Normal and pathological altruism

The psychoanalytic literature on altruism is sparse, although much has been written on this topic from a sociobiological perspective. Freud (1917) fir st described the concept in "Libido Theory and Narcissism." In 1946 Anna Fr eud coined the term "altruistic surrender" to describe the psychodynamics o f altruistic behavior in a group of inhibited individuals who were neurotic ally driven to do good for others. The usefulness and clinical applicabilit y of this formulation, in conjunction with the frequent coexistence of maso chism and altruism, encouraged psychoanalysts to regard all forms of altrui sm as having masochistic underpinnings. Since then, there has been a confla tion of the two concepts in much of the analytic literature. This paper ree xamines the psychoanalytic understanding of altruism and proposes an expans ion of the concept to include a normal form. Five types of altruism are des cribed: protoaltruism, generative altruism, conflicted altruism, pseudoaltr uism, and psychotic altruism. Protoaltruism has biological roots and can be observed in animals. In humans, protoaltruism includes maternal and patern al nurturing and protectiveness. Generative altruism is the nonconflictual pleasure in fostering the success and/or welfare of another. Conflicted alt ruism is generative altruism that is drawn into conflict, but in which the pleasure and satisfaction of another (a proxy) is actually enjoyed. Pseudoa ltruism originates in conflict and serves as a defensive cloak for underlyi ng sadomasochism. Psychotic altruism is defined as the sometimes bizarre fo rms of caretaking behavior and associated self-denial seen in psychotic ind ividuals, and often based on delusion. We consider Anna Freud's altruistic surrender to combine features of both conflict-laden altruism and pseudoalt ruism. Two clinical illustrations are discussed.