As a psychiatrist and novelist concerned with people’s inner conflicts, I’m often asked whether people can truly change.

The answer is: yes, and no.

Most mental health professionals agree that our deeply embedded traits and tendencies are ingrained by the time we’re adolescents. Yes, there can be some minor modifications after that, but our basic way of interacting with others is pretty much set by the time we’re 17 or 18. We interact with others in a fairly inflexible and deep-rooted manner. It’s our “way of being.”

So what about someone seeking psychotherapy because of unhappiness with relationships and how life is going? What about the person who repeats endlessly the same maladaptive patterns of behavior leading to frustration, failure, unhappiness, and even depression? Or the person whose relationships are tainted by neediness, or dependency, or the wish to dominate others; or any other traits that make for problems interacting with people?

You’ll notice these aren’t symptoms such as a phobia, or panic episodes, or an onset of a symptom causing psychic distress. Rather, these are enduring personality traits, not temporary states of being.

The goal of any psychotherapy is to help a person develop a better understanding of one’s self. It’s called insight. Hopefully, by developing an awareness of personality flaws, a person can recognize them, and nip them in the bud before they exert themselves and ruin relationships. If this can be accomplished, the person may experience less conflict or tension with other people, and lead a more fulfilling life.

For example, a man comes for counseling because he’s been fired from three different jobs. During sessions (to which he always arrives late), he realizes that as far back as elementary school, he undermined his own success by tardiness and by not completing tasks on time. In high school, he received Cs instead of As because he never submitted his work by the stated deadline. In business, he repeated the same pattern.


He also learns in the psychotherapy sessions that as a child, being late or dawdling was a way to get much-coveted attention from his parents. Without realizing it, throughout his adult life, he’s been repeating this pattern with every authority figure. This has been the source of conflict, failure, firings and general unhappiness throughout his adult life.

With awareness of this tendency, he can begin working to change this maladaptive and self-destructive behavioral pattern — this deeply ingrained trait. He may not always be successful in this effort, but some positive and adaptive changes in his behavior can occur.

While his trait may not have been eradicated, his behavior and interactions with others can begin to change for the better.

I like to think of it in this simple way: Imagine personality style as a 90-degree angle. If a person can move that angle a mere three degrees, then a significant change in how one interacts with other people is surely possible. This can lead to positive changes.

So once again, can people change their basic personality patterns?

Yes, and no. While they don’t alter their basic personalities, through insight, they can change their behavior and become more skillful in their interactions.

 By Mark Rubinstein, MD 

Mark Rubinstein, M.D. is an award-winning novelist, physician and psychiatrist. 
He’s the author of Bedlam’s Door: True Tales of Madness and Hope,
a non-fiction memoir with actual patients’ stories that read like fiction.
 For more information, please visit www.markrubinstein-author.com

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