Homoeopathy and personality disorders

Dr Mayuri Trivedi, M.D.(Hom) N.I.H., KOLKATA

Abstract: Personality stands for the true self or soul of the individual. It covers the whole nature of an individual. Psychology regards personality as a dynamic character of the individual which finds expression through his conduct and activities. 

Keywords: Personality, Temperament, constitution, Personality disorders, Neurosis, Psychosis, Intrinsic factors, Environmental factors, Introvert, Extrovert,  predominant Miasm.

INTRODUCTION
Personality refers to individual differences in characteristic patterns of thinking, feeling and behaving.

The term temperament refers to the emotional aspects of personality, namely the persons enduring emotional disposition. For example, a person may be anxious, pessimistic or cheerful in temperaments. In the time of Hippocrates & Galen four temperaments were described corresponding to the four humours- blood, black bile, yellow bile & phlegm and  we still use terms derived from this concepts, e.g. sanguine, melancholy, choleric,  phlegmatic, etc. Very many classifications of personality have been proposed in modern times, e.g. Introvert & Extrovert types of Jung, Schizothymic & Cyclothymic types of Kretschmer.

DEFINITION:
In psychology the term personality refers to the sum total of a person’s psychological & physical characteristics which make him a unique person. The term personality embraces his behavioural tendencies, his intellectual qualities & his emotional disposition.

DETERMINANTS OF PERSONALITY:   

Personality is the product of the interaction of genetic constitutional (intrinsic) factors & the environmental (extrinsic) factors.

1. INTRINSIC FACTORS

1. Genetic factors– Genetic studies in animals & the human have shown that certain emotional & automatic characteristics are inherited. What the individual gets at birth from his ancestors is a great factor of personality. The hereditary factors are those that reside in the child from the moment of conception. 

    The closer similarity in personality is seen between siblings than between unrelated persons. The correlation found in identical twins in personality attributes testify the importance of heredity. 

2. Constitution– It denotes the sum total of an individual’s morphological, physiological & psychological characteristics determined mainly by heredity.

               Physical constitution- There is a relationship between mental & moral qualities & physical attributes has been held from ancient times.

              Various types of physique are held to be correlated with personality. In 1922 Kretschmer described the following types of body fluid:

1. ASTHENIC OR LEPTOSOMATIC characterized by narrow & shallow thorax with narrow subcostal angle. The limb are long & slender neck  with  a prominent ad’s apple. They tends to be associated with shyness, seclusivness & self-centerdness.
2. PYKNIC type is characterized by large body cavities, relatively short limbs   & large subcostal angle with rounded head & short, fat neck. They are associated with an outgoing, frank, sociable & extroverted personality with a tendency for recurrent changes in mood from depression to elation (excited).
3. ATHLEIC type has wide shoulders & narrow hips with well developed bones & muscles.

Sheldon of U S A, given three types of variations in physique – Endomorphy, Mesomorphy & Ectomorphy.

CORRELATION BETWEEN VARIOUS PHYSICAL TYPES, PERSONALITY & VARIOUS DISEASES

Typology	Hippocrates:	Habitus Pthisicus	Habitus Apoplecticus
	Kretschmer:	Leptosomatic	Pyknic
	Sheldon:	Ectomorph	Endomorph
Personality characteristics		Introvert More persevering Inhibition, anxiety Depressive tendencies Quicker tempo	Extrovert Less persevering Sociability Cheerful emotions Slower tempo
Neurosis		Anxiety Reactive depression	Hysteria
Psychosis		Schizophrenia	Manic depressive psychosis
Physical diseases		Duodenal ulcer Cardiac Neurosis (effort syndrome) Pulmonary tuberculosis.	Gall bladder diseases Coronary diseases Arterial diseases

3. ENDOCRINE GLANDS: Glandular secretion determines personality. Over activity of the thyroid gland makes the person over-active, restless, tense & anxious; personal tempo is increased, there is a general alertness & a quick response to stimuli.

When the thyroid functions inadequately we get the apathy & inertia found in myxoedema, the person is slow & lacking in energy & inactive & he finds everything too much trouble. His skin is dry & his hair tends to fall out.

Similarly, female sex hormones influence mood & interests. When the oestrogen level in the blood is high, women tend to more active & restless, whereas high progesterone level is associated with a calmer & more receptive attitude.

2. ENVIRONMENTAL FACTORS

1. Family Influences: Mother & other family members have the main role in determining the child’s behaviour & reactions. The first five years of life are the most important in moulding future personality & character. Normally, personality development in children requires:

1. Adequate affection & love.
2. Security.
3. Consistency in relationships.
4. Proper balance between stimulus & outlet.

If the family unit is happy & stable & their child is accepted, loved & brought up with consistency then he will have favourable conditions for his personality development & future adjustment to society will be helped.

