5 : Reich’s Work on the Impulsive Character: 1922-1924 71
throughout. Reich’s work was extremely important in furthering his social interests since the
clinic served laborers, farmers, students, and others with low earnings who could ill afford
private treatment. Not only did he have the opportunity to deal with the emotional prob-
lems of the poor; he could note how economic conditions contributed to and exacerbated
their suffering—social implications that were later significant to him. As was so characteris-
tic of Reich, a given opportunity was useful in several directions at the same time. From a
more narrowly psychiatric and psychoanalytic viewpoint, the clinic population was rich in
patients not usually seen by analysts persons whose diagnosis was “impulsive character” (a
term coined by Franz Alexander) or what today would more likely be termed “character dis-
order” or “borderline” patients.
Until this poly clinic opened, psychoanalysis had been available mainly to middle-
class patients suffering from the so-called symptom neuroses, for example, patients with
obsessive-compulsive complaints such as endless hand- washing, or hysterical complaints
such as a paralysis of a part of the body without any organic basis. Reich’s study of the
impulsive character provided a nice transition to a broader study of the personality, for this
malady was typified not by specific symptoms so much as by a chaotically disorganized style
of life. These patients, who had frequently been diagnosed as “psychopaths,” were often
regarded as more “bad”than “sick.” They were frequently anti-social and showed self-
destructive tendencies in the form of criminality, addictions, outbursts of uncontrollable
rage, or suicide attempts. Even today exceedingly difficult to treat, such people are general-
ly considered “troublemakers” and are tossed back and forth among the courts, prisons, and
mental health centers.
In 1925 Reich published his first book, a monograph entitled Der Triebhafte
Charakter(The Impulsive Character)^1 .As he was later to do so frequently, Reich began with
some broad theoretical issues. Following Freud’s direction in the 1920s, which gave more
emphasis to the ego, the character, in contrast to the earlier period of psychoanalysis, which
had focused heavily on unconscious impulses and wishes, Reich argued for a “single, system-
atic theory of character ... a psychic embryology.” Put more simply, he stressed that we do
not understand how the variation in human personality comes about. True, fragments of a
psychoanalytic embryology existed. Freud, Ernest Jones, and Karl Abraham had posited that
persons fixated at the anal stage ofdevelopment often showed specific character traits such
as frugality, orderliness, and stubbornness. But why one person with such a fixation devel-
oped a symptom, such as compulsive hand-washing, while another showed only the charac-
ter trait ofcleanliness, was not clear.
Reich then went on to define the impulsive character and to differentiate it diagnos-
tically from the symptom neuroses,on the one hand,and the psychoses, on the other. He
saw the impulsive character as a transitional stage from neuroses to psychoses (well con-
veyed by the current term “borderline” case). The further details of his differentiations need
not concern us here save to note that Reich placed a heavy emphasis on the fact that the
impulsive character,unlike the symptom neurotic, often rationalized his illness. He would,
for example, blame others for his unbridled excesses and not perceive himself as emotion-