current life.

Inevitably, the patient’s idealized image must he challenged, but this must be done carefully and slowly because it is the basis for thepersonality, wounded but not destroyed, that the patient brings to analysis. Eventually, the idealized image must be replaced by a morerealistic self-concept. The term shrink, applied to the analyst, seems particularly fitting for this function.

PARENTAL BEHAVIOR AND PERSONALITY DEVELOPMENT

Neurotic problems begin early in life, within the family, where the “basic evil is invariably a lack of genuine warmth and affection” (Horney,1937, p. 80). Parental behavior that undermines a feeling of safety will lead to neurotic development. This includes parental neglect,indifference, and even active rejection of the child.

One of the goals Horney described for psychoanalysis was to advise parents how to raise healthy youths, thus breaking the repeating cycle ofneurosis through each generation. Psychoanalysts exploring these issues suggest it is important for parents to pay attention to their infants’emotional experiences. This requires that the mother (or other caregiver) be able to understand the infant’s emotion and to respondappropriately, for example, by mirroring an infant’s distress or joy. If this experience is deficient, the child will develop with deficits inaffective regulation (Glucksman, 2000).

Research supports her ideas. The trait of neuroticism in parents contributes to their abuse of children, apparently by making the parents lessable to tolerate the negative emotions that come from stressful interactions with their children (Belsky, 1993; McCrae & Costa, 1988).Longitudinal research shows that parental acceptance and nonauthoritarian punishment in childhood predict higher ego development at age30, particularly for women (Dubow, Huesmann, & Eron, 1987). One particularly impressive study, using a longitudinal design, correlatedparental behavior during preschool and the children’s development as young adults. Fathers and mothers were evaluated according to the“poisonous pedagogy” formulation of psychoanalyst Alice Miller, whose ideas are similar to those of Karen Horney. As predicted, parents whotreated their children with criticism and excessive control produced anxious, poorly adjusted children; parents who expressed affection andencouraged their children produced warm and socially well-adjusted young adults (Harrington, 1993). Other studies of parenting stylesconfirm that neglectful parents have children who have greater difficulties. Authoritative parents, who provide both direction and acceptance,rear better adjusted children (Lamborn et al., 1991).

6.3 THE RELATIONAL APPROACH WITHIN PSYCHOANALYTIC THEORY

Theories build on earlier theories. In contrast to Freud’s emphasis on the unconscious and intrapsychic conflict, many of his successors todaystress disturbances in the relationships that people have developed, beginning with early family experience, a theme that Horney and othersemphasized (see Table 6.4). The relational model was presented as an alternative to Freud’s drive model (Greenberg & Mitchell, 1983; Mitchell & Aron, 1999), and it influences even many therapists who were trained in the Freudian tradition (Sudak, 2000).

The relational approach emphasizes interpersonal relationships, especially the impact of early relationships with parents (Greenberg &Mitchell, 1983). The mother is more important in this approach, in contrast to Freud’s emphasis on the father (Grotstein, 1993). Earlyrelationships are particularly influential because the very young do not yet have a sense of themselves as separate persons. Earlyrelationships are the basis for developing internal representations of self and others that will guide relationships throughout life, and thatprepare us to expect love or rejection, nurtur-ance or disappointment, from people. Whether people seek support from others in adulthoodor avoid doing so and dwell on depression and self-criticism is related to the way they describe their parents, even though they are oldenough to have moved on to new relationships (Mongrain, 1998). A relationship with an empathic, nurturant parent begins this process in ahealthy way. But rejecting or abusive parenting sets the stage for internalizing much more negative images of others and of the self.

relational approach

approach in modern psychoanalysis that emphasizes interpersonal relationships

Table 6.4 Important Persons in the History of the Relational Approach

Theorist

Theoretical Ideas

MelanieKlein

Young children are very needy; they relate to “part objects” (such as the breast) instead of the whole parent; theirambivalent feelings cause guilt about their negative feelings about their parents.

W. R. D.Fairbairn

People have a fundamental need for relatedness. Maternal indifference and lack of love for the child contribute to thedevelopment of child pathology. The child defensively splits the rejecting mother (which is internalized) from the hoped-forloving mother, which impedes development from immature to mature dependency.

HarryStackSullivan

Children attempt to avoid anxiety in interpersonal relationships by constructing an understanding of self that includes a good me, a bad me, and a not me.

