Impulsivity and Its Bioenergetic Relationship to ADHD
Peter A. Crist, M.D.
Reprinted from the Journal of Orgonomy, Vol. 29 No. 2
The American College of Orgonomy
For more than 40 years Reich wrote, "Noisiness and biopathic hypermotility are often mistaken for natural behavior." (6) Making this distinction was more difficult with J than with other children because his ability as an actor made him an excellent con man. Discerning natural from biopathic (genuine expression from deception) requires the ability to know and sense the difference. To understand and manage children such as J, parents, teachers, and therapists must distinguish natural healthy expressions of primary impulses from secondary pathological impulsivity. J's typical behavior had an irritating, harsh quality compared to the straightforward lively expression of healthy impulses. Both of J's parents said they did not want to inhibit his natural energy and liveliness. Unfortunately this commendable desire became a rationalization for their failure to discipline his neurotic behavior. Gratifying the secondary impulses reinforced them and increased the tendency for their expression to be used defensively. On the other hand, J's parents were encouraged to support rational physical outlets for his energy and noted he was calmer at home after particularly hard workouts in soccer and baseball. [Footnote 4] (His teachers were also aware that J's behavior in class was better after an especially physical recess period.)
Theoretical Discussion
Impulsivity
Reich's landmark study of impulsivity more than 70 years ago revealed it to be not merely a moral problem, "bad character," but rather an emotional defense accessible to character-analysis. [Footnote 5]Subsequent discussion in the orgonomic literature has addressed characterological, biophysical, and therapeutic aspects of the treatment of the impulsive character. [Footnote 6] In addition to these aspects, J's case allows us to focus on some theoretical and bioenergetic issues and suggests some relationships they might have with the diagnosis of ADHD.
Reich identified the impulse-inhibited and the impulsive character as two distinct types (11). Figure1 shows Reich's general diagram of instinct and defense (12).
Figure 1
Reich illustrated this with an example of specific impulses (Figure 2) (13).
Figure 2
This example represents the typical impulse-inhibited or "compulsion neurotic" character. In this type, a great deal of energy is bound in the unconscious defense labeled [2] in Figure 1.
In contrast, the impulsive character engages in behavioral discharge ([1] in Figure 1) as his defense against a yet deeper impulse (Figure 3).
Figure 3
Here the energy of the defense is found more in the secondary expression ([1] in Figure 1) than in the inhibiting force. In this type, the external behavior is typically an action or an aggressive attitude (such as arrogance) rather than an inhibition or fearful attitude (such as exaggerated politeness) seen in the impulse-inhibited type.
J's emotional dynamics are like those seen in Figure 3 and can be more specifically represented as in Figure 4.
Figure 4
Because impulses are continually being expressed with partial energy discharge, there is less of the original repressed instinct (labeled [3] in Figure 1) bound in this type character. For example, in the inhibited type one often feels the presence of the love impulses, albeit held back and unexpressed, but J seemed very unloving until his neurotic expressions were curtailed.
Many character types demonstrate impulsivity, although it is not the central character mechanism as it is in the impulsive character. Each unsatisfied block (regardless of the stage during which it occurred) has a dynamic similar to figure 3 and a tendency toward impulsivity. [Footnote 7]
Biological Pulsation
The orgonomic concept of pulsation and its relationship to the autonomic nervous system (ANS) grounds our understanding of these emotional processes in biological functions. [Footnote 8] A biopathy can mani-fest as a tendency to be stuck either in contraction or expansion. [Footnote 9]
Charts 1 and 2 compile and organize elements of this basic antithesis in the natural and biopathic states respectively. These concepts serve to better define the bioenergetic basis of J's emotional problems and properly place them within the spectrum of biopathies.
