Difference between driven, workaholic, perfectionist, and obsessed?

[neurologyoncall]

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I am premed and just had a psych question. There was a surgeon that friends and I were talking about and I said he's such a driven guy and someone said no, he's so OCD or obsessed or something like that. Another said, no it's because he's a perfectionist. Nobody said "workaholic" but I might as well throw it in there. What's the difference?

 

[erg923]

I am premed and just had a psych question. There was a surgeon that friends and I were talking about and I said he's such a driven guy and someone said no, he's so OCD or obsessed or something like that. Another said, no it's because he's a perfectionist. Nobody said "workaholic" but I might as well throw it in there. What's the difference?

One is a clinical diagnosis/disorder (OCD), one is a state of mind (driven), one is a non-clinical behavioral description/label (workaholic).

 

[nitemagi]

Also look at:
OCPD
Hyperthymic temperament

 

[neurologyoncall]

Thank you Drs Erg and Nitemagi. I am a little confused. Are you saying someone with mental illness could be a surgeon?? Obviously you don't know the guy so you can't diagnose but in theory, how can you be a surgeon and have OCD or OCDP or something? I guess unless someone takes meds for those illnesses. But just the idea of a surgeon having mental illness sounds strange. Because we're talking about someone who is fully functional and doing things that most normal healthy people could not do because they lack intelligence or emotional strength or physical ability. I usually assume those people are just really driven.

 

[Ollie123]

They aren't diagnosing anyone, you just asked for definitions. Your post was the one saying those labels applied to this individual.

Though it is absolutely possible for surgeons to have a mental illness. Available evidence suggests that it might even be more common among surgeons and other medical professionals than the general public. Just because someone has a good job does not remotely indicate they are fully functional, nor does mental illness always prevent someone from functioning.

 

[nitemagi]

noc - You're asking much more complex questions, that require long explanations.

The short of it -

1. Most people define mental illness as causing functional impairment (DSM)
2. Functional impairment doesn't preclude someone from working
3. Many mental illnesses never get treatment
4. Certain aspects of society tolerate illness and even impairment without treatment, and will tolerate specific personality pathology without pushing treatment
5. Many mental illness and personality pathologies are Adaptive in certain environments and may even be helpful in certain situations
6. In reality conditions exist on a spectrum, with varying or even no direct impairment
7. Physicians are asked to self-report conditions that impair functioning. Little is done to check up on that unless a complaint is filed
8. Be careful not to pathologize all aspects of human behavior. Not every problem needs treatment or Should be treated.

 

[neurologyoncall]

Thank you Dr Nitemagi, and I apologize if I were disrespectful or said something ignorant. But thank you very for the explanation. I had no idea I was asking complex questions. I just have an idea of how hard it is to apply to medical school, with the MCAT, the courses you have to take. Then on top of that to be ability to complete medical school, do residency, become a surgeon. If you are not very intelligent, very committed, very much in charge of your emotions, how can you get there? There are people who have mental illnesses but they're too anxious or depressed or psychotic to even do much less demanding jobs. Or to hold a job for too long because they get in trouble with their boss or the law, etc. So I hope you understand why I was just so shocked to hear a surgeon could potentially have mental illness or personality illness. Thank you so much for bothering to reply to my stupid questions.

 

[erg923]

how can you be a surgeon and have OCD or OCDP or something?

Um, the same way you can be a mathemetician or a musical genious an have schizophrenia (John Nash, Brian Wilson, Syd Barrett, etc). And the same way you can be a succcesful actor and have Bipolar Disorder or drug addiction (too many to name)...

What world do you live in?

 

[cara susanna]

It depends on the person's life and goals. For instance, OCPD is probably more adaptive for a surgeon because it means they would be more meticulous. However, it could also become a problem if the surgeon would have to break a rule or do something that doesn't conform to expectations.

Also, be aware that compulsive personality is so adaptive that it actually almost resembles a normal distribution (along with two other styles) on a common personality measure, the MCMI-III.

