Running head: THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 1

A Comparison of the Unhealthy Expressions of the Enneagram Types

and the Personality Disorders of the DSM-IV-TR

Jenna Talbott

Liberty University
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 2

Abstract

The similarities between the unhealthy expressions of the Enneagram types and the DSM-IV-TR

personality disorders are discussed. Foundational information about the Enneagram and DSM-

IV-TR systems is provided. The background and structure of the Enneagram are discussed first.

The history of the Enneagram is traced from ancient Greece to its modern use as a personality

typing system. The structure of the Enneagram is such that it allows for human variation by

including influences on personality as wings, triads, environmental influences, levels of

development, and the directions of integration and disintegration. The background and structure

of the DSM-IV-TR are discussed next. The reason for the construction of the DSM-IV-TR is

explained, and its use in modern psychology is referenced. The division of possible

psychopathological diagnoses across five axes is explained. Finally, each of the nine Enneagram

personality types is described in connection with one (or two) of the DSM-IV-TR personality

disorders. The similarities between the unhealthy tendencies of each type and the descriptions of

the personality disorders are emphasized. The implications of this comparison and directions for

further research are highlighted.

Introduction

Psychologists have long debated the most useful and accurate method for describing

psychopathology (Oldham, Skodol & Bender, 2009). As standardization has become necessary

to facilitate communication and consistency in the treatment of abnormal psychology, various

systems for classification have been proposed. The clash between personality theorists,

humanistic theorists, and biological theorists has been especially conspicuous (Oldham et al.). It

is a daunting task to attempt to define what is and is not healthy psychology, and to provide a

scale that supplies information about the variety and severity of the unhealthy behavior a patient

may be exhibiting.

The system most psychologists now use to diagnose mental disorders is the Diagnostic

and Statistical Manual for Mental Disorders (DSM-IV-TR). This system treats psychological

maladies much like physiological ailments: for each possible diagnosis, a list of symptoms is

provided, and if a patient exhibits those symptoms he or she “has” that disorder. Despite the

popularity of this system, many psychologists are unsatisfied (Oldham et al., 2009). Many

complain that the DSM-IV-TR misrepresents the true nature of psychopathology, claiming that a

client’s psychology should be viewed on a spectrum from most healthy to least healthy, not as a

polarity between “disordered” and “not disordered.”

Other theories have attempted to offer models of abnormal psychology that more

accurately reflect human mental processes. Personality theorists generally contribute much to the

range of possible explanations. One of these useful personality theories is the Enneagram system.

This theory proposes that there are nine basic personality types, and when a person becomes

psychologically unhealthy he or she will think and behave in certain predictable ways

determined by his or her type. However, just as with the DSM-IV-TR, there is considerable
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 4

opposition to this explanation. Many psychologists claim that the Enneagram is too subjective to

be used as a viable clinical diagnostic tool (Bland, 2010).

The DSM-IV-TR and the Enneagram are obviously drastically different, reflecting two

distinctly dissimilar theories of psychopathology. However, when the unhealthy expressions of

the nine Enneagram personality types and the ten DSM-IV-TR personality disorders are viewed

side-by-side, a remarkable agreement can be observed. In fact, each personality disorder seems

to correspond almost directly with one of the Enneagram types (with the exception of two, which

both seem to correspond to the same type). The implications of this observation are promising. If

a synthesis of these two perspectives could be developed, it is possible that a balance between

objective diagnostics and a holistic view of individual psychology could be gained (Bland, 2010;

Oldham et al., 2009).

To illustrate the veracity of this claim, the similarities between the unhealthy expressions

of the Enneagram types and the DSM-IV-TR personality disorders are demonstrated. First, the

background and structure of the Enneagram system is explained, followed by a similar treatment

of the DSM-IV-TR. Although the various types and disorders are not specifically mentioned

within these sections, an in-depth description of each Enneagram type and its DSM-IV-TR

correlate(s) follows. Finally, implications and directions for further research are presented.