OttoKernberg

Borderline and psychotic patients suffer disturbed identity and interpersonal relationships. Early severe frustration leadsto unmanageable aggression and narcissistic personality disorders. Especially in borderline personality disorder,narcissistic frustrations lead to a splitting of the “good” and “bad” self and object relations, which are kept isolated fromone another, and a grandiose self is defensively formed.

HeinzKohut

A grandiose self is part of normal, healthy development, based on a desire for merger with omnipotent caretakers, whoseadmiration is sought. A healthy, integrated self structure will be formed if the adults respond empathically to the child. Ifless-than-optimal parenting is available, the child will construct an idealized parental imago to support the grandiose self.

MaryAinsworthand JohnBowlby

Infants develop secure attachment, in which they derive comfort from the presence of the mother (or substitute); orinsecure attachment, in which they are not comforted.

NancyChodorow

Children’s gender development is influenced by the different roles that the mother and father play in caring for children (incontrast to Freud’s proposed anatomical determinants of gender).

Some psychoanalysts argue relational theorists do not give Freud the credit he deserves for his insights about relationships. Besides thetransference, Freud proposed that in seeking a marriage partner men seek someone similar to their own mother, and women seek someonelike their father. This prediction finds some research support. A widely used test of personality (the Five Factor Inventory) was administeredto participants (mostly college students) and to their parents, and on several traits, the participants’ opposite-sex parent had a personalitysimilar to their chosen romantic partner (Geher, 2000).

Relationships are often referred to as object relations in psychoanalysis, based on Freud’s idea that other people serve as the objects thatcan satisfy libidinal desire. The relational approach considers the cognitive and affective processes that allow people to form healthyinterpersonal relationships or that impede such relationships. For example, sociopaths have defective object relationships in that they exploitothers for their own selfish purposes. People suffering from borderline personality disorder have another kind of disturbed objectrelationship pattern: They manipulate others and may quickly become intensely attached to someone who is not suitable to meet thisirrational need (Westen, 1991). Borderline personality disorder is associated with such a fundamental sensitivity to rejection that a brainarea that reacts to such emotion, the amygdala, is activated by facial expressions that the general population sees as neutral (Westen,Gabbard, & Ortigo, 2008).

object relations

term used in psychoanalysis for relationships with people, based originally on the idea that people serve as objectsto satisfy libidinal drives

Emotions triggered in interpersonal situations are especially important in object relationships, as we might expect given the role of infantileanxiety and hostility that Horney described. Others may calm us when we are distressed or arouse anxiety when we are not. This effectdepends on experience with early relationships. The emotions we expect from relationships can be measured by projective tests as well as byinterview measures (Barends et al., 1990). By providing ways of measuring individuals’ capacity for healthy relationships—methods that aremore systematic than clinical impressions and can also be used to study people who are not in therapy—researchers are contributing to thedialogue between clinical and research-oriented psychologists (see Table 6.5).

Drew Westen and his colleagues have developed an instrument to measure affect regulation styles, using a Q-Sort technique in which clinicaljudges sort statements describing each patient’s emotions into nine piles, according to how well they describe the person: the AffectRegulation and Experience Q-Sort (the AREQ). They suggest that psychological problems are more severe among people who have difficultyregulating strong negative emotions (Westen et al., 1997).

In a cross-sectional study of children, Westen and his colleagues (Westen et al., 1991) report evidence for increasing maturity from grade 2 tograde 5 (about age 8 to 11 years) on three dimensions of relationships: complexity of representations, capacity for emotional investment, andunderstanding social causality. These results show that object relationships are not so fixed in the preschool years as Freud theorized, butinstead they continue to develop for many years thereafter.

Table 6.5 Measurement of Object Relations from TAT Stories

Scale

Description

Description of LowScore

Description of High Score

Complexity

Complexity, differentiation, andintegration of representations ofpeople

Poor differentiationbetween people

Complex, multifaceted, integratedrepresentations of people’s subjectiveexperience and enduring dispositions

Affect-tone of relationshipparadigms

Expectation that relationshipswill be safe and enriching ordestructive and threatening

Expectation thatrelationships will bedestructive andthreatening

Expectation that relationships will be safeand enriching

Capacity for emotionalinvestment inrelationships and moralstandards

Emotional orientation that isselfish, or that unselfishly investsin people, values, and ideals

Investment in one’sown need gratificationand desires

Commitment to values and relationshipsthat acknowledge needs of self and others

Understanding of socialcausality

Logic, complexity, accuracy, andpsychological mindedness ofattributions

Absence of causalunderstanding

Complex understanding of the rolemental events play in social causation

Source: Adapted from information in Westen et al., 1991.

