(1904-1988) - German neurologist, psychiatrist and psychologist. Professor of Neurology at the Neurological Clinic of the Charité University. Humboldt in Berlin. Specialist in many border areas, including the psychology of accentuated personalities. He developed a typology of accentuated personalities, in which ten pure types and a number of intermediate ones were identified. According to their origin, the identified types have different localizations. Temperament, as a natural formation, of L. included such types as: hyperthymic (desire for activity, pursuit of experiences, optimism, focus on success); dysthymic (inhibition, emphasizing ethical aspects, worries and fears, focus on failure); affectively labile (mutual compensation of traits, focus on different standards); anxious (fearfulness, timidity, humility); affectively exalted (inspiration, sublime feelings, elevating emotions to a cult); emotive (kindness, timidity, compassion). Character, as a socially conditioned formation, included such types as: demonstrative (self-confidence, vanity, boasting, lies, flattery, focus on one’s own self as a standard); pedantic (indecisiveness, conscientiousness, hypochondria, fear of self-inconsistency with ideals); stuck (suspiciousness, resentment, vanity, transition from elation to despair); excitable (temper, heaviness, pedantry, focus on instincts). Finally, the following types were assigned to the personality level: extroverted; introverted. L. author of works: Individual Therapie der Neurosen, 1963; Biologische Psychologie, 1966; in Russian Transl.: Accentuated Personalities, Kyiv, 1981; Rostov-on-Don, 1997. I. M. Kondakov
PERSON AS AN INDIVIDUAL AND AS AN ACCENTUATED PERSONALITY
People are distinguished from each other not only by innate personality traits, but also by developmental differences associated with the course of their lives. A person’s behavior depends on what family he grew up in, what school he attended, what profession he is, and what circles he moves in. Two people with initially similar natures may subsequently have very little in common with each other, and, on the other hand, the similarity of life circumstances can develop similar traits and reactions in people who are fundamentally different.
The so-called life types, for example, the type of employee, officer, merchant, scientist, teacher, waiter, are formed due to the fact that a certain position or position leaves an imprint on the way of life. Of course, this is often facilitated by the fact that the tendency inherent in a person by nature interacts with the chosen profession; moreover, a person often chooses a certain profession precisely because it corresponds to his individual inclinations. The imprint in question in an adult cannot seriously affect the diagnosis of personality, because external forms of behavior are determined to a much greater extent by acquired habits than by the manifestation of internal orientation. So, for example, a teacher has a certain self-confidence and self-confidence that is natural, since he is accustomed to playing an important role in the children's team. A completely different impression is made by a person whose self-confidence is not determined by his profession. By the way, along with self-confidence, a teacher can have unconditional modesty. Or let’s take an officer who is distinguished by exceptional discipline and accuracy. Such a trait in the military is more justified than the extraordinary pedantry inherent in human nature itself.
Typically, behavior associated with professional habit is not confused with behavior that reflects the internal identity of a person. It’s a different matter if traits of great originality appeared already in early childhood. Here it can be difficult to establish how deeply this uniqueness is reflected in the structure of the adult’s personality.
I must make a reservation that the question of the origin of accentuated personality traits is not the subject of special attention in this work: these traits occupy us only in the form in which we directly observe them in the individuals being examined. For example, it can be considered established that any person has a natural desire to earn praise and approval, that any person is not alien to feelings of pity. It is quite possible that the impressions of childhood left a certain imprint on the characteristics of the manifestation of these traits in an adult. However, one thing is indisputable: both the inclinations and the direction of a person’s interests come from the outside. In which direction a person’s ambitious thoughts are directed depends solely on external incentives. Two equally ambitious people can be bitter enemies due to the fact that they set directly opposite goals for themselves. The sense of duty can be directed in different ways. Which direction a person chooses largely depends on the society in which he lives. In the same way, the innate orientation of interests and inclinations in no way impedes educational influence. Moreover, it is precisely the innate orientation that is the basis of education; without it, education is generally impossible. If a person did not have a tendency to develop a sense of duty, then through education it would be impossible to induce him to do one thing and not do another.
People differ from each other no matter how the difference arises. Just as one person is always different from another in appearance, so the psyche of each person is different from the psyche of other people.
And yet, speaking about individual traits, we do not imagine them as some kind of boundless range of possibilities, in addition with many transitions: there can be no talk of an infinity of unique individual traits. The following thesis can be put forward: the main features that determine a person’s individuality and character are very numerous, but still their number cannot be considered unlimited.
The traits that define a person’s individuality can be attributed to various mental spheres.
Let us first name the sphere that would most correctly be designated as the sphere of orientation of interests and inclinations. Some interests and inclinations are selfish in nature, others, on the contrary, are altruistic. So, one person may subordinate everything to the thirst for profit or have exorbitant vanity, while another is sympathetic, kind, and has a highly developed sense of civic responsibility. This area also includes a sense of justice, fearfulness or hatred of a person. If one of these properties of the psyche is very clearly expressed or, on the contrary, poorly developed, then there is reason to talk about them as individual traits of a person, i.e. the vivid expression of the described individual traits cannot yet be considered the main reason for the accentuation of individuals who are invariably something stand out from average people.
It is easy to establish that deviations in one direction or another in unaccented individuals are always within the limits of universal human norms. These traits, inherent in a person by nature, precisely because of their universal significance, constitute such a strong framework that special individual “discord” is usually not observed. Variations in human reaction are not excluded, of course: there are people who are more or less selfish or altruistic, more or less vain, more or less conscious of their duty. In this way, that is, against the background of variations in the direction of interests and inclinations, various individualities arise, but they cannot yet be classified as accentuated personalities.
The second sphere can be designated as the sphere of feelings and will. The nature of internal processing of phenomena also determines significant individual differences. The result is modifications to personality and character. We are talking about the very process of emotions, about the speed with which they take possession of a person and then weaken, about the depth of feeling. This also includes types of volitional reactions, to which we include not only weakness or willpower, but also internal volitional excitability in terms of choleric or phlegmatic temperament. The properties of this emotional-volitional sphere also, to one degree or another, determine various variations in behavior, endowing people with specific individual traits. However, they do not in themselves define a personality that would clearly stand out from the average background.
The third area is related to intelligence, which is usually not included in the concept of personality. There is, however, an area of associative feelings (cit. cit., pp. 117-140), in which the beginning of such personality traits as interest and the desire for orderliness is laid. This sphere can be called associative-intellectual. Such a human trait as love of order cannot immediately be categorically defined as an anancaste’s need for orderliness. Quite often this trait is just one of the individual manifestations of the associative-intellectual sphere, which should not at all be associated with personality accentuation traits.
To understand the essence of a person, it is necessary to take a close look at the various features of the above-mentioned mental spheres characteristic of him. In this book I will try to illustrate the characteristics of accentuated personalities with specific examples from life. The same should be done with regard to the listed variations of human individuality. But even if you want to, it’s not easy to do. The specific properties mentioned here are not so striking that they can be convincingly confirmed by appropriate material. Neither observations nor conversations with people help to unambiguously describe and define the variations mentioned above. But they can be very clearly imagined if you look at a person from the inside. This is exactly the opportunity writers give us. They not only depict the purely external actions of the heroes, convey their words and even statements about themselves, but often tell us what their heroes think, feel and what they desire, showing the internal motives of their actions. In characters in works of art it is easier to identify very subtle individual variations. If a person shows fearfulness or self-confidence, compassion or a sense of justice, or even without showing these qualities he attributes them to himself, then it is difficult to say with certainty whether he has stepped over the boundaries of normal reactions. But when we encounter a character in a writer who exhibits the named traits, drawn with talent, with all his thoughts and feelings, this in most cases makes it possible to unmistakably recognize the manifestation of one of the spheres of individuality. So, the characters of fiction give us the most interesting examples of individual variations in the human psyche.
