ASCAP July, 1996, 6-14
The
Expression of Hostility in Complementary Relationships
Change due to Depressed Mood
(Presented
to ISHE at Tutzing, Germany, in July, 1986)
Summary
A hypothesis relating depression to the
yielding component of ritual agonistic behaviour predicted that the expression
of hostility by depressed patients would depend on the relative rank of the
object of the hostility. A literature
review showed that relative rank was not a variable which had been considered
in the many studies on the expression of hostility by depressed patients. Therefore a study was made of 21 outpatients
who had developed a depressive episode since marriage. When rank relative to spouse was compared
with change in hostility expressed to spouse, there was a not significant
tendency for dominant spouses to express more hostility and subordinate spouses
to express less hostility than before the onset of the depressive episode.
Introduction
In the tradition of applying the methods and
data of comparative ethology to psychiatry (Feierman, 1987) we recently put
forward a hypothesis which related episodes of human depression to the yielding
component of ritual agonistic behaviour (Price and Sloman, 1987; Sloman and Price,
1987). According to this hypothesis the
biological function of the depressive episode, which has been responsible for
its selection during evolution, is to enable the individual to accept a
subordinate social rank. The depression
achieves this end in two different ways:
firstly, it inhibits the expression of hostility and aggression (or,
rather, what we have called catathetic or
"putting down" behaviour) towards higher ranking individuals; and, secondly, it signals low competitive
capacity, or Resource Holding Potential (Parker, 1974) on the part of the
depressed individual towards those of higher rank, so that the latter are
reassured that the depressed individual is not a threat to them, whereupon they
desist from lowering the depressed person's Resource Holding Potential further,
and the social group is able to switch from the agonic to the hedonic mode
(Chance and Jolly, (1970) and get on with other matters which are important for
survival, such as generating resources and competing with other groups. Most of the features of depression, which
otherwise appears a totally maladaptive form of behaviour, can be accounted for
in this way (Price and Sloman, 1987).
The hypothesis is a subdivision of that of
One
prediction of the hypothesis is that, during an episode of depression,
expressed up-hierarchy aggression is reduced whereas expressed down-hierarchy
aggression may be increased. In this
paper we present briefly the derivation of the prediction from the hypothesis; then we look at the
literature to see whether existing studies on the expression of hostility in
depression can refute or confirm our prediction; then we describe a series of cases which were
studied from the point of view of the prediction; and finally we discuss the problems likely to
be encountered in making a more rigorous test of the hypothesis.
Derivation
of the prediction
The function of ritual agonistic behaviour is
to convert a symmetrical relationship between two individuals into a
relationship which is complementary for agonistic behaviour, one becoming
dominant or higher-ranking and the other becoming subordinate or
lower-ranking. In the terminology of
Gregory Bateson and his colleagues in
The
allocation of roles between Definer and Acceptor may occur without argument at
the beginning of a relationship, as when a protege
signs on with a mentor or when for any other reason there is an obvious
disparity in rank between the two; or
the allocation may be the result of some sort of mutual negotiation, such as a
fight.
In a
symmetrical relationship, an offered definition by one party elicits an
alternative definition from the other, just as attack elicits attack, so that
there tends to be an escalating level of hostility, as in an arms race, and the
relationship is unstable. In a
complementary relationship, an offered definition by the Definer elicits
acceptance of the definition from the Acceptor, just as attack by a dominant
elicits not attack but escape or submission from a subordinate; and a display of
acceptance by the Acceptor means that the Definer needs to define less, in the
way that a display of submission by a subordinate reduces the expression of
hostility by a dominant. Whereas in a
symmetrical relationship, a signal elicits "more of the same" from
the other, in a complementary relationship a signal elicits "less of the
same" or "something different" from the other,
and this makes it stable. The ability to
form complementary relationships is probably a necessary condition for living
in groups.
