Many years ago, when I was still allowed to teach medical students and trainees in psychiatry (residents), I would start my talk with a question: “At the beginning of your first lecture on your first day in psychiatry, what was the name of the model of mental disorder the professor he said he would be discussing?” Invariably, the answer was: “He didn’t. He just started talking about neurotransmitters and genes and brain enzymes. Nobody ever mentioned models.” That is, without any proof, mental disorder is deemed biological in nature. The implicit message the students were given was that the biology of the brain will give a full explanation of mental disorder with no interesting questions unanswered. Thus, when we got to the section on personality disorder, I asked: “OK, folks, before you can talk about personality disorder, you must have an understanding of normal personality. What was the name of the model of personality you were given?” This question never drew an answer. All I ever got were blank stares of incomprehension and shuffling feet. Full disclosure: I think personality is everything. In human affairs, in politics, economics, academia (especially), and in psychiatry, personality is everything.
I mention this because a colleague sent a paper published in the prestigious journal Nature Human Behaviour a few months ago with the engaging title: A genome-wide investigation into the underlying genetic architecture of personality traits and overlap with psychopathology (here, if you’re determined). “What do you make of this?” she asked. The paper’s eleven authors came from the length and breadth of the US to study the vast database of their Veterans’ Administration known as the Million Veteran Program. Apparently, this has the usual psychological profile administered on enlisting as well as the details of each veteran’s genome (it helps in identifying people blown to bits). They performed immensely complicated statistical analyses to see if particular patterns of personality correlated with unusual genetic features. I can’t get any details of their grants but it must have cost a fortune in computer time alone. So after all the legerdemain, what did it reveal? The short answer is – Nothing your grandmother didn’t know.
The long answer will require a bit of a detour through territory which psychologists have long regarded as their own. First, why are psychiatrists interested in personality stuff? Normally, they’re highly dismissive of it but the military are paying for this. They have long wanted to know in advance which soldiers are likely to break down on service but psychologists haven’t been able to give a clear answer. I suspect that psychiatrists have convinced the generals that the genome will provide the answer. Bearing in mind what Henry Kissinger said of the military (“Military men are just dumb, stupid animals to be used as pawns in foreign policy”), the Defense Department said “OK, we’ll go with that. How much do you want?” Trouble is, regardless of how much it cost or how it boosts the authors’ careers, this report won’t help them, just because it has no scientific basis.
The authors start with the anodyne statement: “Personality dimensions influence behaviour, thoughts, feelings and reactions to different situations.” This is followed by a list of the five most commonly accepted dimensions: Openness, Conscientiousness, Extraversion, Agreeability and Neuroticism (usually known as OCEAN). They continue:
Personality dimensions could be playing an important role in the susceptibility and resilience to diagnosis of psychiatric disorders and their relationship with other health-related traits and responses to treatment.
In English, that says personality factors may mean the difference between surviving a battle or breaking down, which was certainly known in the First World War. After that brief introduction, the paper loses itself in the tangles of arcane statistical studies, finally emerging to conclude: “This study improves our comprehensive understanding of the genetic architecture underlying personality traits and their relationship to other complex human traits.” How it comes about that “personality dimensions influence behaviour, thoughts, feelings and reactions” is nowhere explained.
Having read it several times, I don’t know why they bothered. I can only presume they’re trying to use personality factors to draw a direct line between the genome and frank mental disorder. If they can link the genome to personality, then link personality to psychiatric outcome, then they should be able to omit personality and link the genome directly to a particular psychiatric outcome. That is, if you’ve got Gene X and Gene X is related to mental disorder, you won’t be allowed to join our war party. They want to write personality out of the equation because, as they admit, “Personality traits are known to have complex interactions with other human behaviours” (that’s an artfully misleading academic euphemism for “We don’t have a clue how any of this works”).
