We recently celebrated the forty-first anniversary of the Apollo 11 landing, when a soft spoken astronaut named Neil Armstrong made a giant leap for mankind. Isn't it about time for other reflective, idea-oriented people to get their due? We think so. Instead, simmering under the surface of our cultural consciousness is a belief that introverts are impaired.
Is there really something wrong with you if you're an introvert—or among that 50 percent of Americans who are more energized by their quiet time than their social time? Possibly yes, according to the World Health Organization and the American Psychiatric Association. Each organization produces an authoritative manual used for diagnosing mental disorders.
For decades "introverted personality" and "introverted disorder of childhood" have been in the WHO's manual—the International Statistical Classification of Diseases and Related Health Problems (ICD-9 CM), and the APA is now considering a proposal to include introversion in the next edition of its Diagnostic and Statistical Manual (DSM-5). The proposal would make introversion a contributing factor in diagnosing certain personality disorders.
This takes us back thirty years, when the APA proposed adding the more blatantly pathologizing diagnosis, "introverted personality disorder," to its manual. A letter writing campaign among mental health and personality type professionals helped persuade the APA to withdraw the proposed diagnosis. With introversion back on the diagnostic table, those in the healthy introversion camp again recently wielded their pens in protest.
Is the APA listening? After numerous requests for updates from the APA, we've only received murmurs from insiders that introversion is being replaced with another word. According to Naomi Quenk, Ph.D. a clinical psychologist who for years has studied healthy introversion as an aspect of personality types, the proposed DSM descriptions of introversion refer to an "absence or deficit of extraversion." She says that rather than avoiding extraverted activity, introverts move toward what they prefer—for example, reflecting on the day's events or sharing ideas with a close friend.
Imagine if the tables were turned and extraverts were criticized as lacking introversion. Perhaps mental health professionals would then be more concerned with "solitude avoidance" than with "social avoidance."
So what makes you an introvert? You're probably an introvert if you choose activities like reading, writing, and solving complex conundrums (think Neil Armstrong) over gunning for "life of the party" status. And introverts are better at thinking in their heads than on their feet. However, even if you contribute to advances in the sciences, technology, the arts, and the humanities, just being an introvert comes with a stigma. You may be passed up for a promotion because you don't speak up more, or seen as a snob because you don't attend a social event, or assumed to be depressed because you want to reflect rather than talk.
We know what happens when a naturally occurring orientation is determined to be unhealthy while another is upheld as the standard of health. As recently as the 1970's, the WHO and the APA considered homosexuality a psychiatric diagnosis. Inclusion in the ICD and DSM justifies existing stigmas—whether targeting homosexuality or introversion. Such diagnoses mistake difference for illness.
In the United States giddy and garrulous are good, and quiet and contemplative are suspect. The WHO's definition and APA's proposed definition of introversion align with that rigid Western bias. Martin Kommor, Ph.D., chair of the Department of Behavioral Medicine and Psychiatry at the West Virginia University School of Medicine, Charleston, says, "We psychiatrists know too well that many of our diagnostic labels have been more a reflection of the political/moral climate than any real disease."
It is the ultimate irony that professions committed to promoting mental health make it harder for millions of introverts to accept their natural gifts. So should the APA keep the word introversion out of the DSM-5? Absolutely yes, according to Quenk. Words carry power—for good or for ill. Still, we know from history that changing a word does not go far enough.