The Enneagram

The Enneagram can most aptly be described as a humanistic trait theory. The Enneagram

is humanistic in its emphasis on movement toward self-actualization and accurate introspection

(Bland, 2010). However, the Enneagram is also a trait theory because it makes no attempt to

investigate the cause or past behind an individual’s traits, focusing only at the qualities possessed

and the predictions that can be drawn from those personalities (Ciccarelli & White, 2009). The
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 5

nine Enneagram types are usually visually represented as a symbol: a nine-point star, made of a

hexagon and a triangle, within a circle (Bland). Each of the Enneagram types are generally

described using various statements about their most basic thought processes, actions, fears,

motivations, and unique combinations of recognizable qualities (Riso & Hudson, 1996). The

Riso-Hudson Type Indicator can be used to determine a client’s type, although self-reflection

and the discretion of the therapist are generally sufficient (Riso & Hudson).

Background of the Enneagram

The modern Enneagram system draws on a varied and extensive history, reaching as far

back as ancient Mesopotamia and Greece (Riso & Hudson, 2010). It is commonly accepted that

Pythagoreans and Neo-Platonist originally used the Enneagram symbol between 500 and 100 BC

as a mathematical symbol of repeating decimals and perpetual self-renewal (Riso & Hudson).

The personalities now associated with this symbol developed from at least two sources. The first

was the influence of the early Christian fathers in the deserts of Egypt around the 5th and 6th

centuries AD, and the subsequent Medieval European conceptualization of the seven deadly sins

(Riso & Hudson). The second source of influence came from the Jewish mystics of the early

centuries AD, and the Kabala (a more modern sect of Jewish mysticism) in Europe in the 12th

and 17th centuries (Riso & Hudson). The Enneagram symbol was also used by the Islamic Sufi

orders during the 14th and 15th centuries, but they also seem to have added their own unique

flavor to the theory (Bland, 2010; Riso & Hudson).

Ivanovich Gurdjieff, a Russian philosopher of the early 20th century, brought the nine-

pronged symbol of self-renewal to the West, calling it a “harmonious circle” (Bland, 2010;

Hudson & Riso, 1996). Gurdjieff also began teaching about his own personal system of character

typing, claiming that people could be divided into three types: thinking, feeling and instinctive
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 6

(Riso & Hudson). In the 1960s Oscar Ichazo solidified the combination of the symbol with the

personality types that had been associated with it for centuries (Riso & Hudson). He combined

elements from the Neo-Platonic “9 mystical states,” the Kabala’s 10 “Sephirot,” the seven deadly

sins (with two additional sins: deceit and fear), and Gurdjieff’s thinking, feeling, and instinctive

orientations (Riso & Hudson). Following Ichazo’s work, the Enneagram began to be recognized

as a legitimate psychological theory, especially after the system’s further development by

psychologist Claudio Naranjo, partially due to the Enneagram’s popularity in the Jesuit

community (Riso & Hudson).

The viability of the Enneagram as a personality measurement system has been validated

in a number of studies (Bland, 2010). The efforts of Don Riso and Russ Hudson, in partnership

with the SHL Group, has shown the Enneagram to be a valid and useful system, comparable to

those used more commonly in the corporate world (The Enneagram Institute, n.d.). In a 2005

Enneagram Institute press release about one study of the validity of the Enneagram system,

Professor David Bartrum is quoted affirming, “The nine personality types of the Enneagram are

real and objective, and…stand on a par psychometrically with the Myers-Briggs system, the Big

Five, and other well-known, accepted psychological systems.”

The Enneagram system is not only reliable, this technique also often provides a more

complete and accurate understanding of the person being studied, and can be very helpful in all

realms of life (Bland, 2010; Palmer, 1995). One of its great strengths lies in its practical

application, especially in counseling (Bland). Studying the Enneagram can lead to a better

understanding of self, and a better understanding of others (Bland). As Palmer explains, “The

Enneagram allows us to look deeply within our own character and to clarify relationships with

clients, co-workers, family, and friends” (p. 9).

Structure of the Enneagram

According to the Enneagram theory, although the elements of each personality type are

inherent in everyone, each individual will generally express one type in their worldview,

interactions and motivations more emphatically than all the others (Bland, 2010). No orientation

is superior because each type has its own strengths and weaknesses (Riso & Hudson, 1996).

