The International Library of Psychology PERSONALITY AND MENTAL ILLNESS Founded by C. K. Ogden The International Library of Psychology ABNORMAL AND CLINICAL PSYCHOLOGY In 19 Volum es I Psychotherapy with Children Allen II Personality and Mental Illness Boivlby III Inferiority Feelings Brachfeld IV Abnormal Psychology Coriat V Dimensions of Personality Eysenck VI The Dynamics of Anxiety and Hysteria Eysenck VII Psychology of the Normal and the Subnormal G oddard VIII The Neurotic Personality Gordon IX Mental Conflicts and Misconduct Healy X The Concentric Method in the Diagnosis of Psychoneurotics Laignel-Lavastine XI A Handbook of Psychiatry Lichtenstein XII The Psychology of Emotion MacCurdy XIII Psychosurgical Problems Mettler XIV Personality and the Frontal Lobes Petrie XV Psychotic Art Reitman XVI Conditions of Nervous Anxiety and their Treatment Stekel XVII Emotion and Insanity Thalbitzer XVIII A Short History of Psychotherapy Walker XIX Constitution-Types in Delinquency Willemse PERSONALITY AND MENTAL ILLNESS An Essay in Psychiatric Diagnosis JOHN BOWLBY Prefatory Note by Edward Mapother First published in 1940 by Keg an Paul, Trench, Trubner & Co., Ltd. Reprinted 1999, 2000, 2001 by Routledge 2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN Transferred to Digital Printing 2006 Routledge is an imprint o f the Taylor & Francis Group © 1940 John Bowlby All rights reserved. No part of this book may be reprinted or reproduced or utilized in any form or by any electronic, mechanical, or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. The publishers have made every effort to contact authors/copyright holders of the works reprinted in the International Library of Psychology. This has not been possible in every case, however, and we would welcome correspondence from those individuals/companies we have been unable to trace. These reprints are taken from original copies of each book. In many cases the condition of these originals is not perfect. The publisher has gone to great lengths to ensure the quality of these reprints, but wishes to point out that certain characteristics of the original copies will, of necessity, be apparent in reprints thereof. British Library Cataloguing in Publication Data A CIP catalogue record for this book is available from the British Library Personality and Mental Illness ISBN 978-0415-20920-5 Abnormal and Clinical Psychology: 19 Volumes ISBN 0415-21123-9 The International Library of Psychology: 204 Volumes ISBN 0415-19132-7 Printed and bound by CPI Antony Rowe, Eastbourne ist Murderer: We are men, my liege. Macbeth : Ay, in the catalogue ye go for men ; As hounds and greyhounds, mongrels, spaniels, curs, Shoughs, water-rugs and demi-wolves, are clept All by the name of dogs ; the valu’d file Distinguishes the swift, the slow, the subtle, The housekeeper, the hunter, every one According to the gift which bounteous Nature Hath in him closed, whereby he does receive Particular addition, from the bill That writes them all alike : and so of men. (M a c b e t h , Act III, Scene i) This page intentionally left blank CONTENTS PAGE Pr e f a t o r y N o t e ix Pr e f a c e xi I . I ntroduction : M o d e s o f Ps y c h i a t r i c C lassification i I I . Pe r s o n a l i t y T y p e s a n d t h e Ps y c h o s e s 1 3 I I I . M e t h o d s o f M e a s u r i n g a n d D e s c r i b i n g Pe r s o n a l i t y 2 7 IV . S o m e T r a i t s D i s t i n c t i v e o f S c h i z o i d Personalities 4 4 V . T y p e s o f Sy n t o n ic Pe r s o n a l it y : 69 A. Depressive Personalities 72 (1) Cautious Obsessive 72 (2) Anxious Depressive 77 B. Hyperthymic Personalities 80 (1) Cheerful Hyperthymic 80 (2) Quarrelsome Hyperthymic 84 C. Circular Personalities 85 Relation of Personality-Type to Form of Psychosis 91 Changes of Syntonic Personality from one type to another 95 V I . T y p e s o f S c h i z o i d Pe r s o n a l i t y 10 4 A. “ Normal ” 106 B. Saint-like 109 vii C. Cold Solitary D. Apathetic Asocial E. Hysterical F. Shameless Antisocial (Psychopathic Personality) Schizoid Types and Form of Psychosis Changes from one type to another V II. T h e Ps y c h o -neuroses A. Introduction B. Anxiety States and Neurasthenia C. Conversion Hysteria D. Obsessional Neurosis E. Hysterical Personality F. Psychopathic Personality (Sociopath) V III. T h e B a s is o f Ps y c h i a t r i c D i a g n o s i s A p p e n d i x A . T h e S p e c i f i c i t y o f 3 3 S c h i z o i d T r a i t s A p p e n d i x B . 