 

[neurologyoncall]

thank you for further explanations drs. I'll make last post before going to college. Compulsiveness sounds interesting. What are the the other two personality measures?

Re the other point, I was aware that many actors have mental health issues and drug problems. There are so many stories about actors being fired or having the whole crew work around their moods and desires and so forth. Having certain math geniuses with some mental issues also makes sense, like the socially awkward and absentminded professor. I just have a different view of surgeons. And doctors in general. It's not just the MCAT, and the courses you have to take, it's also the interview and people skill and ethics and requirement that you be very reliable and dependable. Lab tech maybe but a doctor with no people skill? How would he get through interview, seeing patients, etc? Or someone who keeps changing jobs or gets in trouble with everybody at work and keeps changing jobs? Or doc cancels surgeries several times a month because of mood swings? Or sweating bullets because of social phobia when he sees a patient? I expect "weirdness" and cancelled appointments when meeting some math genius or actor, but not doctor.

 

[Psychadelic2012]

Re the other point, I was aware that many actors have mental health issues and drug problems. There are so many stories about actors being fired or having the whole crew work around their moods and desires and so forth. Having certain math geniuses with some mental issues also makes sense, like the socially awkward and absentminded professor. I just have a different view of surgeons. And doctors in general. It's not just the MCAT, and the courses you have to take, it's also the interview and people skill and ethics and requirement that you be very reliable and dependable. Lab tech maybe but a doctor with no people skill? How would he get through interview, seeing patients, etc? Or someone who keeps changing jobs or gets in trouble with everybody at work and keeps changing jobs? Or doc cancels surgeries several times a month because of mood swings? Or sweating bullets because of social phobia when he sees a patient? I expect "weirdness" and cancelled appointments when meeting some math genius or actor, but not doctor.

WOW, you certainly have a starry-eyed view of medical doctors!! Holy cow. It's like they came straight from Heaven or something. Can they do no wrong in your eyes? Have you not heard of any doctors who have ever been sued or arrested or lied to their patients or assaulted anyone?! I have. Doctors are no different than the rest of the population. More intelligent in certain ways, yes. But because of that you imply that they are completely mentally healthy??

You also have a very dismal view of mental illness. You do realize that the mentally ill are no longer committed to institutions for the rest of their life, right?

You are confusing certain emotional disorders with all emotional disorders. Anxiety or mood swings aren't the only mental disorders. How about narcissistic personalities or other personality disorders, which are actually more morbid and harder to treat than anxiety or mood disorders? I would venture to say that doctors have more of these types of traits, actually, since it takes that type of personality to even pursue that field.

 

[erg923]

thank you for further explanations drs. I'll make last post before going to college. Compulsiveness sounds interesting. What are the the other two personality measures?

Re the other point, I was aware that many actors have mental health issues and drug problems. There are so many stories about actors being fired or having the whole crew work around their moods and desires and so forth. Having certain math geniuses with some mental issues also makes sense, like the socially awkward and absentminded professor. I just have a different view of surgeons. And doctors in general. It's not just the MCAT, and the courses you have to take, it's also the interview and people skill and ethics and requirement that you be very reliable and dependable. Lab tech maybe but a doctor with no people skill? How would he get through interview, seeing patients, etc? Or someone who keeps changing jobs or gets in trouble with everybody at work and keeps changing jobs? Or doc cancels surgeries several times a month because of mood swings? Or sweating bullets because of social phobia when he sees a patient? I expect "weirdness" and cancelled appointments when meeting some math genius or actor, but not doctor.

