When I am hostile I am:

• sarcastic, filled with bitter humor

• biting and acerbic in my criticism of others

• cynical and unmoved

• suspicious and often unlikable

• defensive, paranoid and self-protective

• untrusting and disbelieving in others

• "self-focused" rather than "other focused"

• lacking in tolerance for the behaviors of others

• turned off to other's concern, caring or nurturing

• blinded by my own self-absorption

• bitter over real or imagined negative treatment I've received from others, past or current

• sour on life

• quick to attack others for their real or imagined faults and failings

• inwardly outraged over the unfairness of life

• quick to believe that nothing good is happening in my life

• unable to see the redeeming graces or features in people, places, or things

• hiding behind a wall or shield, unwilling to allow others into my life

• disagreeable, filled w/the "yes, but" attitude

• ready for a fight or argument

• antagonistic in my attitude towards others

• a bomb ready to be detonated

• setting myself up to be abused, rejected, disapproved or unloved

• fulfilling the prophecy that "others don't care about me" by turning them off without giving them a chance.

Hostility can result in physical experiences of:

• tightness in my chest

• throbbing in my heart

• warm blush in my face

• profuse sweating

• high blood pressure

• tightness in my jaw

• churning in my stomach

• constipation or diarrhea

• coldness in my hands and/or feet

• tenseness in my forehead

• tension headaches

• pounding in my temples

• profound exhaustion

• fear and confusion regarding the reactions and opinions of others

• disinterest in the feelings of others

• wanting to have attention drawn to me

• wanting to be given sympathy

• self-pity

• being lost and unclear about the direction my life is taking

• feeling cheated in life

• feeling betrayed, unsupported and uncared for

• desiring revenge or personal vindication

• being unable to forgive or forget the real or imagined hurts

• lacking generosity or goodwill for others

• needing to protect myself at any price

• wanting to attack before I'm attacked

• lacking enthusiasm for personal growth activities

• bitterness about the status of my life, both emotionally and materially.

• sense of absolute futility of life

• submitting to negative beliefs, like "life's tough and then you die."

• hopelessness and a bleak outlook for the future

Why am I hostile?

Hostility is aroused in me when I: 

• consider all the inequities of life.

• realize the perversity of people, business, or politics.

• consider the offensive treatment I received in my family of origin.

• review all the real or imagined failures in my life.

• see wicked people get ahead in life.

• perceive that I'm being or have been treated unfairly.

• find that my efforts toward self-improvement have reached a plateau.

• realize that I will need to exert increased efforts to attain my goal.

• blame others for keeping me from success in life.

• recognize that things over which I have no control prevent me from experiencing the good things in life.

• feel coerced, forced, or cajoled into doing something I really don't want to do.

• feel like I'm being backed into a corner.

• realize that I'm the target of someone else's efforts to change or alter my behavior.

• am reminded of things I've said or asked for in the past, which I no longer believe in or want to pursue.

• realize that what others are telling me is correct, but I stubbornly hold onto my negative beliefs because they allow me my self-pity.

• am being interrupted in the midst of my "pity party."

• someone challenges my negative or critical viewpoint.

• someone offers a more promising, optimistic point of view.

• recognize that as a human being I'm subject to making mistakes and experiencing failure.

• recognize that the human condition brings with it pain, suffering and death.

• realize that I am an imperfect mortal.

• can't get others to share my high expectations for work or community performance.

• made aware of the tragedy, travails and hardship we're confronted with daily.

• fear that I'll never be able to accomplish my lifelong dreams because of things out of my control.

• feel cheated because after a life of hard work, honest and clean living I'm suffering a major setback in my life.

• recognize that coming from a dysfunctional family got me off on the wrong foot.

• am confronted about my backsliding or relapsing by those who care about and support me.

• when my personal problems are outlined for me in a behavioral intervention by the people who love me.

• experience chronic rejection, disapproval or disinterest at the hands of those with whom I desire a closer relationship.

• see my dreams slipping more and more out of my reach.

