The brain, specifically its synapses, makes us who we are.
Joseph LeDoux Synaptic Self: How Our Brains Become Who We Are
Three critical questions should be answered to formulate the best treatment approach:
1. What is the problem?
2. Who is the person with the problem?
3. What is the best strategy to use to help that kind of person deal with that type of problem?
The purpose of this chapter is to provide our approach to the as-sessment of questions two and three. Our clinical experience suggests that people without severe psychopathology can be roughly grouped, or “clustered,” into one of three general personality styles. The clus-ter hypothesis is a generalization derived from our observations of the clinical pattern of patients who were given the Hypnotic Induc-tion Profile (HIP) and who had intact scores, excluding softs and
decrements (see Chapter 4, Administration and Scoring). The intact profile indicates a potential capacity to experience what is called flow (Csikszentmihalyi 1991). By flow, Csikszentmihalyi means a harmoni-ous integration of all relevant feelings, knowledge, and motivation that fulfills a specific goal with a seemingly timeless effortlessness, similar to the artist’s “aesthetic rapture” or the athlete’s “zone.” On the other hand, the nonintact profile (i.e., those with soft profiles and those with decrement profiles) indicates an erratic or total inability to experience such harmonious integrated flow. Variability among people in the nor-mal range from low to high hypnotizability has been, in our clinical experience, associated with three personality types or clusters of at-tributes. These clinical observations have also been compared with other measures, including independent diagnoses and psychological testing. The three major personality types that emerge from the data are Dionysian, Apollonian, and Odyssean. Dionysians are intuitive, feeling, and trusting of others; they tend to be highly hypnotizable.
Apollonians are logical, organized, and prefer to lead rather than fol-low. They tend to be at the low range of hypnotizability. Odysseans fluctuate between action and despair but are more balanced in the dia-lectic between feeling and thinking. They tend to be moderately hyp-notizable. First, we describe these types briefly and then discuss them in more detail.
Dionysians
The chariot of Dionysos is bedecked with flowers and gar-lands, panthers and tigers stride beneath his yoke. If one were to convert Beethoven’s “Paean to Joy” into a painting, and refuse to curb the imagination when that multitude pros-trates itself reverently in the dust, one might form some ap-prehension of Dionysiac ritual. Now the slaver emerges as a free man: all the rigid, hostile walls which either necessity or despotism has erected between men are shattered. (Nietzsche 1956, p. 23)
Our initial observations about the Dionysian personality style grew out of some intriguing psychological problems encountered by patients at the upper range of hypnotizability on the HIP (H. Spiegel 1974a).
These individuals had a high eye-roll and high response on the behav-ioral aspects of the test. We called them grade 5 because, in addition to their high eye-rolls (scored 0–4), the individuals performed all of the usual hypnotic experience on the HIP and showed the following addi-tional hypnotic features: 1) age regression in the present tense, 2) post-hypnotic amnesia, and 3) persistent psychosomatic alterations. Our observations of these so-called grade 5 patients resulted in the impres-sion that they had certain clusters of characteristics that were more or less consistent with their high hypnotizability and with their ability to spontaneously slip into trance states: Their daily functioning and inter-personal relationships seemed hypnotic-like. Grade 5 patients adopted a naive posture of trust in relation to many, if not all, of the people in their environment, were prone to suspend critical judgment, had a ten-dency to affiliate easily with new events (one patient became nauseated every time her friend’s sick dog was nauseated), and demonstrated a telescoping of their sense of time so that their focus was almost exclu-sively on the present rather than on the past or the future. They further demonstrated a tendency to use extreme trance logic (Orne 1959) in that they were relatively comfortable with logical incongruity, had ex-cellent memories, and had an unusually good capacity for intense and focused concentration.
In addition, patients with high hypnotizability and considerable psychological dysfunction showed a fixed personality core of beliefs that was relatively nonnegotiable, although these individuals were in other ways very compliant. Especially troubling was their role confu-sion and fixed sense of inferiority: These two characteristics often served as a rationalization for a naive posture of trust and uncritical acceptance of cues from others. These patients tended to say to them-selves: “Who am I to know anything about this, compared to the person who is directing me?” As one might expect, they were very prone to spontaneous trance experiences and uncritical acceptance of casual comments as posthypnotic signals. One such patient described herself as a “disciple in search of a teacher.”
Apollonians
It then occurred to us to look for what we call Apollonian character-istics in the low and nonhypnotizable patients within the intact range
of the HIP. We expected to find these people more cognitive, orga-nized, critical, aware of the periphery in their style of concentration, and therefore less trusting of others. We found clinical and research data to support this hypothesis.