The
analysis of complementary relationships may be facilitated by the introduction
of a self-concept called Resource Holding Potential (RHP) as a hypothetical
construct used as an intervening variable in the calculations. RHP is a term derived from behavioural
ecology and is a measure of the fighting capacity which an individual can
mobilise to defend his resources (Parker, 1974). We have adapted this term for use in
psychology as an alternative to less well defined terms such as ego strength
and self confidence (Price and Sloman, 1987).
RHP consists of a substantive component such as material resources and
allies, and a ritual component which is conferred and taken away by others; it also has an
endogenous component which reflects mood.
Thus RHP can be lowered by loss of resources or allies, by receipt of
hostility from others, and by endogenous lowering of mood. The relation of the variables is such that
receipt of hostility (which is not returned in full measure) lowers RHP, and
lowering of RHP (beyond certain limits) triggers a depressive state, part of
which consists of a further lowering of RHP.
In systems terms the relation between RHP and depression is similar to
that between the value of a currency and devaluation. Outside scepticism of RHP (value) leads to
hostility (selling) by which RHP (value) is reduced from outside in a manner
which escalates to the end-point of depression (devaluation), in which RHP
(value) is reduced from within.
The
main "output" of RHP is reflected in the decision to attack or
flee/submit. This involves comparing
"own RHP" with "other's apparent RHP" to give
"relative RHP". To take the
simplest case, it may be obvious that "own RHP" is superior to
"other's RHP" in which case a judgement of "favourable relative
RHP" is made, and then (assuming the context is an agonistic one) the
individual attacks. If, on the other
hand, "own RHP" is clearly less than "other's RHP", a
decision of "unfavourable relative RHP" is made, and the individual
flees or submits. We can now define
relationships in terms of RHP. A
symmetrical relationship is one in which both parties make a judgement of
"favourable relative RHP" and
are therefore both oriented to attack, whereas in a complementary relationship
one of the two makes a judgement of "unfavourable relative RHP" and
is therefore oriented to flight or submission.
In a complementary relationship the Definer signals that he has made a
decision of "favourable relative RHP" by attacking, or offering a
definition (which are both "catathetic
signals"); whereas the Acceptor
signals that he has made a decision of "unfavourable relative RHP" by
submitting, or accepting the offered definition without argument (both of which
are "anathetic signals"). It is the perception of favourable relative
RHP, plus the evidence that the other has accepted the role of Acceptor, that
confirms the role of Definer, and enables the Definer to decide that the difference
in RHP is sufficient (i.e., the "confidence-gap" is large
enough). The Definer then stops
attacking (and any Definition statements are seen by both parties as redundant)
and the relationship can switch from the agonic to the hedonic mode through a
process of reconciliation.
An attempt at mathematical formulation
The difference between a symmetrical
relationship and a complementary relationship can be expressed, somewhat
crudely, in the following equations. In
a symmetrical relationship:
H1
= R1H2 + RHP1
H2
= R2H1 + RHP2
where H1 and H2
represent the amount of hostility expressed by the two individuals, R1
and R2 are constants which represent the retaliatory tendency of
each individual, and RHP1 and RHP2 represent relative
Resource Holding Potential (Price and Sloman, 1987) which roughly expresses the
degree to which each individual feels more powerful than the other. It can be seen that each individual's hostile
behaviour increases, the more he is attacked by the other and the more
confident he feels. The system escalates
until some change occurs in the equation, and the simplest change is a change
in the sign of the terms, to those we have suggested as the basis of the
complementary relationship. In a
complementary relationship:
HD
= RDHA - RHPD
HA
= RHPA - RAHD
where HD and HA
represent the hostility expressed by the Definer and Acceptor respectively,
etc. The Definer increases his expression of hostility if he is attacked, but
reduces it if he feels confident (the Acceptor then being no threat). In contrast, the Acceptor reduces his
expression of hostility if he is attacked, but increases it if he feels
confident enough to challenge the position of the Definer.
It can
be seen from these equations that a drop in RHP has the effect of increasing
the hostility expressed by the Definer to the Acceptor, whereas it reduces the
hostility expressed by the Acceptor to the Definer.
