Life as Art

How our world shapes who we are and how who we are shapes our world

"Designer" Personalities?

Should we manage our personality with drugs?

The age of designer babies (in which gender, eye color, height, and even IQ of offspring can be preselected) seems to be looming in the not-too-distant future. But is the age of designer personalities (in which our personality traits can be pharmaceutically altered to achieve optimum success and happiness) already upon us? And if so, is this a good thing for society or a disaster?

I began seriously pondering this question after two incidents occurred on the same day last week. First, a colleague contacted me to see what I knew about the biological basis of sociability. Concerned parents had brought their teenage son in for treatment because he preferred solitary activities, didn't have many close friends, and was getting only mediocre grades in school. The parents were convinced that there must be a drug their son could take to make him friendlier and more motivated. Severe problems with asociality (lack of desire to engage in social relationships) and abulia (lack of motivation), such as are often seen in schizophrenic patients, can be treated fairly successfully with dopamine agonists (drugs that enhance dopamine functioning in the brain). Dopamine agonists are also prescribed for personality changes due to brain injury or dementia.

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So why wouldn't concerned parents wish to use these same neurochemical treatments to try to give their child the best possible chance for success and happiness? On the same day, a friend called me to complain about her husband. He had lost enough weight recently that his doctor took him off the beta blocker medication that had been taking to control his blood pressure. My friend liked her husband better when he was taking the medication...she said his personality was less irritable and more easy-going. She even joked about sneaking some crushed form of the medication into his food to keep him amiable.

These two incidents got me to thinking about designer personalities and how parents and spouses are sometimes willing, nay eager, to alter the personality of loved ones a la Stepford Wives to achieve some ideal of behavior. As a psychopathologist I am all in favor of using drugs in combination with psychotherapy to relieve the suffering that accompanies diagnosable mental disorders, such as depression, Bipolar Disorder, bulimia, PTSD, or OCD. But every drug has side effects...that's why professionals are in favor of limiting drug use to disorders that cause dysfunction or severe distress. In these cases, the negative side effects of the drugs are outweighed by the negative effects of the illness they treat. However, there seems to be a growing trend to prescribe mood- and personality-altering drugs to individuals who have no psychiatric diagnosis. I know people who have been on drugs such as Wellbutrin and Prozac for years without being diagnosed.

One friend "went on Prozac" after having an argument with her husband and has remained on the drug ever since. She told me: "I used to get upset when we argued, but now it doesn't affect me at all. It's wonderful." One of my doctor acquaintances prescribes Wellbutrin to patients who complain that that they have no energy and that life has lost its zing. Think of the number of reports that suggest children who are hyperactive or disruptive may be put on Ritalin to "calm them down" without going through appropriate neuropsychological testing. A student of mine related to me that she had been on Ritalin five days a week since she was 12. She took weekends off the drug to reduce tolerance. She reported that she was "spacy," impulsive, fun-loving, but easily frustrated on the weekends when she was off the drug. The doctors and her parents had always told her that the drug let the "real" personality - the person she was capable of being if she didn't have ADHD - shine through. But Kate still wondered which was her "real" personality: the weekday Ritalin-regulated Kate or the weekend space cadet?

Of course, the idea that personality is mediated by biological chemicals is not new; it dates back to Hippocrates and the ancient Greeks. Remember their theory of the Four Humours? In this theory, the humours (or personality types) are associated with an excess of a particular bodily fluid: an excess of blood was associated boldness, impulsivity and arrogance; black bile was associated with a tendency to be sad or depressed; excessive yellow bile led to anger, aggressiveness, and need to dominate; and phlegm was associated with laziness and lack of motivation. Fast-forward to the 20th century: psychiatrist Robert Cloninger has developed an influential theory of the psychobiology of personality, in which each of the major personality traits is associated with one of the major neurotransmitters in the brain. We currently have pharmaceuticals that can alter the production of each of these neurotransmitters.

Shouldn't we be using our knowledge of neurochemical functioning to make people as happy and high-functioning as possible?
Or is life imitating art as we begin to enact Huxley's Brave New World by soma-tizing our personalities into mindless, unnatural contentment and complacency?

Shelley Carson, Ph.D., is an instructor and researcher at Harvard University, where she teaches creativity and abnormal psychology.

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