[11 November 2000]
Images Updated: 9 January 2005; 25 March 2006;
Last Updated: 25 March 2006. Modified: 29 March 2008; 22 July 2012;
Last Modified: 28 January 2013.
A brief survey, with modern applications.
The concept of temperaments in Western medicine finds origin and early elaboration
in ancient Greece; subsequently, it was developed and expanded by the Arabs, followed by Galen and the Romans. In the protomodel,
four cardinal elements (Air, Fire, Earth, Water) were imagined to comprise the world; all things were composed of these
elements, in differing proportions. Elementary forces or qualities were seen to act upon all things.
These qualities were innumerable, but four came to be regarded as especially significant: heat, cold,
dry, and moist. The protomodel of four elements and four qualities proved useful in the understanding and
classification of natural observations, but was not sufficiently specific to organic life. Attempts
to comprehend the basis of health and disease required a new formulation, a new schema.
Certain substances were observable in the human body. Blood, for example, was commonly observed from wounds. Phlegm,
too, could be seen, running from the nose. Bile might be vomited up from administration of a cholagogue. Early
treatises assumed unlimited humors in the body, but four, including Water, became definitive. Water, however, was
one of the universal elements. It was not directly observable in the body: urine, though watery, is not Water. Another
substance, black bile (congealed blood), had been regarded as a pathogenic agent in writings of the fifth
century B.C.. According to Henry E. Sigerist, M.D., black bile "was held responsible
for a great variety of diseases, ranging from headache, vertigo, paralysis, spasms, epilepsy, and other mental
disturbances, to quartan fever and diseases of the kidneys, liver, and spleen".1 In
the latest of the Hippocratic writings (The Nature of Man), atrabilious black bile is distinguished
from the bilious humor, yellow bile, and named as one of the four cardinal humors. Sigerist reports that
this treatise, commonly attributed to Polybus, is the starting point for humoral theory.2
Equilibrium among these humors (blood, yellow bile, black bile,
phlegm) was thought to constitute health.
The Emergence of Constitutional Types
In observing similarities among individuals with respect to traits, behaviors, and patterns of disease, the idea of
constitutional types began to emerge. The philosopher-scientist Theophrastus (B.C. c372-c287) noticed
that black bile appeared to dominate in men of genius, and this dominance did not indicate inherent pathology. Here was
the first delineation of a psychobiological constitutional type. The Arabs developed typologic characteristics for all
four humors. "Combined with astrological elements", says Sigerist, "the theory was developed and extended still further
in the West, in the Middle Ages and the Renaissance."3 These
ideas provided foundation for the work of Galen (aka, Claudius Galenus, A.D. c130-c200), a Greek physician
and writer, who practiced in Rome. In a revolutionary undertaking, Galen dissected the Barbury ape in an effort to discover
the loci and actions of humors in organs of the body. His clinical concepts of causation were empiric, including ideas of
initial, evident, external, preceding, active, conjunctive, adjuvant and maintaining causation; this had great appeal for
physicians and scientists alike.4 But his
deductive, rather than inductive, approach to constitutional types and temperament made it necessary for him to seek examples
of the constructs he generated, and this proved problematic.5
His theories and system of therapeutics were to influence the study and practice of Western medicine until the renaissance, some
1400 years later6, but the Galenic
types bear little resemblance to our concepts of the temperaments today.
In the 19th and Early 20th Centuries...
The perception that people are similar, that they exhibit characteristics or attributes which may be classified by type, was
a key premise in the psychologies of the past century. The number four figured prominently in many of the theories developed
during this period. William Strauss and Neil Howe tell us that the four temperaments "regained some of their former esteem", in
the twentieth century.
The idea of the four humors has deeply affected our concept of personality. Sanguine, choleric, melancholic, and phlegmatic
remain meaningful adjectives in our vocabulary. Popular books on humoral typology appear from time to time. The Four Temperaments in Children7, published in 1896, is the
oldest in my possession; it was written by Bernhard Hellwig as a guide for teachers. A neatly penned script on the page of
Critique: Psychologists say it's unscientific - lacks rigor, precision, control of facts. Nevertheless it sure is widespread in
use and application, or trials at it! Feb.29.40. R.N.S.
The turnabout came in the years around World War I, when a new generation of European psychologists revolted against positivism and made fourfold
thinking popular again. E. Adickes wrote of four worldviews (traditional, agnostic, dogmatic, innovative); Eduard Spranger of life types
(theoretical, aesthetic, religious, economic); Ernst Kretschmer of abnormal temperaments (anesthetic, hyperesthetic, melancholic, hypomanic); and in
the twentieth century's best know quaternity, Swiss psychologist Carl Jung wrote of attitude types based on psychological functions
([thinking], intuition, feeling, sensation). 8
[This note provides a table of the twentieth century temperament schemata listed by Strauss & Howe in the above excerpt.]
