Thursday, April 21, 2011

Can an Extravert Do My Job?

This is from a recent article on mcmanweb, which in turn is based on three pieces I did for HealthCentral's BipolarConnect. At the moment, I am back in my element of restorative splendid isolation following a Saturday of being on conspicuous public display during our NAMI San Diego Walk.

The NAMI San Diego Walk video I posted a couple of days ago lends the impression that I'm an extravert who thrives amongst people. Wrong! It's very complicated, but chances are a lot of this applies to you, as well. Let's get crackin' ...  

In a post from last year, I reported that most of us with mood disorders are introverts rather than extraverts, which brings on a dangerous tendency to isolate. This in turn makes us sitting ducks for depression.

I am a card-carrying introvert. I can testify to this. But neither introversion nor extraversion is all good or all bad, though not everybody sees it that way. "What's concerning me," commented one of my readers, "Jane", on HealthCentral's BipolarConnect, "is that the pdocs of the world have decided we need to be a nation of Rotarians."

Nothing against Rotarians, but you get the picture. Give me a nice quiet cave on a mountain top in the most remote region of Tibet for the next ten years, any day of the week. But eventually, I must return to a world of Rotarians. I may be a one-man majority in my personal cave, but out in the real world three out of four individuals on this planet are extraverts.

So, the ex's have it. Extraversion IS the norm, with introverts the outsiders, struggling to fit into a world set up for the numerical majority.

If anything, psychiatry is collaborating with our oppressors. Personality tests based on the five factor model (FFM) measure for positive traits, including extraversion. The new version of the DSM, due out in 2013, incorporates the FFM into its new criteria for personality disorders, focusing on what it sees as the negative trait of introversion. This might be forgivable if extraversion/introversion were only a small piece in the personality puzzle, but that is hardly the case. The FFM, for instance, also tests for "openness" and "agreeability." An "agreeable" personality to an introvert is hardly going to be an agreeable personality to an extravert, and guess who is likely to be doing the assessing? As Freda at BipolarConnect remarked:

Where [introversion] was once, some years back, considered quaint and "tolerable," it is now considered snobbish, offensive, and completely not accepted, at least in my circle of the world. ... I am repeatedly informed and I must be trained and taught and given "coping skills" to master.

It gets worse. The FFM fails to measure for traits that play into our strengths, such as introspection, insight, imagination, and creativity. In other words, psychiatry - reflecting the world-at-large - values sociability over personal reflection, superficial social connections over deep thinking, pat answers over nuanced problem-solving, and conformity over breaking the mold.

Off the top of my head, George W Bush would be psychiatry's ideal poster boy. Is something very wrong with this picture?

What psychiatry fails to recognize is that someone out there needs to be generating ideas and new ways of looking at the world, and these tend to come from the type of people who enjoy being alone over long stretches of time, or at least know how to function in solitude. Even those who perform in public are obliged to master their craft in lonely settings. Writers definitely need to be alone. Same with those in science and technology and a host of other disciplines.

How does an extravert handle these situations? Not too well. As Diana reports on her younger sister:

She dies a thousand deaths each night she is alone. She lives for companionship and would almost rather be with the wrong person than to be alone. She is either on the phone or with someone or planning her next outing - all the time. ... And when she is alone, she feels abandoned.

Ironically, when we introverts do surface, we are often mistaken for extraverts, precisely because we're bubbling with fresh thoughts and ideas, much to the amusement (or consternation) of the extraverts in our company. But if they are fascinated (or appalled) by us, we quickly become bored with them, unless they, too, can feed us new insights.

Extraverts thrive in glad-handing, banal-conversation situations. We suffocate. The air we breathe is in our nourishing and stimulating private world. Diana's sister can't hack it in this environment, yet she is considered the normal one, an FFM-DSM model of perfection.

To each his own, you may say. If only that were the case. But not with the extravert majority judging us.

Could an extravert do my job? I asked in a post on Bipolar Connect. Over six weeks in the beginning of 2011, I hunkered down in my quiet corner of the universe, blotting out all distractions, completely overhauling my website. This involved being at the keyboard at about nine every morning, and calling it a day around midnight, seven days a week, with frequent (but mostly solitary) breaks in between.

I was totally in my element. By contrast, an extravert - a citizen in "a nation of Rotarians" -  would be climbing walls. Or, perhaps Citizen Rotarian would have attempted to drag me out the door, thinking he was doing me a favor.

Oh, and by the way, introversion nearly killed me (though that was much earlier).

The extraverts are right about one thing. Strange things happen to our brains when we shut ourselves off from the outside world for too long. Extraverts need to come up for air, fast, which is why they could never do my job. But, eventually, there comes a time when I can't do my job, either.

They can't spend too much time in my world. I can't spend too much time in theirs. But for my own sanity, I do need to set aside special time for their world. Of all things, once I acclimate myself to the chill waters, I do enjoy myself. I perk up, I become animated. Neurons spark. I make connections.

But the effort drains me, and I have to return to my world. It's all about balance. My concept of balance is very different from an extravert's concept of balance, or, for that matter psychiatry's concept of balance. We're the minority. The majority out there is never going to understand us. They think that what's good for them is good for us. They're wrong, of course, but every once in awhile they're right.

Postscript: My post-Walk recuperation ends today. I'm meeting a couple of mental health advocates for the first time for lunch in a restaurant with valet parking. Shit! The place probably has tablecloths, too, which means no jeans for me. The last time I wore dress slacks had to have been six months ago, which I recall throwing very carefully on the bedroom floor. I think they're still there. I'll be fine ...


Tony Previte said...

It may have been tiring, but you certainly seemed to be in your element at the walk.

John McManamy said...

Hey, Tony. Yeh, that's the really funny thing. I felt like my "normal" self out there. But then normal gets too much and I have to take a break from it. Then I settle into my "real normal." The reason I know it's my real normal is I don't need to take a break from it. There is almost certainly a connection to my mood and energy cycles. It's like I need to hibernate to recover from all the strain on my metabolic processes.

But, yeh. I had a great time Sat and was right in my element.

Smitty said...

We introverts also need people, but we need recovery afterwards. I too am in my element with others, and get energized by being part of something larger than myself. But my creativity requires reflection in order to return my whole self back to me.

So Dear John, I need to ask you if your perspective on the pharmaceuticals today is different than when you wrote your award-winning book?

Do you tell this story on this blog, too?

John McManamy said...

Hey, Smitty. Yes it is. In several senses it is the same, namely meds are only one small part of the equation and that Pharma is all about marketing rather than science and treatment and that we need to be smart about our meds rather than waiting for our docs to come up with answers, that our docs tend to over-medicate us, and so on.

But over the years I have brought these viewpoints into much sharper relief. In the course of redoing my website (which I refer to in my piece), I rewrote virtually all the article in my Treatment section. Among other things, I said that meds should be a complement to our recovery strategies, not the other way around. I never would have said this several years ago.

Also, when I first started out there were high hopes for the new generation meds. It's now pretty clear that the best evidence we have shows how badly they work rather than how well they work, despite Pharma spinning a different story.

I think my readers have also changed over the years. They're asking hard questions and digging deep, and these days I am more guided by them (us) than by the researchers.

For instance, it was some of my readers that pointed out to me that introversion was not necessarily a bad thing. The thought kind of fermented in my head for at least a year, then a big "holy crap!" popped out.

I'm very grateful to the researchers, but in so many cases my readers are way more insightful and ahead of the curve. I've always been guided by my readers, but now more than ever.

On every level, things are way different than when my book came out four and a half years ago. And this will be true four and a half years from now.

Thanks for asking and feel free to follow up.