However, the types are not fixed, static parameters; they refer instead to a character orientation, a

habitual pattern (Bland). This system prevents the limitation of variability. The structure of the

Enneagram allows for an unlimited number of variations in how a type is expressed, allowing for

the full range of human uniqueness. These variations include the influence of “wings,” “triads,”

environmental influences, levels of development, and the directions of integration and

disintegration.

Wings, triads, and environmental effects.

Several factors of the Enneagram structure that can account for human variation and

complexity, and can provide a deeper understanding of personality, are wings, triads, and

environmental influences. The first of these, the “wing,” is described as a strong tendency for

each type on the Enneagram star to manifest characteristics of one or both of the types adjacent

to it (Riso & Hudson). For example, a “one” might exhibit characteristics of a “nine” or “two,” a

“six” might exhibit characteristics of a “five” or a “seven,” and so on. According to Riso, “The

wing complements the basic type and adds important, sometimes contradictory, elements to it”

(1993, p. 12). Riso also explains that there is generally one dominant wing that affects

personality more heavily, and one secondary wing that only minimally affects personality (Riso).

Another structural element of the Enneagram is the three triads. Originally proposed by

Gurdjieff, the nine types are divided into three groups, each with a different emotional core
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 8

(Bland, 2010; Riso & Hudson, 1996). These emotional cores are: heart-centered, head-centered,

and gut-centered (Bland). Each of the groups contains three of the types, effectively creating

three triads. The feeling triad consists of the heart-centered types: twos, threes and fours (Bland;

Riso & Hudson). Types five, six and seven form the feeling triad, because they are head-centered

(Bland; Riso & Hudson). The gut-centered types, eight, nine and one, make up the final group,

the instinct triad (Bland; Riso & Hudson).

Finally, various other environmental effects can influence how each Enneagram

personality type presents. For instance, there is a propensity for children to emulate the types of

their parents, especially if the parents were admired. Similarly, childhood experiences can shape

variations in personality manifestation. Socially and culturally acceptable behaviors can also be a

determining factor in how an Enneagram type is expressed or repressed. Other analogous

confounding and explanatory factors could be construed.

Levels of development and the directions of integration and disintegration.

To accommodate the full range of human uniqueness, and to allow the reflection of

psychological health and pathology, the Enneagram structure also includes a measurement of

development (Riso, 1993). The nine possible levels of development create a continuum of traits

within each type, and the same type can look very different depending on a person’s level of

development (Bland, 2010; Riso). Enneagram theorists propose that when people change, they

shift along this continuum, but do not actually change types (Riso).

The levels of development are not synonymous with traditional developmental theory

because movement up and down the scale can occur at any time during the lifespan, and is not a

reflection of maturity. It is instead a reflection of wellbeing, with categorization based on the

psychological health of the individual (Bland, 2010; Riso, 1993; Riso & Hudson, 1996). Each
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 9

individual generally moves to the next level up as they move toward self-actualization, and

continue movement up the levels as they become healthier (Bland). This is called the direction of

integration (Riso & Hudson). However, at anytime the individual may begin moving down the

levels – essentially becoming less healthy – in the direction of disintegration (Riso & Hudson).

Although movement through the levels tends to follow the order of levels, meaning levels are not

generally skipped, movement through the levels can occur very quickly or very slowly

depending on the individual and his or her situation (Riso & Hudson). There are three unhealthy

levels, thee normal levels, and three healthy levels of development (Bland; Riso; Riso &

Hudson).

It is worth mentioning that Enneagram theorists also propose that movement through the

levels of development, both disintegration and integration, is represented visually by the

Enneagram symbol (Bland, 2010; Riso, 1993; Riso & Hudson, 1996). The symbol is a combined

hexagon and star, and each type is located at a “point,” so that each number is connected to two

other types by the two lines leading away from the point (Bland; Riso; Riso & Hudson). The two

points the lines connect to are alternatively called the stress and security points, or the

disintegration and integration points (Bland). If the lines of the Enneagram star are traced they

represent a sequence: if followed in one direction, toward the security point, the line represents

the direction of integration and health, if traced in the opposite direction, toward the stress point,

the line signifies the movement toward disintegration and unhealthiness (Bland; Riso; Riso &

Hudson). The direction of integration is 1-7-5-8-2-4-1 and 9-3-6-9, and the direction of

disintegration is 1-4-2-8-5-7-1 and 9-6-3-9 (Bland; Riso; Riso & Hudson). This is significant

because as a person moves toward another point, they begin to show characteristics of the type

they are moving toward (Riso & Hudson). Thus, as a one becomes less healthy he or she begins
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 10

acting like a seven, a seven begins acting like a five, and so on. On the other hand, as a one

becomes healthier he or she begin acting more like a four, a four begins acting like a two,

etcetera.