The stage for contrasts was set. As an alternative to Dionysus, Nietzsche describes Apollo:
Apollo is at once the god of plastic powers and the soothsay-ing god. He who is etymologically the “lucent” one, the god of light, reigns also over the fair illusion of our inner world of fantasy. The perfection of these conditions in contrast to our imperfectly understood waking reality, as well as our profound awareness of nature’s healing powers during the in-terval of sleep and dream furnishes a symbolic analogue to the soothsaying faculties and quite generally to the arts, which make life possible and worth living. But the image of Apollo must incorporate that thin line which the dream image may not cross under penalty of becoming pathologi-cal, of imposing itself on us as crass reality; a discrete limita-tion, a freedom from all extravagant urges, the sapient tranquility of the plastic god. (Nietzsche 1956, p. 21)
The ongoing theme of Apollonian individuals is control: reason over passion. As we scrutinized those with low scores on the HIP, we found that they put tremendous emphasis on reason and understand-ing and were very much prone to plannunderstand-ing for the future and to usunderstand-ing their critical faculties to the utmost. One patient who proved to be an intact-1 spent most of the first session debating the issue of free will—whether all hypnosis was self-hypnosis or whether the hypno-tist would be implanting something in her mind by hypnotizing her.
It was only at a second session that we could set aside these argu-ments and proceed with the profile.
Odysseans
For Nietzsche, the ground between Apollonian reason and Dionysian ecstasy was filled by the Greek tragedians. We describe those people with mid-range scores on the HIP with reference to their extreme characteristics. We named them after Homer’s tragic hero, Odysseus,
a man whose name literally means trouble, or to give pain and receive pain.*
Walking beneath high Ionic peristyles, looking toward a ho-rizon defined by pure and noble lines, seeing on either hand the glorified reflection of his shape in gleaming marble and all about him men moving solemnly or delicately, with har-monious sounds and rhythmic gestures: would he not then, over-whelmed by this steady stream of beauty, be forced to raise his hands to Apollo and call out: “Blessed Greeks! how great must be your Dionysos, if the Delic god thinks such en-chantments necessary to cure you of your dithyrambic mad-ness!” To one so moved, an ancient Athenian with the august countenance of Aechylus might reply: “But you should add, extraordinary stranger, what suffering must this race have endured in order to achieve such beauty! Now come with me to the tragedy and let us sacrifice in the temple of both gods.” (Nietzsche 1956, p. 146)
This quotation reminds us that many Greek temples had altars both to Apollo and to Dionysus and that the greatness of Greek trag-edy was its embodiment of the never-ending tension between the de-sire and capacity to experience extremes of joy and sorrow, and the hope that reason would provide a clarity and order to human experi-ence to transcend mere sensation. To Nietzsche, tragedy represented a high artistic expression of the fact that the tension between reason and passion is never eliminated in human experience; it is rather to be savored and suffered. Hence, the Greek tragic vision that humans can never fully succeed in the satisfaction of their desires and yet they are never far from the will to achieve what is beyond themselves.
The Odyssean group is the vast midrange (grades in the 2–3 range on the HIP) composed of mixtures of the opposing Dionysian and Apollonian qualities. We call the group Odysseans, named for a wanderer of fluctuating moods, capable of heroic bravery and pro-found despair—not a mythical deity, like Apollo and Dionysus, but a mythical human. For these individuals, the tension between reason and feeling is in some ways more trouble than for Apollonians and
*We are indebted to Professor Jacob Stern of the Department of Classics at City College, City University of New York, for reviewing our data and suggesting the term Odyssean.
Dionysians. Odysseans are less settled and are more compelled to find a formula for integrating their conflicting priorities, a formula that Nietzsche described as the stuff of which tragedies are made.
And yet these individuals are often productive, normal people who have the kinds of life crises that we have learned to identify as part of normal growth and development.
Certain clusters of characteristics were found to be generally present among low-intact patients. They were steady, unemotional, organized individuals. They were not devoid of passion but were far more prone to value reason than passion. However, when passion was expressed by manipulating and controlling, some Odyssean fea-tures appeared to embellish the Apollonian format. We label this per-sonality type Apollonian-Odyssean (AO).
In the structuralist sense, all phenomena are best understood not merely as things in themselves but rather in the context of alternative possibilities. Thus, even those people who make up the majority of the psychiatrically healthy population are best understood in terms of the possible extreme personality characteristics of which they rep-resent a kind of integration. We have broadly characterized Odyssean style in terms of action and despair. Odyssean individuals fluctuate between periods of absorption and involvement in life and periods of a more critical and at times despairing review of—or response to—
this style of living. Their clusters of characteristics are explained in the remainder of the chapter with illustrations from our own clinical experience and from literary sources.