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Understanding the client's 'type': a widely used personality tool can help professionals tailor treatment.

Practitioners in recovery work need an approach that is effective with a variety of people representing an entire spectrum of personality types. This diversity explains why a good relapse prevention strategy for one person may be disastrous for another. Professionals need a system that offers insight into how people see the world, express and defend themselves, deal with the past and future, have fun, and fall in love.


Such a system exists in the Myers-Briggs Type Indicator (MBTI). The MBTI is one of the most widely used personality inventories in the world, transcending national and cultural boundaries. Because it is neither judgmental nor pejorative, it helps to raise self-esteem in the client. In the counseling process, the MBTI often helps us pinpoint the work to be done and the healing we need to be open to.

Development of the instrument

Carl Jung (1875-1961), a Swiss psychiatrist and keen observer of human nature, suggested that differences in behavior result from innate preferences in people's personalities. He believed that healthy development requires people to accept and nurture these preferences. He saw the maturing process as becoming aware of and accepting one's preferences.

Jung introduced the terms "extravert" and "introvert" into everyday language. (1) He intended us to recognize two different preferences in the ways in which individuals focus their attention in order to replenish their energy: from the outer world of people and things, or from the inner world of thoughts and ideas. He also identified two ways of taking in information: through experiencing the present (sensing; S) and imagining future possibilities (intuiting; N). In addition, he determined that some individuals process information and make decisions through logic and analysis (thinking; T) and others through a more personal process (feeling; F).

Katharine Cook Briggs and Isabel Briggs Myers, an American mother-daughter team, spent decades developing ways to measure these preferences, eventually creating the MBTI. They added a concept related to how people live their everyday lives, with the two attitudes of judging (J) and perceiving (P). Judgers like to make plans and reach closure by deciding. Perceivers like to go with the flow and stay open to last-minute options.

Although everyone uses all functions and attitudes every day, the psychological profile identifies which functions and attitudes we prefer and use predominantly. The MBTI was tested for years at Educational Testing Service (ETS) in Princeton, New Jersey, and was made available to the public in 1975. It identifies 16 distinct psychological profiles.

Individuals with ISFJ Myers-Briggs preferences (introverted, sensing, feeling, judging) are the type that is often most heavily represented in reports from substance abuse treatment centers. (2,3) A review of two actual clients with ISFJ preferences illustrates how adapting therapeutic strategies to their MBTI results facilitates recovery for both.

Case studies

Catherine and Carlos (not their real names) both demonstrate ISFJ preferences. They are quiet, friendly, practical, loyal, responsible, and conscientious workers when in their recovering selves. Because they are dominant sensors, they focus on the here and now--today's reality as opposed to the past or future.

Catherine, five years into recovery, is a 38-year-old office manager, divorced with no children, and the third of five female siblings. Carlos, six years into recovery, is a 39-year-old carpenter, single, and the oldest male sibling in a family of four.

Being of service to others is meaningful in their lives. Their characteristic concern with making others happy makes them susceptible to getting stuck in codependent behavior, an experience both have had in their families of origin and in adult relationships.

During the intensive phase of their behaviorally focused treatment program (Carlos was in residential treatment and Catherine was in day treatment), they both appreciated the facilitator, who worked in an orderly fashion, clearly stated the agenda, and stuck to it. Whenever the facilitator seemed unprepared or spontaneously followed another direction, or another staff member unexpectedly filled in, Catherine and Carlos discounted the possibilities of the session. When they felt safe enough to speak about these experiences, they expressed negativity and judgments.

They both prefer quiet personal support and approval for feedback. But because they are prone to codependency, both also exhibit a strong need to be needed by others, thriving on the idea that "you can't do it alone." A facilitator's feedback to them about their situation does not by itself meet this personality type's need to be helpful to other clients in treatment.

It helped both Catherine and Carlos that other clients in the group modeled how to work with interventions in the initial portion of the program. Typical of dominant sensors, both remembered these instances in detail and used them as a way to find the necessary courage to take the next steps for themselves. This shows how group therapy may be beneficial in the intensive phase of the program, even though some group members may not be ready to do the deeper work until much later.

Learning to recognize what is known as the "shadow function" is important in relapse prevention. This refers to the least prominent of the four functions, but it is the function in which transformation takes place. The letter of the shadow function does not show in the client's profile but is the opposite of the dominant function. For Catherine and Carlos, the dominant function is sensing. Their shadow function is intuition.

The fourth function for Catherine and Carlos, after sensing, feeling, and thinking, is largely unconscious, is not often used, and does not have much chance to develop. It slips out when people least expect it, causing problems and leading them into dysfunctional behavior and/or relapse. When this fourth function surfaces, Catherine and Carlos each have a specific way of getting stuck in it.