Over protection tends to give rise to timidity & delay in emotional development. Rejection produces a variety of reaction from apathy to resentment & aggression.

Maladjustment & delinquency are sometimes traceable to faulty homes & parental attitude. Similarly, attitude to brothers & sisters, jealousy & undue rivalry can influence the personality of the child.

2. School & community influences: It affects the development of character by education & interpersonal relationships.

3. Experiences in early life can play an important role in determining personality. If the child is deprived of his mother or a satisfactory substitute at an early age, or has not the advantage of a stable family background, he will be at a disadvantage in personality growth & development.

4. Reaction to disability:  The person’s reaction to a disability varies; some reactions are favourable, others are not salutary.

A person can react to the disability such as paralysis of one or more limbs in the following possible ways:

1. He can accept the disability & try to compensate for his deficiencies in a way which helps his happiness & adjustment. This method is the most satisfactory.
2. He may use his disability to avoid taking his proper role in life & and to avoid responsibility. He succumbs to the disability & uses it as an excuse for his short coming or failures.
3. He may over-compensate for his disability in an undesirable way such as becoming unduly aggressive, competitive or hostile, or by becoming spiteful & trying to elevate himself by running other people down. He may become shy & spiteful & jealous & become morbid in his personality in this way.

5. Social-cultural influences: This play a very important part in determining the characteristics of a race or nation & individual personality differences.

PERSONALITY DISORDER
This is chronic maladaptive, inflexible, recognisable patterns of behaviour whereby individual always behave in an exaggerated, unusual or abnormal way, even in absence of stressful events. An individual with a disordered personality may or may not experience discrete episodes of psychiatric illness. But they increase an individual’s vulnerability to particular disease.

TYPES OF PERSONALITY DISORDER

TYPE A personality- 

• Impatient.
• Sense of urgency.
• Competitive.
• Exaggerated need for achievement.
• Fear of failure.
• Does not like to be slowed down.
•  Prone to develop- Hypertension, Coronary artery disease, Peptic ulcer syndrome
• Predominant miasm- Psora-sycotic
• Medicine having very close similarity- Arsenic album, Nux vomica.

ANXIOUS  personality- 

• Worrying over trivial things.
•  Highly strung, irritable, restless, tense.
• Constant anticipation of setback & stress.
• Prone to develop- Neurotic & Psychomatic Disorders.
• Predominant miasm- Psora-sycotic
• Medicine having very close similarity- Arg-nit, Gels.

HYPOMANIC personality-

• Happy go lucky type.
• Talkative, often a chatterbox.
• Extrovert, friendly, sociable.
• Energetic, pleasure loving.
• Judgement is often superficial.
• Cannot subordinate him.
• Predominant miasm- Psora-sycotic
• Medicine having very close similarity- Cann ind,  Hyos.

AGGRESSIVE  personality-

• Explosive in nature.
• Sudden outburst of irritability and anger.
• Tends to demands for their right and fight for them.
•  Dominating; gets other people to do what he wants by frightening them.
•  Treat people under his control (child, student, patient, prisoner etc) harshly.
• Predominant miasm- Psora-sycotic
• Medicine having very close similarity- Nux vom, Staph.

ANAKASTIC (OBSESSIVE-COMPULSIVE)   personality-

•  Inflexible, Rigid, Perfectionist.
•  Sets for himself very high ethical standards.
•  Wants everything neat & clean & in Order.
•  Needs To Check Everything Repeatedly.
•  Indecisive, Tendency to Doubt.
• Overcautious.
• An unreasonable insistence to others to do things his way.
• Predominant miasm- Psora-sycotic
• Medicine having very close similarity- Ars.alb.

HISTRIONIC personality-

• Inappropriate exaggerated display of emotions & behaviour.
• Emotions are vivid, shallow, unstable, characterised by vain.
• Demands attention.
• Exhibitionistic, dramatising.
• Prone to develop- conversion reaction.
• Predominant miasm- Psora-sycotic.
• Medicine having very close similarity- Ign.

MELANCHOLIC  personality-

• Pessimistic, submissive.
• Feeling of hopelessness.
• Depressed, sad, gloomy.
• Inclined to be lonely & solemn.
• Prone to develop- endogenous depression.
• Predominant miasm- Psora-syphilitic.
• Medicine having very close similarity-Aur-met, Nat-mur.

CYCLOTHYMIC  personality-

• Alternating fluctuating moods.
•  At one time, he is bright, gay & optimistic, Then suddenly bursts into tears & the outlook is dismal, gloomy & grim with passim But after a moment is as cheerful as ever.
• Prone to develop- manic depressive psychosis.
• Predominant miasm- Psora-sycotic.
•  Medicine having very close similarity- Ign,  Nux mosh.