A less mathematical derivation
Paraphrasing the above, we can say that the
function of hostility is to create and maintain confidence gaps within
couples. If a husband is
"one-up" on his wife, he feels more confident than she looks, she
feels less confident than he looks. The
bigger the gap, the less hostility is shown.
If for some reason (such as the wife going into therapy, or the husband
getting a bad time from his boss) the confidence gap narrows and the husband
becomes insecure about his one-up position, he "puts her down", using
sarcasm or criticism, or possibly even verbal or physical abuse. If she sees him as less confident, or feels
more confident herself, she is likely to say to herself
"Why should I put up with that from him?" and she asserts herself by
"answering back". Then if the
husband feels more confident or he sees his wife as being depressed and lacking
in confidence, he has no need to put her down any further, the confidence gap
being sufficiently large, and he refrains from hostility. When he does criticise or abuse her, she lacks
the confidence to answer back. Thus, if depression occurs in the dominant
spouse the confidence gap is reduced and the hostility of the depressed spouse
increases; if
depression occurs in the subordinate spouse the confidence gap is increased and
the hostility of the depressed spouse is reduced. We can talk interchangeably of a
confidence-gap, an RHP-gap or a control-gap.
The gap is monitored by the Definer who ensures that it is sufficiently
large to ensure that he (or she) is comfortable.
Testing
the hypothesis
It follows from the above argument that, other
things being equal, when a (one up) Definer gets depressed his expressed
hostility to the (one down) Acceptor should increase, whereas when an Acceptor
gets depressed, his expressed hostility to the Definer should be reduced. Our first attempt to test this hypothesis
consisted of a review of previous studies of the relation between depression
and hostility.
Depression and hostility
The relation of hostility to depression has
been a subject of debate since Karl Abraham in 1911 formulated depression as
aggression turned inward against the self (Abraham, 1927). Early studies showed that aggression was
reduced in depressed patients, as might be predicted from Abraham's hypothesis. However, more recent studies have failed to
confirm these early findings, probably because the subjects were out-patients
with less severe forms of depression. In
fact, the relation between depression and aggression has been the subject of
considerable debate (Kendell, 1970).
Gottschalk et al. (1963) used verbal samples to generate
scales which measured "hostility inward", "hostility
outward" and "ambivalent hostility" (the last measured hostility
directed by others to the self); in a
series of psychiatric patients they found that ratings of depression showed a
low positive correlation with "hostility inward" and a low negative
correlation with "hostility outward".
Using the same scales, Gershon et al. (1968)
confirmed the correlation between depression and "hostility inward"
but found a zero correlation between depression and "hostility
outward". Fernando (1969) and
Millar (1983) used Foulds' Hostility and Direction of
Hostility Questionnaire (Caine et al., 1967) which is
mainly concerned with distinguishing between Hostility-In and Hostility-Out. Cochrane (1975)
used a projective test, the Object Relations Technique, in which the subject
identified both agent and victim of aggressive acts, but there was no measure
of their relative rank, or of their rank relative to the patient.
Weissman et al. (1971) compared a sample of depressed women
with a control sample and found no difference in overall "hostility
outward", but the depressed women showed more hostility to close relatives
and particularly to their children and less hostility to distant relatives; data for hostility to husbands were not
presented separately and dominance relations were not determined. Hooley at al.
(1986) confirmed work by Vaughn and Leff (1976) that
depressed patients were more likely to relapse if their spouses expressed
critical comments about them to the investigators, but again in neither study
were dominance relationships within the marriage considered.
In
studying communication between depressed patients and their spouses,
In
summary, apart from an increase of hostility to their children by Weissman and Paykel's depressed
women, we can find no evidence to bear on our hypothesis from published
data. This is because the studies
reported have not included as a variable the relative rank of the patient and
the object of the hostility.