• realize how unfulfilled and unaccomplished I really am.

• see how much more work, energy and effort I need to exert to attain even a slight degree of personal growth.

• am confronted with the need to give up my addictive behavior, i.e., alcohol, drugs, sex, food, gambling, shopping, smoking, etc.

• feel lost or out of focus in my life.

• feel the song, Is That All There Is, applies to my life.

What irrational beliefs arouse my hostility?

• No matter how hard I try, I'll not reach my goals of success and happiness.

• Why should I always be the one who is giving, caring and forgiving, in my life?

• I should be rewarded for my good deeds, hard work and sense of fair play.

• I shouldn't have to suffer all this disappointment, pain and suffering.

• The good should always win out over the bad in life.

• I should be treated fairly by others in my life.

• There isn't anything that I should be unable to overcome in my life.

• If I had education, good looks and money things would come easily for me.

• Evil, rotten and unfair people should have to suffer in life, not me!

• There should come a time when I no longer need to exert all this effort and energy to get ahead.

• I should be rewarded for all of the suffering, turmoil, tragedy and misfortune I've experienced.

• Others should be supportive of my desire for self-improvement.

• I shouldn't have to suffer confrontation when I am backsliding or relapsing. I deserve a break!

• Others should treat me gently when they're giving me their support, caring and nurturing.

• There should be no injustice, suffering, or tragedy in life.

• I should be able to live the way I want for as long as I can with no pestering from others to change or reform.

• No one is going to tell me how to live and enjoy life.

• People should do what I say, not what I do.

• People should give me what I want, not what I ask for.

• Why can't things go my way?

• No matter how hard I work and try, I never seem to get ahead.

• Life's tough and then you die.

• Evil always wins out in the end. The good guy finishes last!

• No one would like me the way I really am, so I'll reject them before they reject me.

• I should be able to live forever.

• I should be able to be successful, rich and healthy with little or no effort on my part.

• I shouldn't have to make sacrifices or experience self-deprivation in order to achieve the things I want.

• My parents should have given me a better start in life.

What are the negative effects of my hostility?

Because of my hostility, sarcasm and cynicism, I find that: 

• people seek me out infrequently.

• it's hard to sustain friendships and close, lasting relationships.

• there's less enjoyment in my work, play and life in general.

• I'm not sought out to be a support person in someone else's life.

• my philosophy of life is open to criticism and attack.

• I'm a ready target for personal attacks.

• I'm often misunderstood.

• I often feel ignored, invisible.

• I lack motivation in my desire for personal growth, recovery and wellness.

• I feel cheated by life and feel a need to get revenge.

• I hurt others' feelings, then can't understand why they feel hurt.

• I become an open target for abuse, negative confrontation and criticism from the others in my life.

• I tend to seek out others who are at least equally hostile, sarcastic and cynical to feel good about myself.

• I look down on those who are making an honest, concerted effort toward their own self-improvement.

• I'm caught up in a cycle of self-fulfilling prophecies of self-failure, self-defeat, rejection, disapproval and lack of personal success.

How can I overcome my hostility?

In order to overcome my hostility, sarcasm and cynicism, I need to: 

• rethink my philosophy of life.

• make an honest inventory of my behavior toward others.

• analyze the effects of my hostile behavior on me and on others.

• develop a set of rational beliefs about the realities of being a mortal being in the human condition.

• become less "cause'' oriented in my view of life.

• recognize that the underdog can be successful if that person takes control of his own life and stop wasting energy blaming others or engaging in self-pity.

• give permission to the support people in my life to give me honest feedback and confrontation when I'm being unfaithful to my program of recovery.

• recognize that I can control only myself and my reactions.

• abandon the struggle to control things and people out of my control.

• recognize that most of my hostility, sarcasm and cynicism is a recognize-related problem, namely my being unwilling to let go of the need to control.

Step 2: Once I've admitted that hostility is a problem for me, I need to inventory my philosophy of life.

