Psychiatry & Psychotherapy Podcast - The Big Five: Agreeableness

Episode Date: October 22, 2020

In this episode, we continue our discussion on the Big Five. We will do a deep dive into agreeableness discussing it's sub facets: trust, straightforwardness, altruism, compliance, modesty, and tender-mindedness. We will also discuss the strengths and weaknesses of having high trait agreeableness. By listening to this episode, you can earn 1.75 Psychiatry CME Credits. Link to blog. Link to YouTube video.

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All right, welcome back to the podcast. I am joined today with my medical. student team again. Today, Adriana Alvarez has spearheaded an episode on agreeableness. It is one of the big five personality types. And it is one that is very important for psychotherapy. I often will see highly agreeable people, men and women, and all the potential issues that they will face uniquely because of their high trade agreeableness. Sometimes we see low trade agreeableness patients or partners partners of patients and different issues that we run into with kind of the high trait agreeableness and the low trait agreeableness partner pair. So in this episode we're going to be going through

all things high trait agreeableness, low trade agreeableness. We're going to start out with kind of a roundtable going through our own scores. I'm doing this again because I feel like it really does solidify the domains in people's minds. It makes maybe a little bit more fun than just dryly going through what the different domains are. So we got Adriana Averaz, Ryan Hollis, Carl Wallencomf, Kyle Logan, and David Puder, that's myself. So here we go. Okay, the first domain is trust. So Adriana, can you tell us a little bit about trust? Sure. So trust is defined as the tendency to attribute benevolent intent to others and distrust as the suspicion that others. And distrust as the suspicion that others are dishonest or dangerous.

Okay. So people who are low in trust, what are some of the commonalities there? So people that are low in trust, they believe that people may not be as nice as they appear, that people are trying to take advantage them, or that, you know, kind acts might be with suspicious intent. And then high trust people generally have believed that people have good intention. and they find others honest and trustworthy and have a general faith in human nature. Okay. So let's see how we scored in that.

I scored average. So right in the middle. Are you guys surprised? No. I think that's healthy. Yeah. Interestingly enough, I think we're all within one standard deviation. I think you have the highest.

Actually, I'm pretty high. almost too. Adriana has one standard deviation above the mean. So you are high trust. Do you see yourself trusting people easily or believe in the best? In general, yes. There are definitely certain settings that it goes down. But I think my overall outlook is I generally tend to trust people.

Yeah. Ryan, you scored pretty average. And Carl, you scored average right in the middle. Yeah, I got the same score that you did, 51. Nice. Kyle, he scored average as well. So, yeah, Adriana, has your trust ever gotten you into trouble? Yes, but it's more rare than when it hasn't.

Yeah. Yeah. I think I probably would be naturally higher, but just living life a little bit, you know, you become a little bit more realistic, you know, that there are some bad characters out there. I think it's a healthy level of suspicion. You know, you believe the world's a good place and there's a lot of good in people, but you have like just a certain level of suspicion to everyone. Yeah. Mm-hmm. Mm-hmm. Yep. All of us are nodding. We're kind of like that. Yeah, and I think that's probably a healthy place to be, right? So if you're, if you're low in this, you're not easily manipulated, you're not considered gullible. If you're high in this, you assume the best in others. So there definitely is some strengths in both low and high trust. Okay,

the next one is straightforwardness. Do you want to, Carl, do you want to take us through what straightforwardness is? So straightforwardness is characterized by not being considered crafty or sly if you're high in straightforwardness, that you are not going to manipulate other people if you're high in this, whereas if you're low, you might be willing to manipulate. You might try bullying or flattering someone. You might not think that being 100% honest is the right way to go. So a strength of being low and straightforwardness is you will get your own needs meant

because you take an alternate route rather than directly confronting someone, the strength of being high in straightforwardness might be that you can build relationships out of trust and belief rather than taking alternate roots. Yeah, so people who are really high in straightforwardness will not be Machiavellian. They'll not be trying to manipulate people. What you see is what you get. And people really low are kind of more of that Machiavellian sort of character who you know, is willing and able to manipulate people.

And so there's, there's this aspect of, you know, that they're slick with dealing with others. They're, you know, may be able to get their needs met by sort of moving people around like chess pieces. So let's see how we scored. I scored average. So somewhere in the middle, Adriana scored low. Mm-hmm. Ha-ha. You've been positioning yourself.

I think a lot of it comes from, I mean, it's one thing to know what people want and how to respond to make things go as smoothly as possible in that kind of sense. I think intent is very important, you know, just because you, do know how someone will respond in order to manipulate them doesn't necessarily mean that you are trying to manipulate them or that's malicious it's malicious yeah yeah would Ryan very low Ryan do I have to be concerned about something here standard devilates when you watch house of cards do you resonate with the main character Ryan just kidding um I don't think I'm I'm super super manipulative I think that I'm definitely willing to build trust and stuff in my relationships,

but I think maybe where that comes from is that I really value my own needs a lot. I think because maybe earlier in my life not doing that got me into some trouble, so maybe I kind of veered hard into that direction of like I'm not going to let anyone get in between me and that, regardless of maybe I give up a little bit of trust and belief. in that process. Yeah, well, it's interesting because I'm looking at all of your scores, and this is like the only one that's low. Yeah.

Right? So sometimes when that happens, I think to myself, okay, is this a learned behavior to protect one self, right? Right. So, yeah, interesting. So do you resort to flattery to convince others? I would say I do. Yeah.

Okay. So when you told me that compliment yesterday, Oh yeah, I was just marinating you. You're just marinated me? I'm just joking. He hasn't complimented me yet. Does not believe in 100% honesty. Do you believe in 100% honesty?

I don't. I don't. I think it can be hurtful in a lot of situations. Yeah. Do you feel like, especially in medical school, you kind of have to play the part to get through and just kind of... I do feel that way. Yeah.

You kind of do honestly. Like, you're on rotations. you kind of have to like figure out what people's goals are and then you have to figure out okay how do I just like not rock the boat too much right? Definitely. And if you have a really good attending, you can speak up, speak the truth or if someone's going to die you have like I feel like you have a moral imperative to. But other than that, just keep your head down.

Keep your head down. Yeah. Yep. Okay. Carl, average. I think in that sense, I think I was balanced by a few different things. For example, I don't think anyone would consider me crafty or sly or manipulative, but at the same time, I think I differentiate honesty from being frank with people, and I think I'm rarely frank. I don't think I nearly ever tell someone just right up front what I think about them, but I don't.

I don't ever intend to lie or deceive them. So I'll tell a separate true fact about how I perceive that person that may not be my frank assessment. Yeah. But it will be a true assessment. Like I'll say something I honestly think about that person. Yeah.

But it wasn't my global perception. And you're one half of a standard deviation below the mean on this. So maybe that's kind of what you're leaning into there a little bit. Right. Yeah. I had this one person, so people, you know, when they signed into the resource library,

they leave me a note. And this one person said, quote, I want to learn how to lie better. And I was like, I was like, what? Yeah, like, how straightforward. Right. Right. So they would probably score a little bit lower on this.

Or actually, that is a very truthful answer at the same time, right? So it's both a truthful answer, but it's also a truthful answer. that they're not straightforward. Dun, dun, uh, oh man.

And I was thinking, um, you know, as, as therapists, we want to be honest with our patients, because I think honesty

can be felt on a mere neuron system, like people know when you're not being honest. Like, I think about that with my kids. If I say, hey, I'm really proud of you

and I'm not proud of you, it's just words, but when I really am proud of them, they can feel that, right? And it resonates. So if my words resonate with my like internal experience, then it actually represents into them, like, okay, this is what the word means, right?

So it's like we want, I think the goal of, of, you know, working through our own countertransference, working through our own feelings that might push us away from a patient, from liking a patient, from being able to work with the patient. Like working in our own countertransference can allow us to be more authentically present and emotionally available in a meaningful way. Ryan, what are you thinking?

No, I'm definitely agreeing with you. And I feel like I definitely believe in a lot of honesty. And I think that's exactly the reason why is because people can tell when you're honest and it makes a big difference. Are you being honest with you right now? I'm being 100% honesty right now. Right. So here we go. Kyle, you scored average.

I think I have a healthy, want to fulfill my own needs. And I mean, I'm not like naturally inclined to manipulate people. But just right in the middle, you know. Yeah. I'm thinking of residents who would score really, really high on this. I don't know if you guys have met Ariana. She did the microexpression series with me. She would score like super high on this one. All of these actually. She would score really high.

Because it's like what you get is like right there. You know, there's no guile. There's no like pretense. Some people are wired that way. Interestingly, I think politicians probably score lower on this in general. But a good politician will look like they score high on this. Right? Right.

