Reply to Sloman

Leon and I have discussed this theory at length, and I agree with Leon's stress on the clinical importance of the termination of submission and yielding - we have discussed various situations in which an individual wants to submit but cannot for some reason; for instance, a dominant mother prevents a wife from submitting to her husband in certain matters. In this situation the agonistic encounter between wife and husband continues and the involuntary yielding of depression may supervene.

The terminology is difficult and I think the term "submissive responses" may be ambiguous. I prefer to use the term yielding for all losing behaviour, regardless of whether it is acute or chronic, oriented towards escape or submission, or whether it is voluntary or involuntary. By involuntary I mean outside of conscious control, like depression or hero worship or the slavery of love. By voluntary I mean that the decision to yield is taken in full awareness, balancing those pros and cons which are available to the conscious mind. Unfortunately voluntary also has the meaning of "willing", and some acts of voluntary yielding may be very "unwilling". I think the potential semantic confusion is such as to justify a couple of examples.

Say I am queuing for a cup of tea at the station buffet. Someone barges in front of me. I look at him and see that he is a loutish creature, rude, ill-mannered, but unfortunately larger than me. I yield and allow him to precede me. This is voluntary yielding, even though I was unwilling to yield because of my pride (and I may be in a hurry). I am unlikely to have made any submission signals apart from drawing back. The episode leaves me feeling hurt and angry and put down. On another occasion while I am standing in the queue, the King comes in, obviously wanting a cup of tea. I bow to him, offer him my place, possibly even offer to pay for his tea

(knowing the Royals seldom carry loose change). This is "willing" voluntary yielding, and I have made submission signals which have been accepted. The episode leaves me feeling happy and boosted, with something to tell my wife proudly when I get home. Alongside these acute voluntary forms of yielding, it is possible that there are involuntary varieties. For instance, the sight of the large lout might induce a panic attack in me, in which I become incapable of opposing him; or he might knock me out. In the case of the King, I might be so overwhelmed by his majesty that I fainted, thus giving up my place by default. But I do not think these acute involuntary states of yielding are of importance as ultimate causes of psychopathology. I use them merely to illustrate the terminology. I submit to the lout by withdrawing, and to the king by bowing; submission in this sense is a conscious, directed act. However, when I yield to the lout with panic and to the king with paralysing awe, I am using types of behaviour which should not be called submission, and in the absence of a better label I suggest "acute involuntary yielding."

The difference between voluntary and involuntary becomes important when we come to chronic (or subacute) yielding. Let me give another example, and since I have introduced royalty as an extreme example of high RHP, let us continue with royalty (Leon's "alpha individual, who is accustomed to dominate"), but this time in the role of yielder. The speech by the King in Shakespeare's Richard 11 must be the greatest yielding speech ever pronounced. It is so majestic that I beg Russell's indulgence in quoting it in full:

What must the king do now? Must he submit?

The king shall do it: must he be deposed?

The king shall be contented: must he lose

The name of king? o'God's name, let it go.

I'll give my jewels for a set of beads,

My gorgeous palace for a hermitage

My gay apparel for an almsman's gown,

My figur'd goblets for a dish of wood,

My sceptre for a palmer's walking staff,

My subjects for a pair of carved saints,

And my large kingdom for a little grave.

A little, little grave, an obscure grave;

Or I'll be buried in the king's highway,

Some way of common trade, where subjects' feet

May hourly trample on their sovereign's head;

For on my heart they tread now whilst I live;

And buried once, why not upon my head?