Im curious why you 1.) equate having a mental health dx to being functionally impaired in all aspects of life and work? 2.) Apparently view all mental health dxs as essentially the same in their symtomatology, severity, and functional impact? 3.) Why you want to make medical doctors (surgeons in particular) impervious to emotional disturbance? Again, I dont know what world you come from, but being a doctor is about drive and intelligence (memory in particular). Nothing more. And if you've never met a socially akward physician..I'm not convinced you have ever actually left your home. 🙂

Do you not think people can learn coping mechanisms to deal with and/or mask their symptoms when needed (e.g., a job interview) or something? People with psychaitric illness can be just as "intelligent" as anyone else. Part of that "intelligence" is the natural human ability for adaptation...so one can function as normally as possible.

 

[Therapist4Chnge]

Some of the greatest artists were bipolar (or schizophrenic).
Some of the best business people were narcissists.
And so on.

 

[AcronymAllergy]

thank you for further explanations drs. I'll make last post before going to college. Compulsiveness sounds interesting. What are the the other two personality measures?

Re the other point, I was aware that many actors have mental health issues and drug problems. There are so many stories about actors being fired or having the whole crew work around their moods and desires and so forth. Having certain math geniuses with some mental issues also makes sense, like the socially awkward and absentminded professor. I just have a different view of surgeons. And doctors in general. It's not just the MCAT, and the courses you have to take, it's also the interview and people skill and ethics and requirement that you be very reliable and dependable. Lab tech maybe but a doctor with no people skill? How would he get through interview, seeing patients, etc? Or someone who keeps changing jobs or gets in trouble with everybody at work and keeps changing jobs? Or doc cancels surgeries several times a month because of mood swings? Or sweating bullets because of social phobia when he sees a patient? I expect "weirdness" and cancelled appointments when meeting some math genius or actor, but not doctor.

I could be wrong, but wasn't the increasing prevalence of the "doctor with zero bedside manner" stereotype one of the reasons they began including instruction on personal interaction/communication in medical school curriculum? After all, having your patients like you significantly decreases the chance you'll be sued for malpractice, and significantly increases the likelihood your patients will adhere to your treatment recommendations.

 

[cara susanna]

thank you for further explanations drs. I'll make last post before going to college. Compulsiveness sounds interesting. What are the the other two personality measures?

Narcissistic and Histrionic.

 

[nitemagi]

Again, I dont know what world you come from, but being a doctor is about drive and intelligence (memory in particular). Nothing more. And if you've never met a socially akward physician..I'm not convinced you have ever actually left your home. 🙂

Small point. Memory is primarily useful for the first 2 years of medical school and for some pre-med courses, but is Not what is test on the MCAT, nor what is tested in clinical clerkships. It's the critical thinking and integration of knowledge in combination with examination skills and various other data points that gets trained into a physician.

Just so we're not reductionistic to believe that anyone that memorizes well will get into medical school or do well in it. Many who have excelled because of their ability to memorize struggle in medical school because of the other skills it calls on.

 

[Ollie123]

I'd really encourage you to spend a little time volunteering somewhere that you can interact with physicians. They are perhaps a bit more intelligent and motivated than the average person, but you'll quickly realize they are normal people who experience the same sorts of problems that everyone does. I've yet to meet one with superpowers, and the ones who think their completion of medical school means they can do no wrong are, ironically in this case, the ones who likely have some serious psychopathology. Similarly, not everyone with a mental illness is living under a bridge and begging for change on street corners. Many are working on Wall Street, designing the next great technological advance, or yes, even in the OR.

There's no doubt that med school is tough, but so are lots of things. Overcoming obstacles in no way guarantees that one is and always will be free from psychopathology. Those difficulties can even contribute the development of mental illness.

 

[RayneeDeigh]

This is such a fascinating thread.

Medical doctors are just regular people. A psychiatrist I knew once told me that she knew of at least 3 guys in her graduating class who made it through med school by cheating on exams. They have substance/alcohol problems, personality disorders, mood disorders, and quirks just like the rest of the population. There are a whole bunch of sociological factors that probably make the medical population "unique" in terms of personality, but the same can be said for pilots, firefighters, cops, etc. Some doctors are Type A, some doctors are Type B and would be late to their own funeral.