Personal Philosophy of Life

Step 3:   With a new, less hostile, less sarcastic and less cynical philosophy of life, I need to integrate the new rational beliefs into my emotional responses.

A. How open am I to changing the way I view inequities of life?

B. Am I ready to hand over the responsibility of control to others? How detached from others can I be?

C. What emotional responses would be healthy for me when I see suffering, hurt, pain and failure in others?

D. When I experience a set back, failure, or loss, what emotional response do I need to evoke in myself to keep from relapsing into my old hostility, sarcasm and cynicism?

E. What other emotional responses could I develop to handle my hostile, sarcastic, or cynical behavior?

Step 4: Once I have integrated the new emotional responses into my belief system I need to change my behavior to reduce my hostility, sarcasm and cynicism.

A. What new behavior patterns could I develop to reflect my amiable, approving and confident self?

B. How can I give to my network of supporters permission to confront me when I slip into my old behavior patterns?

C. How can I reinforce the increase and sustaining of these new behaviors? What cues would catch my attention?

D. How can I reflect my new found belief that I must accept that I'm unable to control the uncontrollables in life and that this fact is OK with me?

E. How can I measure my success in achieving a change in my hostile behavior?

F. Will people always give me the chance to change from my old, hostile ways? How will patience and understanding help to keep me on track?

G. My amiable, approving, confident behavior will include:

Step 5:  Now that I have:

• (a) realized the need for a less hostile philosophy of life 
• (b) integrated my new emotional responses to reality
• (c) identified a set of new behavior traits to overcome this hostility

I'll assess the status of my hostility, sarcasm and cynicism. If I still feel the negative effects of hostility, I'll return to Step 1 and begin again.

My own clinical experience is a case in point. In my work with adults and adolescents over the years, hostility has been one of the most remarkable and consistent features of patient productions - eminently useful grist for the psychoanalytic mill.

Early on (Kalogerakis, 1974), I was impressed to discover that confusion about it - chiefly in the failure to differentiate it from anger and to fully appreciate its destructiveness -existed not only in my patients, but also among residents in supervision, my own peers and just as often in the parents of children and adolescents with whom I was working.

Increasingly, I came to understand the importance of differentiating hostility from the other negative affects and it soon became a cardinal feature of my clinical style.

In approaching the subject at this time, my thesis is simple: that hostility is among the most significant issues we encounter in our clinical work, that it's equally important in the child-rearing situation and that the adolescent stage of development offers a critical opportunity to examine the problem in statu nascendi, before it becomes entrenched as a central feature of the adult personality, when it contributes so often to disabling and lifelong maladjustment and unhappiness.

Affect Theory

Psychoanalysis came rather late to the study of affects, which remains to the present a frontier area of psychological investigation (Shapiro & Emde, 1992). Affects, or emotions (most writers use the terms interchangeably) are a normal and universal part of human biological inheritance.

Like thought (or cognition), they're a basic, primary component of human psychological development. They differ from cognition in having a palpable drive component and are thus more quantifiable (one speaks of the strength of the emotions). There is a continuous interrelationship between affect and cognition, such that either can influence the other, altering it in different ways (Fischer & Lamborn, 1989).

Of particular importance to the psychoanalyst is the fact that emotions can exist at both the conscious and unconscious levels, although not all analysts would agree (see Brenner, 1982). It's also generally accepted that when normal affective development is disrupted during childhood, unless it's subsequently adjusted by corrective emotional experiences, the impact will be felt throughout the life of the individual.

Emotions involve a variety of feelings that, in the normal situation, enrich a person's life. Optimally, in the adult, the full range of human emotion is available and is experienced with different intensity, depending in part on the strength of the stimulus.

In addition to being experienced internally, affect will commonly find outward expression, both verbally and nonverbally, although this can vary greatly with the stage of development of the child.

In the abnormal situation, which can result from inborn error or an unfavorable environment, emotions may be globally or selectively suppressed, repressed, overstimulated, or altered. Negative emotions may predominate, giving an angry, depressed, or maladaptive cast to an individual's life.

