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At MIT, there is a seminar for researchers
called "Dangerous Ideas." The main question each researcher is asked
is "Why should I fear your research?" The idea is that much science
is conducted in a routinized manner: the last technique is slightly improved
upon, a previous study is replicated. But science is, at its root, about
making important discoveries about ourselves and the world, discoveries which
often shake our previous beliefs. So if you are doing important scientific
work, there should at least be some potential that some of us should fear your
It is worth recalling the work of Thomas Kuhn, who
argued for two kinds of science, normal and revolutionary. Normal science adds
bit by bit to past knowledge; it is not particularly novel but it moves the
bounds of ignorance backwards slightly; it is the kind of research that
receives funding from the National Institutes of Health and which leads to
presidency of professional associations, chairmanships of academic departments,
and lengthy curriculum vitae. Revolutionary science, on the other hand,
involves a paradigm shift, challenging conventional notions, creating new
hypotheses that are not simply accretions to past knowledge but new conceptions
altogether. Both kinds of science are needed, but it is not an exaggeration
in psychiatry to say that we have replaced an era of revolutionary theories
(Freud vs. Kraepelin vs. Jaspers vs. Jung etc) with an era of normal science.
Today's psychiatric literature is replete with data, but short on concepts that
pull the data together, and very short on any critical thinking about the
assumptions that underlie the data.
Robert Cloninger is clearly a revolutionary
scientist. He constantly challenges his own theories, and after testing them
with normal science, creates new paradigms to test. In today's world, we need
more psychiatric thinkers like him. He may or may not be right in his
theories, but he at least is offering us visions that can pull together the
mass of data that assails us.
is biology -- not
The basic narrative of this book is the story of Cloninger's
research. He wanted to understand human personality. At first, he took a
purely biological and materialistic approach, developing a theory of four
dimensions to temperament: harm avoidance, novelty seeking, reward dependence,
and persistence. He found that these dimensions differentiated between persons
with personality disorders, but they did not distinguish those with no
personality disorders at all from those with any personality disorder. In other
words, Cloninger could not distinguish himself and his friends from his
patients based on temperament! Further, temperament seemed to remain
uninfluenced by treatment (psychotherapy or medications) and did not develop
with time (only harm avoidance increased somewhat with age). Yet we view personality
as developmental and its disorders as treatable.
This disappointing result led him to conclude a purely
materialistic assessment of personality based on biological inherited
temperament did not suffice.
is biology plus character -- maybe
Next, reviewing the available literature on
personality psychology and philosophy, Cloninger concluded that he had left out
the aspects of personality that are more psychological as opposed to
biological, in other words what we learn as we experience life. Calling this
aspect character, he defined and tested three subtypes: self-directedness,
cooperativeness, and self-transcendence. He now found that combining
temperament and character allowed him to distinguish those with no personality
disorders at all from those with any personality disorder (his friends from his
If Cloninger had stopped here, he would have been a
conventional scientific success story. Yet he had greater ambitions. He felt
that he had still not adequately captured human personality. The problem was
that individuals still could have similar scores on his tests of character and
yet differ in important features of their personality: some believed in God,
others were quite skeptic, some felt connected to the universe, others felt
subjectively alone. Further, Cloninger was impressed by recent research in
psychology and neuroscience that demonstrated that the most unique kind of
memory in humans was episodic memory, the ability to personalize recollection
in a subjective time and place (as opposed to the abstract knowledge of
semantic memory). Further this episodic memory occurred in a part of the
brain, the hippocampus, which was plastic, which changed with time and in
reaction to life experiences.
In other words, Cloninger concluded that neuroscience
and neuropsychology could not be ignored: they told him that part of
personality involved a very personal and subjective kind of knowing that was
not abstract and general -- intuition.
So here was his scientific dilemma. He had described
human personality as best as was possible with standard objective empirical
methods. But those same methods now took him to a conclusion that was anathema
to empirical science: the importance of subjective intuition.
spirituality, and self-consciousness: Should a scientist go there?
Cloninger describes well how he hesitated on his
next step and how most of his colleagues discouraged him. Most of his
colleagues told him that the job of psychiatrists and psychologists was to treat
disease, not to create happiness. Cloninger concluded however that health was
more than absence of disease, and he needed to understand happiness to give an
adequate account of personality. His reading of science had led him to examine
intuition, direct awareness of knowledge, which led him in the direction of
spirituality, if not mysticism.
Now it is clear that the National Institutes of Health
would be unlikely to sponsor such research, and that his more materialistic
colleagues would look at askance at such work, but Cloninger is, shall we say,
obviously somewhat novelty seeking and independent-minded, and he persisted.
Most of this book is an attempt to show how intuitive
experience and spirituality are relevant to both understanding human personality
and achieving happiness. I will leave it to readers to judge whether he
succeeds in this task. This is a hefty book, one that cannot be swallowed
whole, the summary of a deep and meaningful scientific career -- a book that
demands slow reading, over time, careful chewing, and repeated reference. Yet
for those who wish to understand the relationship between human personality and
happiness, it will repay such efforts.
© 2006 Nassir Ghaemi
Nassir Ghaemi, M.D., M.A., M.P.H., Associate Professor, Department
of Psychiatry and Behavioral Sciences; Director, Bipolar Disorders Program,
Emory University School of Medicine. Dr. Ghaemi is author of The
Concepts of Psychiatry: A Pluralistic Approach to the Mind and Mental Illness,
Johns Hopkins University Press, 2003.