SNAP!. Gary Small

others. They exaggerate their own achievements and seek constant praise and admiration.

       • Schizotypal. These patients usually appear peculiar in their dress, thinking, beliefs, and behavior. They may hear voices whispering to them and experience other odd perceptions. Many engage in “magical thinking,” wherein they believe that their inner feelings, thoughts, or desires can affect the external world. They are often uncomfortable with close relationships and can be suspicious of others.

      The Slow Lane of Personality Change

      Thankfully, less than 10 percent of the population suffers from a true personality disorder that debilitates their lives. However, the other 90 percent of us are not necessarily happy with each and every aspect of our own personalities. Many of the patients I see believe that one or more of their character traits are holding them back from reaching their professional goals, forming satisfying and supportive relationships, and remaining mentally and physically healthy. And for the longest time, there didn’t seem like much we could do about it, outside of the slow and laborious changes that can sometimes be achieved through psychoanalysis.

      Psychoanalysis is a branch of psychiatry and psychology that has been successful in helping some patients with personality traits that disrupt their lives. It involves intensive, long-term treatment approaches and can also help some patients with borderline, narcissistic, or other personality disorders. In Freudian psychoanalysis, a patient with problems or mental symptoms verbalizes their free associations, fantasies, and dreams to the analyst. The analyst then interprets the unconscious conflicts that are thought to cause the patient’s issues. Once the patient gains insight from the analyst’s interpretations, the symptoms often improve, but it can take years of nearly daily treatment, which is expensive and obviously very time consuming. Also, controlled systematic trials proving the effectiveness of psychoanalysis in altering personality traits are limited.

      New Research Turns Personality Science Upside Down

      If you’ve known someone for a long time, you may have noticed that certain aspects of his personality have gotten mellower with age. Real-life experiences and milestones—like becoming a first-time parent—may have altered his perspective and made him more conscientious in order to meet his new responsibilities. Perhaps with age he began to worry less about peer pressure or future events going wrong. Studies have shown that these gradual and modest changes happen throughout life. Whether they occur in young adulthood, middle age, or even late in life, they tend to soften us. Over time, we do gradually become more agreeable, confident, conscientious, and stable. And although this can be an upside of aging, the degree of change is very modest and it takes decades to occur.

      How Do You Perceive Your Own Personality?

      Place a number between 1 (strongly disagree) and 10 (strongly agree) for each of the following statements to quickly see how you rate your own personality on the Big Five Inventory. The higher your score, the stronger your personality trait.

Personality Domain	Statement	Your Score
Extraversion	I am outgoing and assertive.
Openness	I am creative and adventurous.
Emotional stability	I am self-confident and easygoing.
Agreeableness	I am supportive and cooperative.
Conscientiousness	I am organized and focused.

      In a 40-year study, investigators assessed personality traits in elementary school students and then reassessed those volunteers four decades later. They found remarkable consistency in the volunteers’ personalities: impulsive kids remained impetuous as adults, and agreeable youngsters were still cooperative decades later. A limitation of this and many other studies was that researchers were tracking personality traits in people who never received any psychological treatment or used any self-help strategies.

      Based on all available research to date, most psychiatrists, including myself, have been trained to operate under the assumption that true core personality traits are fundamentally set by early childhood. In therapy, we could help patients change specific behaviors but not necessarily the basics of their personalities.

      But now, startling new research contradicts that long-held tenet. The latest science points to a new conclusion that has literally reversed our assumptions about how—and how rapidly—personality can change. To explore whether it’s possible for personality traits to change quickly through interventions like therapy and just how rapidly such change could occur, psychologist Brent Roberts and his coworkers at the University of Illinois did an in-depth assessment of hundreds of studies looking at assorted types of treatments.

      This approach to answering a scientific question is called meta-analysis, which uses statistical methods to combine the results of multiple scientific studies. The statistical methods pool estimates from the various studies to reach a conclusion that is valid. Many investigators consider meta-analysis to be one of the most robust forms of scientific evidence, but it is essential for the investigators to choose the right studies to include.

      Did You Know?

       • Although firstborn children tend to score higher on intelligence tests, birth order has no influence on self-reported personality traits.

       • People who identify themselves as dog lovers tend to be more extroverted, while those who consider themselves cat people tend to be more introverted.

      Plenty of psychological and mental health studies have demonstrated that certain forms of psychotherapy or medication treatment can benefit a range of mental states such as depressive episodes, panic attacks, or psychotic breaks. However, relatively few studies have targeted stable personality traits like conscientiousness or agreeableness. The researchers at the University of Illinois included only well-controlled investigations that specifically focused on measures of personality as outcomes of the interventions.

      They systematically searched for the best-controlled studies that asked whether different interventions changed personality. The scientists searched for not only studies of therapies involving mental health professionals but self-help strategies as well. They wanted to include investigations and interventions that used control groups (i.e., volunteers who received no interventions at all) because patients often respond well to an inactive placebo treatment or by simply getting on a waiting list to receive a treatment. Those nonspecific influences on personality change needed to be factored out of the equation.

      After an extensive search, they identified more than 200 studies that were of high enough quality to include in the meta-analysis. Each of the studies contained enough subjects to draw meaningful conclusions. And they all assessed one or more of the Big Five personality categories as outcome measures.

      The number of volunteers totaled more than 20,000. Study subjects were mostly women (63 percent) and ranged in age from 19 to 73 years (on average, 36 years). Although personality change was the focus of the new meta-analysis, many of the research subjects were being treated for other mental conditions such as anxiety, depression, or substance abuse, while others had no specific mental disorder during the course of the study. Interventions also varied from medication treatments to various forms of psychotherapy and self-help approaches. Many of the interventions consisted of one-on-one therapies, while others involved group treatments or do-it-yourself methods.

      Types of Interventions That Can Change Personality

       • Cognitive behavioral therapy

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