THE SENSE OF SELF IN RELATIONSHIPS

Our sense of self is rooted in relationships. Early disturbances, coming from relationships with inadequate parents, leave a person with aweakened or enfeebled sense of self (Kohut, 1984). In terms of relational theory, disturbed interpersonal relationships stem from earlyexperience in which parents do not properly “mirror” the baby’s experience and emotions, failing to provide the experience needed todevelop a healthy sense of self. Thus the developing person lacks accurate awareness of his or her own self, identity, and emotions, producingunhealthy interpersonal behavior later in life (e.g., Vanheule & Verhaeghe, 2009). The sense of self is central to the understanding of defensemechanisms in relational theory. Defenses serve to protect self-esteem (Cooper, 1998).

Children who have not been adequately nurtured or loved develop a belief (which may be unconscious) that they are not worthy, and thisimpaired self is at the heart of much pathology. Patients diagnosed with borderline personality disorder report what Westen and hiscolleagues call “malevolent” early memories, in which people were injured (e.g., being pushed to the ground in an early school experience)and little help was given (Nigg et al., 1992). In contrast, adolescents who describe their parents as warm and fostering independence, as“ideal parents,” are less likely to suffer from a variety of personality disorders than those who recall less benign parenting (Brennan & Shaver,1998).

Relational theorist Stephen Mitchell (1970/1999) suggests that the early parent–child relationship is one in which parents’ more or lessdistorted views of themselves and their child set up a distorted, grandiose self-image in the child. For example, the parents might create anunrealistically good and obedient image of their child, which is too limiting for a real child to have room to develop his or her full personality.Object relations theorist Fairbairn (Celani, 1999) describes the defense mechanism of “splitting” as a result of inadequate parenting. Theparental object is seen as two separate objects: the bad object that has been rejecting or abusive and the good object that the child longs toplease. The child develops both a despised self that in a warped sense justifies the parental rejection or abuse and a grandiose good self thatcould ideally be the basis for earning parental respect and love. These ideas are quite similar to Horney’s description of the despised real selfand the grandiose self, and in both theories, the split stems from bad parenting.

Our role relationships with other people throughout life are based on early relationships, and they recapitulate the weaknesses and thedefective sense of self that are the legacy of the past. People whose early object relationships are unhealthy because of early physical, sexual,and emotional abuse or other mistreatment are vulnerable to self-destructive behaviors, including suicide (Twomey, Kaslow, & Croft, 2000).They remain in relationships that seem obviously unhealthy. Why would this be? The need to maintain a relationship with an importantobject, such as the parent, is so strong that extreme measures are taken to maintain the relationship, including blaming oneself (Grand &Alpert, 1993; Westen, 1991).

NARCISSISM

Too much focus on the self can get in the way of healthy relationships. An unhealthy self-focus and self-admiration constitutes narcissism. Inless than 1 in 100 people, narcissism is severe and impairs the person so much that it can be diagnosed as a mental disorder, narcissisticpersonality disorder (American Psychiatric Association, 1994). People who suffer from this disorder are extremely self-focused; they do nothave much empathy for other people’s experience. Their sense of being special, that they deserve attention and admiration, leads them to useother people as admiring audiences and supporters instead of as separate individuals. When undergraduates who score high on a measure ofnarcissism are asked to describe a shameful early memory (a manipulation theorized to confront the early basis of their narcissism), theysubsequently express considerable hostility on an ambiguous projective picture of a child; but those in the experimental group asked to recalla positive memory projected much less hostility onto the picture. Nonnarcissists did not show these effects, which supports the interpretationthat narcissists’ hostility is tied to early shameful experiences (Heiserman & Cook, 1998). It is easy to see why narcissism, which is based ondisturbed relationships, may lead to domestic violence (Zosky, 1999), and why narcissists sometimes react very strongly when they areinsulted (Horton & Sedikides, 2009).

narcissism

unhealthy self-focus that impairs the ability to have healthy, empathic relationships with other people

The insight that a disturbed sense of self is closely related to disturbed relationships with others helps us understand puzzling findingsreported by researchers. High self-esteem, that is, thinking you are a worthwhile person, is generally a healthy characteristic. High self-esteemhas its downside, though. For one thing, people with high self-esteem sometimes take on tasks that are too difficult, apparently trying toprove how much they can do (Baumeister, Heatherton, & Tice, 1993). They also may persist too long at tasks that cannot be finished and areprone to other self-defeating behaviors (Baumeister, 1997). Surprisingly, it has also been found that people with high self-esteem may also bemore aggressive than other people (Baumeister, Smart, & Boden, 1996), at least under some circumstances—specifically, when they are alsonarcissists and they are insulted (Bushman et al., 2009).