Yeah. Okay. The next one is altruism. Kyle, do you want to talk to us about altruism? So altruism is selflessness and concern for others. So someone high in altruism regularly would go out of their way to help others. They're very liked, charitable. And someone who's low could be perceived as cold, calculating, selfish, or egotistical.

One of the strengths of having low altruism is that you're not afraid of putting your own needs before someone else. his needs and therefore can get your needs better met. One of the strengths of having high altruism is probably more likely to be seen as thoughtful and considerate and liked by others. Yeah, so, you know, people who are high in this are courteous, charitable, liked by many, goes out of their way to help others. Like, I think it's more than just the image of it, too. It's like the authentic sort of, is this person really doing it? this behind closed doors, right, behind when people are watching. I think there's a lot of sort of social media altruism where it's like they do it just for the post or whatnot,

which, you know, maybe it's good that they're doing it at all, right? Okay, how did we score? I scored high, 63, so that's one and a half standard division above the mean. and you know I would like to perceive myself as And so it's like when I'm like looking at this is you know part of it's like okay how much of this is my internal perception of myself right like versus how would someone else score me so some of these probably more questions like this I would almost want if I wanted a really authentic assessment probably a couple of people close to you would want to say, I don't know. I think I would probably score you a little higher. Okay. Really? Yeah.

You know, I constantly, when I go work out of your house, there's other people. It's like you have a gym for the, you're like your friends. You know what I mean? Yeah. And that's really cool. You help students a lot, help us, you know, get stuff done here, get us lunch. I think you're really altruistic. Thanks, man.

Yeah, the lunch makes a difference. Yeah. Yeah, you know, I think food brings people together. I'm a big fan of food. So if you're listening to this and you're in attending, the one thing you can do to really improve your student's lives is to make sure they're fed. Even if you're just sending them to go get food for themselves, you know. I think I can honestly say I can remember every single time an attending or resident has purchased me food.

Actually, yeah. now that both reflects how important it was to me and how few times it's happened but i think it's deeply meaningful yeah i think um i can remember maybe one attending taking me out to food multiple times actually a couple people yeah so maybe like three or four they're coming to my mind now and it's always meaningful you know and and as as a student you're like paying three hundred dollars a day to up basically to medical school. Now I don't get paid $300 a day for you guys to be here, but someone's getting paid $300 a day. And so, yeah, it's, I think it's like you're at a tough time in your life. And food is like feeling like full and it's like, you know, it brings community, brings

warm. So it's a good thing. So, yeah, I love feeding people. Like I like to make people good food at my house. If you're one of my friends, you know what I'm talking about. So it's like definitely one of my love languages to feed people. And I love cooking. So let's see. How did you guys score on this? Adriana, you scored high 60. Okay. I think I'm not surprised. I'm pretty much scoring you high on all of these. Yeah, it's decent. And then we got... I scored pretty high. high as well, just around a standard deviation. And I think that's kind of expected in a room full of people that went into med school a little bit, just because you must be wanting to help others to want to go through this, right? You know, interestingly, like, I think a lot of people

later on in medical school, when they get burned out, they get pushed away from kind of that core reason that brought them in medical school. I see most people in the mental health field and in like medicine as like tending to tending towards altruism when they get when we get burned out when we get tired when we get exhausted it can be it can be sucked away from us a little bit and and so if you're listening to this and you're in the field and you're like you know yeah I used that's why I went into it but I don't feel it right now it's it's probably because you're feeling a little burnout and you know what this is this is like in the COVID season this is like when a lot of essential workers are feeling that.

So, yeah, I'm not surprised. Compassion fatigue is another word that's often used in conversations about burnout. Yep. I think that's a great phrase. Yeah. And so I know that when people are at their best, that's who they really are. Like, I think when you're rested, when you're well fed, right? When you're not super stressed out, like that's who you are.

Yeah. That's when your brain is working fully. and I would say most people in this field are probably high in this. If you don't think you're high in this, you might be a little bit more critical of yourself than necessary. Like Carl here scored high, okay. Kyle scored average. Kyle, you're a little bit critical over yourself, I think.

Yeah, I agree. Yeah. I agree. You're definitely altruistic. Oh, thank you guys. There were a couple of those questions that we, that you answered, we may have questioned your altruism in those moments. We were discussing taking the test.

It's just joking. That's foreshadowing approach. Yeah. It's a different conversation. Well, Kyle, if you listen to the conscientious episode, he scored himself low on some of those. And I think it's really, really his sort of internal critique of himself. I do feel very critical of myself. Yeah. So we're going to work on that.

the next couple years we got some plans psychotherapy here we come after a week of knowing kyle i'd rate him higher than 47 like he constantly volunteers to do different things while we're walking around and goes and gets the food and everything so absolutely yeah okay um let's go to the next one so the next domain of agreeableness is compliance ryan do you want to take us through this one sure okay so someone in compliance is not easily phased with insults and hesitant to express anger. Someone low relies more on retaliation, hard-headedness. They're really stubborn, sarcastic, cutting when they need to be. They let others know when they're disliked and can get into arguments a little bit more easily.

Some of the strengths of being high in compliance would be relying on cooperation over competition. and when you're low, you're not a pushover and you're not easily taken advantage of. Yeah, a pushover is such a strong word here. But that's, I mean, someone who's very high in agreeableness may not be a good negotiator. They may not stand up for themselves, and they may need to learn those things.

My wife, very high in agreeableness, naturally, right? So very oriented towards maternal things, very high affective empathy. she's spent 10 years reading books on boundaries, you know? And like, that's what she's, like, passionate about because it's, it's helped her so much. It's having a voice, speaking up for yourself, learning to negotiate, all these things I've had to learn myself. It's, like, easier for me to be hesitant to express anger. Yeah.

So if you look at some of these very low compliance people, it almost, has like this sort of a little bit antisocial characteristic or like um like psychopathic and i think that's to the extreme right like when you get three standard evasions below the mean it's probably headed that direction okay let's see how we scored so compliance i scored very high yep 67 so 67 is a one and a half standard evasions above the mean basically um yeah i mean i guess My impression of you over the first few days of working with you would just be that I could tell like you really like collaborative effort. And so I'm not surprised about this one in terms of like, you know, you really thriving in like the cooperation aspects and stuff like that. Yeah, I don't like retaliation, forgiveness.

You know, I did an episode on forgiveness. So it's kind of like, my anger, if you look at my neuroticism score for anger specifically, anger hostility, I scored basically two and a half standard invasions below the mean. So it's very low on that. So I do not easily get phased by insults. Actually, when I'm telling my wife what people said, she's like, she kind of gets riled up for me and like angry for me. And I'm like, oh, should I like, well. And I like my brain naturally makes sense of why people said that, you know, like, oh, this person was just feeling a narcissistic injury, you know, and kind of retaliating from that injury, from that point of injury. And it's really more about them than me.

And my brain goes there so quickly that I don't like get phased, I guess, too much. Okay. I can see things kind of like just rolling off your shoulders and not really affecting you too much in that sense. Yeah. I also scored very high on compliance. And I think I was looking at a part of the assessment. It says that men scoring in this range, I scored a 67, have difficulty expressing anger. And I think this may be one of the reasons why my straightforwardness score is slightly lower.

Simply because when I'm angry or frustrated at something, I find that I'll often make a sarcastic joke. and I found this in my relationships with people. I'll make a sarcastic joke. And for example, my fiancé will say like, Carl, like you weren't kidding. I'll say, no, no, no, I was making a joke. And she'll say, no, there was too much truth in that for it to be a joke. Smart woman.

Smart woman. She really is, Carl. So I do think that that's a problem for me. I have a difficult time expressing like straightforward anger in a way that would build relationship so I'm much more likely to be sarcastic. Yeah. Yeah, I'll have patients who are like that that I'll see the micro expression of anger so I know it's there and then you hear the comment and it's sometimes a jab at you and I'll be like, hey, let's like slow down and look at that. You know, like, and then I might like try to normalize it. Like I think you're entitled to be frustrated at me

if that's what you're feeling. Not that you're feeling that, but if you were, you know, I think you're entitled to be frustrated. I would like to look at that if you have the, if, if, if that's what's going on, you know, to kind of like let a decrease maybe some of the defenses that might be there and talking about it, right? Because your defense against maybe being angry is that it was not adaptive early on for you to be angry, you know, in your, in your family system, right? Does that make sense? Yeah. Okay, let's see. Adriana, you scored? Yeah, so I scored average on compliance. And I was also thinking about this, or kind of putting together the straightforwardness. And like Carl said, going back to neuroticism, so I scored very high on

impulsiveness. And I think that's kind of balancing the straightforwardness and the impulsivity kind of lands in this compliance, average compliance center, because, you know, I, in general, I don't like conflict, but I am the kind to point it, I will bring something up if it needs to be brought up. So with that impulsivity to always bring things up, it's kind of counteracted by this slow straightforwardness where I want to find the best way to bring things up

and not rock the boat if it's not necessary. So I don't know if that makes sense to everyone. But that's kind of how I see it. I'm like holding myself back from constantly being the one to bring unnecessary things up if I don't think it's absolutely necessary. Hmm. Okay. Yeah.