It is not always easy to draw a clear line between the traits that form an accentuated personality and the traits that determine variations in a person’s personality. Oscillations are observed here in two directions. First of all, the characteristics of a stuck, or pedantic, or hypomanic personality can be expressed in a person so insignificantly that accentuation as such does not take place, one can only state a deviation from a certain “pattern” pattern. This is especially clearly expressed when determining certain properties of temperament, representing all the intermediate stages of its types, up to almost neutral. Accentuation always generally involves increasing the degree of a certain feature. This personality trait thus becomes accentuated.
Many traits cannot be strictly differentiated, that is, it is difficult to establish whether they relate to a number of accentuations or only to individual personality variations. For example, if we talk about ambition, we should first of all determine whether it belongs to the sphere of interests and inclinations or is a feature of accentuated stuckness. The last definition is possible if this trait is clearly expressed: stubborn, blind careerism can hardly be attributed to the sphere of interest. In addition, stuckness is never manifested by ambition alone; it is accompanied by increased sensitivity to insults and a strong resentment.
We encounter a similar situation when observing vivid manifestations of a sense of duty. It can be attributed to the sphere of orientation of interests and inclinations, but one can also see in it a feature characteristic of anankasts. Differentiation should take into account the following points: in cases where a sense of duty is simply a characterological feature, a person is distinguished by smooth, calm behavior, his devotion to duty is devoid of tension and is a trait that seems to go without saying; For an anancast, the sense of duty is associated with anxiety, constant questions about whether he is acting selflessly enough.
It is very interesting and significant from a psychological point of view that stuck individuals exhibit manifestations of egoistic feelings (ambition, painful resentment), and pedantic ones exhibit altruistic manifestations, in particular a sense of duty. It should be emphasized that the traits of being stuck are interconnected mainly with egoistic feelings, and the traits of doubt and constant hesitation (anankastic) are associated with feelings of an altruistic order. The more a person hesitates in his decisions, the more altruistic feelings take over the consciousness and influence decision-making.
The contrast is even more striking when comparing an anankastic personality not with a stuck one, but with a hysterical one, since hysterics are even more prone to selfishness. They often make rash decisions, rarely weigh their actions, remaining in the selfish circle of interests that are closer to them (see: op. cit.).
Anankastic and hysterical traits also intersect with other personality traits. I have already dealt with the question before (see: op. cit., pp. 218-219) whether prolonged deliberation when making a decision is not a mild form of anankastic predisposition, or whether it is simply one of the properties of the sphere of feeling and will. In parallel with this, I also tried to establish whether the readiness for rash actions is an expression of a slightly hysterical bias or whether it should be regarded as an independent manifestation of a property from the sphere of feeling and will. There are other ambiguities of this kind.
A highly developed area of emotions in a person activates altruistic feelings - a feeling of compassion, joy for someone else's success, a sense of duty. To a much lesser extent in such cases, the desire for power, greed and selfishness, indignation, and anger due to infringement of pride are developed. An emotive nature is especially characterized by such a property as empathy, but it can also develop on other grounds.
There is no single genetic basis for such personality traits as anxiety (fearfulness). To a normal degree, fearfulness is characteristic of many people, but it can become dominant, leaving its mark on all human behavior. In these cases, the physical basis of this condition is often discovered in the form of increased excitability of the autonomic nervous system, which, acting on the vascular system, can lead to a physical feeling of tightness, fear and melancholy. Probably, only in the latter case is there a tendency to step over the boundaries of average manifestations of fearfulness and cause accentuation of the personality.
Due to the large number of intersections, some experts believe that, when considering the individual traits of people, one should abandon all classifications and only describe what is observed in a general way. I take a different point of view, and therefore can expect the reproach of trying to squeeze into a diagram something that cannot be clearly defined. And yet I am convinced that there are basic features of human individuality, they exist objectively and that, because of this, science should strive to isolate and describe them. Naturally, this is associated with great difficulties, because the question is not about adapting scattered material to a more or less acceptable scheme, but about revealing objectively existing traits that underlie the concept of “personality”, despite the presence of their numerous intersections .
Accented features are not nearly as numerous as varying individual ones. Accentuation is, in essence, the same individual traits, but with a tendency to transition to a pathological state. Anankastic, paranoid and hysterical traits can be inherent to some extent, in fact, in any person, but their manifestations are so insignificant that they elude observation. When more pronounced, they leave an imprint on the personality as such and, finally, can acquire a pathological character, destroying the structure of the personality.
The personalities we designate as accented are not pathological. With a different interpretation, we would be forced to come to the conclusion that only the average person should be considered normal, and any deviation from such a mean (average norm) would have to be recognized as pathology. This would force us to take beyond the norm those individuals who, by their originality, clearly stand out from the background of the average level. However, this category would also include that category of people about whom they speak of “personality” in a positive sense, emphasizing that they have a pronounced original mental make-up. If a person does not exhibit manifestations of those properties that in “large doses” give a paranoid, anankastic, hysterical, hypomanic or subdepressive picture, then such an average person can be unconditionally considered normal. But what is the forecast for the future in this case, what is the assessment of the state? It can be said without hesitation that such a person will not face the uneven path of life as a sick, quirky, loser, but it is also unlikely that he will distinguish himself in a positive way. Accented individuals potentially contain both the possibility of socially positive achievements and a socially negative charge. Some accentuated personalities appear before us in a negative light, since life circumstances were not favorable to them, but it is quite possible that under the influence of other circumstances they would have become extraordinary people.
A stuck person under unfavorable circumstances may become an intractable arguer who does not tolerate objections, but if circumstances favor such a person, it is possible that he will turn out to be a tireless and purposeful worker.
A pedantic personality, under unfavorable circumstances, may develop obsessive-compulsive neurosis; under favorable circumstances, he will become an exemplary worker with a great sense of responsibility for the work assigned.
A demonstrative personality can act out rental neurosis in front of us; under other circumstances, it can stand out with outstanding creative achievements. In general, with a negative picture, doctors tend to see psychopathy, and with a positive picture, rather, an accentuation of the personality. This approach is sufficiently justified, since a mild degree of deviation is more often associated with positive manifestations, and a high degree - with negative ones.
The designation “pathological personalities” should be used only in relation to people who deviate from the standard and when external circumstances that impede the normal course of life are excluded. However, various edge cases need to be taken into account.
There is no hard boundary between normal, average people and accentuated individuals. Here, too, I would not like to approach these concepts too narrowly, i.e., it would be wrong, on the basis of any minor feature of a person, to immediately see in him a deviation from the norm. But even with a fairly broad approach to what qualities can be called standard, normal, and not conspicuous, there are still many people who have to be classified as accentuated personalities. According to surveys conducted at the Berlin Clinic by Sitte among adults and by Gutjahr among children, the population of our country, at least the population of Berlin, is 50% accentuated individuals and 50% standard type of people. For the population of any other state, the data may turn out to be completely different. German nationality, for example, is credited with not only such a flattering trait as determination, but also a rather unpleasant one - careerism. Perhaps this can explain the fact that Sitte found many stuck and pedantic individuals among the people she examined.
