"Yeah, I just think it's ridiculous," I told my brother-in-law. We were talking about the Enneagram. The Enneagram is a personality test that sorts people into 9 different types, each categorized by a number. It had recently exploded in popularity in our circles.
"How come?" he asked.
"Well, most personality tests are no better than horoscopes, and the Enneagram is worse than most. Not only do you have your personality number, but you also have wing numbers and stress and health numbers. So one person is always 4 out of the 9 types. There's no way a test like that is valid or reliable."
"Yeah, I'm not a big fan of it either," he said, "but you know, I've seen it help a lot of people."
"Really? How?" I asked.
"I've seen a lot of my married friends have 'aha' moments. It's like reading about their spouses personality type gives them a different perspective on their spouse."
Suddenly, my brain exploded.
In this article I'm going to talk about how a test which is technically wrong can be right, what it teaches us about good design, and what this means for us as therapists.
So let's start by talking about game designers.
Gamification and human-focused design in counseling
Function-Focused vs. Human-Focused Design
Gamification experts draw a distinction between function-focused and human-focused design.
Most EHRs have all sorts of buttons and features, but the interface is so complicated that they are a headache to use. When I worked in a hospital, we had to use this EHR that no one liked. If we could have, we would have all gone back to using paper charting instead.
That's function-focused design. The EHR does what it says it will do, but the design isn't intuitive to use.
On the other side, there's the iPhone, this incredibly powerful pocket-sized computer with an intuitive design. When I got my first iPhone in the early 2010s, no one had to teach me how to use it. There was no tutorial. It just made sense.
This is human-focused design. the iPhone performs a clear function but also works with human psychology. Human-focused design is so important because design drives engagement. If your product is difficult to use, people won't use it, no matter how many features it has.
This took a long time for me to understand. Just because something works doesn't mean people want to use it.
The Enneagram sits somewhere between function-focused and human-focused design. It actually lacks functionality; it's not actually a valid personality test. But something about the way it's designed is deeply engaging to a large number of people. It connects with human psychology.
To understand what makes the enneagram so engaging we have to talk about criminal profilers.
Human-focused design and the psychology of the enneagram
There's this old Malcolm Gladwell article about criminal profilers. You know, the "Criminal Minds" types. Cops who are so talented they can look at a murder scene and say, "Yes, we're looking for a white male, late fifties, probably from the mid-south or a rural background. He's got repressed anger. And he likes puzzles."
Turns out there was a period where profilers were regularly studied by psychologists. And they all came to the same conclusion. The psychologists discovered that the profilers were frauds.
Like all of them.
Their profiles were wrong. The demographics they provided were wrong. Not a single one of them added anything useful to the investigation.
When this came out, profilers and cops rioted. Every cop had a story where the profile led them directly to the killer. Every profiler had a "brilliant case" where their profile had saved a life.
The science said profilers were wrong, but every profiler's experience says they were right? How does that make sense?
Psychologists began looking very closely at the profiles themselves and made a huge discovery.
The profilers were using the techniques of psychics.
Psychics use a technique called "cold reading" where they say things that sound specific but are actually very vague. When you do this with a sense of certainty and conviction, and with people who believe in psychics, you become very persuasive. People have the sense that you deeply understand them.
"Astrologers and psychics have known these tricks for years. The magician Ian Rowland, in his classic 'The Full Facts Book of Cold Reading,' itemizes them one by one, in what could easily serve as a manual for the beginner profiler.
First is the Rainbow Ruse—the “statement which credits the client with both a personality trait and its opposite.”
“I would say that on the whole you can be rather a quiet, self effacing type, but when the circumstances are right, you can be quite the life and soul of the party if the mood strikes you.”
The Jacques Statement, named for the character in “As You Like It” who gives the Seven Ages of Man speech, tailors the prediction to the age of the subject. To someone in his late thirties or early forties, for example, the psychic says,
“If you are honest about it, you often get to wondering what happened to all those dreams you had when you were younger.”
There is the Barnum Statement, the assertion so general that anyone would agree, and the Fuzzy Fact, the seemingly factual statement couched in a way that “leaves plenty of scope to be developed into something more specific.”
(“I can see a connection with Europe, possibly Britain, or it could be the warmer, Mediterranean part?”)
And that’s only the start: there is the Greener Grass technique, the Diverted Question, the Russian Doll, Sugar Lumps, not to mention Forking and the Good Chance Guess—all of which, when put together in skillful combination, can convince even the most skeptical observer that he or she is in the presence of real insight.
-Gladwell 2007, Dangerous Minds. Formatting mine.
Turns out the profilers had written the profiles the same way.
Say you're a cop living in Arkansas, USA, and the profile for your murderer reads, "we're looking for a white male, late fifties, probably from the Midwest or a rural background. He's got repressed anger. And he likes puzzles." The profile seems to have merit because the profile sounds really specific, but, if you take a second look, the profile is actually quite vague.
Think about it, what does it mean to "like puzzles"? Does he do crossword puzzles? Or does he like working on old lawn mowers because he sees small engines as a puzzle? Also, what does it mean to have repressed anger? Are his murders a way to express anger he can't express otherwise? Okay, how does that help me catch the guy? How do I vet suspects to see if they have repressed anger?
The other parts of the profile are equally useless. Arkansas is 75% white with large rural areas. So just about everyone is white with a rural background. Also, we know the murderer is probably a man -- most violent crime is committed by men. What I actually need is something which distinguishes the murderer from the basic demographics, like he's a salt water sailor. Not a lot of oceans in Arkansas.