Very interesting. Okay. Ryan, you scored average? Yeah. average on this one as well. I think what you were saying about family dynamics, I can kind of reflect that because I have like my mom and my brother who are like super like non-confrontational. But then I have like my dad and my sister who are intensely confrontational. So I kind of had to learn how to deal with both sides of that. Okay. Tau, how did you score?

I scored 53, so average. I like cooperating. I'm kind of stubborn sometimes. I don't know. I feel like I'm a healthy right in the middle. Healthy right in the middle? Okay. Not that the middle is always healthy.

Okay, let's go on to modesty. Idarana, do you want to take us through modesty? Sure. So people low in modesty might bracket. about their talents or accomplishments, kind of have a high opinion of themselves, you know, maybe like the narcissist. And people with high modesty might keep their achievement to themselves. You know, they don't really want to show off.

And they would rather, you know, celebrate other people and not bring attention to themselves. So, you know, some of the strengths of maybe being low in modesty would be being able to take pride in yourself. and not be easily deterred by others' accomplishments. So I think one of the strengths in being low and modesty is you may actually convince people that you have accomplishments or maybe that you have a better ability than you really do. And that may actually, when you partners or when you movement forward in different business ventures, right?

because part a lot of success is just like the projection of success you know like gosh just take instagram for an image of that right it's like you can have someone who's very dysfunctional who is able to present this like image of themselves that is very very different than who they actually are and they may actually like get a lot of attention for that or get people sliding into their DMs right so sexual attention or just success in different ways. I was talking to someone today, and they were talking about how, like,

they know this person on Instagram, and their room is all clean, right, for their pictures of Instagram, but all of the junk is just shoved underneath things, right? So you can't even, like, open up the closet. You can't, like, the closet is, like, completely frozen shut because of all the junk. And then all the trash is put outside the door, right?

So it's like that image of, like, you know, you may not actually see what you're getting. So that's low, okay? The advantages of being high in this is, you know, to some degree, people can see through, you know, the reality of things eventually, right? So maybe initially you'll get a head start with kind of this image, but then eventually maybe it may catch up to you and people can kind of see through it. also it's i think it's more cooperative right that to believe that you are not better than anyone else that may win you more friends usually friend you know usually people don't want to be friends with someone that believes they're better than you and if if people are hyper competitive that might

sort of push people away would rather celebrate other people right wouldn't you rather have a friend who would prefer to celebrate you like authentically right And, you know, it's like that gratitude and that celebration kind of, I think is a good thing. Okay. So let's see how we scored on modesty or our perception of ourselves with modesty. Okay. Why don't we start with Adriana? You scored? Average. Average. Yeah, I mean, I think I definitely am the kind to, I really like to celebrate my friends.

I really like to lift up the people around me. But I think also I do like to be complimented. And I do generally accept what people tell me, you know, if it's a positive thing about me, then I try to internalize it. Doesn't always happen. But, yeah, so I think there's a good balance there for me. Yep. Yep. What about you, Ryan?

I'm high. I think I have the highest score here. And I thought that wasn't surprising at all. Definitely do not see myself as better than anyone else. And I don't feel comfortable talking about myself or my achievements. And I think I'm kind of struggling with that right now. I'm working on applications that are due next week and stuff like that. I'm just trying to figure out how to present myself in a way that I feel comfortable with, but that still shows off all the things I've been able to achieve during my time here.

Yeah. Carl, scored average? I'm interested on scoring average. I do think of myself as modest in a number of ways. I think my opinion of myself is strong and solid, but I think I readily acknowledge when other people have done things better than I have or have more accomplishments than I do. But I'm also interested in, like, I think my highest score in this assessment was under

extraversion, my assertiveness is very high. It's like two and a half standard deviations above the mean. Okay. And so I'm just interested in how I think oftentimes I don't think I necessarily have the best idea, but I will promote it a lot. Okay. So I'm trying to figure that out. Yeah.

Yep. Yep. Well, your Sensorium episode that we've been working on, I think, is the best idea, Carl. I'm just kidding. Just the first time. I think, you know, like I'm looking at my score, guys. I scored one standard deviation below the mean on this. Yeah. So when I was, I thought I was looking at yours, Dr. Puder.

Yep. But I was looking at Ryan's and I read 63 and I said, no, he's low. Like this isn't correct, but then I went up and I saw 38 and I said, he's right about there. Okay. I don't think you're necessarily like braggy, but you're very confident when you found a system that you think works, like your lifting program. Yep. And you were very confident. And then you like, you won me over and I'm like, okay, well, I got to try this now.

So I think, like, Ryan and I could deal with, it would be beneficial for us to be a little less modest at times and more confident when we think we do have like a good idea or a good one. way of doing things. Yeah. I mean, I think just by the nature of like being in, you know, social media, being in the world of, you know, podcasting, I'm putting my stuff out there quite a bit. So I think although, you know, if you look at my overall agreeableness, I score high. I score about a standard division above the mean. So, you know, these things usually run together. So it's kind of interesting that this is low for me. I think it's because, yeah, when I do have an idea and I do feel really like this is the best idea, like I feel very passionate about that idea.

And, you know, it's good if my ideas are correct. And so I like to bounce my ideas off of other people. And I take other people's like sort of thoughts seriously on the validity of different ideas I have. and I've reshaped them. I'll probably reshape various ways of doing things over the next 20 years. And that's okay. But I feel like when it comes to certain domains like, you know, strength training or exercise or financial stuff,

it's like once I figured out kind of like what I thought was the best thing, it's like, okay, then I'm going to try to help other people to understand that as well. So maybe there's a lot of the confidence there. not a lot of modesty oh man it's it's embarrassing to put this out there but there you go um okay let's go on to the next one tender mindedness okay uh carl you want to take us through tender mindedness sure uh tender mindedness refers to the tendency to be guided by feelings particularly those of sympathy and making judgments informing attitudes So a person characterized by high tender-mindedness would likely consider those at risk of being hurt.

We'll think of the poor and elderly as essential to our community. Prioritize human effects over economic consequences. May exhibit sympathy for those who are less fortunate. Would prioritize mercy above justice. And they would have the strength of holding respect for others to the highest regard. Now, those who are lower in tender-mindedness may not have as much sympathy for the less fortunate, may not be concerned about people on the margins. Their strength may be that they are not easily taken advantage of when it comes to scams or people asking for money.

Okay. So, let's see. I scored average. Adriana scored very high. Ryan scored very high. Carl scored high. Kyle, you scored low. I don't like the word sympathy.

I don't think having pity for someone's situation helps them or you. I'm like, I like the word empathy more. Like being able to, like, I feel like I have a lot of empathy for people, but not just a lot of sympathy. Okay. Yeah. So yeah, I'm somewhere in the middle here between the two. That's interesting. Yeah, what do you think, Adrienne, about scoring high on this?

I mean, I think it definitely fits me. Especially, you know, being in medicine and, you know, considering like psychiatry as a field, I feel like these are very important things to consider. And I think it makes me more suited to really care about people's issues and especially, like, the disadvantaged. You know, how can I do what I can to make sure that they can have the things that they need in order to make themselves better? I guess that applies to everyone, but definitely see myself as more tender-minded and, I guess, like, a bleeding heart in some cases. So I also scored very high in this, and it says that you believe that humans are more important than economics. I don't know if I would necessarily agree with that statement that it's more important, but I would say like maybe the ideal world would be a world where humans have the least possible amount of suffering.

Yeah. So, yeah, I probably scored that one pretty low, honestly, because I think that good economics can lift the most people out of suffering. Right. Whereas like, so I think that there's kind of like a big meta thought that I have in my mind that if you have, if you have justice and if you have good economics, you can lift more people out of suffering maybe. And maybe, you know, I mean, justice is a big issue in our culture right now. Like how do we increase the justice for the most people possible? And it's a very complicated question. So it's not like I have the answer for that question, but in general I would say,

having a certain level of justice will create a society that can flourish. And that flourishing will affect many, many people downstream. So that's probably why I was somewhere in the middle of the road for this one. I feel like all of these things are kind of saying the same thing, because if you have good justice, then that promotes more mercy. And if you have good economics, it does bring people up, which ultimately puts humans in a better standing. So yeah I think it's just it's just like do you do you side with the person that you can literally see in front of you or do you decide do you side with this like ethereal idea right?

And I think because I'm pretty high ideation, high openness, I can kind of see that the ideas would actually lift people up potentially on a more global level. Whereas some people it's like they really value like the person in front of them. maybe more, right? And they would make a decision based on that individual. But then my thought would be if I had a person in front of me, like empathy for that person in their situation is like one of the ideals that I would espouse as a valuable and necessary thing. I'm curious for the people with the higher scores, Adrona and Ryan.