PARANOID  personality-

• Pervasive and Unwarranted Suspiciousness of others                
• The tendency to misinterpret friendly actions of others as hostile & contemptuous.
•  During Illness-Develops persecutory symptoms.
•  Readily misinterprets medical advice.
•  Becomes critical about treatment given.
• Predominant miasm- Sycotic.
• Medicine having very close similarity- Anac.occ, Hyos.

SCHIZOID ( SCHIZOTHYMIC)  personality-

• Lack of spontaneity, appear dull, indifferent & indolent.
• Quiet, doesn’t talk much.
• Shy, timid, introvert, reserved, does not make intimate interpersonal contacts & friendships.
• Solitary interests and hobbies.
• In severe cases, retreats into world of fantasy.
• Neglect of personal appearance, family & home.
• Predominant miasm- Psora.
• Medicine having very close similarity- Sul.

INADEQUATE personality-

• Lacks self-confidence.
• Lacks self-esteem.
• Judgement is defective.
• In spite of average educational & other opportunities, and of normal intelligence, he fails in emotional, economic, occupational & social adjustments.
• Exaggeration of risks & dangers in everyday life.
• Reserved in social situations because of fear of saying something inappropriate or foolish. Being unable to answer a question.
• Predominant miasm- Psora-sycotic-syphilitic.
• Medicine having very close similarity- Lyco.

DISSOCIAL ( PSYCHOPATHIC ) personality-

• Nonconformist to social norms with respect to lawful behaviours.
• Antisocial traits before age of 15: Lying, stealing, frequent fighting, cruelty to animals, truancy from school, substance abuse.
• Lacks feelings of shame, guilty, remorse.
• Family- frequent fights with partner, even to physical assault.
• Frequent divorce.
• Frequently drifts into alcoholism & drug addiction.
• Predominant miasm- Sycotic.
• Medicine having very close similarity- Thuja.

NARCISSISTIC personality-

• Grandiose sense of self importance.
• Preoccupied with fantasies of unlimited success, power, beauty, & and fame.
• Exaggerates achievements & talents.
• Expects to be noticed as special.
• Keeps fishing for admiration.
• Arrogant & haughty.
• Lack of empathy.
• Predominant miasm- Sycotic.
• Medicine having very close similarity- Palladium, Platina.

PASSIVE- DEPENDENT personality-

• Lacks of mature self confidence & self reliance.
• Falls passively with wishes of others.
• Requires constant approval & reassurance from others.
• Inability to function independently.
• Predominant miasm-  Psora-syphilitic.
• Medicine having very close similarity- Puls.

PASSIVE- AGGRESSIVE personality-

• Works poorly with others & causes demoralising effect on group.
• Becomes sulky, irritable or argumentative when asked to do something, he does not want to do.
• Avoids obligations & suggestions from others regarding improving himself.
• Predominant miasm-  Psora-sycotic.
• Medicine having very close similarity- Staph.

Conclusion- The personality of the patient is at least as important as the physical characteristics in individualising the case and finding the similimum. Personality disorders is not so easy task to manage. Warmth and acceptance are the two most important characteristics of the child parent relationship. Sympathetic friends, teachers and considerate parents among others can also help the adult out of his difficulties. Self acceptance or the recognition of his own imperfections helps to live in peace with himself. A constitutional remedy which covers the totality of a patient’s mental and physical characteristics should be prescribed. Role of psychotherapy is beneficial.

BIBLIOGRAPHY

• Ahuja N.; A short text book of Psychiatry; Seventh edition 2011; Jaypee Brothers Medical Publishers(P) LTD.
• ALLEN H.C.; KEYNOTES  rearranged and classified with leading remedies of the Materia Medica and bowel  Nosodes: 10th edition; B. Jain Publishers Pvt. Ltd., New Delhi-110 055                                  
• Bailey P. M; Homeopathic Psychology, First Indian Edition, 2002 ; B. Jain Publishers Pvt Ltd, New Delhi- 110055.
• Bhattacharyya P.N.; A Text book of Psychology, Part One, Fourth edition, 1986; A. Mukherjee & Co. Private Ltd, Calcutta- 700073.
• Boericke W. ; Pocket manual of homoeopathic Materia medica & repertory  ;student edition2004;   B. Jain Publishers Pvt. Ltd., New Delhi-110 055                                  
• Chauhan V. K.; Homoeopathic principle and practice of medicine; reprint edition 2008;  B. Jain Publishers Pvt. Ltd., New Delhi-110055                                  
• Choudhuri N. M.; A study on Materia Medica; B. Jain Publishers Pvt. Ltd., New Delhi-110 055 
• Rees Linford W. L.; A short text book of Psychiatry; Third edition, reprint 1986; Richard clay (the Chaucer press) Ltd, Bungay, Suffolk.