Below I detail my understanding of the accented personality. However, since at the same time I always turn to pathological individuals, it would be worthwhile to set out in detail the essence of my differences of opinion with some famous scientists dealing with identical problems. Let me first point out that Bergman, dealing with combined pathological traits, noted how much our views coincide with the scheme proposed by K. Schneider. In a small book, “Childhood Neuroses and the Personality of the Child,” I set out my views on these issues more fully, so here I will limit myself to a few brief comments.
Pedantic, or anankastic, personalities, which K. Schneider does not single out at all, represent, in my opinion, a particularly important group, both due to their prevalence and due to the very wide scale of deviations from the average level.
The same can be said about demonstrative, or hysterical, individuals, whom a number of scientists have recently also refused to classify as a special group. Meanwhile, anankastic and hysterical traits can have a strong impact on a person’s personality.
I interpret the concept of “paranoid” somewhat differently than has been accepted until now, since I consider its most significant aspect to be the tendency to get stuck in affect.
I do not include unstable, unstable personalities in my taxonomy, since in their description I do not find a unity of personality structure: when you read about such people, you see before you either hysterical, or hypomanic, or epileptoid personalities. Even if instability were understood as mere weakness of will, I would still not be able to attribute this trait to accentuation, but would attribute it only to variations in individuality: after all, weakness of will can never reach such a degree at which one could talk about leaving an imprint on personality as a whole. It should be noted that under the current diagnostic conditions, instability is the most common form of psychopathy. This is due to the fact that the concept of instability also includes many more pathological personality traits, while at the same time weak-will itself is often not included in this concept.
In the chapters on personality accentuation, I do not consider insensibility, which is sometimes designated by the term heboid.
In these cases, we are talking, judging by the last term, about latent mental illness. As for the usual coldness of feelings, we encounter it only with variations in character, and not with its accentuation.
Hyperthymic, dysthymic and cyclothymic personalities are distinguished by me according to Kretschmer, but it must be stipulated that I regard them as individuals who have a labile temperament, and therefore constantly fluctuate between the hyperthymic and dysthymic states. On the contrary, I consider syntonic people to be people who, as a rule, have an average, balanced mood. From the general mass of cyclothymic individuals, I single out those who are affectively labile, prone to constant excessive mood swings, as if between two poles.
Due to the area of thinking and psychomotor, it would be necessary to increase the number of special groups of temperament accentuation, since some individuals exhibit special excitation or inhibition precisely in the process of thinking, which is associated with their psychomotor, in particular the liveliness or lethargy of facial expressions. Trostorff described these phenomena in detail.
Introverted and extroverted individuals should be dealt with in more detail here, since there is no such information in the works I cited. I also attach a meaning to these concepts that is somewhat different from the generally accepted one, although they already only partially retained the content that Jung once put into them.
In my opinion, these concepts are closely connected with the period of adolescence, that is, with the period of formation of the child’s psyche as an adult (see: op. cit., pp. 228-237). I will briefly outline my views on this issue.
The child is extroverted: he is drawn to processes that affect his feelings and reacts to them with appropriate behavior, without thinking much. An adult, compared to a child, is introverted: he is much less interested in the environment, the external world, his reactions are much less immediate, he tends to pre-reflect on an action. With extroversion, the world of perceptions predominates in thoughts and behavior; with introversion, the world of ideas prevails. For an extroverted adult, the joy of making a decision is much more intense, because he is more focused on the external world around him and therefore
reasons to a much lesser extent, weighs various possibilities; for an introverted person, the tendency is to pre-think and evaluate decisions. An extroverted person is characterized by the manifestation of purely external activity, independent of thought processes, that is, significantly greater impulsiveness of behavior: this trait is also akin to child psychology. The indecision of an introverted person is associated with increased work of thought, but despite this, he is less able to feel joy in connection with making a decision.
In childhood, extroversion in both sexes has the same form of expression. In adolescence, the turn to introversion in boys is much more dramatic than in girls. Therefore, a woman is always more connected with the objective events of life, more dependent on them and in most cases has a more practical mind. However, making a rash decision inspired by the moment and acting without weighing the consequences is always a real danger for her. A man better understands the interconnection of phenomena and the true, not always obvious reasons for them, he is more inclined to generalizations, his thought works in the appropriate direction more effectively. The danger for a man is that he indulges in theoretical reasoning and misses those opportunities that require immediate action. As a result of this difference, accentuated extroversion and introversion in men and women cannot be assessed equally. What is the norm for a woman is extroversion for a man, and vice versa, what should be considered the norm for men should be considered introversion for women.
An extroverted decision may be less realistic and less objective than an introverted one, since the latter, made after thorough and comprehensive weighing, is always more sensible and sober. I agree with Jung when he says: “Extroverted natures are guided by given specific facts, an introverted person develops his own opinion, which he, as it were, “pushes” between himself and the objective reality.”
I will dwell on what Jung writes further: “When talking about introversion, we must also keep in mind another type of thinking, which, in fact, can even more likely fit under this heading, namely the type that is not oriented towards direct objective experience, nor on general ideas obtained through objective calculations.”
So, Jung here comes to the conclusion that not only a specific orientation to an object excludes introversion, but also such ideas that “start from the object.” At the beginning, Jung said that an extroverted person accepts objective reality as it is, while an introverted person internally processes it; Subsequently, he puts forward the position according to which an introverted person generally perceives everything objective under a subjective sign: “I use the term “subjective factor” in relation to those psychological actions and reactions that, experiencing the influence of an object, give rise to a new fact of a mental order.”
It goes on to explain even more clearly what exactly thinking is on the introverted plane: “It cannot be denied in such cases that the idea has its origin in an obscure and gloomy symbol. Such an idea has a certain mythological character: in one case this idea is interpreted as a manifestation of originality, in another, worse, as eccentricity. The fact is that an archaic symbol for a specialist (scientist) unfamiliar with mythological motifs always seems veiled.” Specifically, this means that a considerable number of ideas can only be associated with extroversion. In addition, we read: “In the process of practical thinking of a businessman, technician, or natural scientist, thought cannot help but be directed towards the object. The picture is not so clear when it comes to the thinking of a philosopher who deals with the field of ideas. In this case, it is necessary first of all to establish whether these ideas are not just abstractions that arise in the process of cognition of a certain object. If this is so, then the corresponding ideas are nothing more than general concepts of a higher order, including a certain sum of objective facts. If the ideas are not abstractions from directly received experience, then it should also be established whether they were adopted from somewhere by tradition or borrowed from the surrounding intellectual environment. If yes, then these ideas also belong to the category of objective data, and thus this thinking will also have to be recognized as extroverted.”
I consider the mental work of a natural scientist to be extroverted only in those cases when his activity is in the nature of collecting, collecting. The more he mentally processes what he observes, the more his brain activity approaches the plane of introversion. To a philosopher who develops certain ideas, I attribute only an introverted character of mental activity, even in those cases when the course of his thought is based on objective sources or facts.
