Best practice in psychological care: Shifting the focus from symptoms to personality

In previous newsletter editions we have touched on the developmental process of constructing a sense of Self or said otherwise, defining an identity. Similarly, personality formation is also a developmental process. If identity is who we are, then personality can be thought of as the internal psychological structures and processes that govern how we function. Much attention has been given to what influences individual differences amongst people, with the early years of life considered a critical formative period for shaping our adult selves, including the development of our personality.

Many theories of personality are narrow with a reductive focus on categorising fundamental dimensions of human personality, such as the five-factor model of personality.

Known as the Big Five, the model organises personality traits in terms of five basic dimensions: Extraversion, Agreeableness, Conscientiousness, Neuroticism, and Openness to Experience. However, personality is a far more complex and multifaceted construct that extends beyond these five dimensions.

Personality refers to the organisation of our inner life; it is how we are 'put together' —and, at times, how we fall apart. It encompasses our characteristic patterns of thought, feeling, behaviour, motivation, defensive functioning, interpersonal relating, and the ways we navigate both inner and outer realities. While personality is often seen as a relatively stable psychological structure, contemporary perspectives increasingly recognise its plasticity — the capacity for adaptation and change across the lifespan in response to experiences, such as meaningful relationships. The potential for change, makes personality a primary site for therapy work.

However, various systemic pressures have led psychological approaches to become less therapy and more brief intervention with a focus on symptom reduction. Nancy McWilliams describes the concerning trend of reducing mental health care as “comparable to arguing that cancer patients should receive aspirin”. Typically, the problems that bring a person to therapy are not isolated; they are deeply intertwined with their lives and embedded in the person’s overall way of thinking, feeling, and interacting — essentially, their personality. Focusing on symptoms and disorder overlooks what psychologists must truly understand for lasting and meaningful change to occur: that is the need to engage with the person’s inner workings that create psychological vulnerabilities and recurring problems. Best practice in psychological care comes not from focusing on symptoms, but on addressing characteristic underlying personality patterns.

Over the past two decades, empirical research has identified the major personality types and their core features. Some of these personality types will be explored in more detail in upcoming newsletter editions.

March 2025