Care-Eliciting Behaviour in Man

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Care-Eliciting Behaviour in Man. Scott Henderson. Journal of Nervous and Mental Disorder, 1974, 15, 3, 172-181

One of the earliest papers to make link between attachment theory and common presentations in general psychiatry. It expounds on the idea of dependence as a phylogenetically important behaviour, with its deviant manifestations presenting as psychopathology. He proposes alternate terminology to dependence as ‘care-eliciting’ behaviour, defined as a pattern of activity on the part of one individual, which evokes from another responses that give comfort. In its healthy variant, it has evolutionary value in ensuring that the infant is adequately fed and protected, adult man and woman stay bonded for long periods, and for a group to maintain strong social bonds between all its members. However, in its pathological variant, it tends to present in variety of symptoms when an individual perceives himself to be receiving insufficient caring behaviours from others. It has the specific characteristics that the behaviour or symptom is initiated by the individual himself, is likely to be driven by unconscious factors, is appetitive, and is disruptive for the person and/or others. It tends to elicit ambivalent responses in others, particularly health professionals, as it is often an infringement of the code relating to genuine illness behaviour. It remains to be examined if people presenting with one pathological variant of this behaviour also at higher risk of suffering with other variants, as in, is a person who presents with self-harm behaviour also likely to suffer with anorexia or conversion hysteria or neurotic depression, or abnormal illness behaviour?

We have made some progress in responding to the final question posed by this paper – we do see it commonly in clinical practice the comorbidities with such ‘care-eliciting’ syndromes. It is also commonly noticed that such presentations to ED, public hospitals, and community centres often elicit only ambivalent responses from health professionals, and not considered as the ‘real’ psychiatric illnesses. This paper presents an alternative formulation for such presentations and encourages health professionals to consider phylogenetic drivers to this behaviour, and respond by providing care instead of overly relying on pharmacological means to control person’s behaviour or dismissing the person.

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