A clinical test of the hypothesis
The relationship most available for the
psychiatrist to study is the marital relationship and therefore we formulated
the hypothesis in terms of the expression of hostility within marriage. It is almost folk knowledge that a man gets
depressed at work after receiving criticism from his boss and comes home and
takes it out on his wife. This is in
accord with ethological ideas on aggression redirected down the hierarchy, the
only difference being that the boss and the wife occur in different social
environments. However, aggression is not
redirected up the hierarchy, so what happens to the man who is subordinate to
his wife? Folk knowledge tells us that
he takes it out, not on his wife, but on the dog, the children, the furniture
or preferably the firewood. Our
hypothesis states: in those marriages in
which the husband and wife exist in a complementary relationship, the onset of
a depressive episode in the dominant spouse (the Definer) causes an increase of
expressed hostility to the marriage partner, whereas the onset of a depressive
episode in the subordinate spouse (the Acceptor) causes a reduction of
expressed hostility to the marriage partner.
Method
During a six month period one of us (JSP)
screened the patients referred to him by general practitioners and selected those
patients who were currently cohabiting (with the same partner for at least two
years) and who were undergoing a depressive episode whose onset post-dated the
commencement of cohabitation (regardless of the actual reason for referral).
These
patients were interviewed together with their spouses and separately and were
rated on the following two variables:
1.
Patient is: a. Definer b. symmetrical to spouse c. Acceptor.
2.
Expressed hostility to the spouse since the onset of the depressive
episode is: a. increased b. unchanged c. reduced.
The observations were made in a clinical
setting in the course of normal clinical work and therefore it was not possible
to make any assessment of the reliability of the measures used. Although there was more than usual
exploration of marital relationships and expression of hostility this was
within the range of normal history taking and was relevant to patient
management and therefore no informed consent was sought,
nor was permission obtained from the hospital ethical committee.
Results
Of 86 patients referred during the 6 month
period 22 did not keep the appointment and of the remaining 64, 28 were either
unmarried or had been cohabiting with the current partner for less than 2
years. Of the remaining 36 patients 21
were judged to be suffering from a depressive episode which had started since
the marriage. In four cases it was not
possible to interview the spouse, but these cases have been included. In only three cases was there no change in
hostility, and these were all accepting wives who showed no hostility to start
with; they have
been included in the "hostility reduced" column. The results for the twenty one couples are
given below:
hostility
increased hostility reduced
male female male female
Definer 2 1 0 1
Symmetrical 1 2 1 4
Acceptor 1 0 4 4
Combining the data for husbands and wives into
a 2 by 2 contingency table of Definer/Acceptor by hostility increased/hostility
not increased, the results just fail to support the hypothesis at the .05 level
of probability (chi square with correction for continuity = 2.73, p =
.0984; Fisher's exact test, p =
.0517).
The
results are subject to observer error in that the same person evaluated both
complementarity and hostility with full knowledge of the hypothesis. In addition, there is the problem of circularity
of reasoning because it is difficult not to take expressed hostility into
account when judging complementarity, and although the comparison of
complementarity applied to the situation before the onset of the depression,
whereas the change in hostility applied to the period after the onset of the
depression, in practice it was not always easy to discriminate between the two
time periods. We regard this very much
as a pilot study, in which the clinical details are likely to be more valuable
than the statistical result.
Clinical details
Of the two defining husbands whose hostility
was increased, one was referred because he had been charged with sexual abuse
of his step-daughter; he was a
primitive, chauvinistic man who treated his wife like a chattel and frequently
beat her up; he was depressed because of
unemployment due to physical disease;
the other came because his wife had threatened to leave him on account
of his violence to her which had made her terrified of him; he was depressed because his employer had
required him to do work which he considered too menial. These two cases accord with our previous
experience that men who take their depression out on their wives with physical
violence are not likely to come spontaneously for treatment.
One
defining husband had never shown any hostility to his wife and when he became
depressed he became less supportive in terms of praise, encouragement,
compliments and interest in her activities, but he did not express hostility.
The
defining wife whose hostility was increased appeared to be depressed because of
aggravation from her mother, to whom she related as Acceptor, and her hostility
to her husband presented as premenstrual irritability.
