Michael Eriksson
A Swede in Germany
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Dr. House and social skills

The misunderstood Dr. House

I have repeatedly seen references to Dr. House as someone who is a brilliant physician but entirely lacking in social skills. However, anyone who pays attention to the show will find that his social skills are almost as strong as his diagnostic ability. What many people, in particular those who know the show just by reputation or have watched just a few episodes, fail to do, is understand why he behaves like a bull in a china store; and they then jump to the incorrect conclusion that he simply lacks even the most basic understanding of how the human mind works. The true reasons include (but are probably not limited to) the following:

  1. He sometimes deliberate uses his skills in a way that seems insensitive in order to get patients (or their relatives) to do what he wants, e.g. give up information he needs for his diagnosis or consent to a risky procedure. This is not because he lacks sensitivity, but because he knows that the emotions he puts his patient through makes them more likely to consent. This may or may not be ethically disputable or a display of faulty priorities (depending on POV); however, it is not social incompetence.


    Side-note:

    Here it is important to remember that House’s first priority is solving the case—even saving the patient appears to be a highly secondary concern. Respecting the patients’ feelings, the sanctity of their homes, and various legal and ethical boundaries, well, that is no concern at all.


  2. He does not have the strong interest in social interactions, being liked by others, etc., that most others have, nor does he have the patience and will to invest in this area for career reasons. This is not in any way a sign of lacking social skills but just a different way of being. Unfortunately, all-too-many of the extroverted majority assume that introverts are somehow defect, or unable to build the social circle they actually want—the truth of the matter is that introverts just have different interests. Speaking for myself: I do not spend most Friday nights at home with my computer because I have few friends; on the contrary, I have few friends because I prefer to spend Friday night at home with my computer—my social needs are fulfilled much faster than those of most others, and I have many strong interests that do not involve other people.

    (Note that there are many people who are extroverted, yet have a similar life-style, because they are too shy, have social phobias, or similar, and who are miserable as a result; however, they are a very different group from the introverts.)

  3. He has a number of personal issues that make it hard for him to build friendships, make him push people away, possibly even deliberate hurt people, etc. Certainly, this is a defect and a personal weakness; however, again, it is not a lack of socials skills. (Interestingly, this is a good demonstration on how we all tend to show less understanding of ourselves than of others, and are more prone to want to remove defects in them rather than ourselves. In the case of House, self-understanding and personal development is the Achilles heal of his seemingly invincible warrior.)


    Addendum:

    The “seemingly invincible warrior” is an almost comical claim in the light of later seasons of the series (when the original version of this page was written, I was some way into season 3).

    However, the general principle holds: His problems stems from an inability or unwillingness to develop himself in the right direction or even to put a stop to an ongoing negative development—despite the fact that he (unlike many others) should know better, probably even does know better. To be fair, this is an area where many people have problems (including yours truly, during some phases of my life), but so extreme examples are rare.

    On the plus side, the later seasons shows a greater amount of self-insight and personal progress. Then again, his problems have by that stage gotten so out of hand that he still struggles severely.


Without a doubt: If House wanted to be “Mr. Popular”, had the corresponding interests, and the patience needed, he would be highly successful in this regard. In fact, considering the immense psychological insights and deep understanding of the human mind he regularly demonstrates, he could easily be the chief/dean of medicine of a hospital twice the size of Princeton-Plainsboro.

Contrasts

Wilson

An interesting contrast is Dr. Wilson (or, for that matter, most other characters on the show): He seems to be smooth, confident, socially skilled, extremely likable, and someone who has “EQ” down pat; however, in his interactions with House, he almost always ends up second—even though it should be obvious to him that House plays competitive games to a much higher degree than most other people. Even when he is clearly infuriated, even when his career is threatened (cf. the police arc of season three), he often fails to show any actual ability in, or even attempt at, handling House. This is the more surprising, because a lot of the problems he has with House stem from the latter’s testing of boundaries, much like a teenager. As no boundaries are found, House, again like a teenager, pushes further and further out, with Wilson getting a shorter and shorter end of the stick. By starting to draw lines and tolerate no passing of those lines, Wilson could eliminate a large part of the problems. (The reader may note that I made similar mistakes with BA2; however, her provocations and boundary crossings were much smaller. Even in my old misguided tolerance of her incompetence and lack of respect for others, I would never have let her get away with the extremes House has gone to with regard to Wilson.) Notably, it is not sufficient to explain Wilson’s reluctance to take a stand with their friendship or his tolerance for House’s eccentricities: Even here a lack of psychological insight is present, because nothing is gained by either party by this reluctance—taking a stand would benefit not only Wilson himself, but House too, and very likely strengthen, not weaken, their friendship.

