A frankly amazing interview took place last month on The Diane Rehm Show (NPR), one that was too rich not to share here. Diane sat down with Dr. Henry Kellerman, a renowned psychoanalyst, to talk about his new book, Personality: How it Forms. A broad subject for a discussion, but one which quickly took an interesting–and highly relevant–turn. According to Dr. Kellerman, while there is a strong inborn element to who we are, much of the “nurture” aspect of our personality is shaped by our history with the word No. Specifically, what we do and where we go with the anger (and fear) it produces. Fight, Flight, Appeasement being a few responses we’ve recently mentioned on this site. But Kellerman takes the opportunity to speak at some length about the nature of anger, a timely topic if ever there was one. And let’s just say he’s got some fascinating things to say. We can talk about anger in society, or anger about something specific but no one wants to admit that they’re angry on a personal level–“upset” or “stressed” or “bothered” are much more acceptable alternatives–but this reluctance often functions as a vehicle for repression and, therefore, escalation. Kellerman wisely suggests that there is a clear social hierarchy of negative emotions (perceived law), with anger being the least acceptable. Fear and disgust are both preferable.

But the relationship between anger and judgment (and, by implication, the unavoidably integral role of the law in all of our lives and upbringings, not to mention the roots of theological anger) is only part of the interview. There’s also the fact that his phone goes off not once, but twice during the interview, provoking some indignation (don’t say the A-word!) from Ms Rehm herself. Even if you’re not a huge 2 Cor 1:18-20 person, the entire thing is very much worth listening to and/or reading–I haven’t reproduced their exchange about the murder of his son, for example–but some of the more directly relevant sections include:

KELLERMAN: [Part of psychoanalysis is to help a patient remember when—and from whom–they first learned] the most important word in any language. And what is that word? What’s the most important word in any language, Diane? You tell me. It has two letters and the first one starts with an N. What do you think it could be?

REHM It is no.

KELLERMAN I know you’re very smart, right? I know you’re very smart, yes. It’s no.

REHM And we remember that person who said, no.

KELLERMAN Well, let me expand that a bit. You’re right, of course, but you see with No, is accompanied a certain implication and that implication is two words, or else. We always experience the or else. So that is known as birth of compliance. Children begin to comply because they’re always worried about a certain kind of experience that they don’t want to have, just like all little animals that want to have that experience with their mommies. And that is they don’t want to be abandoned. The or else always refers to abandonment. And therefore with these no’s that we hear, we’re constantly getting our wishes blocked because little children always want what they want when they want it, how they want it, to what extent they want it. …when the No is said so many times, and when wishes are blocked, the child or the young child will become dissatisfied or moody or upset or stressed.

All of them are code words for anger and the anger is instantly repressed and forgotten. Why? Because of the fear of abandonment, you cannot be angry. You can be a little bit dissatisfied. You can show a little bit of momentary dissatisfaction, but you really can’t be rage-ful consistently and to a very intense level. If you are, then we call that a bipolar, you know, emotional disturbance… [But] the fundamental issue is when anger is repressed. You see it’s the birth of a symptom. No symptom can survive with repressed anger whether it’s a phobia or whether it’s an intrusive thought or whether it’s a compulsion or an obsession. No symptom can survive with repressed anger. The axiom or the self-evident truth would be, where there’s repressed anger, not only will there be a symptom, there must be a symptom… Where there is no repressed anger, not only will there not be a symptom, there cannot be a symptom…

REHM: [One listener] writes, the word no also represents the child’s first sense of empowerment, when he or she says no.

KELLERMAN That’s exactly right. And it also means that it’s driven by a certain kind of angry impulse, because the angry impulse says, what do you mean I can’t have it. Yes, I can have it. I want it. And so the no is driven by anger. And anger is always an empowerment, always an empowerment. Here’s the personality of anger. Are you ready for this? Anger has an aggressive drive. Like all primary emotions, it’s inborn. Anger is expansive, it wants to get bigger. It has explosive potential. It wants to burst out. It has a confrontational inclination. It wants to get tough. Anger has an attack inclination, it wants to attack. It has an entitled frame of mind. It feels the right — it feels it has the right to get tough. Anger is an empowerment. It eliminates feelings of helplessness. So that anger is usually considered a negative emotion, but it’s not always a negative emotion.

…It’s always a conflict with children growing up, with all of us. The conflict is between what we have to do, which is usually good for us; and what we want, which is not always good for us. So that, yes, of course, we have to comply. We have to comply.

REHM: What happens when the anger becomes the dominant factor of a personality and how it forms?

KELLERMAN Well, when it becomes dominant like that, we get certain diagnoses that are very, you know, detrimental to the person’s functioning in life. For example, there’s a diagnosis known as borderline personality. And it’s a person with what we call a thin ego, and anger is constantly just a scratch beneath the surface. And, you know, it takes over the person’s life. It’s very difficult to live with such a person. And such a person usually winds up, you know, very much alone.

… I had a patient once that came in to see me and I asked her why she was there and she said, well, you know, things happened that bothered me. I said, okay. I thought I’d take a chance because you really can’t tell people they were angry. They don’t accept it. But I wanted to take a chance and I said, well, I guess you feel angry at that — whatever it was. And she says, no, no, no. I don’t feel angry. I just feel upset. Okay. So upset is a code word for anger and people — you see, if you’re upset, it’s socially desirable. If you’re angry it’s socially undesirable.

REHM: And what about depression? Is that the flip side of anger?

KELLERMAN I wouldn’t even say it’s a flip side, but, you’re right. It’s a synonym. And it’s a displaced symbolic, you know, way of expressing anger. You know anger has the largest glossary of any primary emotion. For example, dissatisfied, depressed, moody, bored even, frustrated, upset and the cardinal synonym for anger that people use, this code word, stressed. Stress is nothing but feeling angry underneath. People don’t want to know that they’re angry, but they don’t mind knowing that they’re stressed. They don’t mind knowing they’re upset. Any word that is socially desirable is okay, but anger’s not okay because it’s socially undesirable. Even anger related traits are socially undesirable. Sullenness is not desirable. Argumentativeness is not desirable. These are anger related traits. Fear related traits are much more desirable. Caution, for example is considered desirable…

REHM: Here’s an email from Gregory in Cary, N.C., who says, “How likely is it that a person with anger issues can change his personality? Someone I know has alienated most of the people in his life because he cannot control his anger. What would the process of the friend be toward this person?”

KELLERMAN You know, Diane, we have to recognize, it seems to me, that there are certain things in life that not always can be easily addressed. And one is if someone’s angry, very angry for a long period of time and just flips out at virtually everything and can’t control anything, it could be a function of a certain diagnosis, which we call a borderline personality. And that is very resistant to talking cures. Some problems need medication, plain and simple. There’s no doubt about it. I published a book called, “A Psychoanalysis of Symptoms,” in which I describe two classes of symptoms. One is an acute symptom that people get and they come and go. And those can be cured through the talking method, but chronic, very chronic, lifelong symptoms really need medication. That’s the way I would answer that.

REHM So would you say to this caring friend, perhaps just being there for that person, as opposed to trying to help, actively trying to help that other person would be the better choice?

KELLERMAN I’m not sure about that, Diane. I think that when someone’s very, very angry people don’t stick around too long.

Bonus Points if you can name the Mbird conference speaker to whom Dr. Kellerman once served as mentor.