Three
of the accepting husbands whose hostility was reduced were depressed in
relation to work, and their behaviour at home was characterised by social
withdrawal. One spent most of his time
in bed, one retired to the garage and the other was described as "going
quiet". None of them had ever been
very assertive at home. The fourth had
been Definer in the early days of their marriage and had been violent to his
wife on many occasions in the context of morbid jealousy; three years ago they joined a sporting club
where, much to his horror, his wife excelled at the sport and was chosen for
the club team; the pain he suffered when
she went off to play mixed doubles in away matches was excruciating, but
instead of attacking her he resigned from the club, spent his spare time alone
at home, and soon became too depressed to go to work.
The
accepting wives whose hostility was reduced or absent were dominated creatures
who were stuck in unhappy marriages, constantly exposed to "angry,
controlling behaviour" as described by Hauck (1977).
The
accepting husband whose hostility was increased is of particular interest. He had married two dominant women and during
his marriage to the first wife she had a son by a man of different race. This son was now nine and although the racial
difference from his parents was obvious he had not been told about his
parentage. Although his second wife was
faithful and kind, he felt excluded by her close relationship with his
stepdaughters, and he was depressed because he had avoided approaching his
first wife to discuss how to break the difficult information to the son. As part of his depressive syndrome he started
having attacks of expressed hostility at home which he described as
follows: "Like when you're a kid,
you have a tantrum, you know you're not going to win.......You're on the roller
coaster, there's no way of stopping (thumps table with fist).......I take
myself away, hurt - I go outside."
His wife was frightened by these outbursts but she did not perceive them
as a threat to her dominant position in the family.
One accepting wife who was also bossed by her
mother and who had not expressed hostility was able, with the help of therapy,
to obtain a part time job where she formed a close relationship
with her female employer
who was going through a divorce. This lady
gave the patient a lot of support and self-confidence so that she was able to
stand up to her mother in a non-aggressive way and completely redefine the
basis of their relationship. Having done
this her depression of ten years duration cleared up and she decided to divorce
her husband and at the time of writing is living in a symmetrical relationship
with him until the house is sold. He is
bewildered by what has happened and hopes that she will soon "come to her
senses".
In
general, patients and spouses found it very difficult to give the details of a
hostile interaction. The episodes were
first described in such terms as "Then he lost his cool" and it often
took many questions to discover what actually happened or was said. The facts often seemed very banal in
comparison with the emotion accompanying the general description, and gave us
the impression that the subject had been affected by the ritual aspects of the
hostility rather than by the actual words or actions.
Assessment of Marital Asymmetry
Research studies
A lucid and detailed review by Gray-Little and
Burks (1983) emphasises the difficulty of measuring the power relationships in
a marriage. Three methods have been
used:
1.
Reporting of decision-making processes by the marital partners. Most studies divide the marriages into
husband-dominated, wife- dominated and egalitarian; some divide the third category into syncratic (in which decisions are made jointly) and
autonomic (in which some decisions are made by the husband and others by the
wife).
2.
Observations of couples performing tasks, or interacting in some other
way. The number of directive statements,
and the proportion obeyed, give a division into husband-led and wife-led
marriages.
3.
Assessment of relative resources, such as age, popularity, income and
capital, socioeconomic status of family of
origin.
As yet,
there is no valid instrument for assessing complementarity in a marriage. What is very much needed is a study which
will show a correlation between complementarity as assessed by self report
inventories and complementarity as assessed by direct observation of the couple
interacting together. A step towards
this might be a self report instrument which would show reliability between
husband and wife.
Clinical studies
Clinicians have found it possible to assess the
direction of complementarity in marriage and to distinguish complementarity
from symmetry. Lidz
et al. (1957) identified "marital skew" in which the husband was
subordinate to the wife, and they distinguished this from "marital
schism" in which the relationship was symmetrical and antagonistic; both these states
in the parents were associated with schizophrenia in the children. Cohen et al. (1954) found marital skew in the
parents of manic-depressive children, in that there was "a rigid splitting
of parental roles: the mother was
usually seen as the decisive, orderly and prestigious parent, the father as a
rather weak outsider and as despised (overtly or covertly) by the mother." Stierlin et al.
