Time and the Character Disorder
Milton Miller’s paper appeared in 1964 in the Journal of Nervous and Mental Disease, one of the world’s oldest and most respected psychiatric journals. It is a poetic clinical exploration of the absence of temporal continuity in the inner life of the psychopath. He implicitly suggests that an absence of attachment may impair the capacity to choose some potentialities, while surrendering others, and therefore may fail to deepen one’s relationship to objects; instead, the psychopath “seems to be walking through snow without leaving footprints.” One aspect of this failure to surrender potentialities that Miller does not comment on is its usefulness in maintaining fantasies of immortality, a temporal aspect of the psychopath’s grandiosity. If he loses nothing, he grieves nothing, and nothing ends.
Throughout the centuries there has been a kind of person whose way of living in the world has confounded, confused, occasionally inspired, but more typically infuriated or worried his contemporaries. We have known him by many names and currently we call him the “character disorder.” He is ordinarily understood as a person with whom something is wrong or amiss and, depending upon the genesis of evil in the particular era in which he lives, that which is believed to be wrong has been variously explained. There was a time when he was thought to be suffering from “bedevilment” in the concrete sense of the word. He has been depicted as deficient in protoplasm, overly or inadequately nurtured in early years, and, in recent decades, has been described as suffering the consequences of preoedipal sexual conflicts of unresolved nature. Johnson and Szurek (1952) have suggested that he is a person who acts out the unstated wish of a parent and thereby provides for that parent the vicarious satisfaction of a desired but denied variety of experience. All of which may serve to emphasize that his behavior is easier for us to describe than truly to understand in a genetic sense.
In any given moment he may resemble his neighbor. It is in the collection of sequential moments of his life that there is the implication that something is disturbed. He may, for example, experience eloquent moments or moments of great despair, those of great sacrifice or of selfish narcissism. Yet, in the following moment, the last one may be far, far away and the time ahead may be separate in toto. The experience of the passage of time as one important dimension of his existence seems sharply impaired. In a certain sense, he seems to be walking through snow without leaving footprints. It is as if, for the character disorder, potentialities in the world were never lost.
To draw from clinical experience:
“You ask me what I’m going to do when I leave here, Doctor? Well, first I’m going back and talk things over with my wife. I’m going to see if maybe we can get started again. I’m ready to settle down now, and she said that if I could promise to settle down, she’d be ready to talk it over. How long since I saw her, you ask? Six years, I guess.”
And another patient:
“About the career, I hope you won’t laugh, but I have given serious thought to medicine. Being in the hospital all these times does teach you something. Of course, it will take some schooling and I’m no chicken any more like a lot of those kids who are doctors, no offense to you, Doctor, but there is a difference in learning from experience. I’d find school tough, but I did enjoy science. You want to know how much schooling I’ve had. Well, I almost finished. I was going to take the GED test in the Army but I never got to it. I imagine if I went back and talked to the principal of that high school that. …”
Or, the patient’s lack of appreciation of the meaning of time may be seen most clearly as he talks of his parents:
“And then, Doctor, I told Mother that she would have to stop making those demands upon me. I told her that I am grown up. By God, I am sick and tired of her ruining my life and advising me. I told her that if ever I was to get anywhere in this world she’d have to loosen up. After all, I’m past 44 now and. …”
I speak of a very ahistoric man, one who is deprived of an understanding openness to the experience of the world by a way of living which obscures the meaningful relationship between the moment at hand and those which are past and future. Our understanding of these individuals requires that the nature or consequences of being deprived of “openness to the world” and the significance of “living in an ahistoric fashion” be further illuminated. Yet, all too obvious are the difficulties implicit in studying any individual’s “way of living.” Little wonder that in clinical practice we often bracket, put aside these matters of “life living,” claiming that they are out of the province of psychiatry, that they are more properly considered by philosophy or religion, and that in any case, insofar as science is concerned, they represent unknowables. We are often all too willing to translate the patient’s concern about life and his life into concerns about one thing or another encountered along his way.
Yet such translations must be suspect. The nature of one’s knowledge about himself is inextricably rooted in knowledge about questions such as, “What is life about? What are its ground rules?” Individually, and as a society, we try to devote ourselves to explication of these questions. Insofar as we know about ourselves, we know a good deal about life, and our lives. Insofar as we are estranged from ourselves, we are estranged as well from an awareness of the ground rules and meaning of life. Others have considered psychopathology as a form of estrangement from oneself (Gendlin, 1962; Rogers, 1957). It is useful to consider psychopathology further in the light of certain commonly shared notions about the nature of our existence.