If this was their intent, it’s ridiculous but none of them, the authors or their military paymasters, will know that because they are all locked into a style of thinking that doesn’t allow for complexity. What is called linear thinking is designed to capture the notion of linear causality that underlies our understanding of the physical or material universe. In the physical realm, time goes in one direction only. The universe is slowly winding down and will one day grind to a halt, although humans will have long since gone. Over centuries, brilliant thinkers and students of nature have assembled a body of knowledge that allows us to understand how nature works. The core of the scientific method, the basis of modern science and all the wonders and disasters it has brought us, is linear thinking, the idea that A causes B which leads to C and ultimately results in D. Inevitably. Hitting a nail with a hammer drives the nail into the wood. It does not yield a fried egg because the nature of the matter-energy equations involved does not permit that (laws of thermodynamics at work here).
Central to the evolution of scientific thought is the concept that the only things we can only reliably talk about are things we can measure. Essentially, it is the reaction against the religious idea that Truth was revealed to the ancients and we can learn all we need to know about the universe by studying their great works. That, as early scientists realised, was nonsense. If you want to know about the world, study it. Are whales fish or are they mammals? A knife shows that the answer lies not in the biblical story of Jonah but within the whale itself. The correct approach to understanding the universe is the diligent, dispassionate collection of facts and their formulation into ever-larger, interlocking and rule-abiding structures of knowledge.
Just on a hundred years ago, this approach was formalised as the doctrine of positivism [1] which completely dominates the whole of Western science: anything important can be measured; if it can’t be measured, we don’t need to/can’t talk about it, and it probably doesn’t exist. Trouble is, the human mind and personality can’t be seen or measured, so does that mean we can’t talk about them? Yes, that’s exactly how it's taken. We see this right at the beginning of the paper where they omit any attempt to define personality: “Personality dimensions influence behaviour, thoughts, feelings and reactions to different situations” (my emphasis). That’s fine, but did you clear up what personality is? Or how mind and body interact? No, they didn’t, and the reason they didn’t is because they don’t know what it is. Their positivist training has told them that, as a mental “thing” (they say ‘construct’ but they mean thing), personality can’t be seen or weighed, so they mustn’t mention it. Except they do because they have to. Only a halfwit would try to say there is no such thing as personality, so they slither around the question, as in the introduction to this recent paper:
The term ‘personality’ is widely discussed by psychologists, so much so that there is not a single theory, but rather a combination of clinical and scientific observations. One of the most recognized theories for studying personality is the five-factor theory, which defines personality according to five factors: openness, conscientiousness, extraversion, agreeableness, and neuroticism [2].
We could have an interesting class on all the errors in just these two sentences. For a start, you can’t have science without an agreed theory. That’s elementary: if you don’t have an articulated theory, what you end up with is “a combination of clinical and scientific observations,” another euphemism, this time meaning a mishmash of prejudice, fantasy and hopes. Pseudoscience, in other words.
Next objection: the five factor thing is most definitely not a theory. It describes how people behave but it does not offer any explanation for their behaviour. In fact, it doesn’t describe how they behave in real life, it describes how they responded to certain questions on a particular day. That’s all it does. The concept of a personality questionnaire is based on the common sense notion that how a person has habitually acted in the past gives the clue to his future actions. That’s nice, but it doesn’t explain why, and people normally go to university so they can say why, rather than just shrug “Well, that’s how it is.” A proper explanation, however, will involve talking about things that can’t be seen or measured, so they pretend they’re not talking about it. It’s like sex in puritanical societies: everybody is doing it but nobody’s talking about it.
Finally, the five factors called OCEAN don’t define personality at all, they simply describe how the answers to the questions sort themselves into loose clumps of similar items. A person who answers Yes to “I always follow rules” is also likely to answer Yes to “I am a tidy, organised sort of person” and No to “I am normally very impulsive.” That’s not a definition or an explanation, it’s pure description.
So we come back to the original paper on military psychiatry which, after burning out several supercomputers, discovered that people who score high on neuroticism are likely to suffer anxiety and depression. OMG, hand me the smelling salts, who could possibly have expected that? They define it as:
Neuroticism, the trait … is characterized by emotional instability, increased anxiousness and low resilience to stressful events … it is usually viewed as a precursor or risk factor for depressive and anxiety symptoms.
Wikipedia tells us that the questions designed to uncover neuroticism are of this type:
I … get stressed out easily … worry about things ... am easily disturbed … get upset easily … change my mood a lot … have frequent mood swings … get irritated easily … often feel blue … am relaxed most of the time … seldom feel blue (reversed questions).
