What is Anal Retentive?

For those who have a friend or family member that is anal retentive, it may be difficult to tell whether they are simply being annoying or have a mental health disorder. However, this personality trait can lead to constipation, a severe and painful condition.

A study found that the anal retentive behavior features are significantly more common in patients suffering from functional constipation than healthy subjects. Paranoid, antisocial, narcissistic and obsessive-compulsive personality beliefs are also higher in these patients.

Sigmund Freud’s Theory

Freud was a medical doctor – a neurologist and psychiatrist – who gave sexual drives an importance and centrality to human behavior and actions that were new (and for some, shocking). His theory is often criticized for being hetero-centric, binaristic, and misogynistic.

The anal stage is the second within Freud’s psychosexual stages of development. It is during this stage that children learn to control their bowels and bladder, and he believed that psychological conflict arises in the child/toddler’s desire for anal gratification and their toilet training to delay this gratification. He thought that if the caregivers were too harsh during toilet training, then the children would become fixated on this stage, and develop into what he called an anal-retentive personality. This type of person would be stingy and compulsive in their pursuit of cleanliness and order.

If the caregivers were too lenient during toilet training, then the children could also become fixated on this stage and develop into what he called an anal-expulsive personality. This type of person would be messy, careless, and disorganized. The anal-expulsive person would be obsessive and compulsive in their pursuit of pleasure, putting their own needs before others. For example, they may use only one square of toilet paper and only spend a certain amount of money each week. This behavior can be annoying for those around them, but if the anal-retentive individual functions well and is not bothered by their quirks by others, then they probably do not need any treatment for this personality disorder.

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Freud’s Definition

A person with an anal retentive personality is often obsessive about their appearance and habits to the point that they become annoying for people around them. For example, they might research a product endlessly before making a purchase or insist on always using a specific brand of toilet paper.

According to Freud, if a child experiences conflicts with their parents during toilet training or is punished for accidents they may develop an anal fixation in adulthood. He believed that anal fixation leads to a compulsive concern with order and cleanliness. Later psychoanalytic theorists like Ernest Jones and Karl Abraham added to Freud’s description of the anal personality by describing traits such as being stubborn, obstinate and overly self-reliant. Other traits included being obsessed with cleanliness, detail oriented and having a passion for classifying or organising objects.

Another theory of anal retentive personality is that it is caused by the anal stage which occurs between the ages of 1 and 3 years. It is during this time that a child discovers the pleasure of controlling their defecation. The anal stage is also the time when a child forms their superego. When a child becomes anal fixated they will continue to display behaviour features from this stage into adulthood.

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Symptoms

Few ideas that have been thrown around as psychiatric diagnoses stand more for comic value than “anal retentive,” a concept that originated in Freudian psychoanalysis and has since faded into the ether. Nevertheless, there are personality traits that have the potential to be anal retentive and, if they do show up, it’s important to determine whether this is a quirk or a symptom of a mental health condition.

In Freud’s theory, anal retentive traits reflect the anal stage of psychosexual development, which is associated with erogenous pleasure and occurs from ages 2 to 4 years old. He believed that difficult toilet training could have long-lasting consequences on a child’s personality, with anal retentive fixation being a consequence of overly passive toilet training.

Anal retentive personality characteristics are characterized by orderliness, frugality, and obstinacy. The child that creates a mess during toilet training may grow up to be an adult who is neat and tidy and has strict rules about money and schedules. Anal expulsive fixation, on the other hand, is characterized by irresponsible behavior and rebellion against authority.

A recent study has shown that some of the same behavioral characteristics found in a person with anal retentive personality features are also present in those with functional constipation. The researchers studied 47 patients with functional constipation and measured anal characteristic features, as well as obsessive-compulsive, antisocial, narcissistic, and paranoid traits.

Treatment

In some cases, anal fissures heal without treatment. Others will need ointments, or the doctor may recommend sitz (salt) baths. They also may use baby wipes instead of toilet paper, as this reduces the chance of bleeding or a recurrence of anal fissures.

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More severe anal fissures require surgical correction. This involves removing the anal fissure and scar tissue, and occasionally a thin slice of muscle from the anal sphincter. This operation is called a lateral internal sphincterotomy, and it normally prevents future anal fissures.

If your anal sphincter is weak, or you have anal stenosis (narrowing of the anal canal), you may need surgery to repair this too. This involves releasing a flap of skin from the area outside the anus on the inner side of the buttocks (the perianal region). Your surgeon will then cover this with the anus, closing the gap and stitching it up.

A person who has a need to control things to an extreme can also be diagnosed with a psychiatric disorder called obsessive-compulsive personality disorder, or OCPD. People with OCPD often display the same behaviours as people who are anal retentive, such as a need for order in their lives and problems delegating tasks. They can also be obstinate and resentful of other people’s needs or feelings. They also often make lists and have trouble spending money or getting rid of things.

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