Sunday, April 11, 2010

The Problem with Labeling People

I watched an episode of "Bones" the other day that was poignant (for me and thousands of others, it's safe to say, having stumbled upon an intense online conversation about the episode on Pop Watch).  I was married to a Bones for many years (no, not the actual character, but very much the same type of person her character is based on, and I'll get back to why what I've just done is so misleading -- read my account of Rex the Dog first meeting her here) and learned a lot about the challenges, pitfalls and brick walls these brilliant individuals face, as well as difficulties the tragic folks who attempt to partner with them have to deal with. I also learned the truth about 'labels' that psychologists and, more and more commonly today, lay people, use to describe unique individuals.

The problem with labels is that most of us throw them around as though the label is the individual's personality. Maybe I'm not being very clear. What I mean is that, once we ascribe a label to someone, we stop thinking about them as a complex amalgam of traits and, smugly (quite frankly), assume we've got a clear picture and stop trying to understand them, their complexities, their more subtle strengths and weaknesses. They become lumped into the 'cookie cutter' personality type that describes what the average person diagnosed with that label has.

What TV shows like Bones, Monk and even Macgyver do is actually dig deep into the inner workings of complex personalities and exploit them to create an ongoing narrative without coming out and stating what the 'label' is that these individuals would be painted with if they took a standard psychological profile. These shows actually do a much better job at demonstrating just how unique an individual with, for example, Asperger's Syndrome, can be from others with the same diagnosis than most people do after having watched the show, yet most folks tend to assume that, having 'got to know' Bones, they know exactly what others with that diagnosis are like, intimately. So often I hear people say "Oh yeah, I know what he/she must be like, I've seen a few episodes of Bones.

What I think most people on the planet never 'get' is that 'labeled' individuals are not unfortunate victims of fate who 'were born with a disability,' or 'came down with a problem,' or even 'succumbed to a weakness.' These unique people don't 'have' something, they're merely more at the extreme end of a series of 'sliding scales' of personality traits than you or me. We ALL have all of the same traits, just at a different level. YOU 'have' ADHD, uncontrollable rage issues and anorexia, though testing might never put you on 'the spectrum'. I have all of them, too, just to varying (perhaps negligible) degrees.

One of my clients, one of several who struggle with Founder's Syndrome (the latter is a 'label' describing successful entrepreneurs, MANY of whom have what is called ADHD and use it to accomplish much more breadth and depth of business start-up steps than average people do), in her initial 'defensive/denial' phase of dealing with this new information, angrily 'projected' back onto me: "You're telling me I have ADHD, I don't! YOU do! I know people who have it, I'm not one of them!" To which I kind of smiled and replied: "Well of COURSE I have ADHD! We all do to some extent. Mine is fairly high -- just not high enough to be a successful millionaire..." (Note that what is called ADHD, attention deficit hyperactivity disorder, is really mixed with a very high degree of OCD, obsessive compulsive disorder, in the individuals who end up doing quite well in business, I'm convinced.)

I suspect my client did not understand me, however, as she's busy trying to avoid the stigmatism that most people think comes with being labeled.  I get that, hence this post.

Here's the thing, there is no such thing as a 'normal' person.  There is a 'normal' median on every scale of personality extremes and there is a theoretical center point when we merge all the scales together, but no human being, with all our individual eccentricities and predilections, is at the exact middle on every scale.  To illustrate, here are a few 'scales' to think about:


Now there are not really an infinite number of these scales, but there are a HUGE number of subtly different scales (e.g. the 'jealous scale' being different than the 'envious scale').  When you start lumping together (weighting) any individual's strongest scores, you end up with (I'm visualizing) an egg-shape  that is more heavily skewed in one direction than someone else's 'egg':


Now we commonly think that all of us can work hard to be a better employee and push our scores toward the right on every attribute, but the reality is that on any scale, there's actually going to be a 'bell curve' wherein the average people score around the center and only a few people are a naturally good 'fit' for the extreme ends of any given scale:


When you think about this bell curve phenomena and what the scale would look like if we selected only the people you who score high on certain attributes we want in hiring a retail team of staff, for example, the 2-D visuals would look like this:


Given that none of us are 'normal,' however, it's impossible that we'd end up with consistency in this group. Despite the fact we selected for high scores on all these attributes, one individual might score well as an ideal employee, but might have one attribute that throws their 'egg-shape' off (unbalances it):


(The scale above originated at the time that a Tim Horton's Coffee Shop employee in Canada was fired for giving a crying child a small piece of doughnut.  What emerged in the ensuing discussion was a study that identified the 26% of employees convicted of theft who, when asked, said they'd steal from their employers again if they got the chance.  Many of them were good employees on other measures, but they couldn't shake their feeling that, as workers being 'exploited' by a profitable employer, their company could afford to provide them with additional benefits. On the 'moral/ethical scale,' they'd likely score low.)