 

[voyeurofthemind]

Oh Erg, my feelings towards you constantly vacillate between love / hate -- when it comes down to it you always have great things to say, your arrogant delivery is something less desirable though. Take this as a friendly rub ;-)


"Um, the same way you can be a mathemetician or a musical genious an have schizophrenia (John Nash, Brian Wilson, Syd Barrett, etc). And the same way you can be a succcesful actor and have Bipolar Disorder or drug addiction (too many to name)...

What world do you live in?"

 

[erg923]

Oh Erg, my feelings towards you constantly vacillate between love / hate "

I do not develop emotional attachments or feelings towards to internet posters. 😀

 

[paramour]

I do not develop emotional attachments or feelings towards to internet posters. 😀

I love you, man. 😍

 

[Therapist4Chnge]

I do not develop emotional attachments or feelings towards to internet posters. 😀

To adopt a great monologue from one of my all-time favorite movies....The more we dislike erg923, the more we will learn. He is hard, but he is fair. He does not look down on any SDN poster, he believes we are all equally worthless. His orders are to weed out all non-hackers who do not pack the gear to serve SDN.

3 awesome points to anyone who gets the reference, without looking it up. 😀

 

[paramour]

To adopt a great monologue from one of my all-time favorite movies....The more we dislike erg923, the more we will learn. He is hard, but he is fair. He does not look down on any SDN poster, he believes we are all equally worthless. His orders are to weed out all non-hackers who do not pack the gear to serve SDN.

3 awesome points to anyone who gets the reference, without looking it up. 😀

I love my Kubrick collection.

This thread makes me so emotional. 😍

 

[neurologyoncall]

Oh Erg, my feelings towards you constantly vacillate between love / hate -- when it comes down to it you always have great things to say, your arrogant delivery is something less desirable though. Take this as a friendly rub ;-)


"Um, the same way you can be a mathemetician or a musical genious an have schizophrenia (John Nash, Brian Wilson, Syd Barrett, etc). And the same way you can be a succcesful actor and have Bipolar Disorder or drug addiction (too many to name)...

What world do you live in?"

Yes, I was taken aback and thought that was a rude reply but I did not say anything because I was reminded that Dr Erg himself/herself was pointing out that becoming a doctor says nothing about a person's social skills or sanity.

 

[postitnote]

I look at these traits as lying on a dimension of personality--conscientiousness/compulsivity--which includes (at maladaptive low AND high levels) certain pathology, but can also include adaptive personality functioning. It's when a trait is extreme in both degree and maladaptivity that it can cause functional impairment, which as others have noted here, does not necessarily indicate occupational impairment. I am hopeful that most surgeons have adaptively high levels of compulsivity/conscientiousness though I know that is not necessarily the case.

 

[neurologyoncall]

I look at these traits as lying on a dimension of personality--conscientiousness/compulsivity--which includes (at maladaptive low AND high levels) certain pathology, but can also include adaptive personality functioning. It's when a trait is extreme in both degree and maladaptivity that it can cause functional impairment, which as others have noted here, does not necessarily indicate occupational impairment. I am hopeful that most surgeons have adaptively high levels of compulsivity/conscientiousness though I know that is not necessarily the case.

Let's look at definition of personality disorder.

"The deviation must manifest itself pervasively as behaviour that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e., not being limited to one specific "triggering" stimulus or situation). There is personal distress, or adverse impact on the social environment, or both...."

So not traits, but actual disorder. Again, I wonder how it could be that you can manage being a surgeon. How could a personality disorder actually fit here in this very intellectually and physically demanding occupation, where high self discipline, emotional intelligence, reliability, leadership skills, teamwork, etc, are a must. I don't think you can "mask" the symptoms or adapt because if you could, you would not have a personality disorder in the first place. These people can't adapt. So the only one that comes even close is, like you mentioned, "compulsivity" and I suppose that is helpful if you're just following a manual or assisting the main surgeon but what you're the main guy, the team leader. Don't you need to be flexible, rely on your judgment, etc? In fact, that is the main difference between the responsibility of people in lower positions and higher ones, the room for decision making and reliance on personal judgment as opposed to following the rules. A guy in admin position in government, yes, but imagine having a president who meets the full criteria for OCPD.

