Are all disorders interpersonal?

cheli personality disorders

Today I spoke at the Workshop “Personality and Its Disturbances in Philosophy, Psychology, and Artificial Intelligence,” organized by the University of Montgomery. The presentation is part of the activities of the Evolution and Personality Lab.

The objective of the talk was to analyze three different hypotheses on the role of the interpersonal domain in psychopathology: specifically, whether none, some, or all disorders should be considered interpersonal. In evaluating these three theoretical positions, I present a general thesis and an antithesis for each, aiming to bolster an interpersonal perspective in psychotherapy. This perspective draws on principles formulated almost a century ago by Harry Stack Sullivan. The null hypothesis (“none” disorders) offers a critical analysis of modern psychopathology beginning with Freud; the quasi-interpersonal hypothesis (“some” disorders) focuses on Wright, Hopwood, and Pincus’s proposal to redefine personality disorders as interpersonal disorders; and the fully-interpersonal hypothesis (“all” disorders) reviews possible integrations between psychopathology and personality from an interpersonal perspective.

Finally, I discuss an evolutionarily-informed synthesis of all the proposed theses and antitheses. Drawing from models in evolutionary psychology and behavioral ecology—specifically the Social Brain Hypothesis, Life History Theory, and Tinbergen’s four questions—I attempt to motivate a radical interpretation of Sullivan’s thought.

My tentative conclusion is that the history of our species, human personality, and thus mental health and psychopathology, have always and distinctly evolved socially. Implications for conceptualizing and treating psychopathology are discussed.

An alternative view at needs and motivations

Yesterday I attended a symposium on needs, goals, and motivations. The introductory lecture was by Carol Dweck, followed by various perspectives based on Schema Therapy (e.g., Eskhol Rafaeli), CBT (e.g., Francesco Mancini), and Compassion Focused Therapy (e.g., Niki Petrocchi). I presented an alternative view of needs and motivations. My perspective was informed by evolutionary theory and aimed to offer a critical reading of these constructs. A special thanks to Maurizio Brasini who chaired the symposium and invited me.

In particular, I sought to emphasize two points. First, psychological constructs such as needs and motivations are created ex post to explain probabilistic processes such as natural and sexual selection. Defining general human functioning (e.g., personality) based on these low-order aspects risks making us forget a principle known since Gestaltpsychologie: the whole is not the sum of its parts.

Second, the phylogenetic trajectory of Homo sapiens is now primarily defined by cultural systems (which represent an analogue of genotypes), and many of the motivational models are almost exclusively consistent with Western cultural contexts—contexts where the individualistic, purposeful, and additive perspective on processes undoubtedly dominates.

This was an alternative view at needs and motivations of mine. A view rooted in an evolutionarily informed look at human personality.

The French philosopher François Julien, in discussing the effectiveness in East and West, cites two examples. On the one hand, Ulysses, who single-handedly resolved a decade-long war in one night. On the other, Sun Tzu, who saw the ideal of war as not taking the field. Perhaps what we think is certain is uncertain or undetermined.

For those interested, below is my presentation at the symposium:

Personality disorders and evolutionary psychopathology

Personality disorders and evolutionary psychopathology offers an intriguing perspective. Martin Brüne and I wrote a chapter on a new book published by Cambridge University Press.

“Personality” is considered as a set of individual characteristics and behavioral dispositions based on both temperamental (partially genetic-driven) and developmental (partially culture-driven) components that are relatively stable across time and context. We suggest that these two intertwined components progressively shape autopoietic processes operating at an individual and a social level in accordance with the theory of evolution and its application to human behavior. We discuss existing evidence linking personality traits to the manifestations of personality disorders and diverse forms of psychopathology. Particular attention is dedicated to the evolutionary concept referred to as Life History Theory, considering its utility in predicting the development of personality traits. We also emphasize the need to explore sources of critique and further research, suggesting that a multifaceted approach to the understanding of personality dimensions is crucial.

We hope this chapter may foster research on personality disorders and evolutionary psychopathology. For those interested in the topic here’s our Lab on personality and evolution!