The only way to really visualize an individual's full personality spectrum would be in 3-D (but I don't have the resources!).  Essentially our complex individual 3-D shapes would, given each of our tendencies to be more one way than another, a lumpy blob, with some people looking neatly egg-shaped, while others might have many bumps and spikes, or even blobs on spikes.  Here's the example above in an attempt to bring the 2-D to life (mouse over and use the 'pause' button if it's going too fast):


The point, however, is that we are ALL on each scale, the one that has uncontrollable rage issues at one end, the one that has ADHD, the one with antisocial, the schizophrenia scale, autism, dyslexia, Borderline Personality Disorder (BPD), genius (IQ), etc.  Being labeled with one of these extremes doesn't mean you cannot score high (or low) on another scale that would surprise the psychologists, even if most of the people with one diagnosis TEND to not be high (or low) on other specific scales.  Some people who have Asperger's Syndrome are very romantic, or very sexually charged (TV's "Bones" claims to be GIB!), but most aren't.  Many people with ADHD are really clever, many are not.

My point?  People can't be pigeon-holed, not even people who happen to fall into a specific 'label'. Our human brains are just too complex to be conveniently and simply labeled and categorized.  So next time you find yourself, or someone else, assuming a lot about the personality or predilections of anyone who has been 'labeled', just keep in mind they're likely to surprise you!  Many low-functioning autistics are WAY smarter than the people who look down on them, as Charlie  learned of his brother Raymond in the movie "Rainman".

November 2013 Addendum:  Something had been niggling around in the back of my brain regarding Pareto distribution of individuals who fall into a specific, complex combination of being at the extreme end of many bell curves of spectrums, leading them to be diagnosed as, for example, psychopathic serial killers.  What finally popped into my brain was the fact NOT that a reversed Pareto distribution curve fits neatly into the extreme end on either side of a bell curve, but rather that the points on a Pareto distribution represent the points where, crossing over in three dimensions, the spectrums that lead to a diagnosis intersect.  Tough to illustrate without 3-D animation, but here is a typical Pareto distribution (ignoring the subject matter):


I'm noodling on it.  A better explanation of what I'm getting at will come....

September 2016 Addendum:

While I had the insight back in 2013, it wasn't till now that I had the chance to sit down and come up with a better visualization.  I worked for many years with a narcissistic psychopath (independent scoring on the PCL-R by 6 of her longtime employees came back consistently above 33) who was also a high functioning autistic and had extreme OCD/ADHD (of the latter you rarely see one without the other, and this may be true of the most extreme narcissistic psychopaths who may always exhibit autistic traits).  She was brilliant at memorizing things, including medical procedures (she is a medical practitioner), but cannot figure out a conceptual problem to save herself (or her patients).

She has zero empathy, other than the learned type that autistics pick up on and memorize, but an equally strong determination to excel at practicing her trade.  She is virtually totally self-absorbed (examples abound, like asking "How was your weekend?" then clearly zoning out and never listening).  She had tremendous difficulty with focus and continues to walk off to make unimportant phone calls in the middle of procedures on a patient because "I'll forget to do this if I don't do it right now", then evidences no recognition of patients' annoyance or pain upon returning.   

Now this female psychopath would never be a serial killer, despite having a bunch of combined, or overlapping traits.  So why do very few of the quite numerous psychopaths living among us never 'become' (or start off being) serial killers?  I believe the distribution illustration above explains it.  Take a look at this illustration:


My point here, falling out of my theorizing in the article above, is that for far too long we have, as we humans tend to do, been talking about 'personality disorders' as unique from each other.  I don't believe they are.  We are ALL on every single spectrum, but given that the Pareto Distribution of people on any bell curve dictates that MOST people are on the average to low side of the diagnosable individuals, we tend to believe that those who are diagnosed are somehow uniquely, and extremely, disadvantaged.  Most are, but in many cases I believe that they 'cross over' into the most narrow segment of the bell curve for that spectrum only because they happen to be on one or the other extreme ends on related, intersecting spectrums.

But that's just one cynic's opinion...

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