More Contemporary Schemata...
Let's examine a few more recent schemata that have developed along this line.
The model below is adapted from the work of Melvyn Kinder, in Mastering Your Moods9 Kinder
posits two continua, one indicating action tendency in terms of extroversion and introversion, and the other, state of arousal. He identifies four temperaments (sensor, focuser,
seeker, discharger), placing each in a quadrant indicating its action tendency and threshold of arousal. For instance, the sensor is extraverted and easily aroused. Kinder provides
descriptions for each temperament10, and one clearly can see in these the key features of ancient
Hans Eysenck studied two continua (extrovert~introvert and stable~unstable), plotting his results in four quadrants
which, it is suggested, might represent the four temperaments (Melancholic, Phlegmatic, Choleric, Sanguine). These quadrants
are further divided by keywords, to create a circle of subtypes.11
I've adapted Eysenck's model, below.
Dragan M. Svrakic et al. present a seven-factor model of temperament and character, developed to facilitate differential diagnosis in personality
disorders. They evaluate the efficacy of self-reports to read a comprehensive personality of seven dimensions, including novelty seeking, harm avoidance, reward dependence, persistence,
self-directedness, cooperativeness, and self-transcendence. At issue was whether such self-reports could serve as a reliable guide in differential diagnosis
and treatment. The results were positive.12
In the same issue of Archives of General Psychiatry, C. Robert Cloninger et al., with Svrakic contributing, describe these seven factors in terms of a psychobiological model of
temperament and character. They delineate self-directedness, cooperativeness, and self-transcendence as character traits; novelty seeking, harm avoidance, reward
dependence, and persistence were distinguished as temperament traits.13
Cloninger's psychobiological delineations of novelty seeking, harm avoidance, reward dependence, and persistence 14 do
not square perfectly with with Kinder's formulations. The theses are different, but the predicates bear sufficient resemblance to classical humoral theory that, with due care, we can
establish the following correlations between the formulations presented by Cloninger and Kinder.
In 1998, when I first read Cloninger's work, it struck me that persistence was a better descriptor for melancholic, rather than choleric temperament. Certainly persistence is
a key feature of the former; and reward dependence, construed as striving to gain an objective, is a goal-oriented choleric thrust. Closer scrutiny of Cloninger's temperament
dimensions suggests that reward dependence more properly correlates with the melancholic, where the "reward" involves gain from social attachment and approval of others. But let's apply
a little latitude, here.
What if we deemphasize the heriditable bias of sentimentality and need for approval, and instead construe reward dependence in more intrapersonal terms, rather than interpersonal?
Would that denature the dimension too much? Perhaps so. Kinder's Focuser is more persistent than reward dependent, and his Discharger, more reward dependent than persistent. Persistence,
"perseverence despite frustration and fatigue", applies to melancholic and choleric, simply in different directions, introversive versus extroversive. Where reward dependence is
cast in the sense of Cloninger, emphasizing social attachment and approval of others, it suggests a proclivity toward sadness and depression, the melancholic. Similarly, where persistence
is evaluated with respect to extroversive activity, it correlates with the choleric. I therefore set the correspondences in deference to Cloninger, but add my own in contrast, because both
seem to apply.
In this sketch of contemporary schemata, we have seen that contemporary formulations may be correlated with the temperaments of humoral theory. Although there arose a split between mind and body in the
subsequent history of Western thought, there was no separation in ancient theory. Contemporary psychobiological models are exploring this unicity again, in dimensions quite beyond the scope of the ancient
schema, even as Freud and Jung anticipated.
Yet there remains substance in the observations presented to us from antiquity. Popular books on the four temperaments often facilitate one's identification of type by means of an inventory of traits. In
the following adaptation of a questionnaire presented by Xandria Williams15, for instance, the objective is to identify which one of the four
types predominates in personality. Williams tells us that where one temperament is dominant, it will usually prove easy to read. Some people exhibit a dual temperament, and others, a trinity. Only rarely
does one come across a quaternity and, says Williams, "certainly not a balanced one".
Scan the lists below, see what you think.
Kinder's four temperaments are readily correlated with those of humoral theory.
As do Myers-Briggs core types
Williams provides a useful correlation between the four temperaments and the Myers-Briggs core types. She then
organizes the sixteen types of the Myers-Briggs Type Inventory (MBTI) in four groups of four, and regards these
as temperament subtypes.