Of particular interest to this discussion are the unhealthy extremes of each personality

type. The Enneagram system has retained vestiges of its varied background, including elements

of medieval Christianity (Riso & Hudson, 1996). One of these extant influences is the use of the

seven deadly sins (and two additional sins: deceit and fear) and their counterpart virtues to

describe both the greatest strength and the greatest weakness of each orientation (Bland, 2010;

Riso & Hudson). The unhealthy expression of each Enneagram type corresponds to excess of

one of the sins. The unhealthiest levels of development result in the realization of each type’s

basic fear: that these sins will overtake them and dictate their personality (Riso & Hudson).

Unhealthy ones will give into pride, twos to anger, threes to deceit, fours to envy, fives to

avarice, sixes to fear, sevens to gluttony, eights to lust, and nines to sloth (Riso & Hudson).

When the Enneagram types and the DSM-IV-TR personality disorders are compared

below, a general description of each Enneagram type is given. Further explanation of the

Enneagram’s unique perspective on psychopathology is specified by emphasis on the unhealthy

expression of each type. But first, the background and structure of the DSM-IV-TR are

summarized.

The DSM-IV-TR

The Diagnostic and Statistical Manual for Mental Disorders (DSM) is essentially a

diagnostic guide. The DSM-IV-TR is the latest revision of the DSM, published by the American

Psychiatric Association (APA). The DSM-IV-TR reflects a medical perspective of mental

disorders, which are evaluated much like a patient’s physical symptoms would be evaluated at a
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 11

hospital (Oldham et al., 2009). A committee-determined list of recognized mental disorders is

provided by the DSM-IV-TR, and criteria for each diagnosis is given in checklist format (APA,

2000). A clinician uses the DSM-IV-TR by interviewing a client, selecting a diagnosis that

seems to represent the client’s difficulties, and verifying the diagnosis using the checklist.

Additional influences that impact a patient’s diagnosis can also be reflected by additional

descriptions. This method of defining psychopathology has proved to be highly useful in

describing symptoms and prescribing suggested treatment. The DSM-VI-TR’s objectivity and

consistency have resulted in its widespread and pervasive use in clinical psychology today

(Oldham et al.).

Background of the DSM-IV-TR

The American Psychiatric Association’s Diagnostic and Statistical Manual for Mental

Disorders was born out of a need for standardized terminology to assess mental incapacities

during World War II (Oldham et al., 2009). Various theories of psychopathology were

conglomerated into a primitive diagnostic guide, used by medic soldiers (Oldham et al.)

Following this practical field trial, the APA entrusted a committee to incorporate the existing

theories of psychopathology into a more consistent and useful diagnostic manual (Oldham et al.).

Since then, various revisions and editions have lead to the DSM-IV-TR, published by APA in

2000 (Oldham et al.). Oldham and colleagues explain, “In the DSM revision process, an effort

was made to move away from theory-derived diagnoses and to attempt to reach consensus on the

main constellations of personality that were observable, measurable, enduring, and consistent

over time” (p. 8).

Although the background of the DSM-IV-TR is far less varied and eclectic than the

history of the Enneagram, the value of the DSM-IV-TR has been supported by its extremely
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 12

dominant use as the diagnostic standard of choice across many dimensions of health science. The

DSM-IV-TR is used by medical professionals, psychiatrists, psychologists, counselors, and many

others. The popularity of this method is no doubt due to its standardization and objectivity,

which lends itself to easy communication, collaboration, and treatment prescription. The DSM-

VI-TR has repeatedly been confirmed as a valid and reliable method of describing mental

disorders.