(1986) found marital schism among the parents of manic-depressive children, in
that "we frequently observed a symmetrical struggle in which each parent
seemed intent to devalue and hurt the other." Other family therapists have found disorders
in the children of parents who do not fight openly but nevertheless fail to
define the relationship as either symmetrical or complementary (Palazzoli et al., 1978) and Minuchin
(1974) has stressed the importance of a clear and unambiguous hierarchy for
family functioning. Also pathological
for the children are symmetrical marriages in which one of the children gets
"triangulated" into the marital power struggle in what Haley (1963)
has called a "cross-generational coalition". Some family therapists have associated
depression with the "one down" position in a marriage (Haley, 1963; Hoffmann, 1981).
Who defines the relationship?
The concept of dominance in dyadic
relationships has been subject to criticism over the past twenty years, and
ethologists have even suggested that among primates it may be an artifact of captivity (Rowell, 1974). The concept depends on the fact that certain
variables are stable over time and are consistently correlated with each
other. The dominant member of a pair takes
precedence over the other, receives attention from the other, expresses
hostility to the other, displaces the other and has gait and posture which are
upright and "jaunty"; whereas the subordinate is slouched
and furtive, and avoids the other. More
recent studies have supported the dominance concept (Deag,
1977; Kaufmann, 1983) and it may well be that the
previous failure to find consistent dominance relationships was due to the
observation of groups operating in the hedonic mode when dominance relationships
are minimally expressed (Chance and Jolly, 1970).
However, the above considerations, together with problems which arise
due to human language and conceptual thought, incline us to avoid the word
dominant, which has the added disadvantage of carrying overtones of dominating
behaviour. Hinde
(1979), who uses the terms higher-ranking and lower-ranking, has pointed out
that, due to delegation, one can get an infinite regression in the
determination of rank order. For
instance, the wife may make the decision about where they should go on holiday,
but the husband may have told her to choose;
but, again, the wife may have delegated to the husband the decision
about who should choose; and so on, ad
infinitum. The nearest one can get to
ultimate power is the definition of the relationship. For instance, a man who says to his fiancee "I insist that we both have equal power in our
marriage" is giving a unilateral definition of the marital relationship,
and thus assuming the dominant role.
This is an example of a "double bind", in which the form of
the statement invalidates the content.
It is interesting that the only way the fiancee
can get out of it (other than by metacommunicating)
is by offering a "counter double bind" with a statement such as
"On the contrary, I insist that you adopt the dominant role in our
marriage", by means of which she herself makes a bid for the dominant
role. It does not matter what the actual
definition of the relationship is; the one who makes the definition has
the power, the one who accepts the definition (even of himself in the
"dominant" role) concedes the
power. Can the power to define a
relationship be delegated? In practice
this does not appear to occur, and therefore in talking of Definer and Acceptor
we feel that we have got as near to the ultimate distribution of power as is
necessary for our hypothesis.