If I, despite differences of opinion with Jung, use his terminology, this is for two reasons. Firstly, in medical psychology these terms have taken root more in the meaning that I ascribe to them. Secondly, with a practical approach to the issue there is not such a large discrepancy as in the field of theory. The more specific the examples Jung gives, the more I am inclined to agree with him. For example, Jung writes: “One person, as soon as he hears that it’s cold outside, immediately rushes to put on his coat, another considers this unnecessary for the reason that “you need to toughen up”; one admires the new tenor for the reason that everyone is “obsessed with him”, the other does not admire him at all, but not for the reasons that he does not like him, but because he is deeply convinced: if everyone admires something, then it is This does not mean at all that this phenomenon deserves admiration; one submits to existing circumstances, because, as his experience shows, anything else is impossible anyway, while the other is confident that even though such a result has already happened a thousand times, the thousand and first cases can turn out differently.” I view these opposing types of behavior from the same angle as Jung.
Sometimes experts do not clearly differentiate between extroverted and introverted behavior and temperamental traits. For example, hypomanic individuals are constantly distracted, they are entirely oriented toward the events happening around them, and are ready to become involved in them at any moment. They can also be designated as an extroverted type, but their behavior is devoid of the specificity of extroversion.
Eysenck, for whom extroversion and introversion play a primary role in personality diagnosis, in my opinion, did not avoid the above-mentioned danger and also included hypomanic temperament among the symptoms. About an extroverted person, Eysenck writes: “He loves to joke, is very resourceful, constantly looking for entertainment and variety; he is an optimist, laughs a lot and willingly. An extremely active person, prone to aggression, he is often overcome by impatience. Does not monitor restraint in the manifestation of feelings; you can’t always rely on him.” In this description, there are clearly notes of a hypomanic temperament, which is fundamentally different from the temperament of an extroverted personality. A person who is always serious, not prone to optimism, and who does not like to laugh can also show signs of extroversion, but only his extroversion is not so striking. On the other hand, a hypomanic personality may have introverted traits. We will further illustrate this with relevant examples.
There is another factor of insufficient differentiation of types, which manifests itself in the sphere of contacts between people. Thus, a person who lives primarily in the world of perceptions easily establishes contact with other people; It is more difficult for someone who is more self-absorbed to establish relationships with others. However, such a dependence is not always observed. An introverted person does not show great readiness to engage in communication, and yet he can quickly make friends with someone, while another person, always oriented to the environment, living “wide open”, may experience difficulties in establishing contacts. What is the reason for this? Obviously, in establishing direct understanding between two people, which is largely associated with the area of expressiveness, expression of behavior. Undoubtedly, some people have a special gift to influence others with an expressive, inviting manner of communication, to sensitively understand the subtlest shades of feelings and moods of others. But there are also people who are deprived of such a gift, such sensitivity. In the first case, contact is established quickly even in the presence of introversion, in the second - even for extroverted people, establishing contact with others is difficult. The ability to establish contacts and weakened contact-making function are often considered to be identical to extroversion and introversion, respectively. Especially often, the terms autism or schizoid character are deciphered as introversion plus weak contacts. Trostorff managed to draw a clear line between one and the other.
After the preliminary remarks I have made, I can turn to the diagnosis of accentuated personalities. Even where my diagnostic method is no different from the methods of other authors, its description will still not be superfluous: it will show how one can specifically distinguish one accentuated personality from another.
Kurt Schneider said that his scheme of psychopathy is difficult to apply in practice, since a number of individual traits transform into each other too imperceptibly. Because of this, in most cases he prefers such a general designation as “psychopathy.” I have repeatedly objected to this approach. In this work, I would like to specifically show that those accentuated personalities, which I propose to distinguish from each other, in most cases can be recognized quite clearly, regardless of whether we are talking about one accentuated trait or several. Personality diagnostics must be carried out using proper methods.
Who first introduced this concept? This was done by Karl Leonhard, whose biography will be described in this article.
Milestones of a long journey
He was born in 1904 in Edelfeld, located in Bavaria. As a child, Karl Leonhard dreamed of becoming a lawyer, but gradually medicine became his main hobby. After graduating from university, he chose psychiatry as the direction of his work and scientific activities. His first place of work in 1931 was a psychiatric clinic in Gabersee. A year later, Karl Leonhard, whose photo is presented in this article, becomes its chief physician. However, in 1936, he left this post and moved to the Frankfurt University Clinic for Nervous Diseases and soon received a scientific degree. In 1944, he was already a freelance professor at this university. Karl Leonhard then became professor of psychiatry and neurology at the Medical Academies in Erfurt and Berlin. In 1957, he began working at the Charite clinic.
Favorite topics
While teaching at universities, Karl Leonhard does not leave his private practice. In addition to her, he is engaged in scientific research, the results of which are essays and articles. He devotes most of his attention to schizophrenia. In his works you can find the classification and clinic of this disease. Leonhard is willingly accepted into national and international scientific communities, often becoming their honorary member, despite the fact that some of his scientific research does not find approval among other scientists. For example, his attempt to isolate cycloid psychosis as a separate disease. While only depressive psychosis and schizophrenia were officially recognized. German psychiatrist Karl Leonhard also studied. He believed that the symptoms of this disease appear already in childhood. During this same period of a person’s life, such a diagnosis can be made. Additionally, he described developmental disorders of the intellect.
Broad interests
Leonhard also studied neuroses and behavioral therapy. He devoted a lot of time to the psychopathology of human behavior. The pathologies he noticed were described in the monographs “Instincts and ancient instincts of human sexuality”, as well as “Expressiveness of facial expressions, gestures and human voice”. Many of the psychiatrist's works were ahead of their time. For example, those related to the topics of classification of schizophrenia, neuroses and temperament. The latter was studied by him thoroughly. Based on the study of mood disorders, Leonhard wrote the scientific work “Accentuating the Personality.” In it, he divided accentuations into types and described them. Additionally, he gave a description of each type using the example of the characters of literary heroes.
Emphasizing personality
Karl Leonhard's monograph is divided into two parts. In the first of them, he conducts a psychological and clinical analysis of accentuated personalities. The second part consists of examples. Leonhard analyzed the characters of literary heroes born from the imagination of more than 30 writers known all over the world. These are the heroes of the works of Stendhal, Goethe, Balzac, Gogol, Dostoevsky, Shakespeare, Cervantes and others. In our country, the book “Accented Personalities” was published in 1981. Not only specialists in the field of psychiatry, but also ordinary readers found it interesting, thanks to the author’s special style of presentation. The monograph has also been translated into many languages. Among them are Romanian, Italian, English, Japanese and others.
according to Leonard
According to the psychiatrist, there are only 10 pure personality types and several intermediate ones. He divides them according to temperament, character and personal level. In his opinion, temperament is given to a person by nature. There are several types of personality with temperament. Types related to the personal level: introvented and exposed. Types related to character: excitable (temper, pedantry, submission to instincts); demonstrative (vanity, self-confidence, flattery), pedantic (conscientiousness, indecisiveness, hypochondria); stuck (touchiness, suspicion). He classified the following temperaments as: emotive (compassion, kindness), anxious (timidity, fearfulness), dysthymic (focus on failures, fears, lethargy), effectively-labile (compensation for traits, focus on standards), effectively-exalted (emotionality, inspiration, sublime feelings). In addition, Leonhard gave his own definitions of extrovert and introvert, different from those previously accepted. With his light hand, psychiatrists all over the world began to use them. “Accented Personalities” can be recommended to be read by teachers and parents, those on whom the fate of the child depends. After all, the type of personality determines what profession it is better for him to choose in the future. In order not to be mistaken in its definition, you need to familiarize yourself with the work of Karl Leonhard.
The scientist was not just a recognized expert in his field, but also a very good person. Everyone who knew him noted his delicacy and modesty in communication, his goodwill towards others. Until his very last days, he wrote articles and received patients. Karl Leonhard died in 1988.