Chart 1
Natural Pulsation
| phase of pulsation | expansion | contraction |
| associated primary emotion | pleasure | anxiety |
| predominant branch of ANS | parasympathetic | sympathetic |
Chart 2
Biopathic Disturbance of Pulsation
| biopathic state | stuck in expansion | stuck in contraction |
| intolerance of: | contraction | expansion |
| typical emotions | anger, irritability | fear, anxiety, depression |
| manner of relating | superficial contact | inhibited |
| character type | impulsive | impulse-inhibited |
| type of block | unsatisfied | repressed |
Biopathic Disturbance of Pulsation
biopathic state stuck in expansion stuck in contraction
intolerance of: contraction expansion
typical emotions anger, irritability fear, anxiety, depression
manner of relating superficial contact inhibited
character type impulsive impulse-inhibited
type of block unsatisfied repressed
J's clinical picture is consistent with the expansive, impulsive biopathy. A reactive biopathic expansion is qualitatively different from natural unarmored expansion. Because armor prevents full expansion, one would not expect to see expression of genuine emotions of love and pleasure. In J's behavior we saw non-genuine expressions of love used to con others. He often displayed anger and irritation which result from partially blocked expansive expressions turned harsh by armor. As could be predicted from J's structure, he was most intolerant of the emotions associated with contraction: anxiety, fear, and sadness.
Perception and Excitation
An orgonomic understanding of the relationship between perception and excitation is also helpful in understanding impulsive individuals. Reich identified orgonotic streaming as the common functioning principle of perception and excitation, a functional pair as expressed in Figure 5(17).
Healthy emotional contact and expression occur when energy movement is unimpeded with full integration of perception and exci-tation. "Attention deficit" and "hyperactivity" were noted by Harman to be merely descriptive terms that refer to disturbances in the paired functions in Figure 5. [Footnote 10]"Attention deficit" implies a lock of full perception "Hyperactivity" has as its source, physical excitation. If the movement of energy is relatively free-flowing but prevented from unitary emotional expression because of a perceptual disturbance, it will then be transformed into physical excitation. [Footnote 11] (See Figure 6) When J became disturbed, he discharged his tensions somatically but remained unaware of what he was feeling.
Figure 5
Figure 6
Preventing his physical discharge served to bring him more in contact with his emotions.
By contrast, with decreased orgonomic streaming both perception and excitation re reduced and the individual becomes emotionally deadened. (See Figure 7)
Figure 7
Children who suffer chronic contraction and are inhibited or withdrawn are much less likely to be identified as "difficult" than those who have impulsivity (19). Many of the more overt symptoms seen in children gradually diminish with the passage of time because further armor development and the character formation serve to reduce energy movement.
The Relationship of ADHD to Impulsivity
Most psychiatrists would diagnose J as having ADHD. Certainly, his symptoms of distractibility, impulsivity, and hyperactivity meet the criteria for this diagnosis (20). Without an understanding of the energetic basis of the symptoms, their treatment recommendations would generally include medication, such as Ritalin, and/or behavioral therapy.
ADHD research and the debate about effective treatment continue. Barkley, a prominent researcher and author in the field, has proposed a "new theory" in which he attempts to unify the many manifestations of ADHD under one psychological mechanism. He considers ADHD a "fundamental deficit in the ability to inhibit behavior" (21). This is, in reality, no more than a new name for impulsivity.
The lack of specificity of the symptoms included in the criteria for ADHD has led some professionals to question its legitimacy as a psychiatric/medical diagnosis (22). Long-term follow-up studies of patients who met criteria for a diagnosis of ADHD reveal impulsive symptomatology continuing into adult life (23). While impulsivity is the common denominator in J's character pathology, not all children with impulsive behavior develop an impulsive character. [Footnote 12] The designation ADHD lacks specificity precisely because deficits of attention with or without impulsivity may occur in many different character types, [Footnote 13] as can impulsivity itself. It appears likely, however, that a significant number of those children diagnosed with ADHD go on to develop impulsive characters.
© 2008 The American College of Orgonomy. All rights reserved.