A notable difference between me and House is that he has realized that humans are easy to manipulate and takes full advantage of this, whereas I so far have not been able to overcome my unconscious belief that the average human is rational and intelligent—even in the face of plenty of evidence to the contrary.

Foreman

House is the team leader on the basis that he is the most competent member of the team and despite his way of handling people—something comparatively unusual in the real world. (Historically speaking, it would be more accurate to say that there was House and then the team was built around him, specifically for the purpose of using House optimally.)

Foreman, on the other hand, is someone of comparatively (!) low competence who has simply decided that he wants to be in charge. He has adapted his dress and behaviour accordingly—and has had some highly regrettable success. This, of course, is far more common in the real world. Among the parallels to reality, I note e.g. that Foreman has an extremely authoritative view, appearing to credit himself with “ex catedra” abilities and/or seeing differences in opinion as a threat (the last being an extremely common symptom among people of low competence who are put in charge), whereas House is open for discussion. Yes, House might literally shout his own opinion at the team and is often overly sure of himself; no, he does not hold on to his opinion no matter what and he is open to counter-arguments—often changing his own opinion immediately in the light of a good counter-argument or unexpected test result. (This, in turn, is very common among the highly competent, who know how to reason and think critically, know to differ between ego and truth, and who have enough genuine confidence in their own abilities to not fear being proved wrong.)


Side-note:

Judging the competence levels of fictional physicians is obviously not something that I can do with infallible accuracy. However, I have by now seen the seven first seasons several times each and have never seen any greater signs of competence in him. Notably, even Chase, who superficially gives the impression of being a dumb pretty boy, has had occasional strokes of genius. Certainly, Taub gives a far better impression in terms of both ability and experience—and would seem a far better choice for the new team lead in the wake of House’s absence at the beginning of season 6. (It could possibly be argued that Taub is too lacking in authority, where Foreman errs in the other direction; however, that might well change when authority and recognition is given. Notably, Taub was forced to “reboot” his career under unfortunate circumstances, and the associated loss of status and money does appear to have had a psychological impact.)


Dr. House on the Myers-Briggs scale

I have received surprisingly many hits on this page from search engines with queries like “Dr. House MBTI” or “Doctor House Myers-Briggs”. Since this seems to be a point of interest to the public, I pretended to be Dr. House while taking an online personality teste. The result was INTP.

This result must be seen with some caveats, however, including that I skipped a number of questions where I was highly uncertain about the right answer, the general unreliability of short tests on websites, and the risk that my own personality (INTJ according to a more thorough off-line test) has influenced my answers. Certainly, I cannot guarantee that I gave the same answers as Hugh Laurie or a writer (director, whatnot) on the show would have given, had he tried the same experiment.


Addendum:

Since writing the above, I have looked deeper into the theory, and ironically would tend to view House as the INTJ and myself as the INTP, based on my current understanding of the personality types. (See a more general discussion of MBTI.)

During this research, I also found many discussions on House and MBTI: The opinions vary considerably, but there seems to be an absolute majority in favour of xNTx over all combinations containing S and F; I tends to dominate E, but not entirely conclusively (in particular, some argue that signs of introversion, possibly in the wrong sense, in House would be a result of e.g. child-abuse); and the J-vs-P issue is open.

A regularly made observation is that House’s being fictional brings a number of complications, including that different writers can write different versions, that the portrayal may be sub-optimal in psychological understanding, and that the character may be (intentionally or unintentionally) distorted to match viewer preferences. Another is that House’s mental or abuse problems would be too large for a valid MBTI classification to be possible.