Why? One factor to consider is that “self-esteem” is operationally defined as a person’s score on a self-report measure. Some people whoscore high on such measures truly accept who they are, but others have a fragile, grandiose image of themselves hiding a deeper self-doubt.For them, high self-esteem scores are not so much accurate as they are defensive statements. When challenged, they feel vulnerable and somay behave aggressively in an effort to bully their way to being seen as worthwhile. That interpretation suggests that narcissism, not trueself-esteem, leads to aggression when a person is insulted or provoked. This interpretation is supported by experimental evidence. Subjectswho score high on a test of narcissism behave aggressively toward someone who has insulted them by criticizing essays they had written.When given the opportunity to do so in a laboratory setting, narcissists blast the other person with a loud noise in a computer game(Bushman & Baumeister, 1998). Narcissistic people are readily angered (Rhodewalt & Morf, 1998). Their self-esteem is insecure, subject tothe supports and attacks of life’s transient events (Rhodewalt, Madrian, & Cheney, 1998), and so they defend their self-worth aggressively.

ATTACHMENT IN INFANCY AND ADULTHOOD

Whether we turn to relational theorists, Horney, or even Freud, experts continue to point to the importance of early relationships betweenparents and children as a foundation for personality and relationships throughout life.

Infant Attachment

Infants develop bonds of affection with their mother, called attachment (Ainsworth et al., 1978; Bowlby, 1988). Attachment is based on aninstinct (Eagle, 1996) that functions, in an evolutionary sense, to ensure children’s survival by keeping them near to their parents, on whomthey depend for survival. In historic observations, René Spitz (1945) observed that orphanage babies deprived of human touch and lovebecame ill and even died, despite adequate food and medical care.

attachment

bonds of affection in which an infant turns to the mother or other caretaker for comfort and security; by extension,close interpersonal styles in adulthood

Mary Ainsworth (1972; Ainsworth et al., 1978) studied infant attachment to the mother (as the primary caretaker) by observing infants’responses to strangers. The development of a secure attachment between infant and parent provides a basis for emotional health and copingin later life. It facilitates cognitive development in childhood, presumably because the securely attached child has self-confidence toinvestigate the world (Jacobsen, Edelstein, & Hofmann, 1994). Later love relationships are also healthier when they build on secureattachment.

Table 6.6 Ainsworth’s Description of Infant Temperament Types Compared with Horney’s Model of Interpersonal Orientations

Infant Type

Infant Behavior

Horney’s Interpersonal Orientation

Type A

•Resists being comforted

Moving Away

Type B1

•Securely attached

•Comforted by mother

•Explores new environment

Balance of the three Interpersonal Orientations

Type B4

•Securely attached

•Stays near mother for comfort

Moving Toward

Type C

•Ambivalent toward mother

•Shows anger toward stranger

Moving Against

Source: Adapted from Feiring, 1984.

In the infant attachment studies, researchers observed how infants behaved when in the presence of a stranger. Some infants were frightened;others seemed comforted by their mothers’ presence. The various attachment patterns can be interpreted as confirming Horney’s patterns ofmoving toward, against, or away from people (Feiring, 1984). One type (Type B1) has the balanced interpersonal mode that Horney regardedas most healthy (see Table 6.6).

We should be cautious about blaming the parents entirely for attachment disturbances. Their ability to provide their children with warmthand support may be influenced by their own circumstances, including social position (Stansfeld et al., 2008). Furthermore, childhoodtemperament, produced by genetics, is partly responsible for the greater security of one child compared to another. The same parentalbehavior that is adequate for the average child may leave a temperamentally vulnerable child anxious about attachment. Fortunately, researchon interventions shows that training parents how to be more responsive to their young children can improve attachment (Lyons & Sperling,1996). And we know that attachment is mutual: babies’ smiles influence the mother’s brain activity in a unique way, different from herreactions to other infants (Strathearn et al., 2008).

Adult Attachments and Relationships

Attachment styles continue after infancy (Hazan & Shaver, 1994). Attachment in adulthood helps regulate emotion and reduce stress (Feeney& Kirkpatrick, 1996; Silverman, 1998). Securely attached adults feel more trust toward their partners than do those without secureattachment (Mikulincer, 1998b) and are able to resolve conflicts within relationships more maturely (Corcoran & Mallinckrodt, 2000).Adolescents hospitalized for psychiatric disorders are reported to be insecurely attached, as are their mothers (Rosenstein & Horowitz,1996).