7 2 N o n -S p e c i f i c T r a i t s Bibliography I n d e x PREFATORY NOTE D u r in g March 1940 the author wrote to Professor Edward Mapother asking him if he would write a Foreword to this book. A few days later Professor Mapother died. In these circumstances the author asked permission of Mrs Mapother to publish the private letter printed below and this she very kindly gave. The circumstances in which this letter was written explain themselves. 19 Queen Anne Street, Cavendish Square, W.i. Maudsley Hospital, June $thy 1939. Denmark Hill, S.E.5. D e a r D r B o w l b y , There is of course no objection to the publication of your thesis on account of any information which it contains concerning cases seen at the Maudsley. However, I am very glad indeed to have had the opportunity of seeing it and should like to congratu­ late you. I found it intensely interesting, and as it is relevant to matters that I may deal with in the Maudsley Lecture to the R.M.P.A. which I am due to give in November next, I hope to be able to read it more slowly and carefully. Have you a copy that I could borrow, or is it likely to be printed in the near future ? Hoping you will get for your thesis the recognition which it deserves. Yours sincerely, E d w a r d M a p o t h e r . This page intentionally left blank PREFACE S ome apology is required for presenting to the public a work which is so manifestly incomplete. In defence it may be said that the observations, such as they are, confirm in principle a certain theory of typology, dispose o f many common beliefs and suggest a new basis for the classification of the psycho-neuroses. Moreover, few clinical as opposed to theoretical studies of the questions at issue are available. An attempt has been made to review all the clinical material published in English, to collate it and to compare it with new observations. As a clinical review of the subject it may therefore have some value. The observations reported were begun at the Maudsley Hospital when I was a clinical assistant there in 1933 and 1934. As each patient came under my care I found myself fascinated by the questions, what sort of man was he before he became ill ? In what ways, if any, was he more unstable or neurotic than others ? I spent many hours discussing this with the patients themselves and with their relatives and gradually I came to recognize certain characteristic personalities who seemed specially liable to develop a functional mental illness. A t this stage I re-read Kretschmer and most of the British and American literature on the subject and realized that my own observations when taken in conjunction with those of others enabled many interesting though tentative conclusions to be drawn. The next step was clearly to undertake a systematic enquiry into the matter to check my conclusions, but since 1936 my work has been largely in child psychiatry and opportunities for continuing the work along the same lines were not available. I have nevertheless made use of the principles of classification and diagnosis described here in my work with children and have found that by diagnosing the ‘ neurotic 5 child in terms of his total personality rather than in terms of particular symptoms xi Xll PREFACE more informative diagnoses and more reliable prognoses can be made. But though I am satisfied that this classification has clinical value I should be the last to contend that my hypotheses are scientifically proven, for my observations are confined to a mere 65 patients. Yet it should be remarked that less exhaustive enquiries have been made in a far larger number of cases and the various conclusions tested in this way. These further observations are too scrappy for inclusion here but have influenced me throughout and supported me in my conclusions.