Conservation-withdrawal and action-engagement: on a theory of survivor behavior

In severe continuing adversity, it is postulated that a potential for survivor behavior with common characteristics is evoked that may ultimately result in survival of what at first sight appears to be insuperable odds. The process of survival results in a radical change of values, intensified concern with the body (the survival value of hypochondriasis and narcissism), the establishment of absolute trust in a few others or the equivalent for internalized objects if alone. Communication is paramount. This survivor behavior is distorted in the clinical setting resulting in noncompliance, manipulation of power figures (clinical staff), and distorted understanding, both ways, of communication. Suggestions are offered on the developmental history of the patient as a survivor and how survivor behavior can be incorporated into therapeutic regimes. In line with the concept of conservation-withdrawal, the action-engagement of survivor behavior is hypothesised as being biologically based.