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The Blatt and the Cloninger Models of Personality and Their Relationship with Psychopathology

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The Blatt and the Cloninger Models of Personality and Their Relationship with Psychopathology Isr J Psychiatry Relat Sci Vol 44 No. 4 (2007) 292–300 The Blatt and the Cloninger Models of Personality and their Relationship with Psychopathology Ada H. Zohar, PhD Behavioral Sciences Department, Ruppin Academic Center, Emek Hefer, Israel. Abstract: This paper presents in brief the Blatt and the Cloninger theories of personality and their relationship to de- pression and to psychopathology. Each of the theories is described, the theoretical foundations of the theory are pre- sented, the theory’s view on personality stability, on the relationship between personality and psychopathology, the theory’s efficacy at predicting depression from personality measures, the theory’s explanation for sex differences in de- pression, the measures derived from the theories, and theory productivity. The paper concludes with an analysis of commonalities of, and points of disagreement between the two theories. The choice to present and juxtapose Blatt and Depression (2004; 1), and on Cloninger’s book, Feel- Cloninger arises from a deep appreciation of both ing Good (2004; 2). theories, both new and integrative in their ap- proaches. The two theories arose in different con- texts, and in different disciplines. The Blatt theory is The Blatt Model of Personality and known mainly to psychoanalysts, clinical psycholo- Depression gists, and research psychologists with interests in de- pression and in development. The Cloninger theory Model description is known mostly to psychiatrists, and to psycholo- The Blatt model of personality posits that individu- gists and researchers who are interested in the inter- alsdevelopalongtwodimensions:thatofinterper- face between biology and behavior. There is little sonal relationships and that of identity and self interaction between these different theoretical ap- definition. The dimension of interpersonal relation- proaches; and yet the theories are different enough to ships begins with the infant’s relationship with his provide interesting contrasts and surprising com- mother and extends over the whole lifespan, though monalities. The Blatt theory originated before the the internal representation of the mother forged in Cloninger theory, but the two are currently used and infancy wields a central and enduring influence on studied without an opportunity for argument be- future relationships and their representations. The tween the two. self-enhancing aspect of the interpersonal dimen- Both Sidney Blatt and Robert Cloninger are pro- sion is intimacy and connection, and the downside is lific researchers and writers, and have given rise to a a sense of loneliness, helplessness and extreme wealth of work by others, who have examined their neediness which is difficult for others to alleviate. ideas, as well as the applications and implications of The second dimension is self-definition. It is very ac- their theories. Both are in the full swing of their sci- tive in the second year of life, and is greatly affected entific careers. This short paper does not attempt to by the emergence of the superego. Like the interper- give a complete and comprehensive presentation of sonal dimension, it is also a lifespan developmental theirwork.Rather,itshouldbeviewedasanattempt vector. The self-enhancing aspect of the self dimen- to summarize, analyze and compare some of the cur- sion is a sense of identity, of purpose and of achieve- rent, central features of both corpuses of work, ment. The downside is extreme self-criticism. The which are relevant to the issue of the relationship be- ascendancy of one of the two dimensions in any indi- tween personality and psychopathology. This dis- vidual’s life at a point in time may depend on internal cussion relies mostly on Blatt’s book, Experiences of and on external events. The dimensions are not part Address for Correspondence: Ada H. Zohar, PhD, Behavioral Sciences Department, Ruppin Academic Center, Emek Hefer 40250, Israel. E-mail: [email protected]; [email protected] ADAH.ZOHAR 293 of an individual’s consciousness but have tremen- ria for major depressive disorder (MDD) and, vice dous power over the individual’s feelings, cognitions, versa, patients diagnosed according to the medical actions and life. model with MDD would probably be experiencing For individuals whose development is more in- profound depressive experiences of either depend- vested in the interpersonal dimension, well being is ence or self criticism. associated with issues of relatedness and depend- A second source of inspiration is developmental ency. They may be particularly vulnerable to subjec- psychopathology. Thus in Blatt’s personality model tive experiences of loss and