Like if someone said, like, I feel so sorry for you. Like, how would you take that? I'm more like you, I think. I'm not really interested in this, in sympathy necessarily as well. Yeah. Yeah, I don't see tender-mindedness as sympathy at all. I think it does hold more of it, like an empathy to me, at least. That's what it means to me.

But definitely being very mindful of that. What's the difference between tender-mindedness and openness to feelings? So I think openness to feelings is where you're able to notice what you feel in different situations. Like, oh, wow, I'm feeling like I'm listening to this opera and it's just like I'm feeling this really positive elation. And this is what I'm feeling in my body. This is like, so it's being in touch with your own experience. This, I think actually, you know, there's a quote here. It says, tender-mindedness refers to the tendency to be guided by feelings,

particularly those of sympathy in making judgments and forming actions. attitudes. So it really is, you know, sympathy is like I feel sorry for someone else and their plight. Empathy is more like I see what this person's experience is and I can relay that back to them. I'm feeling part of this person's experience. I can relay it back to them. So, you know, I think that if you're asked a question about sympathy, like, do you have sympathy for you may be like, yeah, I do. And it may be worded in a way that sounds more like empathy. And I don't think there's anything wrong with that.

I think people who are higher in agreeableness are likely higher in sympathy. Right. But I think what you're touching on, Kyle, is that our patients don't really want sympathy. Usually they want empathy. They don't want someone to be like, oh, that's so sad. I see your suffering. I'm sorry you're suffering. I try to get residents to not apologize to patients, but to rather say, you know, when in the midst of your suffering, it's just like you're going through a lot.

Of course you're struggling through this. This is incredibly demanding. And of course, this is such a hard time in your life, you know. So to not like apologize for things, unless they have something to apologize for, right? Like if you've actually done something wrong, then, yeah, apologize for it. but I think a go-to early on in how people are expressing sympathy can be like, I feel I'm sorry that you are blah, blah, blah, you know, which I think for a friend is sometimes appropriate, right? I'm sorry you're suffering. But for patients, they usually don't resonate and connect with that as much as just, you know, showing the adaptive nature of the suffering and empathizing with the suffering.

I think an important part is respect, like treating everyone with the same amount of respect, regardless of their position. Yeah, 100%. I don't know. I think a lot of times when I think of the word sympathy, it's almost like you're seeing them as in a more vulnerable position than you, which they may be in that moment, but still treating them with the same amount, the highest respect as, you know, you would treat anyone. Yeah.

I was literally about to say the exact same thing about respect, and I think that's why we reacted that way to your question earlier, Kyle, is because, yeah, is because of the respect thing. And, yeah, so even in those moments of, you know, of, you know, maybe if this person is homeless or they're begging or whatever, I would respect them just as much as I would, the president. Yeah. And I think that's, I think what I'm thinking right now is that how we read the questions may determine how we answer them. I think that's huge. Right. So if I read sympathy, I may say to myself, like, no, I don't, I don't like value that like I do empathy. So I may answer that question differently.

Just like before with some of the, you know, how the wording of the questions is, you know, determines how you're, going to potentially answer them like modesty, you know, is it is the word, is the thing phrased in a certain way that like to be truthful, it's like, okay, confidence. If you do have confidence in your like ideas and thoughts, it's like, okay. But did you have to work towards that, right? And are you overcompensating? Is there like some defenses around that too? So I think that's where it's interesting when you look at the whole score because some aspects of the score are going to be a lot different than the overall score. I think that's where there's probably more of a compensation or defenses. Like, you'd more naturally be this way, but you've had to learn how to step out.

You know, like for me, podcasting, I sat on the equipment for like a year or two years. And just like I could not get enough sort of like confidence to put it out there, you know. And so it's been a process of learning that. Like I know another, there's another attending here who's like, she wrote a book and I had to keep like championing. like her to do it because it's just not in her to put herself out there in that way, right? It seems very foreign. So when you look at your, when you think about yourself as you're listening to this and where you may fall on these different things, think about as well, like what might be sort of defenses against or adaptive defenses, right? Like adaptive sort of adaptations to, to sort

of counter maybe what's naturally one way. Yeah, I think I, as I was taking the test, like, In the very beginning, I had to tell myself, like, am I taking this test as if I'm in school or as if I'm out of school? Because I'm in two very different modes. So I had to consciously make that choice and like, okay, how do I answer these questions? Because they are very, very different based on the mindset that I'm in. Yep. Very good. One thing I wanted to quickly touch on was I thought it was interesting that for high tender-mindedness, you always consider those at risk of being hurt, but you also hold mercy higher than justice. And I wanted to see how that translated to those with lower scores and how maybe you see that differently.

You would think maybe that if you're always considering those at risk of being hurt, maybe you would hold justice really high because you're trying. trying to protect those people. And I'm wondering if maybe that's how. Oh, it seems like a conflicting statement here, kind of. Right. Like if you want to help those most at risk of being, you know, victimized, but you want to offer mercy to the victimizer. It's kind of a, yeah.

I think it often comes down to how you're defining justice. Exactly. Because I think you can define justice as the search for creating equality. But you could also think of justice as proportionality. So this person does not deserve X because they did not do Y versus they should receive X even though they didn't do Y because we should all be receiving X. So that'd be more like equity. Yeah. So there's like, you know, is justice meant to, you know, create equality or is it meant to ensure proportional outcomes based on what people put into the equation beforehand?

And I think that's a difficult thing in tender-mindedness. Yeah. I think it's like, I think it shows the complexity of like when you're, when you're analyzing sort of different variables, it's kind of hard to answer questions sometimes. Right. And so like how are you overall, I think is the big key because probably most of these domains flow together. So it's going to be unusual that you're very high and one and low in the other one.

And that's where I think you look at the whole picture of like, okay, all of these are pretty much flowing together. And then, you know, how does your sort of interpretation of the questions and the perceptions of how someone's going to read this even or your desired, you know, sort of way of being sort of play into taking the actual test itself? Okay. I think we're going to leave it there. aspect of the roundtable we're going to move on to talking about agreeableness and the different studies involved that we looked at and therapy and stuff like that all right so in this in this section of the podcast we're going to go through kind of the lifespan of what happens to agreeableness so Kyle what do you what do we find there so this is a cool study it's a 28 year

prospective study with 194 participants and it examined childhood behaviors and agreeableness in adulthood. So personality and behavioral data was collected at age 8, 14, 33, and 36 years old. And we have a great table below showing all the findings. And a few of the interesting findings were, was compliance, constructiveness, and self-control at age 8 predicted agreeableness at 33 years old. and high agreeableness in adulthood, age 33, was correlated with less alcoholism, less impulsivity, inhibited aggression, and increased socialization at age 35. Yeah, I'm looking at this and the effect sizes

are not super large for a lot of these. We're looking at effect sizes of, I'd say, small effect sizes, like 0.2 to 0.3 somewhere in there. So I think people do change a lot, but there seems to be some link early on to what happens later in life. Yeah. Which of these, any of these jump out to you guys as important? The ones we just went over?

I would say the most important is just the combination of all of them. Or you have, it seems like, a more tempered individual that would not struggle with, you know, alcoholism, impulsivity and aggression, in general. Yeah, to a slight degree, they would not struggle with those things. And to a slight degree, they would have increased socialization, inhibited aggression. They would have less of that. To a slight degree. So you're looking at like a third of a standard deviation difference, which isn't a huge amount, but it's there, right?

I do think a lot is like one and lost just in marginal benefits and marginal destrements, though. So I think, you know, slight improvements like this, you know, I think they have some value. Okay. Yeah, no, I think that I think that's something to consider. Okay, what about careers? What do they find? Right. So the first thing I found was that unsurprisingly, agreeableness is positively associated with performance in service-oriented jobs.

And one of the interesting studies I looked at was Van Hoy in Turbin in 2015, and they found that when applying to a job, the agreeableness of the employees there at that job increases the attractiveness of working at that organization to someone who's highly agreeable, whereas the low agreeable applicants didn't care whether the employees were agreeable or not. Okay. And surgeons scored lower in agreeableness than physicians in primary care, internal medicine, and hospital service. That's interesting to me. Not surprised. Unsurprising, but interesting. One that was a little surprising was that they found that surgeons generally scored lower in neuroticism. Yeah. I'm not surprised by that either. Like if you look at Navy SEALs, by and large, they scored lower in neuroticism. part of that is because you have to be able to deal with like the high amounts of stress you know and then this next study lee anatoque in 2018 I thought was pretty interesting they found that agreeableness contributes to higher annual income in male workers in Japan but actually acts as a penalty for male workers in the U.S. and they found that the wage

penalty of agreeableness observed in the U.S. labor market is actually differs by firm size. So the negative effects from agreeableness are only pronounced in smaller companies. And when you go into the larger companies, kind of disappears at that point. Yeah, you think about Japan and how sort of falling in line, playing the long game kind of works out, right? Where in America, like, you kind of have to fight for what you need. there's a little bit more of an adversarial, you know, corporate structure at times. So, you know, if you're high agreeableness male in the U.S., I could see why it would be a little bit harder to get ahead because you're not, you know, you're thinking collaboratively where maybe the system is set up to not work collaboratively at times, unfortunately, depending on the company and the culture of the company, of course, and the type of work. Yeah.