Various kinds of adult attachment resemble infant attachment styles. A person who falls in love, marries, and stays in a stable relationshipthroughout adulthood exemplifies secure attachment. Another who is hesitant about love, marries, but divorces not long after and thereafteravoids long-term relationships illustrates an avoidant attachment style (Klohnen & Bera, 1998). Laboratory research that asked collegestudents to recall what they heard about a woman describing her relationships, suggests that avoidant people don’t pay as much attention tosuch information as others (Fraley & Brumbaugh, 2007). Another type of insecure adult attachment is “desperate love,” a style of love withhigh anxiety and the desire to be excessively close to the loved one (Sperling & Berman, 1991). Unhealthy attachment styles leave coupleswith the risk of being overly intrusive toward their partner (Lavy, Mikulincer, & Shaver, 2010).

Sperling and his colleagues have suggested a model of four types of adult attachment that emphasizes both dependence and anger. Theirmodel corresponds well to Horney’s three interpersonal styles, with an additional category reflecting ambivalence between moving towardand moving against (Sperling, Berman, & Fagen, 1992) (see Table 6.7).

Table 6.7 A Model of Adult Attachment Styles

High Anger

Low Anger

HighDependency

Resistant-ambivalent attachment style (compare to Horney’s description ofconflict between achievement and love, that is, moving against and movingtoward)

Dependent attachment style (compareto Horney’s moving towardorientation)

LowDependency

Hostile attachment style (compare to Horney’s moving against orientation)

Avoidant attachment style (compareto Horney’s moving away orientation)

Source: Adapted in part from Sperling, Berman, & Fagen, 1992. The comparisons with Horney’s theory are added.

Other researchers have adopted a three-category model of adult attachment, corresponding to the infant research (see Table 6.8). It is notonly simpler but more optimistic in that it includes a “secure” category (Hazan & Shaver, 1987). Personality tests show securely attachedadults to be higher on extraversion and lower on neuroticism than anxious and avoidant adults (Shaver & Brennan, 1992). Securely attachedadults are also less prone to anger and deal with it more constructively (Mikulincer, 1998a). Adults who are not securely attached havedifficulty expressing anger toward their romantic partners; those who are securely attached, in contrast, can express anger appropriately andmaintain the relationship (Sharpsteen & Kirkpatrick, 1997). Securely attached college students, as yet unmarried, look forward to havingmore children and are more confident about their ability to be effective parents, compared to insecurely attached college students (Rholes etal., 1997). In one study, anxiously attached male undergraduates wrote TAT stories describing violence of men toward female victims morethan seven times as often as the secure group, perhaps reflecting the frustrations of anxiously attached men about intimacy (Woike, Osier, &Candela, 1996).

Longitudinal Studies of Attachment

Longitudinal studies of attachment verify that mothers’ caregiving at 18 months predicts attachment in adulthood (Zayas et al., 2011).Furthermore, disturbed attachment relationships from early life carry over to adulthood. One study tracked down college students up to 31years later when they were in their early 50s. In middle age, the women selected one of several paragraphs that best described them, allowingresearchers to classify their attachment style. Those classified as “avoidantly attached” had already expressed more ambivalence aboutmarriage and family when they were in college. As the years passed, they were less likely to marry than the securely attached group and morelikely to be divorced if they had married. Researchers described the avoidantly attached as less interpersonally close, more defensive andrepressive, and less tolerant to stress from college onward, compared to those who were securely attached (Klohnen & Bera, 1998).

Table 6.8 Three Adult Attachment Styles

Secure Attachment Style

I find it relatively easy to get close to others and am comfortable depending on them and having them depend on me. I don’t often worryabout being abandoned or about someone getting too close to me.

Avoidant Attachment Style

I am somewhat uncomfortable being close to others; I find it difficult to trust them completely, difficult to allow myself to depend onthem. I am nervous when anyone gets too close and often love partners who want me to be more intimate than I feel comfortable being.

Anxious-Ambivalent Attachment Style

I find that others are reluctant to get as close as I would like. I often worry that my partner doesn’t love me or won’t want to stay with me.I want to merge completely with another person, and this desire sometimes scares people away.

Source: Based on Hazan & Shaver, 1987.