Begin with the primordial fact of human existence. I am, and, as an existing being, a myriad of feelings, thoughts, tastes, senses, potentialities are available to illuminate the objects and persons of my world. Yet, a second of the important facts of existence is its imitations. We live in limited time and space. Significantly, the meaningfulness of life seems tied to the vitality with which one recognizes both the opportunities within and the limitations of life. Our meaning becomes actualized as we select from among our potentialities and as we surrender others. The vitality of life resides in an awareness of the necessity for choosing and surrendering. By accepting one potentiality, we surrender another. By surrendering no potentiality, we lose them all.
There is a boy of 17, and his potentialities are boundless. There are so many things he can be and do and feel in the universe. As to career, his future is without limitation. He can be a doctor, a lawyer, an athlete, an engineer, a minister, and indeed, at various times in his thoughts, he is all of these. Perhaps his school will be Harvard, or Yale, or Indiana, or Stanford, or MIT, or Wisconsin, or Chicago. And then one day he chooses. Not quite with finality, however, since he thinks that, perhaps, he will spend two years at his chosen school and then go on later in his career to Harvard or Yale, or Columbia, or perhaps all three. But he chooses. And in doing so, makes certain surrender.
The broad general educational possibilities at the University allow him to sustain into his second semester the potentiality of all the careers. But then there comes another moment, a moment in which he must choose again and perhaps this time for a variety of reasons, he may choose medicine. In this choice there is much surrendering and he does not make it easily. Law, engineering, basic science, architecture, the ministry are all surrendered. Or perhaps, here again he slightly hedges the commitment by combining in his planning law and medicine in forensic medicine, hoping subsequently to take the law degree; or he resolves his conflict between the ministry and medicine by deciding to be a medical missionary; or resolves his conflict between psychology, sociology and medicine by planning to be a psychiatrist. But still he chooses.
About this time, another matter captures his attention. His determination to stay a bachelor, play the field and marry at a mature 35 is tested in his 20th year by a young woman, she also a student in the college, perhaps in music or the arts. He feels she is getting too serious, repeatedly warns her against this, and ultimately, in order to avoid dangerous foreign entanglements, suggests to her that six dates a week is too many and that they each should see other people. He urges maturity, good judgment, prudence, points to the difficulties of early marriage, even offers to help her find other dates, which she tearfully repudiates and instead arranges her own. And then, in a day, after considering the full array of potentialities, including bachelorhood to 35, playing the field, being practical, he chooses her. In this choosing, which for him represents a more or less firm commitment, he has surrendered much, though he hedges the surrendering slightly. Perhaps she will work over the years and the baby or babies will be delayed until after he is able to complete his medical training, his internship in Hawaii, his training in obstetrics at the Johns Hopkins or better, psychiatry at the Sorbonne.
The coming of the first baby, near the end of the first year of medical school and the coming of the second baby during the latter months of his internship at Wesley Hospital in Chicago were not decisive in his ultimate surrender of the possibility of studying psychiatry at the Sorbonne. This surrender followed an interview with a friendly insurance man, the one who sells those “insure now and pay later” policies to protect “that lovely wife and those two swell babies of yours.”
At age 32, his training is over and he is a physician and a psychiatrist. He is in practice and now pays the insurance man for the years of coverage. There are many things that he is not. He is not an alumnus of Harvard, Yale, MIT. He is not a lawyer, engineer, minister, sociologist, physicist, anthropologist, or baseball player. Although he is alive, awake and attentive to the world, certain kinds of contacts with one billion five hundred million humans called “women” are surrendered.* Some things are not surrendered, but were rather traded. The year of internship in Hawaii was traded for Annie; the year at the Sorbonne was substituted for by the coming of Susie. And the hypothesized and thought-about analytic fourth year—this time with a woman analyst—was forsaken and substituted for by a house in the suburbs.
Although there are many things surrendered, and many potentialities lost, there are many things that he is in the world. He is keenly aware of who he is, where he has been, and he is very curious about where he is going. He savors his work and perhaps does it well. He is enriched in his close interpersonal relationships and feels a closeness on many sides. A nursery rhyme from childhood recurs in his thinking, this time with a new perspective—“Why does the lamb love Mary so? Mary loves the lamb, you know.” In surrendering, in choosing and in caring, his life acquires increasing meaning.