Introduction
Karl Leonhard is an outstanding German psychiatrist, known for his approach to the diagnosis and differentiation of the most common mental illness - schizophrenia. He was a continuator of the views of K. Kleist, who believed that, as with neurological diseases, mental disorders should be explained by pathological processes that have their localization in the brain, and the very nature of schizophrenia lies in hereditary degeneration. But nevertheless, in the history of psychiatry and psychology, Leonhard remains as the author of the concept of accentuated personalities. The development of this particular issue is of the greatest interest and necessity for my work.
The concept of accentuated personalities presented in this work is based on the monograph “Normal and Pathological Personalities”, written and published in 1964 (VEB. Publishing house “Volkund Gesundheit”). Much has been borrowed from this monograph. Many amendments and additions were made to the second edition, and in March 1975 in Berlin, the book of the ball was completed and sent to print. However, it is published in the USA by DonaldPress, New York, in 1976.
A few words about the structure of the book. It consists of an introduction and two parts.
The introduction is very short, after which a very important section begins, which is of interest to professional psychiatrists, “Methods of personality diagnostics.” It is written in such clear, specific language that it is accessible not only to a professional.
The first part of the monograph provides a psychological and clinical analysis of various accentuated personalities, i.e. people with a peculiar sharpening of personality properties and a special reaction.
The second part is like an illustration to the first, i.e. it conducts a characterological analysis of the heroes of classical works of world literature by over thirty writers: Tolstoy, Dostoevsky, Gogol, Shakespeare, Cervantes, Balzac, Goethe, Stendhal and others. In the preface to his work, the author explains his desire not to be “an unfounded scientist, but to specifically confirm theoretical reasoning with clear examples taken from life or from the books of great psychological writers.”
This work is devoted to individuals not pathological, but normal, albeit accentuated. If their depiction is sometimes so vivid and expressive that one gets the impression that the people being described are pathological, then this is only due to the intention of one or another author to emphasize the analyzed personal traits as sharply as possible. That is why Leonhard refers to Dostoevsky and Tolstoy, explaining that Dostoevsky shows with exceptional force the differences in the behavior of different people. Accented personalities, who in business professional descriptions represent nothing more than scientific interest, thanks to Dostoevsky become close to us, we perceive them more directly, visibly. Some critics saw Dostoevsky's characters as pathological. However, as the author claims, this opinion is based on a misunderstanding: precisely because Dostoevsky depicted the psychology and actions of people so figuratively, so excitingly, they were attributed a pathological character. In fact, the behavior of all the heroes is the behavior of completely normal people.
Everything is described in living literary language, and the terms are explained in great detail, which makes the publication of a special glossary inappropriate.
In this work, Leonhard does not define the term “accentuation” that he introduced; moreover, he considers accentuation to be a characteristic of temperament, but it is worth dwelling on this.
Accentuation is the excessive sharpening of individual personality traits.
If in a normal person all life difficulties are associated with the difficulties of the external situation, and not with oneself, then with hidden features associated with inclinations or abilities, they are corrected by proper upbringing. And in communication there are no signs of accentuation, but the person himself experiences certain difficulties. When compensatory mechanisms begin to fail, signs of accentuation may come out. With implicit accentuation, personality traits appear only in special cases when the person encounters an obstacle. If the life of an accentuated personality turns out unfavorably, then a complete deformation of the personality may occur, difficult to distinguish from psychopathy.
Let us consider in more detail the contents of the book, which is so outstanding in the world of science.
Accented personality traits.
This book examines the various character and temperament traits that shape a person as an individual in cases where he represents a deviation from a certain standard.
Demonstrative personalities.
The essence of the demonstrative or hysterical type lies in the abnormal ability to repress. The meaning of the process of repression is convincingly illustrated in a passage from Nietzsche (“Beyond Good and Evil”). “I did it,” my memory tells me,
I couldn't do it - pride tells me,
remaining inexorable in this dispute.
And then the moment comes when the memory finally recedes.”
In fact, each of us has the ability to do this with unpleasant facts. However, this repressed knowledge usually remains at the threshold of consciousness, so it cannot be completely ignored. In hysterics, this ability goes very far: they can completely “forget” about what they don’t want to know, they are able to lie without even realizing that they are lying.
Pedantic individuals.
In individuals of the pedantic type, in contrast to the demonstrative type, repression mechanisms are extremely poorly represented in mental activity. If the actions of hysterics are characterized by a lack of reasonable weighing, then pedants “delay” in making a decision even when the stage of preliminary deliberation is finally completed. Before they begin to act, they want to make sure once again that a better solution cannot be found, that better options do not exist. The pedant is not able to repress doubts, and this slows down his actions. Thus, the rashness of hysterics is contrasted with the indecisiveness of pedants. Of course, the decisions with which the pedantic subject hesitates must be to some extent important to him. What is not of serious importance for a person, consciousness represses without any difficulty; for this, even a pedant does not need to make a special decision.
Stuck individuals.
The basis of the stuck, paranoid type of personality accentuation is the pathological persistence of affect.
Feelings that can cause strong reactions usually subside after the reactions are “given free rein”: the anger of an angry person goes away if it is possible to punish the one who angered or offended him; The fear of a fearful person goes away if the source of fear is eliminated. In cases where an adequate reaction for some reason did not take place, the affect ceases much more slowly, but still, if the individual mentally turns to other topics, then normally the affect passes after some time. Even if an angry person was unable to respond to an unpleasant situation either in word or deed, it is nevertheless possible that the next day he will not feel strong irritation against the offender; A fearful person who has failed to escape from a fearful situation still feels freed from fear after a while. For a stuck person, the picture is different: the effect of affect ceases much more slowly, and as soon as you return your thoughts to what happened, the emotions accompanying stress immediately come to life. The affect of such a person lasts for a very long time, although no new experiences activate it.
Excitable personalities.
A person with insufficient controllability of character is very interesting. This is manifested in the fact that the decisive factors for a person’s lifestyle and behavior are often not prudence, not the logical weighing of one’s actions, but drives, instincts, and uncontrollable impulses. What is suggested by reason is not taken into account.
The reactions of excitable individuals are impulsive. If they don’t like something, they don’t look for an opportunity to reconcile; tolerance is alien to them. On the contrary, both in facial expressions and in words, they give vent to irritability, openly declare their demands, or even withdraw angrily. As a result, such individuals, on the most trivial occasion, get into conflict with their superiors and employees, are rude, aggressively throw away their work, submit their resignations, without realizing the possible consequences. The reasons for dissatisfaction can be very different: they don’t like how we are treated in this enterprise, the salary is low, or the work process is not satisfactory. Only in rare cases is it about the severity of the work itself, because excitable individuals, as a rule, have a tendency to engage in physical labor and can boast of higher indicators here than other people. Most often, they are irritated not so much by hard work as by organizational issues. As a result of systematic friction, frequent job changes are observed.
As the anger of a person with increased excitability increases, he usually moves from words to “deeds,” i.e. to assault. It happens that physical assault among excitable people precedes words, since such people are generally not very inclined to exchange opinions. After all, an exchange of opinions is equivalent to an exchange of thoughts, and the level of thinking of such people is quite low. And yet you cannot say that the actions and actions of these impulsive people are reckless; rather, on the contrary, their frustration is latently growing, gradually intensifying and looking for a way out, a release.
Hyperthymic individuals.