Attachment difficulties are passed down from one generation to the next. For example, in a study of mothers who had a child born with aserious illness such as congenital heart disease, those mothers who were avoidantly attached had worse emotional and psychologicaloutcomes in the coming 7 years for both themselves and their children (Berant, Mikulincer, & Shaver, 2008). In another study, which gathereddata on subjects for 70 years of their lives, subjects whose parents had divorced (a major disruption of attachment relationships for a child)were adversely affected. They were more likely to become divorced themselves, and they were more likely to die earlier, at least in partbecause stable marriage tends to increase longevity (Tucker et al., 1997).

A representative sample of U.S. adults finds adults were less likely to be securely attached if, in childhood, their parents had suffered variousforms of psychopathology (including depression, anxiety, and substance abuse), committed suicide, died, or were absent for long periods oftime. Other traumas and hardships also were related to insecure attachment: physical and sexual abuse, neglect, accidents, natural disaster,financial adversity, and other distressing events (Mickelson, Kessler, & Shaver, 1997). Securely attached adults marry other securely attachedadults; those insecurely attached also tend to marry people with similar attachment problems, which bodes ill for their ability to provide asecure relationship for their children (van Ijzendoorn & Bakermans-Kranenburg, 1996).

THE RELATIONAL APPROACH TO THERAPY

The relational approach to therapy contrasts with Freud’s classic drive model by acknowledging a more significant role of the therapist’sbehavior as an influence in what happens in therapy sessions. In contrast to the traditional psychoanalytic drive model which emphasizes thepatient’s unconscious and defense mechanisms as the “one person” determinant of the sessions, the interaction with the therapist itself isinfluential (Altman, 1994).

Relational therapists suggest that the patient–therapist relationship provides an opportunity for transformation of old maladaptiverelationship patterns to new healthy ones. The transference relationship should be similar enough to old patterns to put these disturbancesin the arena of therapy, even if the old relationships were unhealthy, but different enough to stimulate change (Greenberg, 1986/1999).Paradoxically, a patient may need to cast the therapist in the role of the bad parent to experience that warped attachment—for example,acting out anger against a therapist perceived as hostile and rejecting like the patient’s parent, before being able to move on to healthierrelationships (Knight, 2005).

Looking back to the founder of psychoanalysis, it would seem that analysis has moved far away from the biological model that Freudproposed. Yet interpersonal relationships in the attachment approach can be understood from the perspective of a parent–child bond thatbegins with very physical connections, with attachments serving healthy development by a mirroring of the infant’s physical experience inthe responses of the other. Adult sexual relationships can provide, again, an echo of inner physical experience in the responses of the other(Fonagy, 2008; Fonagy & Target, 2007). And so interpersonal approaches in psychoanalysis, as this theoretical and therapeutic approachdevelops, may have more connections with Freud’s early suggestions than we appreciated, after all.

Summary

· Karen Horney revised psychoanalytic theory to emphasize interpersonal factors, and this theme has been expanded by later relationaltheorists.

· The child experiences basic anxiety as a result of parental rejection or neglect.

· This anxiety is accompanied by basic hostility, which cannot be expressed because of the child’s dependence on the parents.

· The child attempts to resolve the conflict by adopting one of three interpersonal orientations: moving toward people (the self-effacingsolution), moving against them (the expansive solution), or moving away from them (the resignation solution).

· The healthy person can flexibly use all three orientations, but the neurotic person cannot.

· Horney described four basic strategies for resolving neurotic conflict: eclipsing the conflict, detachment, the idealized self, and externalization.

· The neurotic individual turns away from the real self, which has the potential for healthy growth, to an idealized self. The tyranny of theshoulds supports the idealized self.

· In addition, Horney described several secondary adjustment mechanisms: blind spots, compartmentalization, rationalization, excessive self-control, arbitrary rightness, elusiveness, and cynicism.

· Horney emphasized the cultural determinants of development. Parenting patterns vary from society to society; even the Oedipus complexis not a universal human experience in her theory.

· Horney discussed gender roles as developments shaped by particular cultures, which can change if cultures change.

· Horneyan therapy seeks to uncover unconscious conflicts originating in childhood but emphasizes their implications for present life.

· Relational theorists (a newer approach than Horney’s theory) also emphasize early parent–child relationships and their implications for asense of self and for interpersonal relationships throughout life.

· Disturbances in object relationships contribute to many disorders, including narcissism, and to disturbed relationships in adulthood.

· In addition to contributors from psychoanalysis, developmental researchers investigating attachment have contributed to ourunderstanding of object relations.

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