![]() Psychotic altruism is defined as the sometimes bizarre forms of caretaking behavior and associated self-denial seen in psychotic individuals, and often based on delusion. Pseudoaltruism originates in conflict and serves as a defensive cloak for underlying sadomasochism. Conflicted altruism is generative altruism that is drawn into conflict, but in which the pleasure and satisfaction of another (a proxy) is actually enjoyed. Generative altruism is the nonconflictual pleasure in fostering the success and/or welfare of another. In humans, protoaltruism includes maternal and paternal nurturing and protectiveness. Protoaltruism has biological roots and can be observed in animals. Five types of altruism are described: protoaltruism, generative altruism, conflicted altruism, pseudoaltruism, and psychotic altruism. This paper reexamines the psychoanalytic understanding of altruism and proposes an expansion of the concept to include a normal form. Since then, there has been a conflation of the two concepts in much of the analytic literature. The usefulness and clinical applicability of this formulation, in conjunction with the frequent coexistence of masochism and altruism, encouraged psychoanalysts to regard all forms of altruism as having masochistic underpinnings. Freud (1917) first described the concept in "Libido Theory and Narcissism." In 1946 Anna Freud coined the term "altruistic surrender" to describe the psychodynamics of altruistic behavior in a group of inhibited individuals who were neurotically driven to do good for others. The psychoanalytic literature on altruism is sparse, although much has been written on this topic from a sociobiological perspective.
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