 

[erg923]

A guy in admin position in government, yes, but imagine having a president who meets the full criteria for OCPD.

Yes, whoever heard of a high profile politician with personality pathology?!

PS: You dont think Nixon could have meet criteria for PPD? I think a pretty good case could be made.

 

[erg923]

Let's look at definition of personality disorder.

"The deviation must manifest itself pervasively as behaviour that is inflexible, maladaptive, or otherwise dysfunctional across a broad range of personal and social situations (i.e., not being limited to one specific "triggering" stimulus or situation). There is personal distress, or adverse impact on the social environment, or both...."

So not traits, but actual disorder. Again, I wonder how it could be that you can manage being a surgeon. How could a personality disorder actually fit here in this very intellectually and physically demanding occupation, where high self discipline, emotional intelligence, reliability, leadership skills, teamwork, etc, are a must. I don't think you can "mask" the symptoms or adapt because if you could, you would not have a personality disorder in the first place. These people can't adapt. So the only one that comes even close is, like you mentioned, "compulsivity" and I suppose that is helpful if you're just following a manual or assisting the main surgeon but what you're the main guy, the team leader. Don't you need to be flexible, rely on your judgment, etc? In fact, that is the main difference between the responsibility of people in lower positions and higher ones, the room for decision making and reliance on personal judgment as opposed to following the rules. A guy in admin position in government, yes, but imagine having a president who meets the full criteria for OCPD.

Ok. What would it take for you to believe us? Do you need a study titled, "Prevalence of [Insert PD here] in US Surgeons." That study doesn't exist. I dont know what else can be said to you about this that others haven't already said.

 

[RayneeDeigh]

I was inspired to google.

Although, it occurs to me that arguing with someone who's already made up his mind before he asks a question is probably a waste of time... I have a lot of time to waste these days.

http://www.ncbi.nlm.nih.gov/pubmed/20430410

http://www.texmed.org/Template.aspx?id=6836

http://www.eaph.eu/eaph.nsf/AttachmentsByTitle/barcelona_disruptive/$FILE/Disruptive+and+distressed+doctors+-+Relevance+of+personality+disorder.pdf

 

[Ollie123]

You sure about that Erg? This is a whole line of research, though I think its usually looked at physicians as a whole. It seemed to peak in the 70's from what I remember, but people are still publishing on it today. I spent < 1 minute searching and found

http://occmed.oxfordjournals.org/content/58/5/334.abstract

http://www.sciencedirect.com/science/article/pii/0010440X74900078

http://jama.ama-assn.org/content/189/13/989.short

I repeat what I said early on in this thread...available evidence suggests physicians are equally or MORE likely to have many mental illnesses than the general public. I wasn't making that up - I read some of this literature many years back for a class presentation. We can argue about how this should or shouldn't be true, but that's why people do research - to show what reality is. Reality is that physicians have mental illness. Quite frequently. Sorry if that is upsetting to you for some reason (I'm unclear why?) but that is reality.

 

[RayneeDeigh]

I think a really important point that the OP isn't fully understanding is that "mental illness" does not mean the person is completely useless of incapable of achieving great things like becoming an MD (or anything else). One could argue that a PhD in Clinical Psychology is as difficult to achieve as becoming a neurosurgeon, and there are certainly PhD level Psychologists who have personality disorders as well as major mental illnesses.

There is a huge amount of research, for instance, about the "successful psychopath."

Personally if I'm going to a neurosurgeon for something I don't care if he/she is personality disordered as long as my damn brain isn't gonna get scrambled.