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Sidney Blatt has had a distinguished career as a psychologist and he has written extensively on personality and psychopathology, receiving many accolades for his work. He has contributed enormously to psychiatry and psychology, both clinically and academically. Polarities of Experience is a scholarly work examining the development of personality through self-definition and relatedness. Blatt offers self-definition and relatedness as fundamental tensions in the development of personality and considers this approach to have enormous relevance for psychopathology; this is supported by clinical and empirical research. Throughout the book Blatt offers a number of diagrams and scales to effectively elucidate the theoretical understanding of this approach.
In terms of the philosophy of psychology, many of the issues he presents are also essential for an understanding of intersubjectivity as a subject. Philosophers have traditionally tended to deal with intersubjective experiences but Blatt manages to consolidate theoretical and empirical methodology in a creditable way that reinvigorates the need to address the issues practically. Redefining psychopathology in terms of the fundamental dimensions may prove beneficial in the amelioration of many of the problems and criticisms which have beset the contemporary psychiatric approach. Indeed, empirical evidence has been gathering for quite some time highlighting the need to discriminate depression and other personality disorders along anaclitic and introjective dimensions. From his perspective most personality theories can be divided along the lines of an emphasis on separatedness or relatedness. Maladaptive features may arise at any development level of personality stemming from an over emphasis upon either dimension which threatens personality integration.
Blatt outlines his book systematically with four sections covering personality in relation to development, organization, psychopathology and therapy. The first is dedicated to the polarity of experience itself and the supporting evidence for the centrality of the theme. He takes into account the historical emergence and development of western individualism, capturing the societal and intellectual tensions in various theories and definitions. This is followed by personality development in section II, consisting of three chapters covering the antecedents, functionality and the dialectal development of relatedness and self definition. The chapter on the antecedents covers a wide range of studies on attachment theory, the development of initial dyadic relations and the influence on subsequent relations. The section analyses the dialectical interaction along the two developmental lines from infancy to adolescence and through adulthood, moving from internalization to integration. Blatt points to psychoanalytic theorists who have stressed the importance of the concept of we for both dimensions and for the development of integration.
Section III has two chapters examining the two primary dimensions in the structure of personality and psychopathology. He distinguishes the characteristics and personality styles of the introjective and anaclitic, corresponding to an Apollnian and Dionysian personality organizations, including the qualitative differences in defensive organization and the relationship with forms of psychopathology. The distortions and exaggerations within either configuration can occur at any developmental level, as can progression or regression.
The final section deals with the implications for therapy. Blatt examines four major treatment studies that have employed the seperatedness and relatedness perspective on psychopathology and distinctions of anaclitic and introjective configurations. He details the methodology, an analysis of the various scales used and the evaluations of these studies. The patient-therapist relationship is also focused upon. Therapeutic styles and the personality of the therapist have an impact on the patient, dissimilarity between the interpersonal style of the patient and therapist proving to be more beneficial than congruence. Cognitive-affective schemas, taken in terms of thematic content and structural organization, can provide an indication of change throughout therapy. He gives a detailed account of the development of cognitive structural organization, which seeks to bring together psychoanalysis and attachment theory. In his Epilogue he ponders other fruitful avenues to be pursued empirically and therapeutically. The book concludes with quite an extensive reference list.
The work offers significance not only for therapy but also the diagnosis of psychopathology. The current view of psychopathology is criticized with restraint. Blatt believes that the approach he promotes overcomes many of the problems identified with Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV). He briefly addresses these problems and challenges the fundamental assumptions of the DSM. Many of these concerns have been continually raised against the DSM since its inception but Blatt offers an alternative view of a developmental continuum in respect to self-definition and relatedness. It addresses the problems of comorbidity and overlap of distinct disorders and the primary focus on symptoms. While Blatt concedes that a small number of patients represented a mixed group in respect to the two primary configurations, he accepts that this does raise theoretical issues, but the two primary configurations represent a defensive consolidation and the disorganized defensive style appears to makes long-term therapeutic intervention more beneficially significant for this group.
This is an important academic book, converging psychological disciplines and methods in the dynamics of relatedness and self-definition, and he also elucidates a coherent structure in the development of personality. This broad theoretical model does offer an alternative to the current psychiatric approach; it could alleviate many of the problems within psychiatry and, in doing so, much of the resistance towards it.
© 2008 Edmund O'Toole
Edmund O'Toole is a Philosophy PhD student at the National University of Ireland in Galway.