According to my terminology, this is subacute voluntary yielding. The King does not want to yield, but he sees that he has no other choice, and he makes the decision in full consciousness. He is being pushed out of the kingly role, unwillingly. The same act of yielding could have come into one of the other categories of yielding, without altering the overall effect (except how the King felt about it). It could have been willing voluntary yielding, for instance if the King had got bored with being king and wanted to devote himself to collecting stamps; he could have opted willingly out of the kingly role. Or it could have been chronic involuntary yielding which I have labelled depressive yielding: in this case the King would have become unwell, would have been seen to be not himself, afflicted with all sorts of symptoms, prematurely aged and clearly unfit to govern. Perhaps a regent would have been appointed, or he would have said, "I am much too ill to continue as King" and then abdicated. These three ways of exiting from the kingly role leave the ex-king feeling very different. In one, he is a resentful ex-king; in the second, he is a

happy stamp collector; in the third, he is a sick man.

I hope these examples help to illustrate the ways that yielding may be related to psychopathology; and even more important, that there may be an interaction between type of yielding and the presence or absence of psychopathology. If one had been the deposed King's physician, one might have been able to influence the outcome. One could have said, "Here, your majesty, take this nostrum, we'll soon have you fit and back on the throne", thus fuelling his unrealistic aspiration to make a come-back. Or one could have said, "I'm afraid the prognosis is not good, your majesty, and the worry about regaining the throne is impeding your recovery; you should seriously consider abdication." If the king then abdicates, the pressure of his people treading on his heart is removed (along with pressure from competitors) and, the involuntary depressive yielding being no longer required to keep him out of the kingly role, he may recover and become a happy ex-king. Note the paradox that giving a bad prognosis improves the prognosis, whereas giving a good prognosis tends to perpetuate the condition.

In an attempt to clarify matters, I offer the following tentative classification of yielding behaviour:

insert figures here

By voluntary and involuntary, I mean the sort of difference in brain level which must exist, in the realm of temperature control, between turning on the central heating and shivering. The decisions to shiver or turn on the central heating are clearly made at different brain levels, even if we do not know exactly what those levels are. The information used in coming to the decision is different in the two cases. In the rational evaluation of temperature, made in order to decide about switching on the central heating, information from weather forecasts and thermometers may be taken into account, but this information has no direct effect on the decision to shiver. Conversely, information about body temperature may affect the onset of shivering but not be available in making a decision about central heating. With regard to yielding, we do not know how much of the information which is used to make a rational decision of submitting is also available for the evaluation of relative RHP which may lead to involuntary yielding, or whether certain information may be used for the latter but not for the former. Information at a higher logical level, concerning fighting in general (such as rules against fighting), as opposed to information about this particular fight, might affect a rational decision to submit but have no influence on involuntary yielding. And it is possible that information at a somatic level (such as debility following a viral infection) might play a part in determining involuntary yielding but not be available for a decision about submitting.

The voluntary act of turning on the central heating may be willing or unwilling: I may be showing off my new central heating system to loved ones whom I want to keep warm; on the other hand, I may have been coerced into turning on a system which I may believe to be too expensive, harmful

to health, or unnecessary. In the latter case I might switch it off when no one was looking, and this might lead to shivering, in the way that incomplete yielding may lead to depression. It does not make sense to talk about willing or unwilling shivering; no one likes to shiver in the way that no one likes to be depressed.

I think a lot more needs to be said about partial, incomplete and blocked submission, and the ways that these may predispose clinically to depressed states. In some cases submission may be blocked from outside, by social rules or by a third party; and in others it may be blocked from inside the individual, by pride, scruples or the anger of which Leon speaks. At the moment there is a lot of knowledge about sub-total forms of submission, but it is in the minds not of psychologists but of priests, particularly those who hear confessions and who are expert at detecting when the penitent is holding some tiny little something back from his total submission to God. I think a total, complete voluntary submission to a higher power may pre-empt the involuntary yielding of depression, even if the higher power was outside the original conflict (as in the case of the alcoholic submitting to the AA group). This sort of option needs to be talked about clinically, and that is why I think we should reserve the use of the term submission for voluntary acts. Does the patient choose to submit, or does he choose to spare his pride and risk the involuntary yielding of depression? Of course, involuntary yielding can also be pre- empted by victory. And the sensible person avoids agonistic confrontation altogether and takes Michael Chance's advice to stay in the hedonic mode.