Hyperthymic natures always look at life optimistically, overcome sadness without much difficulty, and in general it is not difficult for them to live in the world. An elevated mood is combined with a thirst for activity, increased talkativeness and a tendency to constantly deviate from the topic of conversation, which sometimes leads to racing thoughts. Hyperthymic accentuation of personality is not always fraught with negative consequences; it can have a beneficial effect on a person’s entire way of life. Thanks to an increased thirst for activity, they achieve production and creative success. The thirst for activity stimulates their initiative and constantly pushes them to search for something new. Deviation from the main idea gives rise to many unexpected associations and ideas, which also contributes to active creative thinking. In society, hyperthymic individuals are brilliant conversationalists, constantly in the center of attention, and entertain everyone.
Karl Leonhard (1904–1988) - an outstanding German psychiatrist, neurologist, psychologist, who did a lot for the study of schizophrenia, affective psychoses, neuroses, personality disorders and other disorders, as well as problems of general psychopathology, biological psychology and human behavior, works which had a significant influence on the development of psychiatry not only in Germany, but also far beyond its borders. He worked closely with famous psychiatrists of the Soviet Union, knew the specialized domestic psychiatric literature well, and published his scientific works in Russian.
A specialist in many areas bordering on psychiatry, including the psychology of accentuated personalities. Developed a typology of accentuated personalities. The author of the famous work “Accented Personalities,” in which, based on the analysis of fiction, he gave comprehensive illustrations of accentuated personality types. The mentioned monograph, as is known, consists of two parts. In the first part, K. Leonhard gives a psychological and clinical analysis of accentuated personalities, that is, people with a peculiar sharpening of personality traits and a special reaction. The second part is, as it were, an illustration of the first - it provides a characteristic analysis of the heroes of classical works of world literature by over thirty writers: L. N. Tolstoy, F. M. Dostoevsky, N. V. Gogol, W. Shakespeare, M. Cervantes, O. Balzac, J. W. Goethe, F. Stendhal and others.
K. Leonhard was born on March 21, 1904 in the family of an evangelical priest in Edelfeld (Bavaria). Until 1923, he studied at the humanities gymnasium in Weiden (Oberpfalz). Then, having outlived his initial passions and desire to become a lawyer, he began to study medicine. He studied at the universities of Erlangen, Berlin and Munich.
Having begun his medical career under the leadership of K. Bonhoeffer, K. Leonhard decided to finally devote himself to psychiatry. In 1931, he began working at a psychiatric hospital in Habersee (Upper Bavaria), where a year later he became chief physician. In 1936, K. Kleist invited him to work as a senior physician at the Clinic of Nervous Diseases of the University in Frankfurt, where in 1937 he received an academic degree, and with it the right to teach. In 1944, K. Leonhard became a freelance professor at the university. This was followed by an invitation to the position of professor of psychiatry and neurology at the Medical Academy in Erfurt, from where he moved to the University of Erfurt in 1957. Humboldt in Berlin and began working at the famous Charité clinic, with which many years of his life and work were subsequently associated.
As a follower of the Wernicke-Kleist school, K. Leonhard creatively developed relevant ideas in relation to many mental illnesses - schizophrenia, affective psychoses, neuroses, personality disorders and others, as well as problems of general psychopathology and human behavior. As for the latter, his monographs “Instincts and ancient instincts of human sexuality” (1946) and “Expressiveness of facial expressions, gestures and human voice” (1976) are of particular interest, in which his talent and ability to perceive and analyze various forms of human behavior were revealed. .
In the field of clinical psychiatry, the works of K. Leonhard concerning the classification and clinic of schizophrenia, as well as affective psychoses, are especially well known. They have always attracted attention and are still widely discussed in the works of domestic and foreign psychiatrists. It is known that in the doctrine of schizophrenia the Kleist-Leongard direction is distinguished. Initially being psychomorphological, it to a certain extent develops the methodological positions of Meynert-Wernicke, according to which K. Kleist substantiated the point of view on schizophrenia as a group of systemic hereditary degenerative diseases. The principles proposed by K. Kleist, as well as the method of analyzing clinical material, were later adopted and developed by K. Leonhard.
K. Leonhard nosologically divided schizophrenia into a group of progressive systemic forms - “systematic schizophrenia” and a group of periodic and phase-occurring psychoses. In the last group he included “non-systematic schizophrenia” and cycloid psychoses, which differ from progressive forms in the syndromic structure of attacks and course. In “non-systematic schizophrenia” (affectively intense paraphrenia and periodic catatonia), the course of the disease is paroxysmal. As for cycloid psychoses, K. Leonhard included three forms of psychoses in this group: “happiness-fear” psychoses, confusion with excitation or inhibition, and hyperesthetic-anesthetic psychosis. He noted that with all three forms of cycloid psychoses, catatonic, affective-delusional and hallucinatory disorders can occur. Therefore, when distinguishing between them, the relative predominance of affective disturbances, confusion or motor disorders is important. The course of cycloid psychoses in most cases is favorable in the form of attacks with deep remissions. In his work “Pathogenesis of schizophrenia from the point of view of final states” (1971), K. Leongard substantiates the division of schizophrenia into “systematic”, “non-systematic” and cycloid psychoses with data from pathopsychology, genetics, biochemistry and neuroanatomy. Referring to the genetics of schizophrenia, he wrote: “Non-systemic forms of schizophrenia in general show a greater influence of heredity than systemic ones...”, and further: “... hereditary predisposition only gives schizophrenia in those cases in which at the same time there is a certain personality type... ".
Thus, K. Leonhard made an attempt, along with the two main psychoses that traditionally existed since the time of E. Kraepelin - schizophrenia and manic-depressive psychosis, to identify a third disease - cycloid psychoses. It should be noted that K. Leonhard’s classification was criticized during his lifetime and did not receive support. He himself was sensitive to such criticism, especially to the contrast between his proposed classification and the American taxonomy (DSM - Diagnostic and Statistical Manual of Mental Disorders) and the then existing versions of the ICD (ICD - International Classification of Diseases). He promptly and reasonably drew attention to the excessively schematic nature of American taxonomy. Currently, in connection with the identification of schizoaffective psychosis in some national classifications and in ICD-10, the classification of cycloid psychoses proposed by K. Leonhard looks quite adequate to modern views on the problem under consideration.
Despite the criticism that often fell on his works, K. Leonhard was not deprived of the attention of the world scientific community. He was an honorary member of international and national scientific societies, including the All-Union Scientific Society of Neuropathologists and Psychiatrists.
An understanding of K. Leonhard's work on schizophrenia would be incomplete without mentioning his views on childhood schizophrenia. Recognizing a number of features of childhood schizophrenia (the presence of intellectual development disorders, a certain selectivity of its forms and syndromes), he argued for the possibility of making a diagnosis of schizophrenia in childhood. At the same time, he emphasized that in children it is possible to identify some forms and syndromes similar to those in adult patients. He considered the most typical form of childhood schizophrenia to be catatonic and described its variants as “parakinetic-catatonic” and “form with poor speech.” On the other hand, he noted the absence of paranoid and hebephrenic forms in childhood and the appearance of periodic catatonia only in older children. In general, he considered childhood schizophrenia to be a very rare disease, emphasizing that such a diagnosis “can be made with confidence only when syndromes corresponding to a certain form of adult schizophrenia are detected.”
