Yesterday in my psychiatry class we were discussing personality disorders. I would have to say that personality disorders are my most favoured of psychiatric diagnoses (and I think most psychiatrists would agree). Personality disorders are really just hyperbolic combinations of common, everyday personality traits that are seen in all people. What makes them a disorder is when these exaggerated traits go unrecognized by the individual and they impede on that persons ability to function appropriately in society.
It is uniformly accepted in the medical profession that physicians (and medical students) display many traits that are common to the Obsessive Compulsive Personality Disorder and the Narcissistic Personality Disorder. There is nothing wrong with being a little OCD at times, and really, wouldn’t you want your doctor or surgeon to be slightly OCD – Striving for perfectionism, doing everything in a logical and methodical order, making sure things are done right the first time. The narcissism, however, may be a little less desirable in a physician. At one time or another, we’ve all encountered that doctor with the “God complex” who was arrogant, haughty, grandiose, who had little bedside manner and no capacity for empathy. While that type of narcissism has no place in medicine, I’d argue that some narcissistic tendency is what makes us successful in this field. As pre-med and medical students, we strive to be the best in our class, we want to stand out amongst the crowd, we want to impress our teacher/resident/attending physician, and we thrive on the praise we get when we succeed. We need the praise because without it, the work we put in would never seem worth it! I digress, however.
What worried me during this class yesterday was that there were characteristics from some other personality disorders that were familiar to me as well. I really did not want to recognize some of these other personality traits as my own. In particular, I found myself identifying strongly with the Avoidant Personality.
A person with Avoidant Personality Disorder:
- are inhibited, introverted, and anxious
(Me: check, maybe not so introverted, and check.)
- have low self esteem and are hypersensitive to rejection
(check and double check.)
- are apprehensive and mistrustful
(check, mildly check?)
- are socially awkward, timid, and self-conscious
Huh. I started to think. What does this mean for me? Can I blame all my social problems, my loneliness, my lack of meaningful relationships, my low self-esteem, all of my problems on this possible diagnosis of an Avoidant Personality Disorder? It might seem tempting, and it is the truth that medical students are always diagnosing themselves with all the worse possible scenarios. As I mentioned above, however, these personality traits only become a disorder when they go unrecognized and cause dysfunction in a person’s everyday life. My diagnosis is out the window: Clearly I recognized these in myself, and while they cause me great emotional dysfunction sometimes, I can still function at a reasonably high capacity in the “outside world.”
What does it all mean, then? Why should I care and what can I do about it? That’s where I’m kind of stuck. I’ve been through years of counseling to work out some of these problems and to understand how and why I’m at this point to begin with. Despite all that effort, all my relative compliance, and all the successes I’ve had in my personal and professional life, why does all of this persist? These are all questions that have no answer; maybe they never will. I can say with some certainty that some of these traits are less prominent now than they were before, and some of them I just suppress so that I can do what I need to do. Those other personality traits – OCD and Narcissistic – I recognize those in myself every day as well. Luckily, they clearly have a positive impact on my life and have made it possible for me to succeed in the profession that I love. These avoidant personality traits, however, just make my life so much more difficult than it needs to be.