Cheli, S., & Brüne, M. (2025). When Do Personality Traits Become Pathological?: An Epistemological and Evolutionary View. In K. Banicki & P. Zachar (Eds.), Conceptualizing Personality Disorder: Perspectives from Philosophy, Psychological Science, and Psychiatry (pp. 160–178). chapter, Cambridge: Cambridge University Press.

Two new studies registered

Evolutionary Systems Therapy, Evolution and Personality Lab

Two new studies registered at our lab! The main goal of Evolution & Personality Lab is to investigare personality and its pathology through the lens of evolutionary psychology and psychopathology. Consistently with this goal and ongoing studies, we registered two research protocols.

The first study is aimed to validate cross-culturally the evolutionarily informed conceptualization model we have worked on in the last few years. The protocol has been registered on ClinicalTrials.gov and comprises three studies involving teams from USA, Italy, Spain, Poland, China: (i) to explore the inter-rater reliability of the model in therapists; (ii) to explore the acceptability by therapists and patients; (iii) to explore the cross-cultural and cross-theoretical validity of training and application of the model. We hope this project will confirm that our model can be used within different cultural contexts and by clinicians with different therapeutic backgrounds.

The second study is aimed to explore the clinical utility of the three interpersonal styles and dynamics we have tested in a previous trial. In a recently concluded study we found that patients with personality pathology may show three prominent interpersonal styles that would correspond to the three main spectra of psychopathology: perfectionistic style and internalizing spectrum; antagonistic style and externalizing spectrum; schizotypal style and reality impairing/psychosis spectrum. The methodology used was potentially biased (patients were forced to chose only one style through a dummy variable). In this new study (registered on OSF) we used de-sitgmatizing labels for the three styles and offer a continuous Likert-type scale.

These two new studies registered on ClinicalTrials and OSF will better describe the clinical utility of our protocol for conceptualizing and treating personality pathology: namely, Evolutionary Systems Therapy. This protocol may be hopefully useful not only as and independent treatment. We are not that interested in proving what we do is good! It would be more important to show how an evolutionarily informed conceptualization may support different kinds of treatments (we are involving colleagues from a variety of background: psychodynamic, integrative, humanistic, cognitive, etc.) and may be reliable in spite of the different cultural background and interpersonal style of the patient.

Oddity, Schizotypy and Evolution?

Oddity, schizotypy, evolution, evolutionary theory

My paper on an evolutionary model of schizotypy is finally out! New Ideas in Psychology has published it. As I anticipated in a previous post here, this study aims to summarize existing kowledge about proximate and evolutionary factors involved in schizotypy and oddity, and propose an integrative model.

Such a model suggests how schizotypy may be better understood by looking at the role of social brain in the evolution of our species and the neurodevelopment of those with prominents openness to experience and introversion.

The paper is also the foundation of the the shared conceptualization of newly developed treatment for schizotypal personality disoder, namely Evolutionary Systems Therapy for Schizotypy (ESTS). In the next few months the paper – figers crossed! – about a preliminary randomized controlled trial should be pulished.

Cheli, S. (2023). An evolutionary look at oddity and schizotypy: How the rise of social brain informs clinical practice, New Ideas in Psychology, 68, 10099, https://doi.org/10.1016/j.newideapsych.2022.100993

An evolutionary look at oddity

I’m extending the genetic background of my new paper on an evolutionary look at schizotypy. I have to thank the reviewers we asked me to improve this part of the research. The paper represents the theoretical foundation of my clinical work with those struggling with schizotypal psychopathology.

The idea at the core can be traced back to the long-standing debate about the evolutionary paradox of schizophrenia. In short, we know how schizophrenia hugely impact on quality of life, but it has always been present in our history. Or better we know how it is a very species-specific disoder. I was really surprised by discovering how those with high prevalence of Nehandertal genes were reporting a lower risk to been diagnosed with schizophrenia and if they were so they showed less severe symptoms!

In my paper I focus on schizotypy, that is a broad organization of personality that is reputed to range from healthy states (such as creativity) to severe manifestations such as schizophrenia. The hypothesis that I discuss in the submitted manuscript is that oddity (a core clinical manifestion of schizotypy defined by odd behaviors, emotions, thoughts) would represent the failure in socializing one’s own openess to experience. The latter trait is a healthy side of human personality allowing creativity and discovery, whereas oddity is a defensive stance often leading to emotional suffering and isolation.