For the person whom we call “character disorder” life is somehow different. Things are connected because they occur together, not because they are tied to one another by a life stream. As Straus (1958) has said of the schizophrenic patient, life becomes “sensory.” Feelings of the moment rule one’s existence. Rightness and wrongness in the world are related more or less exclusively to feeling states. Variant symptomatology notwithstanding, this estrangement from a unifying awareness of history and potentiality is inevitably present. And he may be too passive, too angry, too loving, too withdrawn, too active or too inert; he may never marry or may marry often; he may never leave home and parent or may leave in early adolescence. He may never love, may love a much older woman, or a much younger girl. He may posture as if the most virile of men or may wear the clothing of a woman. He may ingest alcohol, dope, candy or may ascribe to the cultist adoration of the human body. If one can see through the fog of symptoms (and the often obscuring concept of visitation by the forces of disease) the essential meaning of “being a character disorder” as a mode of living without choosing from among one’s potentialities in the world can be seen.
The relationship of symptomatology to the delineation and the maintenance of this characteristic mode of life is intricate and fascinating. One man may “bind tension” poorly and thus a moment may seem an eternity. He may be unable to wait, to hold back, to “control his instincts.” Unable to tie together moments in time, he never develops a sense of future and history, lives instead a mode of existence which is marked by its impulsiveness and discontinuity.
“Making the world disappear” and the passage of time with it is another life style which obscures the relationship of one moment to the next. Thus, for the alcoholic, there is a kind of timelessness, since one keeps time only with regard to the last drunk or the next period of sobriety. Somehow all potentialities in the world acquire a pivotal dependency upon the maintenance of sobriety. Similarly, the fat woman or man may evolve a kind of idiosyncratic mode of telling time which has to do with the undertaking of a diet, thence thinness and then time will begin. Similar mechanisms are observed in some who are somatically or sexually preoccupied. For other individuals, the passage of time is experienced in a fashion akin to the way events are related by the “old hands” at a fishing resort. One hears of “that tall fellow who caught a muskie the first time he ever fished and caught it on a line which didn’t have any bait on it,” only to learn that this event happened (or maybe happened) 28 years before. So it is with some old soldiers, old athletes long after the season and old fraternity brothers at reunions. So also with the angry and prejudiced people who sustain an injustice through the years, thereby denying the passage of time, the loss of potential, the uniqueness of the human capacity for enriching discovery and enhanced perspective. It is the same with some of those now separated from the great master and teacher who see time in the intervening days and years as equivalent to a “portal-to-portal” interval.
How does it happen that some individuals grow up without developing an awareness of the significance of temporal characteristics of life? How primordial is a disturbance in the appreciation of time in life as compared with other defects of feeling or behavior? Importantly, how do these vulnerabilities develop?
Although this paper has concerned itself in substantial part with the matter of certain aspects of the experience of time, it is not simply an “informational defect about a clock or a calendar” which will explain “character disorder.” For psychic functioning is not compartmentalized and experience of the significance of temporal relationships is intricately a part of all aspects of what we sense and know. A deepening intimacy with the others and with the objects of our world is attained as the years pass and it is precisely as we live along a continuum of achieving intimacy—in space—over time that the richness and significance of our personal life unfolds. Such descriptive aspects of our day to dayness as “closeness,” “cherished,” “valued,” “intimate,” “trusted” all have a clear temporal as well as spatial component. Maturing requires the development of a personal world which can encompass closeness, values, intimacy. It encompasses as well the necessity of awareness of the temporal limitations of life (Wheelis, 1958).
What is growth? What is maturity? Such definitions are always elusive, but the writer suggests that the matters discussed earlier in this paper seem germane to these questions. A mature person will demonstrate an appreciating openness and curiosity to the many potentialities for life experience and at the same time will possess an awareness of his own limitations in time and space. Understandably, he would want to be the one to select and surrender from his own potentialities and would demonstrate as well an awareness of the special significance of these matters, not only in his own life, but in the lives of his fellows as well. Immaturity (failure of growth) results from those interpersonal, biological and social phenomena which prevent an individual from coming to know about such matters. Thus, immaturity represents a failure to know, a deficit in learning, undiscovered potentials dormant, never developed.
