I'm going to focus on one particular aspect of House about which there seems to be some controversy. The distinction I will invoke is important at least insofar as it could be the difference between viewing House as fundamentally "good" or "bad," winsome or repellant, which might color viewers' experience of the entire show. Admittedly, we're not quite at the level of the fate of the free world, but we're probably close enough for House fans.

Based on some informal research (querying friends and Google), it seems that a lot of people (maybe most people) believe that House typifies what research psychologists call a narcissist. The lay equivalents of narcissism are embodied in concepts like conceit and cockiness. However, these terms do not fully capture the entire scope and complexity of the narcissistic personality. Narcissists have inflated feelings of self-worth coupled with low feelings of empathy for others. They constantly seek admiration from others, and they exhibit a Machiavellian propensity to use people in their environments as mere means to the enhancement of their self-esteem and self-centered objectives (Campbell, Brunell, & Finkel, 2006). Basically, when House acts arrogant, exploitative, callous, and vain, he is acting narcissistically.

If you have already read my preceding blog post (see Dr. Phil & Psychology), you may have identified the connection between narcissism and the motivation to pursue self-esteem. There is, in fact a direct affinity between these ideas. Narcissists avidly pursue self-esteem to the exclusion of other potentially more worthy aims. (Incidentally, we can deduce from this that Dr. Phil, by encouraging self-esteem strivings in others, is in essence facilitating the development of narcissism in his followers, but, I digress).

So, is House a narcissist? Let's first recall the basic features of narcissism:

• Feelings of superiority

• Low empathy for others

• Persistent self-esteem strivings

• Machiavellianism (using others as mere means to the attainment of self-objectives and self-esteem)

Feelings of superiority? Check. House feels better, more unique, and more entitled to have his wishes fulfilled than those around him. Even though we have seen some improvement in these respects entering Season 7, I think practically everybody would agree that he still has a long way to go here. Low empathy for others? Check. Again, despite gains in this area, which are partly due to the influence of his romantic involvement with Cuddy and experiences like the death of Wilson's girlfriend Amber, House still lacks basic concern for others.

I believe the controversy truly comes in with the next two narcissism bullet-points. Does House persistently pursue self-esteem? Despite what many may think, it seems clear to me that the answer to this question is "no." Time and again, we see that House is motivated primarily by his desire to "solve the puzzle." He frequently becomes completely engrossed in this task (just like I am while writing blog posts, LOL), which has nothing to do with his self-esteem. He is what psychologists call intrinsically motivated by the allure of the puzzle (of mysterious medical maladies). This means that he is not solving puzzles in order to bolster his self-esteem or, at least, that he is not consciously doing this. The same idea basically holds for House's Machiavellianism. House does frequently use people as mere means, but the ends involved are usually pragmatic rather than psychological. He does not generally use people to buttress his self-esteem; rather, he uses them to further his material objectives.

So, if somebody claimed that House displays narcissistic tendencies, I would not necessarily disagree, at least not completely. But, if somebody made the stronger claim that House is a narcissist, the picture gets a bit cloudier. The truth is that narcissism is measured on a continuum; it is not an all-or-nothing distintion. House would probably score fairly high on the most popular scale that measures narcissism, the Narcissistic Personality Inventory (NPI; Raskin & Terry, 1979). House is in some ways a narcissist and in other ways not a narcissist. Unfortunately, there is no unqualified solution to the question here. As is so often the case, House does not completely conform to any single concept or category. He is an extraordinarily complex character. You will have to, as House would not hesitate to tell you, deal with it.

 Ted Cascio is co-editor of House & Psychology (John Wiley & Sons).

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