We have long known that emotions play an important role in the development of psychopathology.

Yet how they're affected by mental or emotional disorder, how they become incorporated in the treatment effort and what must be achieved in reordering them in the human psyche remain challenging issues for the psychoanalyst.

Theory of Aggression

The unifying concept for the negative affects is aggression. Early psychoanalytic contributions to the theory of aggression began with Freud's initial attempts to deal with the matter via libido theory and psychosexual development. Oral-sadistic (e.g., biting) and anal-sadistic stages were elucidated, the latter including urges to hurt and dominate others.

With the advent of the oedipal phase, rivalry with the father led inevitably to death wishes. In these formulations, sadism is the first major area of concern that can be related to destructive affects, to be followed sometime later by masochism as the inverse of outwardly directed aggressive impulses.

In subsequent formulations, Freud turned his attention to a less biological and more reactive approach, seeing retaliatory aggression, often accompanied by hatred, as the essential means of self-preservation, which he viewed as the central goal of the ego instincts.

In his final formulation, Freud returned to the concept of aggression as innate, evolving the concept of a death instinct as a universal drive paralleling libido, or the life instinct. It was seen as the source of all destructiveness, whether directed inward toward the self as in masochism or outward as in sadism.

Melanie Klein (1975, pp. 61-93) accepted the dual instinct theory of Freud and was among the first psychoanalysts to turn her attention to the infant and young child. For Klein, love and hate were inborn and aggression was a manifestation of the death instinct, first exhibited as oral sadism projected outward from birth.

From her extensive clinical observations during play therapy, details of the child's mental life that focused on the child's relationship to the mother were elaborated, representing an early contribution to object relations theory. Her work spawned a broad and devoted following that continues to the present.

At about the time that these psychoanalytic developments were taking place, academic psychology was pursuing a more environmental perspective, specifically via learning theory. This movement was led notably by Dollard et al. at Yale, who in 1939 put forth the frustration aggression hypothesis that had a seminal impact on the field of child development for many years.

In this view, anger was seen as the inevitable consequence of frustration. Buss (1961), more than 20 years later, was to add attack and annoying behavior as causes of aggression, while emphasizing that frustration did not always lead to aggression.

The further evolution of psychoanalytic thinking on aggression led to a split between those who adhered to the death - instinct hypothesis and many who saw no basis for such an assumption (e.g., Fairbairn, 1954) and favored the notion that aggression was a learned phenomenon.

Notably absent from all of these theories was a developmental perspective that emphasized the role of preexisting conditions and prior experience in the child's reactions. Notwithstanding their imperfections, both psychoanalysis and learning theory flourished as theories of the mind and became integral to evolving techniques of psychotherapy, remaining so to the present day.

DEFINITIONS

Before tackling the basic questions of the roots of hostility, how it is established and how it evolves, some further discussion of what's actually meant by the term is necessary.

From the foregoing, it's clear that hostility is an affect, or emotion and affect theorists have grouped it with the negative emotions, which are usually placed along the spectrum that runs from annoyance to rage and includes anger, hostility and hate. Saul (1956) identified hostility as an emotion that seeks to harm or destroy another person or persons, in that respect quite different from anger.

Rothenberg (1971) concurred w/this view. Buss (1966) distinguishes between two forms of aggressivity, hostile and instrumental, the latter not containing any intent to hurt. Bowlby (1973) underlined the fact that anger can be functional, that is, a positive force, adding, "Anger with a partner becomes dysfunctional. . . whenever aggressive thoughts or acts cross the narrow boundary between being deterrent and being revengeful" (p. 249).

Somewhat later, Emde (1989), addressing the matter in the context of his organizational model, opined that anger is often adaptive and organizing, becoming the opposite chiefly when excessive, as in rage. In contrast, he saw hostility as never adaptive or organizing, but rather as maladaptive and disorganizing.