As an example, events accompanying the paradigm period of “toilet training” may be explored. The matter at hand during these moments, learning to be “toilet trained,” represents only one of the learning possibilities. Facts about “that significant other human” may emerge at this time, a particularly important fact being that “she returns.” Or, an awareness of “her returning nature” may come later, perhaps on average days of infancy and early childhood or perhaps when siblings come, or later still with teacher, or with difficulty, with kids in the club. Later still, though only with great difficulty, the trustworthiness and returning nature of people may be learned with the love mate, or even later perhaps with that person called “doctor.” Certainly, there must be critical cutoff periods beyond which the richness, meaning and general applicability of what might have been learned is lost or sharply curtailed. Thus, if an individual has not learned that “the loved other returns” and, in adult life, for this or some other associated reason, consults a doctor, a disappointing discovery is often made. It often evolves that the most which can be learned (taught, experienced) is that this doctor, in contrast to all other human beings, so far at least, returns. Unhappily, although doctor returns, he may do so because “he is paid,” or because “he is a saint,” or because “he doesn’t know the real me.”
An earlier awareness that “the significant other returns” provides the basis for a wide variety of associated and exponentially growing experiences. Some first-person statements may serve as examples: “I am the kind of person who lives in the kind of world where people do return.” “I’m worth returning to.” “There is a preciousness of our time together.” “Parting is a sweet sorrow.” “We may choose to stay together or we may part.” Finally, “In the beginning, each time you went away I was terrified that you would not come back. I was helpless, thought only of myself and my abandonment. Later I came to believe that you would always return, I was happy and carefree. I took you for granted. Now, I know that you would always return if you could. The word ‘always’ doesn’t belong. This knowledge has changed me in a puzzling way. I feel enriched, sad, freer than before, able to appreciate and love, yet, most of all, I feel aware.” This awareness is one of the crucial ingredients of maturity.
It goes without saying that many complex events, individual and interwoven, may serve to interfere with a development of this kind of past-present-future awareness (Deiter and Chotlos, 1961; Heidegger, 1962). Biological and hereditary defects may be important. Undoubtedly, a heightened susceptibility to severe anxiety may result from some structural impediment or deficit within the perceptual channels of the central nervous system. Nor is there reason to doubt the particular significance of disordered early maternal-child relationships. For it is with and from the mother that the new child learns the joy and safety of making discoveries, the essential rightness of what he may feel and want to do. From her he derives the pride which comes from being an appreciated individual zestfully making discoveries, enlarging and enriching his world. He learns (in the words of Dr. William Fey) “to trust his guts” because she trusts him. That there are indelible qualities of personality established very early in life seems undisputed and points to probable neurochemical representation within the CNS which results from early maternal-child interaction.
Events beyond infancy and childhood are also important in growth towards maturity. The social structure of family and community seem significant, at least in determining symptom choice in those who develop severe character problems. The high incidence of asocial-anti-social forms of character disorder in low socioeconomic groups is contrasted with that specific form of passive, ever expecting, never really trying, unappreciating, shallow and spoiled individual endemic within certain parts of the upper classes. An adequate understanding of the development of a given individual’s character problem will continue to require detailed study and elaboration of the experiences and the experiencing of the developing person.
Finally, there is a paradox which becomes apparent during consideration of character disorder. Importantly, that disordered mode of existing in the world which is so pervasively present in these individuals is also, for most of us, at times something of our own. Psychoanalysts speak of the character neuroses of our time and from many sides we hear of a societal loss of authenticity and purpose. Writers like Fromm (1955), Whyte (1958), and Wheelis (1960) stress our culture’s estrangement from its history and our individual uneasiness with the vagueness ahead. These writers emphasize the necessity for modern man to begin to accept and treasure his freedom to be who he can be and to choose where he may go.
REFERENCES
Deiter, J. & Chotlos, J. (1961). Motivation from a phenomenological viewpoint. J. Existential Psych., 2:35–48.
Fromm, E. (1955). The Sane Society. New York: Rinehart.
Gendlin, E. T. (1962). Experiencing and the Creation of Meaning. New York: Free Press of Glencoe: Macmillan.
Heidegger, M. (1962). Being and Time. New York: Harper & Row.
Johnson, A. M. & Szurek, S. A. (1952). The genesis of antisocial acting-out in children and adults. Psychoanal. Quart., 21:323.
Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic personality change. J. Consult. Psychol., 21: 95–103.
Straus, E. W. (1958). Aesthesiology and hallucinations. In: Existence, ed. R. May, E. Angel & H. Ellenberger. New York: Basic Books, pp. 139–169.
Wheelis, A. (1958). The Quest for Identity. New York: Norton.
Wheelis, A. (1960). The Seeker. New York: New American Library.
Whyte, W. H. (1958). The Organization Man. New York: Simon & Schuster.
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*Editor’s Note: Population demographics are acutely time sensitive; there are now about three billion females on the planet.