So that's work stuff. Let's talk about the advantages and disadvantages. Adriana, tell us about some of the advantages. So some of the advantages of high agreeableness might be the exhibition of pro-social behavior or having that personality, which can lead to being good at de-escalating conflicts or gaining social capital or fostering harmonious relationships, things like that. So one study found that highly agreeable people strive for conflict resolution in a more peaceful manner, such as through negotiation tactics versus lower agreeable people might use violence, aggression, or legal interventions. So this study was done in 1996 had people rank common conflict resolution strategies in terms of effectiveness in different situations.

and they found that low agreeable men were more likely than high agreeable women to endorse using power assertion tactics as an effective method. And that effect size was 0.78, so it was pretty significant. Yeah, that's a big difference between the two groups. So basically, like, you know, men who are low agreeable would use power. assertion more frequently than women who are high agreeable, which I mean, it's kind of common sense, right? But I think it's good to look at nonetheless. How about agreeable people have increased social capital? What do they what do they find out about that? Right. So a study published in 2018 surveyed over a thousand people and they measured their instrumental social capital and

their expressive social capital. And based on the results, agreeableness is positively associated with social support and the effect size is 0.25, so not huge. But this also means that they have increased expressive social capital in general. So this might be because highly agreeable individuals show an increased commitment to others and the relationships they create, allowing them to build more trust and reciprocity in their relationships and thus be able to exchange their support for resources. Yeah, I tend to see in my practice that it's the high, you know, high disagreeable, low agreeableness males who at times are almost devoid of friendships. And, you know, the high agreeable females have a lot of friends, some of which kind of walk over them, some of which are, it's almost to the point of

like maybe a slightly parasitic relationship towards them, right? But they have a lot, a lot of friendships. They keep their friends. So often highly disagreeable men or women, you know, focus on other aspects of their life, especially if they're high conscientiousness. They're focused on their work. You know, if they're a lawyer, they're working 100 hours a week. Maybe they don't, they prize that. They prize moving ahead. And so it's not like a huge loss to them as someone who's high agreeable to have a lot of friendships. So someone who's high agreeable wants a lot of friendships. So it also kind of changes what their values are. But at the same time, we know friendships are very life-giving. And so it's kind of the final common denominator that someone with mental illness

ends up also having less meaningful relationships. What about some of the disadvantages? Tell me about those. So some of the disadvantages of being highly agreeable might be being more prone to financial hardships. As you said, being taken advantage of or getting involved in unbalanced relationships or friendships, as you were saying before. So, um, yeah, tell me about this one study you found here on, on this and how, how big were these changes? Um, so a study done in, uh, 2020, uh, found that agreeableness was the only big five personality trait that was consistently related to financial hardship.

So basically the study found, um, the following, which is people who are higher in agreeableness are moderately, more likely to do cooperative negotiations, and that was effect size of 0.38. Less likely to value money, although it's a much smaller effect size. That's negative 0.014. It's basically... So, basically... Irrelevant. So, I would say almost realistically they value money about the same. Yeah. Okay. Keep going. Um, slightly more likely to have debt. And that's also kind of smaller, uh, 0.10.

So it's like, it's like literally like a tenth of a standard deviation difference. Yeah. So they're likely to have a little bit more debt, but not that much. Right. slightly less likely to have savings, a negative 0.15. So not much different from debt. And a slightly more likely to default, which is 0.0.9. that's almost negligible also. Interesting, these all point in the same direction. Yeah. Which means to me that there probably is something there. It's just not very strong. Does that make sense?

Because if they all, if they were kind of like, they're likely to have more debt, but they're also likely to have more savings, that wouldn't make sense, right? But they're all kind of pointed in the same direction. People are high agreeable, are more likely to have debt, they're more likely to have less savings,

they're more likely to default, and all of that is a very small difference. But think about when you get out to the fringes of agreeableness, maybe it becomes a bigger deal, right? Because some of these aren't just linear relationships, where some of them are like step-wise relationships. And maybe there's a big step once you get out really, really far. They also found that these domains are stronger in people with lower income. So the difference was more drastic and lower incomes and higher incomes. And I think this is one of those places where even, you know, the effect size, for example, of being more likely to have debt was a tenth of a standard deviation.

But say you have a tenth of a standard deviation more debt than the next person, well, that's tenth of a standard of deviation more interest you're paying on that debt over time. So, you know, if you compound this over 10 or 20 years, there could be an increase. Yeah, that's a good point. So, you know, why might this be the case? Slightly lower income, right? Right. And a lot of it, I think, has to do with negotiation and also, like, how much you value your relationships.

So if you value your relationships quite a bit more, you may, you know, pay the bill more. You may not see money as important as the relationships. And so you may be willing to spend more money on things that build relational currency. And secondly, you might not be able to negotiate as well for your job to get the type of income that you really deserve. Right. And I see that frequently. So I think concluding on this portion, This is why I think in therapy, teaching negotiation tactics, teaching boundaries, teaching high agreeable females and males, how to have a voice, how to put their needs out there, and how to use leverage and stuff like that could be really, really important for career advancement, especially in the United States.

Okay, let's talk about agreeableness in a relationship. Okay, so a study done in 2014 took heterosexual married couples and had them rate their marital satisfaction along with their own personality and their partner's personality. And the study found that actual personality similarities and agreeableness was positively correlated with marital satisfaction by a coefficient of 0.46. Yes, the correlation was 0.46, the correlation coefficient. And interestingly, conscientiousness was quite a bit higher. It was. And neuroticism was a negative 0.3, conscientious is 0.8, and agreeableness, 0.46. So, and the extroversion and openness in this particular study was not that important.

Interestingly, in another study, they found that partners were looking for other partners with high openness. But actual satisfaction, agreeableness, conscientiousness, low neuroticism. Wow, very interesting. Okay, tell me about what the Oxford handbook of the five-factor model said about this. So I thought this was really interesting because it said, in terms of perceived compatibility, men low to average on agreeableness, felt that they would be more compatible with a high-agreable spouse and men high in agreeableness felt that they would be more compatible with a low agreeable spouse. However, women felt most compatible with a high agreeable spouse regardless of their own

agreeableness levels. So I thought it was interesting that contrast. Hmm. Yeah. Yeah, I can think of one friend who's very high agreeable and his spouse is slightly disagreeable and it works. There's a little bit of role inversion like she'll work he'll raise the kids but that works for them and they'll be happy doing that but I could see for so for him to go with the opposite made sense women always want the high agreeable huh I thought that was really interesting they don't always choose the high agreeable that is correct but in a survey They would choose the high agreeable. Yeah, it's funny because there's this thought in some of the subcultures of like the in-cell community that women really want like the psychopath.

And it just is like, it's funny because I'll post something on my social media once in a while and I'll get these people like commenting like, oh, women don't want a high agreeable man. Well, this proves it. They do. They do. I think they probably just don't know how to identify it. Yeah. Everyone wants the bad boy, you know. There's some, well, there's some people who do, right?

And that may be their sort of gut, their gut instinct to go that way, but maybe it's not what's best for them. Okay. All right, so agreeableness in a group setting. Tell me about that, Kyle. So I thought the study was cool because it looked at agreeableness and decision-making behavior in groups. So they took healthy young adult males. and had them perform the balloon analog risk task alone and in pairs. And they found that those with high agreeableness engaged in riskier behavior when making decisions in a group.