K. Leonhard's contribution to the classification of mood disorders is generally recognized. In 1957, he first raised the question of differentiating depression, which occurs without manic and hypomanic episodes, and bipolar affective disorders. Much later, in different countries and independently of each other, this was done by J. Angst (1966), C. Perris (1966) and G. Winokur (1969).
Psychiatrists - contemporaries of K. Leonhard paid insufficient attention to his contribution to the doctrine of neuroses, although he can be considered one of the founders of behavioral therapy.
During the period of his active work, K. Leongard maintained the closest ties with domestic psychiatrists and took an active part in congresses and conferences held in our country. He knew quite well, as we have already noted, Russian-language psychiatric literature, as evidenced by his citing in his works many domestic authors (A. D. Zurabashvili, N. I. Ozeretsky, E. A. Popov, T. P. Simson, G. E. Sukhareva and others). A number of his works were published in Russian.
It is interesting that in the eponymous dictionary of many psychiatric terms, the reference word, i.e., eponym, is the surname of K. Leonhard, whose name is part of the corresponding term. Currently, the following eponymous terms are distinguished with the inclusion of his surname:
Leonard taxonomy of schizophrenia(K. Leonhard, 1957). There are systematic (typical) and non-systematic (atypical) forms. Non-systematic ones are close to cycloid psychoses. K. Leonhard considers the general name of schizophrenia for systematic and non-systematic forms only as a tribute to tradition. Systematic forms include systematic paraphrenia, hebephrenia and catatonia. They are characterized by a slow onset, specific symptoms and course with the formation of a specific defect. Systematic forms can be simple or combined. Non-systematic forms are affective paraphrenia, schizophasia and periodic catatonia. They occur in a remitting, fur-like manner, and defective changes are less pronounced. With affective paraphrenia, along with delusions of grandeur and persecution, affective disorders are noted in the form of states of ecstasy, fear and irritability. Schizophasia, according to K. Leonhard, does not correspond to the understanding of E. Kraepelin, its boundaries are expanded, it comes close, on the one hand, to the psychoses of confusion and fear-happiness, on the other, to periodic catatonia. In the foreground with schizophasia, disorders of thinking and speech appear, but catatonic and paraphrenic symptoms can also be observed.
Leonard's taxonomy of phase psychoses(K. Leonhard, 1957) includes three groups of them:
1) classic manic-depressive illness (corresponds to the concept of circular forms by other authors);
2) pure melancholy and pure mania (periodic monopolar course, the clinical picture is cleaner and free from atypical, mixed forms);
3) pure depression and euphoria (the so-called simple affective diseases, in contrast to the diseases of the previous groups, which are characterized by disturbances in thinking and the volitional sphere). There are five forms of pure depression (agitated-anxious, hypochondriacal, depression with ideas of self-blame, suspicious-distrustful and apathetic) and five forms of pure euphoria (unproductive, hypochondriacal, exalted, confabulatory, apathetic). With pure depression and euphoria, in contrast to pure melancholia and mania, disorders of thinking and the volitional sphere, if observed, are secondary in nature. This statement raises objections among some authors (E. Ya. Sternberg, 1950).
Leonard's taxonomy of cycloid psychoses(K. Leonhard, 1957). Cycloid psychoses are considered as a group of atypical endogenous diseases that occupy an intermediate position between manic-depressive psychosis and schizophrenia, but are not related to these psychoses. Characterized by a relatively favorable course, without the formation of a mental defect. The course is paroxysmal, bipolar. There are three forms of cycloid psychoses: 1) motor with hyperkinetic and akinetic phases; 2) psychosis of confusion, excited and inhibited; 3) fear-happiness psychosis with alternating phases of depression with fear and “ecstatic happiness”.
Leonard phase depression(K. Leonhard, 1954) - a variant of endogenous depression, which differs from the typical circular depression in the absence of manic states in these patients, a later onset (usually after 40 years), a longer duration of the phase (6–9 months), significant severity of anxiety and, often , agitation. The use of lithium preparations for prophylactic purposes is characterized by low effectiveness. The question of the nosological independence of the mentioned depression remains debatable.
Leonhard fantasyophrenia(K. Leonhard, 1936) - one of the clinical variants of paranoid defect schizophrenia, characterized by senestopathies, paramnesias, delusions of grandeur, and impaired identification of those around the patient. Leonhard, fantasyophrenia, along with the hypochondriacal and verbal defects of hallucinosis that he distinguishes, belongs to the “ideologically rich” forms of schizophrenic defect, in contrast to such “ideologically poor” forms as, for example, incoherent defect-schizophrenia or autistic schizophrenia. The main difference is the predominance of productive or negative symptoms.
Leonhard proskynesia(K. Leonhard, 1936) - a symptom of catatonia, which consists in the fact that any external irritation causes a motor reaction. The opposite of the symptom of negativism.
Leonard's neuroses of desire and fear(K. Leonhard, 1963) differ in their psychogenesis. With the former, we are talking about the desirability of the disease (hysterical neuroses), with the latter, neurotic development arises in connection with fears (obsessive-compulsive neurosis, stuttering logoneurosis).
Leonard's concept of accentuated personalities(K. Leonhard, 1964, 1968). Individual personality traits (accentuated) are identified, which in themselves are not yet pathological, but under certain conditions they can undergo development in a positive and negative direction, reaching particular severity in psychopaths and neurotics. These traits seem to be a sharpening of some unique individual properties inherent in each person. Accented personalities are an intermediate phenomenon between normality and psychopathy. The accentuations of personality and temperament differ. There are ten types of accentuation of character and personality: hyperthymicity, tendency to get stuck in affect, emotiveness, pedantry, anxiety, cyclothymicity, demonstrativeness, excitability, dysthymicity (subdepressiveness), tendency to affective exaltation. In pathology, demonstrativeness corresponds to hysterical psychopathy, pedantry - anankastic psychopathy, a tendency to get stuck - paranoid psychopathy and excitability - epileptoid psychopathy. Combined accentuations of various personal characteristics, including intro- and extraversion, were noted.
V. M. Bleicher (1981) rightly emphasized that any new research in the field of borderline psychiatry acquires a peculiar interest not only in the cognitive-clinical aspect, but also in comparison with the works of this kind that we already have and, first of all, with the classical the work of P. B. Gannushkin “Clinic of psychopathy, their statics, dynamics and systematics” (1933).
A comparison of the views of P. B. Gannushkin and K. Leonhard on issues of borderline psychiatry could serve as the subject of a special study. It is worth dwelling only on a few of the theses of P. B. Gannushkin, which echo the provisions of K. Leonhard. This is, firstly, the position that a psychopathic personality with all its characteristics cannot be considered as given at the moment of birth and not changing throughout life; secondly, an indication of the rarity of psychopathy of the same type and the high frequency of transitional, mixed forms, characterized by extreme polymorphism of manifestations and a richness of shades; thirdly, emphasizing in the dynamics of psychopathy the importance of the quantitative side of their study, i.e., determining the degree of psychopathy.
P.B. Gannushkin pointed out that when quantitatively assessing the dynamics of psychopathy, we can talk not only about the intensity of the entire clinical picture as a whole, but also in some cases about the protrusion of individual psychopathic traits, features that depend on external conditions. In this regard, P.B. Gannushkin put forward the concept of latent, or compensated, psychopathy. He saw the difference between them and clinical overt psychopathy in the life manifestation of the latter, i.e., in the syndrome that in modern psychiatry is designated as social maladjustment.