separation. For early development and early representations are of individuals who are particularly invested in the self greatimport,butdevelopmentisviewedasanongo- dimension, well being is associated with a sense of ing process, which does not stop in early childhood, achievement, approval and freedom from inferiority andcanbeseenandinfluencedinadulthood.Itisthe and guilt. They are likely to be particularly vulnera- meeting of the person at his particular developmen- ble to perceived failure or criticism. As both dimen- tal stage with the demands reality imposes that will sions are active dimensions of development for all determine the emotional outcome. individuals, at any point in time individuals can be The Blatt theory is enriched by the wealth of de- characterized by the extent to which they are in- velopmental research, and integrates the cognitive vested in one or the other. stages described by Piaget and his students into the Psychopathology may arise when the challenges scoring of the internal representations of parental an individual faces overwhelm his or her resources, figures. primarily because the internal representations do Last but not least, there is a strong positivist sci- not lend the individual the support necessary for entific approach, so that any proposition in or arising adaptive response. The personality constellation (de- from the Blatt theory is expected to be examined and pendence and self-criticism) also shapes the individ- supported empirically. Because of this strong scien- ual’s experience and affects his or her perception of tificcomponent,theBlatttheoryofpersonalityis life events. constantly being tested, revised and refined. This feature distinguishes Blatt’s work from that of many Theoretical underpinnings psychoanalytic theorists, whose theory is mainly There are several different sources of inspiration for held up to standards of internal consistency and Blatt’s theory. First and foremost there is psychoana- therefore is unlikely be challenged, refuted, or sub- lytic theory, beginning with the work of Freud, and stantially changed. encompassing many of the psychoanalysts who fol- lowed him. It is implicit in the psychoanalytic point Stability of personality of view that depressive symptoms as described in the Personality according to Blatt’s view is always being DSM are of no clinical or theoretical interest. Behav- influenced and formed by the individual’s life experi- ioral symptoms are viewed as epiphenomena that are ences and according to his internal representations, neither specific to depression, nor universal to all pa- which are mostly stable though potentially trans- tients with depression, and are thus an idiosyncratic formable. Thus in adolescence there might be an as- expression of deeper structures. These deeper struc- cendance of the Self-criticism dimension around tures are considered to be of theoretical and clinical issues of identity and values, and ascendancy of the importance since they can be traced to early experi- Dependency dimension around peers and romantic ence, bared in the process of analysis, and changed, relationships. These might change form and empha- to produce a more adaptive, developmentally appro- sis in adulthood depending on the choices an indi- priate inner structure that will afford resilience in the vidual makes and the events of his life. Stability is face of adversity. In this context it is important to enhanced by the internal representations which are point out that while Blatt does not accept the validity formed early and are slow to change. of the medical model, patients who experience deep experiences of depression according to Blatt would Prediction of depression probably qualify by symptom count as meeting crite- Blattwasnotintentonprediction,ratherondescrib- 294 BLATT AND CLONINGER MODELS OF PERSONALITY AND THEIR RELATIONSHIP WITH PSYCHOPATHOLOGY ing, explaining and laying down the guidelines for ef- transactional process with the environment in which fective analysis or psychotherapy. Repeatedly, the those high in dependence seek social-emotional sup- dimensions of dependency and self-criticism have port and are vulnerable to rejection engendered by been found to be correlated with depressive neediness and clinging, while those high in self-criti- symptomotology. There is little evidence that they cism evoke emotional distance, suspicion, criticism directly predispose individuals to contract depres- and rejection which in turn amplifies self-criticism. sion. The prospective studies available suggest com- This approach is similar to the behavior-genetic de- plex interactions between self-criticism and scription of how genotypes construct their own envi- dependency, with other personality dimensions, ronments (10) but in Blatt’s description is free of any with psychosocial events, with age, development and genetic or biological undertones. gender
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