Overview
“Passive-aggressive” refers to a communication style in which someone doesn’t explicitly articulate how they feel while still acting or saying things that suggest they have negative opinions or feelings. Critically, the term did not originate from academic or research circles, but instead emerged in the context of compliance to orders in the United States military.
History and Etymology
WWII
During WWII, military psychiatrists were tasked with evaluating soldiers who resisted orders without openly refusing them. They might have expressed dissatisfaction through visible emotions (called “pouting”), stubbornness before complying with a rule, and a lack of instrinsic motivation to improve efficiency. In some cases, this resistance came in the form of outright noncompliance or sabotage akin to civil disobedience. In 1945, the War Department Technical Bulletin, Medical 203 under William C. Menninger, proposed the term “passive-aggressive” to refer to the hostility or resistance engendered in soldiers who want to resist orders. The model of passive-aggressive behaviors contained two parts: the observed behavior and the inferred (sometimes subconscious) motivations. It appeared under a category called “Immaturity Reactions” and was pathologized as a psychiatric disorder resulting from excessive routine stress. Menninger thought passive-aggressiveness was the most common psychiatric disorder in the military.
After WWII ended, several psychiatric centers under the Veterans Administration (VA) approved the adoption of “passive-aggressive personality” as a clinical term. The War Department Bulletin proposal was reprinted in the Journal of Clinical Psychology in 1946 to introduce it to everyday psychiatry. Shortly after, in 1948, the American Psychiatric Association’s Committee on Statistics set out to esablished an authoritative taxonomic classification of known disorders and diseases. George Raines, who led neuropsychiatry at the Navy Department Bureau of Medicine, argued that the classification system should take in a wide variety of evidence and sources, but it seems the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-I, was still largely influenced by Medical 203 and related literature from the War Department. Even the International Classification of Diseases (ICD) adopted by the World Health Organization (WHO) in 1948 drew heavily from the War Department.
DSM-I
The DSM-I description of “passive-aggressive personality” split its reactions into three interchangeable subtypes based on the underlying response to frustration or stress:
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passive-dependent: stress leads to helplessness and dependency
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passive-aggressive: stress leads to resistance and obstruction
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aggressive: stress leads to overt irritation and destructive tendencies
The model underlying the “passive-aggressive personality” still assumes both an immature dependency or frustrated hostility. The notion of treated disorders as “reactions” came out of the work of Adolf Meyer at Johns Hopkins University and Sigmund Freud, using the contemporary notion within psychoanalysis that psychiatric symptoms were the result of emotional disturbances related to childhood development. This framework claimed that stress can lead to the ego being disorganized and anxiety to overwhelm the individual, with the repressed impulses leading to the behaviors described as “passive-aggressive.”
DSM-II
The DSM-II was established in 1968, led by Ernest Gruenberg. By this point, the 8th edition of the WHO’s ICD was also being released, so there was an ambition to align the new DSM with the ICD for consistency’s sake. The “reactions” within the “passive-aggressive personality” were consolidated as a single personality disorder characterized by indirect resistance and hostility. It still drew from psychoanalytic theories, but less explicitly so, partly because the late 1960s had major breakthroughs in psychopharmacology that reinforced the brain’s biological involvement in psychiatric disorders. While psychodynamic perspectives were still strong, there was a growing understanding that the DSM-I’s categorization wasn’t as stable as previously assumed. The ability to treat disorders pharmacologically opened the door to using treatment information to shape diagnoses and criteria.
DSM-III
The DSM-III was completed in 1980 after psychiatrists had been exploring the use of operational or diagnostic criteria.
Samuel Guze relates the story of meeting William Menninger’s brother Karl at an APA meeting delivering a talk. Karl