So the profile is useless.
To be clear, the profilers didn't know they were using cold reading. They were accidental psychics unwittingly using cold reading to persuade colleagues that their profiles had merit.
Which brings us to why I respect the enneagram.
Human-focused design and couples counseling
Earlier, I mentioned that my brain exploded while talking with my brother-in-law about the enneagram. What he revealed to me was that for a subset of couples, the enneagram cultivated real empathy.
Some couples take the test, realize their partner is different, and have the sense, "Oh wow, I get you now."
The personality assessment is fake. The empathy is real.
I think it works like this. You take the test and get a cold reading.
Healthy fives have a long view of things. They manage appropriate balance between participation and observations, engaging with others comfortably, and demonstrating true neutrality.[x]
Parts of it evoke something inside of you that feels like it's saying something profound about your experience. So you believe the test.
Then you hear your partner's "profile" and pick up on the parts which are different than yours. Because you believe the test, the differences between you and your partner now have weight for you. You go, "Oh, that's why we've had this problem. You are different from me!"
And that's really valuable. It makes you really feel like you're seeing the world through someone else's eyes.
This was certainly my experience.
I took the test and was sorted as a 5. I then asked my wife to take it, and she was sorted as a 2. Reading through her results and hearing about the inner critic of the 2 was a profound experience. I'd never thought about the world that way.
Even though I knew the test wasn't reliable or valid, it still had that effect on me. And I'm glad it did. More empathy is a good thing.
Human-focused design and implications for counseling/psychotherapy
The enneagram is an excellent example of human-focused design if our goal is empathy within a couple. I think therapists can learn a lot from this.
Consider giving simple assessments.
I think we should give assessments to clients in session 1 or 2.
In my experience therapists have 1 of 2 reactions to assessments. Some feel them to be pointless, so they don't really use them. They might have a few questions they ask or they might construct a genogram but most therapists don't have a formal process for assessing.
They just don't see how it's useful in treatment.
Others use assessments out of fear. They need to use assessments for agency-based reasons. Maybe they get funding through a grant and have to use some sort of assessment. Maybe the agency has some sort of credentialing requirements that mandate assessments. Maybe the clinician gives the assessment because they want to be accurate in diagnosing a disorder. If you're doing this, there's nothing wrong with that, but it is a function-focused perspective, which tends to be alienating for many clients.
There's a third way to use assessments. Instead of avoid assessments or merely using them for their functionality, we should use them to build empathy with our client.
I used to give a 10-question trauma assessment called the Adverse Childhood Experiences Questionnaire (ACE).
Now, I didn't just give clients the survey and expect it to do magic. I would give them the survey in their intake packet, and then we'd spend all of session 2 discussing the survey. At the end of the session, I'd say:
"Can I give you some feedback?"
"Sure," they'd say.
"Well, as we've been talking about your story, a few things stand out." And then I would summarize everything they'd said and use it to make sense of their current problem. "So when you were a kid, your dad lived out of state, and your mom worked all the time. Which, on the one hand, was a good thing. You admire her to this day for being so hardworking, but on the other hand, being left home alone, you developed this deep sense that you can't rely on other people, especially for emotional needs. You said 'I don't know how to open up,' and of course, you had to learn to do things on your own from a young age, and now you're in this relationship, and you just shut down instead of talking things out. And that's why you're here, to learn to solve this problem so you can finally have someone who really is with you, instead of you having to be alone all the time. Is that close?"
Clients often said something like, "Wow, I never heard it put that way before."
It was a great way to help clients feel understood, which, of course, is a huge part of having clients come back for another session.
Consider the design of therapy. Is it function-focused or human-focused?
More than just using a survey in your practice, we need to seriously think about how we design therapy. To me, the biggest problem is how we structure the process from a phone call to session 2.
We know from the work of people like Scott Miller that most clients dropout after only a single session, and a large part of that is the therapy intake process. There are a few mistakes we make.
First, many therapists don't respond to calls or emails. That's a problem.
Second, I doubt most clients actually read all the paperwork we send them. I know I don't read much of anything when I see a doctor. I just sign.
Third, oftentimes the clinician doing the intake is not the same person doing the therapy. This is a huge problem because the client has to tell their story twice. No one wants to do that.
The fixes for these are simple:
Respond to all calls and emails within 24 hours (except over the weekend).
Send the client a 1-page "informed consent summary" sheet. Clients sign this sheet, and the rest of the paperwork is given to the client as an appendix document.
The same person doing the initial assessment ought to be doing the therapy. If not, you should have a really good process of handing off clients.
The big idea is that intake is not merely about getting information, that's function-focused. Instead intake is about helping clients feel like they are in caring and competent hands. That's human-focused.
The heart of human-focused design
I know all this lingo can sound complicated, and it's not always easy to think through how we design therapy, so let me make it simple. Really what we are talking about is making it easier for people to get the counseling they need, and feel cared-for along the way.
Human-focused design, at it's core, is about thinking less about people as merely cogs in a therapy machine and more about seeing them as humans suffering and needing compassion. Human-focused design is about empathy.
Which is the point of therapy anyway.
Best,
Jordan (the counselor)
-Fin-
Special thanks to my friend Ethan Bundy. He wrote the code for my enneagram test. Ethan is easily the most creative person I've ever met and is also a computer programmer. You can check out his work at his website : ethanbundy.com. He's also available for freelance projects. Here's his self portrait.
[Notes]
[x] Taken from The Road Back to You
If you liked this post, consider reading this next. I think you'll like it ;) It's more about how gamification can help counselors.