So this fine example of very expensive modern science reveals to us that people who are “easily stressed, easily agitated or irritable, etc” frequently suffer bouts where they are “stressed, agitated, irritable, etc.” as a result of “stressful events” (in which, of course, the military specialises).
What the military wants is a sure-fire means of separating the nervous nellies from the tough he-men who can take all wars throw at them and laugh. There is this notion among military men, which grows stronger as they rise through the ranks, that real men don’t experience anxiety, misery, pain, sickness or any of those weak feminine things. For living, breathing examples of such men, they point to themselves, totally ignorant of the fact that they reason they got to the top is because nothing has ever gone wrong for them. They didn’t get pneumonia and a lung abscess from crawling through mud in freezing rain; they didn’t smash their ankles by jumping down a rocky slope in the dark nor, perish the thought, ruin their backs from doing 40km forced marches across broken ground carrying 80kg of gear (“Pain is weakness leaving the body,” as they drill into the recruits). That they didn’t is all good luck, not good management, but these clowns are delusionally convinced that their good mental health is due to their superior moral equipment, not luck. They would like psychologists and now psychiatrists to give them a means of sorting the mewling pussies and bleating ewes from the tough, ball-bearing billy goats at the outset. But it doesn’t exist.
People can become “stressed, agitated, irritable, etc.” as a result of “stressful life events” (in which, again, the military specialises). Anxiety is the response to the perception of a threat. The threat may be real (as in this report; read what the journalist said) or the person may misperceive events as threatening, which is called an anxious personality. Note that this is explanatory, not descriptive, as it moves one dimension away from the observations to propose an unseen, explanatory mental mechanism. So Billy is agitated, frightened and irritable? That’s because he perceived a threat and is reacting appropriately to his perception. If he habitually perceives neutral event in the environment as threats, then he will be in a more or less constant state of agitation and irritability, etc., called an anxious personality. But that’s a mentalist explanation, which doesn’t fit with linear thinking so our good friends who spent all the money writing the paper won’t think of it and the military, being “dumb, stupid animals,” wouldn’t understand it anyway.
It is war that causes perfectly healthy, well-balanced men and women to become life-long mental casualties. The way to reduce mental casualties from war is not to try to sort out in advance those who relish killing from those who don’t but to reduce and then eliminate wars. Trouble is, the military have endless unaccountable money to throw around to indulge their delusions, and there are heaps of panting academic psychiatrists (and psychologists etc) who would love some of that money to come their way. Those of us who choose to question both the military and unscrupulous/dumb, stupid psychiatrists can only watch in pain and try not to get too agitated about it.
PS. If you feel the need, the OCEAN test is here: truity.com/test/big-five-personality-test
Talking of the military, my submission to the Royal Commission into Defence and Veteran Suicides was finally published – after the Commission finished its work and after its report had been released. The submission is here. All other submissions from 2023 were published many months ago. Unfortunately, it is long and detailed as it sets out a case of corruption in the provision of psychiatric services to the Defence and Veteran communities. I doubt that anybody would think to check on further submissions after the show has ended, so it’s unlikely it will ever be noticed. I don’t see this as an accident.
References:
1. Kolakowski, L. (1968). Positivist Philosophy: From Hume to the Vienna Circle. New York: Doubleday.
2. Mastracusa R et al (2023) Evaluating the complete (44‑item), short (20‑item) and ultra‑short (10‑item) versions of the Big Five Inventory (BFI) in the Brazilian population. www.nature.com/scientificreports. doi.org/10.1038/s41598-023-34504-1
Have you heard about Dr Karen Mitchell’s work? I heard her being interviewed about her new model of personality.
https://static1.squarespace.com/static/64910384d2da1763d7156043/t/65bc5a78ab4aef10b9901a25/1706842827397/Psychopaths+Narcissists+Machiavellians+Toxic+Leaders+Coercive+Controllers++Subsets+of+One+Overarching+Dark+Personality+Type++MITCHELL+PHD+THESIS.pdf
Thanks Niall. Douglas Clifford; formerly med students together (eg Brian Roberman, Norm Marinovich, Carolyn Quadrio, etc etc.) I also grew up on a farm in the South West.