The book by P. B. Gannushkin is dedicated to the clinic of psychopathy, in it the manifestations of latent psychopathy, which are nothing more than a manifestation of personality accentuation in the understanding of K. Leonhard, are subjected to a special study.
After his retirement, K. Leonhard continued his clinical psychiatric research and, almost until his death, regularly traveled to various hospitals to consult patients and carry out follow-up examinations of patients, many of whom he observed throughout his life.
He characterized himself as an introverted and anankastic person. He considered it unnecessary to appear in “hot spots” and speak out on “any issue.” With the greatest modesty, I tried to avoid any honors. Everyone who knew him always noted this modesty, as well as his friendliness and respectful attitude towards the sick and others. After the death of K. Leonhard in 1988, a research forum was created called the “International Wernicke-Kleist-Leonhard Society”, the chairman of which was K. Leonhard’s student and follower, Professor H. Beckmann.
H. Beckmann recalls: “One of the evenings that we spent together with K. Leonhard, he noticed that despite my great age, I have no fear of death. It seems to me that there is a certain pattern in the fact that as a person gets older and gets closer to death, he is less afraid of it than in his younger years. The will to live, which increases due to the fear of death, becomes aimless as we age. Apparently, nature has adapted to this. So fearlessly he died a little later.”
K. Leonhard's legacy is enormous, and his ideas are inexhaustible, original and still relevant. The bibliography of his works includes many scientific works. The following main publications belong to his pen: “On the diagnosis of schizophrenia in childhood” (1963), “On the course of childhood schizophrenia” (1964), “The genesis of schizophrenia from the point of view of final states” (1970), “Pathogenesis of schizophrenia from the point of view of final states "(1971), "Zur Frage der organischen Grundlage bei Schizophrenien" (1974), "Accentuated Personalities" (1981, 1982), "Die defectschizophrenen Krankheitsbilder" (1936), "Involutive und ideopathische Angstdepression in Klinik und Erblichkeit" (1937) , “Die Gesetze des normalen Träumens” (1939), “Grundlagen der Psychiatrie” (1948), “Ausdruckssprache der Seele” (1949), “Gesetze und Sinn des Träumens” (1951), “Grundlagen der Neurologie” (1951), "Aufteilung der endogenen Psychosen" (1957, 1968, 1980), "Individualtherapy in der Prophylaxe der hysterischen, an-ankastischen und sensohypochondrischen Psychosen" (1959), "Die atypische Psychosen und Kleist lehre von der endogenen Psychosen" (1960), " Kinderneurosen und Kinderpersonlichkeiten" (1963), "Prognostische Diagnostik der endogenen Psychosen (mit Sieglinde von Trostorff)" (1964), "Differenzierte Diagnostik der endogenen Psychosen, abnormen Personlichkeitsstrukturen und neurotischen Entwicklungen" (1964), "Instinkte und Urinstinkte in der men schlichen Sexualität "(1964), "Normale und abnorme Persönlichkeiten" (1964), "Die klinische Lokalisation der Hirntumoren in der Kritik der technischen, bioptischen und autoptischen Nachprüfung" (1965), "Biologische Psychologie" (1966), "Der menschliche Ausdruck" ( 1968), “Akzentuierte Persönlichkeiten” (1968), “Biopsychologie der endogenous Psychosen” (1970), “Zum Problem der Nosologie im Bereich der endogenous Psychosen” (1972), “The classification of Endogenous Psychosen” (1979), “Individualtherapy der Neurosen" (1981), "Bedeutende Persönlichkeiten in ihren psychischen Krankheiten" (1988) and others.
It must be emphasized that the concept of accentuated personalities developed by K. Leonhard allows a wide range of readers to gain an in-depth understanding of the nature of the human personality. It allows us to study the role of personality accentuation in the genesis of neuroses, psychopathy and psychosomatic diseases (peptic ulcer of the stomach and duodenum, bronchial asthma, coronary heart disease).
It should be noted that the concept of personality accentuation was used by A.E. Lichko and his colleagues when studying the character of adolescents, especially deviations in their behavior.
In K. Leonhard’s book “Accentuated Personalities,” specialists find exceptionally subtle clinical descriptions of accentuated personalities, get acquainted with the analysis of complex and highly practical cases of combined accentuations, trace the dynamics of personality accentuation both in the direction of psychopathy and in the positive direction that does not lead to phenomena social maladjustment. This book provides an opportunity to penetrate into the research laboratory of K. Leonhard, in which observation (observation) and clinical psychological research are in the foreground, which the author values above any questionnaires or surveys.
V. M. Bleicher, who had the opportunity to communicate closely with Professor K. Leonhard for 10 days in January 1988, recalls with great respect that once, speaking about his research, he said the words: “my psychiatry.” I thought that he had every reason for this: there is not a single section of psychiatry that K. Leonhard has not illuminated in his own way and has not enriched with an original creative concept. He was a real clinical scientist who combined enormous theoretical knowledge of the subject with the ability to examine the patient and analyze the course of the disease.
I attended his clinical discussions. I think that these analyzes themselves, and they were recorded in detail, almost stenographically, by Professor K. Leonhard’s long-term employee Z. von Trostorff (readers of his books know her from numerous references to her works and the clinical observations cited to illustrate the main points), could constitute a very interesting book. A book that would teach psychiatrists how to examine a patient, study the course of his illness, conduct differential diagnostics, and establish a final diagnosis. A book that would teach psychiatric prognostication.
K. Leonhard looked at each patient for at least an hour, without revealing fatigue and without losing interest in the patient’s personality. The patients whom he saw again perceived him as a person close to them, who knew everything about them and remembered everything. I was struck by the subtlety, I would say the sophistication, of the clinical diagnostic method. I observed Professor K. Leonhard interacting with his young colleagues at the Charité psychiatric clinic, which he directed for many years, and at the central Berlin psychiatric hospital. V. Griesinger - their attitude towards him was determined not by the difference in age: it was the authority of the Teacher, in him one could feel the respect that K. Leonhard himself felt for his teacher - Karl Kleist.
K. Leonhard was not a person who closed himself off in his high professional competence. He showed a deep interest in public life and was a great connoisseur of art. However, the reader can easily be convinced of the latter by reading the second part of the book “Accented Personalities.” I was especially pleased to see how deeply K. Leongard knew and highly appreciated the works of F. M. Dostoevsky, L. N. Tolstoy, A. P. Chekhov. Undoubtedly, Professor V.M. Bleicher emphasized, this book is of great interest not only for specialists involved in psychiatry and related sciences, but also for students of medical and pedagogical institutes, all interested in the problem of personality psychology.
Thus, Professor K. Leonhard made a significant scientific contribution to the development of not only German, but also world psychiatry, neurology and psychology, enriching it with major achievements. His high integrity as a citizen and scientist, breadth of scientific interests and originality of thinking, conscientiousness and perseverance in work are the best example for young people who decided to devote themselves to science. Without a doubt, the creative biography and scientific achievements of K. Leonhard are of great interest for domestic and world science and require further careful research, especially his creative collaboration with our domestic psychiatrists and specialized scientific institutions.
Literature
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- Sapozhnikova I. Ya. Karl Leonhard (on the 100th anniversary of his birth) [Electronic resource]. - Access mode: http://www.mediasphera.ru/journals/korsakov/detail/112/1268.
- Bleikher V. M. Preface // Leongard K. Accentuated personalities / Trans. with him. - Kyiv: Vishcha School, 1981. - P. 5–6.
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