Like many authors, Bowlby (1973) appears to treat these emotions as differing only in intensity, that is, quantitatively. Yet the fact that hostility, rage and hate are regularly labeled destructive affects, thereby distinguishing them from anger and annoyance, is in apparent recognition of the fact that the two groups of affects are qualitatively different.

Not always noted is the fact that hostility has an important cognitive component in that, in contrast to anger, it requires the ability to conceptualize doing harm to someone else - a capacity clearly not present, according to Basch (1976), before the 3rd year of life.

Rage, I believe, is best understood as extreme anger that threatens to lead to a loss of control; it's the potential loss of control that makes rage destructive, not an inherent, preexisting wish to destroy the object.

On the other hand, "hate," in its general use, seems to be another name for hostility, perhaps with broader applications, as in racial and religious hatred or prejudice. Some investigators distinguish hate from hostility as a more stable and enduring affect that also involves "internalized representations of self, object and event" (Parens, 1992, p. 89).

This seems valid only if it's compared to the hostile response, as opposed to hostility that has become entrenched as a character trait. Kernberg (1992), drawing on his experience with severe character pathology, eschews the term hostility altogether and substitutes "hatred" for all manifestations of intended hurt or harm to the object (see Table 8.1).

These, then, are some of the definitions surrounding aggression that are in common use and it's apparent that consistency of usage has been an elusive goal. Though the problem is largely semantic, the absence of definitional specificity and general agreement has long rendered effective communication difficult. It's hoped that continuing studies addressing the origins of the various manifestations of aggression in the child will lead to increasing clarity.

Genesis

How and when does hostility originate? Considerable evidence indicates that it begins early and therefore in the home. Although the angry response is evidently universal, likely to be seen at all ages and across all cultures, one of the most striking observations that can be made about hostility is that there are families in which it seems not to exist.

It isn't found in the interactions of family members or between them and the outside world. These are families that are comfortably self critical, aren't prone to casting blame and tend to be free of prejudice and hate. They don't appear to be repressing.

Although the dual-instinct theory leads naturally to the proposition that ambivalence (as expressed in the love-hate relationship) is part of the universal human condition, empirically this doesn't seem to be the case. In my view, it's more plausible to view the hostility of childhood ambivalence as a symptom of matters not being quite right in the child's life.

Assuming that this position is valid, in seeking to understand the roots of hostility in the child, we must not only inquire what specific familial factors are fomenting such feelings but also ask what protects some children from developing hostile responses.

Some of the most fruitful research that has been done in child and adolescent psychiatry in the past 30 years has involved detailed observation of neonates, infants and young children, generally through 3 years of age, in which the stages of development of different components of mental functioning have been studied.

These studies have included a focus on affects, how they're expressed and how they unfold. Hostility has been the particular interest of a number of researchers, among them Parens (1979, 1992), a child analyst and Mahler disciple who has been a major contributor to this area. Among the important developmental findings that have emerged are the following:

* Irritability and rage are seen from birth.

* Anger and hostility first occur in the second half of the first year (the practicing subphase of separation-individuation).

* Hate (as defined previously) first appears in the second half of the second year (the rapprochement phase).

Parens takes the position that - although the biological underpinnings of hostility are present from birth, especially in the form of rage reactions - aggression isn't innate. In this regard, he notes his agreement with Storr (1972), Bowlby (1973), Rochlin (1973), Kernberg (1984), Saul (1976) and Kohut (1977), among others (Parens, 1992, p. 81), all of whom have rejected Freud's final formulation (& presumably, Klein's acceptance of it).

For Parens, hostility in the young child results from extreme unpleasure arising in the caregiving relationship, whatever its source. Thus, the effective stimuli are nonspecific and the necessary element, a reaction of unpleasure, must be particularly intense. In this respect, Parens seems to agree with Bowlby that a quantitative factor is a key element.

Having described rage reactions as "the most primitive form of (nonideational) hostile destructiveness" (Parens, 1992, p. 91) and admitting (in contrast to Melanie Klein), that we can't ascribe intention or a wish to hurt someone else to the infant, Parens (1992) adds that "One might. .  reasonably hold that neither 'hostile' nor 'destructiveness' can be aptly applied to an affective experience w/ no ego-dependent ideational content" (p. 91).

