WAPLT? 6: Historical Antecedents

Millon’s personality theory is not the first to have been developed. In his book Disorders of Personality, Millon provides an overview of the various historical strands that led to the development of his model. While this overview is not comprehensive, I will be using it as a guide for this post.

Hippocrates’ humoural theory of personality is one of the oldest known, and it exhibits several properties that have recurred throughout history. Based on the biology of his time, Hippocrates believed that the liver, gallbladder, spleen, and lungs produced blood, yellow bile, black bile, and mucous, respectively. He hypothesized that the balance of these fluids in the body determined one’s personality. This classification system has taken on many forms over the years, partly because each personality type also corresponds to one of the four elements. This table presents a chronology of its uses:

Table of Hippocrates’ Four Humours

Image from Hippocrates, Galen & The Four Humours

The classification system based on Hippocrates’ humoural theory has been utilized to model various phenomena, including personality, temperament, sources of happiness, and value attitudes, as shown in the table. Its longevity and persistent use suggest that it is worth examining. In our personality model, if we can explain these four types using the fundamental strategies of living beings, it would make sense that they can be applied in various contexts. The combination and recombination of these basic functions and structures give rise to similarities in form across different dimensions of functioning.

In the early 20th century, several European theorists developed models for evaluating character, among them the Dutch psychologists Heymans and Wiersma in 1906-1909. Through a series of empirical studies, they identified three criteria for evaluating character: activity level, emotionality, and susceptibility to external versus internal stimulation. This threefold schema anticipated similar models developed by McDougall, Meumann, Freud, and Millon, each with their own theoretical approach. Heymans and Wiersma combined these criteria and identified eight character types, a classification system that influenced later personality theories such as Millon’s.

I organize their character types into the following table.

Table of G. Heymans and E. Wiersma’s Character Types
Low Activity/PassiveHigh Activity
Low EmotionalityHigh EmotionalityLow EmotionalityHigh Emotionality
External orientationInternal orientationExternal orientationInternal orientationExternal orientationInternal orientationExternal orientationInternal orientation

We turn now to the contemporary schools of thought on personality: 

Millon acknowledges that despite the decline in the status and centrality of psychoanalysis over the past few decades, it has remained highly productive and insightful, especially through the contributions of ego-analytic theorists and the British object-relations school. According to Millon, many of the most innovative and illuminating papers and books on the personality disorders have originated in psychoanalytic foundations. He further highlights the significance of proposals from contemporary thinkers, each of whom has helped enhance our understanding of these disorders.

Otto Fenichel categorizes character traits into sublimation and reactive types, acknowledging that instinctual energy can develop into character forms that are free of conflict resolution. Similarly, Hartmann (1958), Rapaport (1958), and Erikson (1950) recognize that the origins of character may be found in instinctual energies independent of conflicts and their resolutions. According to them, the ego and id instincts are derived from a common biological matrix that differentiates into separate energies for adaptive functioning. They refer to these ego potentials as “autonomous apparatuses” that are pre-adapted to handle typical environments.

Klein (1948) posits that fantasy is a significant primitive ability that exhibits a developmental sequence reflecting the infant’s relationship with the mother. On her object-relations theory, the mind is composed of “preformed internal representations of the infant’s external relationships,” indicating that the mind possesses innate fantasies, which shape the child’s unlearned knowledge.

Kernberg developed a framework that organizes character types by level of severity and proposed a dimension of structural organization as primary. He coordinated character types based on severity and structural organization, leading to the classification of “higher, intermediate, and lower levels” of character pathology. The intermediate and lower levels are referred to as borderline personality organizations. For instance, Kernberg places hysterical, obsessive-compulsive, and depressive personalities in the higher level. He locates infantile and most narcissistic personalities in the intermediate level of organization. Finally, clear-cut antisocial personalities are classified as distinctly lower borderline organizations.

Factor and cluster analyses calculate intercorrelations among variables such as traits, behaviors, and symptoms. Millon notes that psychoanalysis remains productive and insightful, particularly through ego-analytic theorists and the British object-relations school. Many of the most innovative and illuminating papers and books on personality disorders originate from psychoanalytic foundations.

According to cognitivists, an individual’s perception of the world determines their behavior, even if their perception is unconsciously distorted. This stress on perception is unique to each individual. Interpersonal theories focus on the idea that personality is shaped by recurring interpersonal tendencies that create patterns of behavior, thought, and feeling. McLemore and Brokaw (1987) argue that avoidant personality types adopt a consistent fearful and self-effacing approach towards an environment that fails to display the desired experiences of acceptance and intimacy. (Millon 2011 32)

In recent decades, the interpersonal perspective on personality and personality disorders has become a major direction of thought. While there are variations among theorists in the specific constructs and rationales employed, there is agreement that personality can best be understood in terms of recurrent interpersonal tendencies that shape and perpetuate styles of behavior, thought, and feeling. Those of the interpersonal point of view typically suggest that a circumplical structural model can serve best as a framework for organizing their fundamental dimensions. All share the view that there are maladaptive causal sequences between interpersonal perceptions, behavioral enactments, and psychosocial reactions. These interpersonal sequences are rigid and extreme, being activated regardless of their ultimate inappropriateness across numerous social situations. As instrumental styles of coping, these behaviors prove self-defeating in that they are adaptively inflexible and tend to perpetuate and foster difficulties rather than resolve them.

Personality research has long acknowledged the importance of considering multiple sources of data and diverse influences. However, few theorists have succeeded in creating an integrative model that locates personality disorders within a coherent framework. This is precisely where Millon’s model shines, as it starts with an integrative approach that considers the complex interplay of factors contributing to personality disorders. In my view, this is one of the defining strengths of Millon’s approach.

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