The correlation was point four. Participants with low agreeableness did not significantly change their decision-making behavior when in a group setting. And the last thing was, more agreeable participants were less likely to be affected. by unexpected negative feedback when in the group setting compared to the individual setting. Yeah, I think this goes to show that people who are high agreeable tend to be swayed in a group more than people who are highly disagreeable. And that's where sometimes the highly disagreeable person rises as like the leader because they're willing to kind of like challenge others and, you know, like push people, right, push their thoughts.

out, disagree. And so in this study, they actually found that the high agreeable people engaged in riskier behaviors, right, which is unusual for them in like a solo setting. So there's something about the group that not only makes them want to fall in line or cohere to the sort of the norms of the group, but this leads to a riskier behavior. That's interesting to me. It's more like an overcompensation. or an overcompensation um they are they're compensating to socialize with the group norms so this is

where like if you have a one of your kids who's high agreeable you know who their friends are is pretty important you really want to pick or if you i mean this is some degree you can't right but in an ideal setting you would pick friends for them that would not get them into certain degrees of trouble oh man it does seem like highly agreeable people want to please others so relationships are very important right because they feel other people's pleasure so if you're feeling other people's pleasure or excitement or you know you are you are being rewarded by that other person but if you're not feeling the other person's

pleasure, then you kind of don't mind, you know, doing something that would make you feel your own pleasure, but maybe not the other persons. The next study really goes into that. It looks at the association between agreeableness, empathetic accuracy, and brain activation while they're doing this. Love this one. Go for it. So people with higher agreeableness scores were better at recognizing emotions and other people compared to lower agreeableness people. Correlation 0.33.

Okay. And the altruism facet of agreeableness was also associated with a better ability to recognize emotions in other people, correlation 0.26. Okay. And then high scores on the altruism facet was associated with increased brain activity

in the left and right temporal parietal junction and medial prefrontal cortex, with correlations ranging from 0.3.3. to 0.45. So they do, you know, feel other people's emotions. Yep. There's more lighting up in the brain when you are seeing other people's emotions. There's, and that leads to action, right, for altruism.

So I think of altruism in this scale as pretty similar to compassionate empathy. If you've listened to my empathy episodes. So there's like three portions of empathy, affective empathy, cognitive empathy. and compassionate empathy, compassionate empathy as you're moving into action to help someone else. And there's an aspect of choice there. So I know people who are low agreeableness

who are very compassionate and they're doing, you know, huge things for society, but often for, often not because they see the suffering in another person, but because they have ideas about the best way to live, if that can make sense. So I have a friend who works with the homeless.

I think he's a little bit more disagreeable. And he doesn't mind getting into arguments with people. He's not going to be swayed by your opinion just to be nice to you. And all day long he works with homeless. Right? And so he's not getting walked over by the homeless people, but he's doing things in their best interest over and over again. Like he'll take them to the ER, spend 12 hours.

with them there, you know, help them get their needs met, help them try to detox off of drugs. But it's a very thoughtful, he has a very thoughtful way of going about it. So he's read a ton of books. It's, he's really thought through what is the best way to actually help them, right? Where someone maybe just who hasn't thought about it that much may just go and hand some money to someone on the corner of a street because they see them and they look like they're suffering and they feel that instant sort of suffering and they want to help them. Okay, let's keep going. I think an interesting point is we've been talking a lot about how agreeableness is often linked

with ability to interact with others and how you get along with other people. And we're going to cover extroversion later on as a full episode, but just to point out that agreeableness and extroversion are different scales and that they've been like by a paper McCray and John in 1992 is orthogonal, which is just a fancy way of saying you can you can think of them on two different spectra that are at right angles. So you could be high agreeableness but actually low and extroversion. So you could just be a person who understands people well as altruistic but is introverted or you could have a person who's very low in agreeableness but very high in extroversion like a narcissist or something like that.

right and so extraversion is like gregariousness outgoingness it's like energy around people right charisma and so yeah you could be low or high agreeableness and lower high extroversion they're very different right and i think we want to transition a little to thinking about some of the possible other side effects of agreeableness uh sometimes when it's low and when it's high and i wanted to I found, we found an interesting paper by Jigankowski in 2017. If you find that you have a patient, your therapist, you have a patient who has low agreeableness scores, it might be prudent to increase their, to be aware of their possibly increased propensity towards anger.

So this is Jigankowski paper in 2017. He did a few different studies and he found that individuals, he assessed individuals through surveys on their agreeableness, their energetic arousal, sort of like from being very tired to being very active, and an aggression questionnaire. And he found that while anger and energetic arousal itself were not associated, but that when you link agreeableness and energetic arousal and you do a regression analysis, anger is actually significantly predicted by a low level of agreeableness combined with high energetic arousal, which I think is kind of interesting and and he he wanted to see if that was steady over time he just did a short time

lapse of about about a week an assessed average energetic arousal over that week and found that people with high agreeableness whatever their energy level was it was never associated with anger necessarily but people with low agreeableness when they were at a high level of energetic arousal consistently we consistently were linked with um anger or angry, angry thoughts. And there's some interesting breakdown by some other researchers that think this, this may be partially due to explanations that high agreeableness individuals tend to focus on diminishing their angry and hostile emotions by bringing up emotionally positive thoughts

in the face of danger, whereas people with low agreeableness when they're feeling strong emotions and high energetic activity possibly may not use these cognitive strategies to minimize hostile thoughts. and then they may not combat the energetic arousal that is predisposed towards anger. But the pathologies and issues with agreeableness range actually across the spectrum. There are some issues with high agreeableness.

Just one sort of interesting one. This one, the effect is debatable, but there was one study that used population samples from a longitudinal study on mortality, and they had about 1,400 people from this longitudinal, study that started in 1970. They had about 1,400 people a few years ago take an abbreviated five-factor model test. And they found that, interestingly enough, higher agreeableness was actually associated with an increased all-cause mortality risk, which is sort of interesting. They reflect in

the paper that this all seemed to hinge on a specific item that was on the test. So this effect may actually be due to using an abbreviated exam, abbreviated five-factor model. So, you know, you should, I don't think you should worry too much that you're more likely to die by being agreeable. But I do think that there is an interesting comment to make here I found personally as a person who scores high on agreeableness that say I've tried to lose weight in the past, I've tried to change up my diet. And I find that when I'm around other people being agreeable and being compliant with what they're eating and going out to do, I find it very hard to say no to sweets. I find it very hard to say no to sweets. I find very hard to say no when I go over to someone's house to choose the healthy option. So I do think that

while this particular study was self-critical and an important way that this may not be a robust finding, I do think there could be a tendency for high agreeable people to not follow through on their own health goals. Yeah, so there's something about high agreeableness and increased mortality and it had something to do with caregiving burden so maybe they were more likely to help other people in the family who were very sick is that where you were seeing yeah i think i think that can be a part of it and i think giving of yourself and often um the propensity to be to being possibly downtrod and somewhat can also add um different aspects that can lead to dishealth i see a lot of i see, I've seen a lot of this, honestly, like in my practice where it's like you have

this super high agreeable family member who ends up taking care of the whole family. And the other people in the family have like no boundaries. And like, they're more than happy to be taken care of. You know, a lot of the times they're nurses, like who just happen to be high agreeable. And then in their family structure, they just kind of, you know, if someone's sick, they're the ones that are helping out a lot. and stuff like that. So it is an added stress. And sometimes having those boundaries really does help, you know, and having a voice to like,

hey, I need some help here. And we need to help, like, we all need to pitch in more, you know. That leads really nicely into this interesting study, Samuel and Gore 2012, that made an interesting argument that high agreeableness can be linked to adaptive behaviors, but sometimes they can become subsequently maladaptive. Specifically, there are links between dependent personality disorder and certain aspects of agreeableness traits and combined with neuroticism. So Samuel and Gore argue that dependent personality disorder is a disorder, I quote,

of interpersonal relatedness defined by high agreeableness. So if we broke down before different traits of agreeableness at the beginning of the episode, and if you think about traits like trust, altruism, compliance, and modesty, you can have maladapted versions of these that can create dependent personality traits. For example, maladaptive trust can become gullibility, altruism can become self-sacrifice beyond reasonable boundaries, compliance may veer into submissiveness, modesty could become overly meek. And dependent personality disorder in patient cases has been described by clinicians with a list of traits from the five-factor model. and clinicians often use to describe these patients traits that are associated with high agreeableness and neuroticism.

And interestingly, I think they do notice that some people dispute that agreeableness is linked to dependent personality disorder because when people respond to surveys, this doesn't seem to show up much in the five-factor model. But they make an important point that the five-factor model itself in a number of its iterations, the items themselves will focus on adaptive aspects of agreeableness rather than maladaptive ones. For example, they might have an item that says, I try to be courteous to everyone I meet. But when they've changed these items to things like, I am overly courteous to everyone I meet, and they change numerous items to that kind of format, then the test will markedly show its increased associations between agreeableness and dependent personality disorder.

So they just conclude that there are interesting ways in which agreeableness can become maladaptive, and it can be hard to test for using a model that is meant to find adaptive characteristics. That's really interesting, yeah, because I think everyone would want to say, I try to be courteous to everyone I meet. Right. Everyone would want to say that, right? And so a lot of these tests, like people say things, not for how they are, but how they would like to be. You know, and compare that to I'm overly courteous to everyone I meet, which is kind of like, yeah, maybe you don't want to be overly courteous.