This echoes Basch's (1976) view, one which I consider central to my own view of hostility.

Parens (1992) also evinces some doubt as to whether the hostility he has identified in the first 2 years is the same emotion seen later in the school-age child or the adolescent. He notes, i.e., that when the excessive unpleasure is ended, "little more can be seen of the child's hostile reaction" (p. 94).

This observation was also recorded by McDevitt (1983). I'd add that this doesn't appear to be the case when, at a later stage of development, unmistakable hostility occurs. In my experience, it doesn't attenuate, even if the causative stimulus is removed. Thus, although Parens considers the rage reaction of infancy paradigmatic of an early form of hostility, the fact that not every individual who manifests early rage matures into one who is hostile casts doubt on this hypothesis.

From a clinical perspective, it seems more likely that, if anything, such a person will remain subject to anger and angry outbursts as the years pass and that the development of hostility follows a distinct and independent course.

In fact, to my mind, what makes more sense is that the irritability and rage expressed by the neonate and the anger that we see in the 6 -month-old represent an exercising of the child's biological equipment, much like crying (Lester & Boukydis, 1984), while also setting up the neural pathways that'll figure in the continuing growth and development of the child.

As such, I see these reactions more as trial runs of negative emotion than specific precursors of hostility.

To return to the nature versus nurture debate, and in view of the general agreement that hostility is not innate and the likelihood that what appears to be hostility prior to the third year is really something else, what have we learned about the mother-child relationship (or other environmental forces) that casts light on the causes of hostility in the child? There is probably no single factor that is guaranteed to generate hostile feelings, even when repeated or sustained. We can, however, identify several risk factors that become effective once, as already indicated, a child has reached a level of cognitive development at which hostile ideation is possible. Ideas such as "She doesn't love me, she wants to hurt me"; "She is very powerful and can hurt me very badly"; "I can't protect myself-maybe I have to hurt him before he hurts me" are examples. The following is a partial list of what different authors have proposed as intrafamilial causes in the generation of hostility:

* A combination of threats of abandonment and failure to provide protection (Bowlby, 1973)

* Parental hostility to the child (Saul, 1956)

* Severe physical or emotional abuse (many authors)

* Absence of empathy on the part of the parents, accompanied by attacks on the child's self, with threats of narcissistic injury (Kohut, 1972)

* Failure of attachment, when sustained and not compensated for by someone other than the primary caregiver (Bowlby, 1973)

* Failure to deal appropriately with the child's naturally occurring anger (Kalogerakis, 1974)

* Intense attachment to the frustrating mother (Kernberg, 1992)

These items represent different emphases and are not incompatible with one another. None constitutes a necessary and sufficient condition, although Saul's point about parental hostility, when undiluted and sustained, comes close. If there be a common denominator, it most likely lies in the exposure to a threat so severe that it can be labeled a mortal threat. Perhaps this is best captured by Kohut's (1977) and other self-psychologists' (Rochlin, 1973; Gunther, 1980) idea of a threat to or an actual attack on the self, which threatens its disintegration. The child's total dependency, when combined with a threat to its very survival issuing from those charged with responsibility to protect it, constitutes an abdication of that parental responsibility and an unbearable betrayal, and leaves the child defenseless and without recourse. In that context, hostility may be seen as a catastrophic response by a child whose immaturity makes it otherwise incapable of defending itself. With no solution in sight, the child resolves it in fantasy, eliminating the threatening object by wishing it dead. The actual expression of hostility behaviorally may be delayed for some time and is probably dependent on (1) the caregiver's abusive behavior's reaching an intolerable, sustained level, and (2) the beginnings of a sense on the part of the child that it will be able to protect itself.