Assessment of Hostility towards Spouse
There is no valid instrument for assessing the
expression of hostility towards a particular person. In thinking about hostility expressed in a
dyadic relationship we have found it helpful to avoid the terms hostility and
aggression, which are not technical terms, and to speak instead of catathesis or catathetic signals
(or messages, or behaviour). A catathetic signal is defined both according to sender and
according to receiver (Price, 1988). For
the sender it is a signal of favourable relative RHP, and it says "I have
assessed your fighting ability in relation to my own, and have decided that
mine is superior; I
therefore require you to submit to me or to leave the field, otherwise I shall
continue to attack you". For the
receiver it is a signal which lowers RHP unless it is returned in full measure. In common parlance, it is a signal which
threatens to "put down" the other person, who can either retaliate or
"swallow the insult" (and by doing so lose RHP). One advantage of the term catathesis
is that it enables us to exclude a number of forms of hostility (such as temper
tantrums, homicide and running amok) which are not related to ritual agonistic
behaviour, and at the same time to include some types of behaviour which do not
appear hostile but are effective in causing or maintaining rank asymmetry (such
as criticism, patronising behaviour, unilateral relationship definitions and
the taking of unnegotiated precedence). It also facilitates cross-species comparisons
in that we can talk about catathetic behaviour in
animals and man without fear of either anthropomorphism or of reducing man to
the level of animals. The following is a
list of various forms of catathetic behaviour which
are used by human beings:
1. Non-verbal
a. Non-contact
threat stare
curled lip
raised fist, wagging finger
obscene gesture
taking precedence
omission of expected deference or attention
patronising behaviour (e.g. tipping)
b. Contact
pushing, hitting, punching
chasing
corporal punishment of children, servants, etc.
2. Verbal
statement of superiority
threat of hitting, wounding or killing
unilateral definition of relationship
criticism, disapproval
sarcasm
insult, insult to mother or other allies
use of
swear words
lying
omission of expected
deference or attention
patronising statement
ordering, commanding
some forms of boasting
It can be seen how the use of words adds
considerably to the repertoire of catathetic signals,
both in directness and elaboration, so that one can have, at one extreme, a
bald verbal statement of superior relative RHP (such as "I am better than
you"), and at the other, the mutually abusive singing competitions of
Eskimos which raise the expression of catathesis to
an art form (Service, 1971). The
expression of competence or achievement, as in art or literature, is not a catathetic signal but a signal of absolute RHP (rather than
relative RHP). For a detailed discussion
of the relation of RHP to catathesis and anathesis, see Price (1988).
In one
of the few experimental studies of conflict in marriage, Raush
et al. (1974) were able to precipitate exchanges of catathetic
signals (quarrels) in a proportion of couples, and they noted the repetitive,
stereotyped quality of the verbal material expressed at such times; the descriptions of the exchanges were
reminiscent of ethologists' descriptions of ritual agonistic behaviour in
animals.
Choice of Couples
It may well be that depressed patients
attending a psychiatric clinic are not the best subjects for study. Any "blind" study adopting
validated "instruments" would require to be treated as an experiment
to which the patients and spouses would have to give informed consent, and the
procedures involved would not be a good way of commencing therapy with such
patients.
One
alternative would be a study of patients attending a specialised clinic for
premenstrual depression. Such patients
attend frequently, are sometimes in normal health while attending, and might be
expected to be more sympathetic to research.
We would, of course, predict that Definer wives would express
premenstrual hostility to the husband, whereas Acceptor wives, if they express
hostility at all, would express it only to the children (probably at times the
husband is not present). There would
also be a possibility of directly observing interaction between the spouses
both during the depressive periods and during periods of normal mood.
Conclusions
We have presented suggestive but not
statistically significant evidence that the expression of hostility by
depressed patients is affected by the dominance relationship between the
patient and the object of hostility.
Both the conceptual issues underlying the hypothesis and the
methodological problems of measuring the relevant variables are such that we
feel it appropriate to present the findings at this stage, particularly as more
stringent work might be a considerable imposition on patients attending an
out-patient clinic. Therefore a stage of
peer review seems appropriate before more experimental work is done.
In
spite of the tentative nature of the results we claim some success in using an
ethological frame to approach a problem of human psychopathology, an activity
which has been regarded with considerable scepticism by commentators too
numerous to document. The inherited
mechanisms of ritual agonistic behaviour are so widespread among vertebrates
that it would be most surprising if they were not operating in competitive
human interactions, particularly those within the family. It is well known to ethologists
that for any primate to threaten or attack another member of its group is
a matter which depends for its result most importantly on the relative rank of
the attacker and attacked. The fact that
relative rank has not been taken into account hitherto in studies of the
expression of hostility by depressed patients suggests that there is still
considerable scope for the application of ethological ideas to research in
psychiatry.
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