Published online by Cambridge University Press: 01 August 2014
Our starting point was Franz Alexander's well-known hypothesis about the hypertensive personality. According to Alexander (1939), hypertensive patients are characterized by a neurotic conflict between passive dependent tendencies and over-compensatory, competitive, hostile impulses. Hypertensive patients seem to be anti-aggressive, submissive, polite, and reserved. At the same time, they show no direct neurotic symptoms such as anxiety, obsessive ideas, or conversion symptoms. Hypertension may be looked upon as a substitute for symptom neurosis. According to Alexander, hypertensive patients are unable to express freely aggressive impulses, and at the same time unable to repress or absorb the impulses through symptom formation. An accumulation of psychic energy takes place, which manifests itself in constant vasomotoric stimulation. In the long run, this development may be able to change the balance of the baroceptors and finally destroy the circulatory system.
A sample of MZ twins is particularly suitable for studying the influence of inhibited aggression on blood pressure. In addition to the methodological advantages of controlling the genetic and external environmental factors of childhood, one frequently finds a casting of roles with one of the twins dominant and aggressive, and the other as a submissive and timid partner.