BEYOND THE THIRD YEAR: REINFORCEMENT AND INTERNALIZATION

Mayes and Cohen (1993), reviewing the course of normal aggressivity in young children, point to the developmental transformations that take place as the child moves beyond the first three years of life. First, there is an overall diminution in the amount of aggression; second, the physical aggression of the younger child gives way to a more verbal expression in the preschooler. "By school age, aggressivity is more often personally directed, is instigated by threats to the child's selfesteem, and is more often intended to harm the offending other" (p. 155). What is important here is that the authors are calling attention to what amounts to a developmental or normative source of hostility in the maturing child. The authors also underscore how neurocognitive maturation fosters increasing awareness of others' thoughts and feelings and an ability to connect mental state with actions and behavior.

Meanwhile, for the child exposed to an abusive situation at home, the hostility that may have been instilled in the child's first three years can either be reinforced or mitigated. What is the impact of continued abuse? And what do we know of protective factors? What defense mechanisms are brought into play? In a series of 17 cases followed by McDevitt (1983) from infancy through eight years of age, aggression in different forms was found to persist in many of the children, those in whom "regressive forces outweighed progressive forces" (p. 296). In others, the use of adaptive defense mechanisms enabled the child to modulate aggression and achieve some degree of object and selfconstancy.

As one might expect, a continuation of destructive aggressiveness on the part of the caretakers reinforces hostile aggression in the child. What I have seen in case after case with adolescent and adult patients in therapy (see chapter 9, this volume, for case examples) is that the manner in which the patients' anger was handled by their caretakers as they moved through childhood was a critical determinant of whether hostility developed and persisted. Loving, secure parents have no problem allowing their children to express anger appropriately, because they are not threatened by it. The result is that the child vents its anger, whatever the cause; feels that its feelings are being heard; learns how to negotiate one of the basic skills of living; has an opportunity for a dialogue about its grievances; and, with empathetic parental guidance, can come to a resolution of the problem. By not being summarily dismissed, the child feels respected and loved. It will in turn reciprocate those feelings.

When parents cannot tolerate the child's anger, they retaliate punitively. The anger will not dissipate but will be stored. This accumulation, over time, with no place to go, will lead at some point to what I have elsewhere called a malignant transformation of the anger into hostility (Kalogerakis, 1974). A particular example of the failure to handle anger appropriately involves the management of sibling rivalry. Parents who fail to intervene and set proper limits when normal arguments (e.g., over a toy) turn nasty are abetting the establishment of a destructive pattern of relating to others. Not only does the relationship between the siblings suffer, but their respective future relationships with other children may be compromised. One can see in such examples how hostility is sequential, always preceded by anger, that it is in effect anger gone awry. At this point, it is already a precursor to developing pathology. Once this occurs, parental authority is severely compromised, the child feels alienated, and the interactions that formerly provoked anger will now regularly evoke hostility. Over time, this symptom will become part and parcel of the behavioral repertoire of the child. A hostile response will be predictably elicited each time the requisite parental behavior occurs. In short, it has become Α personality trait (see Table 8.2).

It will require more time before such responses are seen in interactions with other people. Such generalization will initially be appropriate to what is transpiring with the other person. Invariably, however, continued abuse at home leads to the establishment of a hostile attitude to the world at large. Projection and projective identification become established defenses, and there is general mistrust and increasing alienation socially. Reinforcement of a distorted perception of the environment will lead inevitably to significant maladjustment and progressively serious problems with self-esteem. As the child loses the ability to tailor its responses to the stimulus, the resulting automaticity indicates that internalization has occurred, has had a pervasive impact, and a hostile personality structure has been established. Much of this unfolds outside full awareness and is thus unconscious.

This sequence is strongly reinforced when both parents deal with the child abusively. When that is the case, and there is no compensating impact from another adult with caretaking responsibility, the impression the young child forms of the world and what to expect is molded exclusively by its parents. It will perceive the world as a hostile place, an anxiety-producing state of affairs that further compounds its problems. Cognitively, the child is learning how to perceive, how to interpret, what to believe, and how to react. At the same time, there is an absence of health-promoting human interactions, the whole comprising a highly traumatic, sometimes devastating childhood experience.

