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Although the title chosen for this paper is the ‘Psychotherapy of Character Disorders’, it is not possible to avoid a discussion of the meaning of the term ‘Character Disorder’. As Fenichel (1945, p. 539) remarks,
The question may be raised whether there is any analysis that is not ‘character analysis’. All symptoms are the outcome of specific ego attitudes, which in analysis make their appearance as resistances and which have been developed during infantile conflicts. This is true. And to a certain degree, really, all analyses are character analyses.
And again,
Character disorders do not form a nosological unit. The mechanisms at the basis of character disorder may be as different as the mechanisms at the basis of symptom neuroses. Thus a hysterical character will be more easily treated than a compulsive one, a compulsive one more easily than a narcissistic one.
It is clear that either the term is too wide to be useful, or else I shall need to use it in a special way. In the latter case I must indicate the use I shall make of the term in this paper.
First, there must be confusion unless it be recognized that the three terms: character, a good character, and a character disorder, bring to mind three very different phenomena, and it would be artificial to deal with all three at one and the same time, yet these three are inter-related.
Freud wrote (1905b) that ‘a fairly reliable character’ is one of the prerequisites for a successful analysis (Fenichel, 1945, p. 537); but we are considering unreliability in the personality, and Fenichel asks: can this unreliability be treated? He might have asked: what is its aetiology?
When I look at character disorders I find I am looking at whole persons. There is in the term an implication of a degree of integration, itself a sign of psychiatric health.