When Carlos is under pressure, his intuition tends to manifest by letting him see very few choices, each one worse than the other, and all leading eventually to disaster. He tends toward a "doom and gloom" worldview that easily leads him to depression. Catherine, when stressed, tends to estimate future events or situations unrealistically. She is either overly optimistic or, when undervaluing herself, extremely pessimistic. Her anxiety level increases, she becomes paralyzed by indecision, and she withdraws and eventually becomes depressed.

It is not difficult to see that under such circumstances compulsive behaviors such as drinking, using drugs, overeating, smoking, gambling, constant TV watching, and acting out sexually become welcome options. Helpful interventions here are transactional analysis, behavior modification, psychosynthesis, voice dialogue, and gestalt and rational emotive behavior therapy. Transactional analysis and/or behavior modification can be used to establish a program in which the client can shift out of intuition and back into the familiar mode of sensing, as soon as the shadow function surfaces.

For Catherine, shifting back into sensing means doing some gardening, balancing the checkbook, or studying the details of a piece of art. For Carlos, it often means working overtime and choosing routine pieces of work that do not call for difficult problem solving. Both are now familiar with psychosynthesis and voice dialogue interventions, as well as relaxation techniques to help them call on the nonjudgmental observer within to preside over the subpersonalities needing to speak.

It is important to build in some skill training for the fourth function in sessions when clients are not stressed. For Carlos and Catherine, this could be brainstorming about some fun on the weekend or future holidays. They can also use intuition to make lists of future goals or things they could plan to see and do if there were no restrictions.

Catherine and Carlos are strongly introverted in an extraverted society, and both have taken the societal judgment to heart, seeing themselves at a disadvantage externally and at times still not OK internally. Both are inclined, after taking in the facts (S), to make decisions from their own unique value system (F). Often they express this very forcefully as good and bad, right and wrong.

Catherine expresses more freely positive feeling judgments that often form an undercurrent in much of her speaking. With her motherly caring, she has made a special connection with her nephew, who genuinely seems to enjoy his aunt. However, her independent teenage niece rejects her severely in this mode, and Catherine finds herself unable to "relate." The niece becomes indifferent toward her, just as Catherine's parents did. Catherine sees this pattern, and we have used it as a stepping stone to call forth her less preferred functions to be used constructively.

The characteristics that come so easily and naturally for Catherine (her warmth, gentle caring, and sweet smile) are applauded by society because they fit the stereotypic female. She also notices that others, especially men, often do not take her seriously.

Carlos had one particularly joyful experience when he connected with his young nephew--a rare event in his life. He experienced great caring and love, was in awe of the child's vulnerability, and wanted very much to protect him. He will not yet allow himself to make close connections with adults, and often claims that others will surely take advantage of him and that he is powerless to protect himself.

Carlos has started to drink again and is more than ever inclined to express his hostility verbally and physically. When he is sober and in his recovering self, he is kind and gentle. These characteristics do not earn him points with his buddies in a macho male world. Carlos, like many other SF males, has a difficult time figuring out how to be himself and value who he is. On the other hand, as a male, he had much more early encouragement than Catherine did to develop his thinking (tertiary function). He does not yet appreciate his feeling fully and does not realize that he is ahead of other thinking males in understanding that this can lead to his powerful capacity for compassion.

Only very few individuals close to Catherine and Carlos are aware of their inner richness and resources, as is often the case with highly introverted individuals in our society.


A key issue for clients is a sense that something is missing in their lives, although what exactly this is may be difficult to define. Our culture does not encourage us to reflect on what our hearts yearn for--to know who we are and why we are here. Therefore, we often give up on ourselves and return to familiar distractions.

An awareness of different personality types, as expressed by the MBTI, helps in recovery work. Our restless yearnings are universal, but how these are expressed is very particular--a filter with which we approach everything in life.

Christine MacDonald-Kramer, MEd, is a psychotherapist trained at the University of Toronto who recently retired from the Donwood Institute, a Toronto residential treatment center for addictions that is now known as the Centre for Addiction & Mental Health.

To send comments to the author and editors, e-mail


1. Jung C. Psychological Types. Princeton, N.J.: Princeton University Press, 1976.

2. Bisbee C, Mullaly R, Osmond H. Type and psychiatric illness. Res in Psychol Type 1982;5:49-68.

3. Luzader M. Chemical dependency and type. J Psychol Type 1984;8:59-64.

by Christine MacDonald-Kramer, MEd
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Title Annotation:personality types
Author:MacDonald-Kramer, Christine
Publication:Addiction Professional
Geographic Code:1CANA
Date:Mar 1, 2006
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