But someone whose high agreeableness would be like, yeah, I was overly courteous. Right. You know, and that's the interesting part is that even people were high agreeable, they'll have some resentment in the midst. of that often, where it's like they know they're being kind of walked over. And so the resentment is sometimes there and it builds up over time. And then they need help. They end up coming into therapy after years and years of that buildup. Let's talk about low agreeableness. Adriana, do you want to take us into psychopathy, narcissism, Machiavellianism? I really do. I'm very excited about this part. So low agreeableness is associated with all three components of the dark triad,

which, as he said, is narcissism, psychopathy, and Machiavellianism, with a special emphasis on Machiavellianism. So study published in 2014 looked at the associations between the dark triad and interpersonally oriented traits, and agreeableness had negative associations with all three. So, Low agreeableness has 0.45 association with narcissism, a 0.58 association with psychopathy, and a 0.66 association with Machiavellianism. So I'm not incredibly surprised when I see that narcissism, psychopathy, Machavelianism, all are more linked to someone who is low trait agreeableness. because someone who's super high trait agreeableness is very relational and I think the dark triad, all of these things, the fundamental issue there is a lack of connection with other human beings. Like narcissism, you're valuing yourself above others, other human beings, your family members even sometimes, relationships, right?

What you can gain is more important than relationships. psychopathy, you are dehumanizing people, seeing people as insects, and Machavelianism, you're moving people around like chest pieces. So it's like people are no longer people, they're chest pieces. So, yeah, I see this. What I thought was especially interesting, so this study went even deeper and looked at Machiavellianism specifically, and they found that breaking down agreeableness into the six facets that we talked about at the beginning of the podcast, Machiavellianism had correlations with five of the six individual facets. So I thought that was really interesting because it's, at every point

almost, it is hitting, especially Machiavellianism because they're trying to manipulate all these people. It's very, very interpersonally related, but in like the opposite direction you want. Wow. Which one was not related? I believe it was modesty. So it was Machiavellianism was associated with trust, straightforwardness, altruism, compliance, and tender-mindedness. Okay. All right. Next, we're going to get into treat So how might a therapist uniquely work with someone who is high or low in agreeableness? So we ideally want to help those who are high trade agreeableness, learn how to negotiate, stand up for themselves, have boundaries.

Ryan, take us into this a little bit. So inagreableness, you're very concerned with social and interpersonal relatedness. And given this interpersonal models of therapy, marital family therapy and group therapy are the recommended ones for those high in agreeableness. And interestingly, persons who are maladaptively high in agreeableness will often fail to have the insight that it is their personality traits that are causing their problems. But they will recognize that they're having a history of troubled, problematic, and even abusive relationships.

And so assertiveness training is particularly beneficial to these patients. Just to mention a study from 2009 from Butcher, he had a few interesting findings. One was that agreeableness displayed a robust association with working alliance, which directly impacts a strong association of high agreeableness to favorable outcomes, mostly measured by fewer symptoms upon follow-up. Right. So someone who is high agreeable are more likely to have a good therapeutic alliance working relationship. Right.

It's true. It's true. People who are low agreeableness are a little bit more tricky and informing that. You know, because it's like they won't, there's kind of an ad, they're open to an adversarial type of relationship. You know, they'll question you. They'll push you. And a lot of therapists have a harder time with that. I have a number of disagreeable patients,

and I imagine that it's like in a tertiary care center where you get referrals from people, especially in the community, psychiatry, who are having a difficult time with certain patients. Sometimes you'll get these types of high disagreeable patients who also need help, right? They also need treatment. And so it's like, okay, how do we help them?

Something else that was quite interesting in this study is they found that agreeableness was more strong, related to overall favorable outcomes when the treatment was one to two years. And they were comparing to six to 11 months or four weeks or less. I thought that was quite interesting. It takes time. It takes time for someone who's high agreeable to develop the ability to recognize their anger, get in touch with what they want, what their desires are, what their needs are.

Because they're used to just reading other people and helping other people get their needs met, helping other people feel good themselves so that they could feel good feeling the emotions from other people. So interesting. And something else to consider would be that in an individual that's really high in agreeableness, you might want to watch for them being a little overly focused on pleasing the therapist in a way that kind of impairs clinical progress sometimes. 100%. This is a very, very common thing that I think initially in my practice when I just started, I was like more than happy that they were very happy, right? That they're there to please you. But then eventually you kind of catch it and you're like,

oh, okay, wait, is this person just trying to please me? And then what will happen if you allow them to please you over time is one it's it's like you're not really doing therapy for them you're really there for yourself which is kind of like the antithesis of the goal of therapy right and secondarily the patient doesn't learn how to get in touch with their own desires their own voice so as a as a therapist if you have someone who's high trade agreeableness it's going to be very hard for you to get them to actually tell you what they think and you need to be ready to to give them the space and to celebrate any small amount of frustration that they share towards you. Because that's the beginning of them learning how to get in touch with their anger, how to get in touch with their needs, how to get in touch and make progress.

Adriana, you're like, you're like, I feel this. You're feeling this. Okay. What are you feeling? Just, I can see all the different dynamics. I mean, I'm not a therapist, so I haven't had personal experience. but just seeing, you know, the people around me and different relationships and how easy it is to try to please other people or how easy it is to be pleased and be okay with that and not really think about the other person. Good stuff. Okay, keep going. So there was a study in 2016. It was by Kushner. And they found that inagreableness, early ratings of therapeutic. Alliance showed an increased reduction in depression severity, while in extraversion and openness,

reduction of depression severity was more related to late alliance. So it seems like agreeableness may have a greater impact on the formation of alliance early in the treatment, whereas extraversion and openness maybe has a greater bearing on maintaining that later alliance. Well, also think about this in terms of pleasing the therapist. The therapist is asking for symptom scores. They're going to be happy if you're doing better, right? And so it's also possible that they're not reporting how well they're doing early on. They're doing worse than they're reporting.

It's possible. They also found that patients who prematurely terminated treatment, unsurprisingly had higher depression severity and neuroticism scores, but also lower agreeableness. And Ramos Grill in 2013, their findings kind of aligned with that. They were seeing that low agreeableness seems to be a prognostic domain specifically for dropouts from treatment. So I think a good treatment approach for patients like that may be to increase the number of sessions of psychological treatments strongly emphasizing motivational enhancement and dropout prevention. Yeah, so they're saying that people with low agreeableness are more likely to drop out.

And they're, you know, they'll feel it's harder to build that therapeutic alliance, right? And that therapeutic alliance leads to the lower dropout rate. And so you kind of have to keep them in in treatment. I see this in psychiatry when you're giving someone, medications. Sometimes they'll keep coming back to you just because they're getting medications. And so that's where, as a psychiatrist, you can end up with more disagreeable people because they're the agreeable ones, find a therapist and get plugged in and keep going, right? Whereas some of the disagreeable patients don't really want therapy. They're not really into that,

you know, unless the therapist can challenge them and keep them sort of captivated. right and so some of it is like them believing enough in the process to keep going which they tend to not want to keep going just because of the relationship because they have to pay for that relationship and why should I pay for a relationship right but if I can see that I'm going to get something out of this gain something move forward in my life and so what is the the pain points you know what are the what are the victory points so if they could see that they're going to advance in their career maybe advance you know keep a marriage together you know they'll value those things despite um because attachments are attachments they're going to value it based on attachment

even even though it might not be the same level as the person that's high agreeable it might it may present differently and so yeah that's interesting Okay. One of the primary figures in this field, Jordan Peterson, discussed highly agreeable people and assertiveness in a Q&A. And I thought it was worth pointing out some of this points here. So he talked a little bit about that people high in agreeableness can find themselves in a place of resentment because they spend so much time and effort tending to the needs of others.

In this segment, Peterson says, a common reason for this resentment is that the agreeable person has something to say or something that they need, but they don't specify it and they don't ask for it. The key is that you must remember that you owe yourself as much as you owe other people and that he says is a moral duty. And I think what he's referring to here is the canteen idea that you have a duty to promote your own happiness in any situation, Because one, failing to do so might tempt you to violate other moral duties and also, two, your happiness falls under the heading of your perfection. And of course, sometimes moral duty requires us to sacrifice our own happiness, but that can't be our universal law as the sacrificing of one's own happiness for the sake of others

would frustrate the happiness of all. I think the general idea here is that duties to oneself are not about self-interest, but about self-perfection and being kind of worthy of one's own humanity. Anyways, if you are high in agreeableness, you are at risk for being taken advantage of, and you must find a way to kind of strategize yourself out of that. A key to doing so is to learn how to negotiate, which also means overcoming your heart. hesitancy to engage in conflict. Peterson describes it this way. Negotiation and conflict are somewhat indistinguishable, and it's easy moment to moment to avoid negotiation conflict, but you pay a terrible price for it in the medium to long term. It is better to face the conflict forthrightly in the present and make peace for the medium to long term, and there is courage in that.