Hostile adolescent boys in psychotherapy will often report troubled relationships w/their fathers. Some will nonetheless be open, however guardedly, to the possibility of accepting some empathy from the therapist. Yet male therapists also clearly face the prospect of a strong negative transference.

The fathers are frequently portrayed as angry, hostile martinets who typically have been relentlessly critical, placing unreasonable demands on their sons while giving very little. Empathy, the essential ingredient of every nurturing relationship, is conspicuously absent. In other instances, the relationship is more ambivalent.

As might be expected, the paternal behavior is often a reenactment of the father's own childhood experience. In the more fortunate situations, the mother is a healthier parent & provides "good enough" nurturing in the early years, the first significant exposure to hostility not occurring until later.

In the reverse situation - when the mother, as the primary caregiver, is the abuser - the father may not be able to exercise sufficient positive or protective influence until considerable damage has been inflicted. According to Saul & others, the hostile response is fixed by age 6 or 7. What can be salvaged after that point is dependent on the extent of prior damage & how significant a role the father is then able to play.

A key element in the reinforcement of the hostile response & its ultimate internalization seems to be the child's growing awareness, probably not before latency, that the parental "love" he or she is receiving isn't love at all but an interest that is narcissistically driven. Where the younger child reacts w/anxiety & insecurity to this incongruity & is apt to blame himself or herself, the adolescent can more readily discriminate between situations in which the fault lies w/the parent & not with the self.

This, in combination w/the reality that the parents have total power over the teen (invariably associated w/a feeling of being trapped) leads initially to anger & ultimately to hostility. This sequence may well be the adolescent equivalent of Parens' excessive unpleasure, resulting at this later stage from unreasonable abuse of parental authority.

The Challenge

In the title of this chapter, therapeutic challenge is included as one of the concerns I wish to address. This is, of course, a somewhat parochial perspective, because we as mental health professionals no more own hostility than we own global poverty or malnutrition.

Quite naturally, I've focused my remarks on the microcosm of the individual child & adolescent in the context of the family. This is appropriate to our professional concerns as clinicians & social scientists. Yet, when all is said & done, the challenge posed by hostility in our midst is in effect society's.

As is the case w/violence, although perhaps less visibly, it's a matter of prevention & therefore a public health concern. In a broader sense, it's certainly a matter for government's attention, although it's not always clear just what government can do. Education of the public on matters of child-rearing might be one useful undertaking.

The assurance of adequate support services to needy families might be another. The school system has a role to the extent that the symptoms of a family's dysfunction are often first detected in the classroom. The astute teacher is frequently able to pick up evidence of child abuse. Children who enter foster care are especially accessible for early intervention.

We can't take leave of the subject of hostility in the human experience w/out noting the relevance of principles derived from the study of individuals & families to the larger social entities of communities, societies & nations. It's no secret that hostility & hatred are as much a factor in human interaction at these levels, w/even more devastating consequences.

We know how often the biographies of political leaders who have changed the course of history read like clinical cases in which child abuse has been prominent. It's also evident that the behavior of nations so frequently parallels the strife we see in families.

There are obvious dangers in extrapolating too freely from the individual to society when so many other variables are at play. At the same time, wherever we encounter it, we know that at the outset hostility is an abnormal, destructive affect that has its roots in the family, finds its greatest expression in the interpersonal setting & can lead to chronic, even lifelong maladjustment.

We know, too, that it's treatable, most appropriately during the adolescent or early adult years. Finally, we know that, untouched, it's often the basis for serious psychosocial pathology, manifested especially in character disturbance & antisocial behavior & violence.

The ultimate verity, now strongly supported by research, that hostility is introduced into a child's life at a very early point makes prevention & early intervention critical components in the total response.

Research on affect at the adolescent level of development is still scarce (Hauser & Smith, 1992), but it's hoped that such research will ultimately include a detailed exploration of hostility at that stage & spur our therapeutic efforts w/these troubled youths.