Another thing you touched on that I thought was really interesting was that people with high agreeableness, tend to keep their critical intelligence hidden. And critical intelligence is like information that can help someone make decisions that will provide an appropriate response to actions by a potential or actual enemy. So people with high agreeableness, they have a really great instinct with regards to figuring out what other people's motives are. However, because they're so agreeable, oftentimes their accurate deduction of another person's motives ends up causing them shame.

There's a couple good things there. It's kind of like what I was saying before with resentment or bitterness or anger, right? So a lot of these high agreeable people end up with a lot of anger. And it's like how do they get through that? Because a lot of that is unconscious stuff down. It only comes out fleetingly because of how they. believe and operate with other people and sort of their kindness and generosity. And so in the midst of that, they need to learn how to stand it for themselves. I think it has to do with if this carries on

for another 10 years just like this, are you going to be in relationship with this person still? The answer is usually no. If someone's walking over you, someone's using you, someone's not valuing you. So the answer is no. you're not going to be in relationship. So it's like, okay, knowing that, how can we put up boundaries? How can we set up a scenario that would potentially allow the other person to change? And so, you know, in a work situation, it would be how do you set up a scenario, have boundaries with your work, so that you have the potential for your work situation to value you enough

so that you do not have resentment over the next 10 years? And if you can't make those choices now, then you will not be in relationship with this person. And so because you can now put that in a perspective of like 10 years out, you can have this perspective that allows you to make a tough decision now. Okay, because you value relationship, because the relationship's not going to be there any longer 10 years from now, you have to have a voice now. You have to stand up for yourself because you care about the relationship, right? and if you are happy and you are content and you are not resentful, you will make a better partner, you will make a better friend, you will make a better employee. Like, no one wants to be in a relationship with someone who's resentful of them, right?

So short term, someone who's high disagreeable may push someone who's high agreeable into doing things that they don't want to do. But if you were to really challenge that disagreeable person, say, do you want this person to be happy or do you want them to be resentful? They'd be like, of course, I want them to be happy. You know, and so, like, there's this kind of process that I take patients through who are high trait agreeable in order to know, like, how to make tough decisions now, how to negotiate for themselves in the here and now.

And further, this idea of they're reading people accurately because people are high trade agreeableness can read people can feel their intentions um what what they do is they they may feel bad about judging people or saying oh this person just wants this or this person is a pervert or this person is you know up to no good right they want to believe the world is a good place trust comes through there right and so that's where i get really excited with teaching things about like psychopathy and Machiavellianism and narcissism, because if you're high trade agreeableness, you're not going to want to believe that other people think differently than you, that other people carry those characteristics, and that potentially will lead you to be in relationships that can be

very toxic. Go for it. No, I'm just like you're preaching and like, it's the gospel. You're feeling it. I think you're high trade. agreeableness is like, yes, I need this. I need this. I mean, it's, it's just like, you know, I, I do have that experience where I feel like I can kind of sense people's intentions a lot of times, but I don't want to believe it. And so dealing with that internal struggle of like, no, like, you know, I'm making this up, I'm reading into things and then in the end ends up being true, it's like, oh, I knew it this whole time. Yeah. But you still don't want to believe it even after that.

Yeah, and so I would say as you develop into becoming a therapist, as a psychiatrist, as a psychiatrist, learning to trust your violin, right? Your tune your violin, pick up those things. If there are any words or thoughts that come to your mind that are abnormal for you, right? You know what your experience is. You live with it 24 hours a day. If all of a sudden you're sitting across from someone and you have new thoughts, that come into your mind, pay attention to those, and label them as potentially not your thoughts.

Okay? So I did this with the resident just this week. He was feeling incredible shame in some sessions with this particular patient. And I said, what if the shame that you're picking up is not your shame? What if it's her shame? And we watched video of his session, and it was her shame. He was embodying it. He was taking it on.

then when you take on that raw thing of shame, then you create your own narratives to it. So that's how we take raw other people's stuff and then put our own narratives to it. Well, I feel shame because four years ago, I failed this one test, step one, right? Or I feel a lot of shame because of this. And so we start putting our own narratives to it,

and that's when we get into trouble. Right? So if we can take that raw information that's coming from other people, not filter and notice it without filtering it too much put the label that's probably from them like so i had a neighbor and whenever i saw this guy immediately i felt incredibly competitive and far beyond my normal level of competitiveness you know and why did i feel so competitive well i mean this guy was like the most competitive guy like a couple standard deviations above the mean

competitive. You know, like, you look at all of his history, what he's doing, his job, how he's making his decisions. It's all based on, like, I want to compete against everyone that I'm meeting in every way possible, you know? So, like, he was going to uproot his, um, gosh, I want to change the story a little bit. I'm going to change it just a little bit. He was going to uproot something in his garden and just throw it away. And I was like, oh, can I have it? And once he realized that I wanted it, he left it there. He left it there. Because it was the, oh, wow, someone wants this, and that makes it valuable, right?

That kind of like competitiveness came through. Okay. So how can we help low agreeableness patients develop empathy, cognitive empathy? So I just wanted to say for the low agreeable people who are struggling with having like aggressive solutions. to conflict, cognitive empathy can be trained. And perspective taking is one example of training cognitive empathy. And I just wanted to put a study here showing the correlation between learning cognitive empathy and having like increased problem solving and decreased verbal aggression during

conflicts. Yeah. So I think, okay, so I, when I think about training someone, in empathy, I'm like 100% they can learn empathy. Like I could take a resident, I have taken residence from day one to day, you know, year four, they have grown in their ability to give empathy. If someone is a good person, it does wonders. If someone is, you know, on the moral bell curve of three standard evasions below the mean,

it's going to make them more Machiavellian. It's going to make them a better psychopath. It's going to make them more potentially destructive, right? And so I'm very cognizant of the fact that what is the internal motivations that are driving people, right? And can I help them not only develop more empathy, but also can I help them develop the right set of beliefs that would lead to society thriving? you know so if i have a someone who's more psychopathic in front of me and they're at an early level of their you know life then it's like okay how do i help this person realize that the largest ability to win in life is actually not just winning very very short term wins you know because they'll try to

win every little game that they're in potentially even when it causes them downstream damage so how Can I convince them that the best way to win is actually to treat people well, for example. The best way to win in business is actually to do what is in the best interest of the person you're selling the car to. So I had this conversation with this guy at the car dealership because these guys were major psychopaths that I was buying this car from. They were lying to me. They were trying to use every tool that they could to get more money out of my pocket and into theirs.

Right? guy he's 22 and he's kind of like in that world where he's being raised by a bunch of older psychopaths on how to be like a senior psychopath and um and he doesn't really like it you know and he's like yeah i don't really like it and i'm like look man someday you're going to have an ability to run the show the way that you want to run it and i would convince you that like before you guys tried to start screwing me over. I would have referred over tons of my friends to come to you to buy a car because this was such a good experience. But after you had me go get my cashiers check, now you want me to pay more out of my credit card. That's ridiculous. And so not only do I not want to refer someone to you

or help you get a job, but I don't want to like, so I was very honest with them, you know, I want to write a bad review. And you know, eventually Yelp is going to be really, really important. if you're trying to sell a car. People are not going to go to the dealership with like two stars, right? People read reviews nowadays. So I was trying to like use all of my ability to convince him that doing what was best for the person,

having like a fiduciary type of relationship is actually what is best for him, long term for his ability to succeed in life, the long game. And you'll see people who start out on this road of being highly disagreeable, psychopathic. And early on, they'll burn so many bridges that they have this like 40-year-old crisis where they're not doing well in life. People who are maybe a little bit more agreeable are starting to pass them a little bit because the relationships matter so

much in the end, right? And so, you know, convincing them that they don't want to leave this trail, this wake of disaster behind them. And the idea, you want to convince them of ideas, And I think I think that's how like that's how they end up making decisions to to value things like empathy and actually learning it because otherwise they're not going to want. They're going to learn it, but they're only going to learn it so that they can sell more or make more money in the short term, right? They're not going to value it for like what it could be. Like this could actually bring you value later on in life.

Like meaningful relationships is valuable in and of itself. Okay. Well, this kind of comes to the end of our episode here. And thank you guys for listening in. If you have any questions, thoughts, concerns. I'm on social media. You can always send me a DM. And thank you guys for coming on. Thank you, Adriana. I can tell I gave you this episode because I knew you were higher agreeableness. I don't know how I picked that up so quickly on Zoom. It's pretty apparent. But you're like, I can tell you're getting a lot out of this. And that's, that's fun. for me. See, it's the double win, right? I win because I have a great episode here that you helped me produce, and you win because you learn something that helps you maybe in life negotiate for your own needs better. And Carl wins because, no. No, this has been a spiritual awakening for me too. Okay. All right, guys, we'll leave it there.