Structure of the DSM-IV-TR

The structure of the DSM-IV-TR approaches brilliance in its simplicity. Constructed with

parsimony in mind, the DSM-IV-TR is basically a collection of checklists, with very little excess

to complicate the system. To facilitate ease of use, the DSM-IV-TR is divided into five large

categories, and each category is further divided into subcategories. The general categories are

identified as the five axes, and the subcategories of a few of these axes are briefly mentioned.

According to the APA, the multi-axial system of the DSM-IV-TR “involves an

assessment on several axes, each of which refers to a different domain of information that may

help the clinician plan treatment and predict outcome” (2000, p. 37). The APA describes five

classifications. An assessment on Axis I describes any clinical disorders, or any episodic

condition that may require clinical attention (APA; Oldham et al., 2009). Clinical disorders are

usually defined as those capable of remission and intensification (Oldham et al.). Axis I disorders

are only occasionally lifelong conditions, and are usually more likely to respond to treatment.

Examples of Axis I disorders include mood and anxiety disorders, as well as psychoses (Oldham

et al.)

The second DSM-IV-TR category is Axis II. Contained within this axis are the

personality disorders and mental retardation (APA, 2000). The personality disorders of Axis II
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 13

are further divided into three clusters: Cluster A includes odd or eccentric disorders, Cluster B

includes the dramatic, emotional or erratic disorders, and Cluster C includes the anxious or

fearful disorders. According to the APA, Axis II “may also be used for noting prominent

maladaptive personality features and defense mechanisms” (p. 39). The addition of a second axis

to assess these conditions was proposed to ensure that the possible presence of mental retardation

or a personality disorder was not overlooked by psychologists distracted by the necessary

attention given to the florid Axis I disorders (APA).

Originally the line between Axis I disorders and Axis II disorders was established by the

belief that those with Axis II disorders did not experience the anxiety or distress that those with

Axis I diagnoses experience in response to their condition, and it was assumed those with

personality disorders or mental retardation were often unaware of, or in denial about, their

psychopathology (Oldham et al., 2009). However, in further DSM revisions this distinction was

abandoned and the emphasis was instead placed on the persistent, enduring, pervasive, inflexible,

and early-onset requirements for the diagnosis of Axis II disorders (Oldham et al.).

The third axis is reserved for description of any of a patient’s medical conditions that

may be relevant to a psychological diagnostic (APA, 2000). Relevant conditions include any

physiological malady that can cause a mental disorder, worsen a disorder, be a result of a

disorder, affect treatment of a disorder, or otherwise be pertinent to diagnosis (APA). Axis IV is

used to describe any psychosocial or environmental difficulties a client may be facing (APA).

This includes any stress from life situation or life events that can have an effect on, or be affected

by, a mental disorder (APA). For example: inadequate social support, drastic negative (or

positive) life events, and environmental deficiency or difficulty such as abuse or poverty (APA).

The APA has constructed a subscale of nine specific categories of Axis IV problems (APA).
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 14

The final axis is reserved for a “global assessment of functioning” (APA, 2000).

Essentially, a description on Axis V is a judgment of the overall level of functioning and ability

to cope that a patient is exhibiting (APA). As early as the twenties, psychologists began to

recognize that personality disorders seem to occur on a continuum, from slight to extreme, from

adaptive to debilitating (Krueger & Tackett, 2006). In the early 60s, the Menninger clinic

developed the Global Assessment of Functioning (GAF) to measure this, which was later

absorbed into Axis V of the DSM-IV-TR (APA; Krueger & Tackett). This axis can be useful in

assessing the necessity and importance of treatment, as well as the selection between treatment

options.

Bland notes that the levels of development of the Enneagram could possibly be relevant

to this axis (2010). However, some propose that the GAF is an inaccurate measurement because

it tries to extract elements of behavior that may be better understood intertwined with the Axis I

and II disorders. This is illustrated by the likeness between the Enneagram type descriptions and

the Axis II disorders. A comparison of the unhealthy Enneagram types to the personality

disorders follows, and descriptions of each of the ten Axis II diagnoses are included.

Description and Comparison of the Enneagram Types and the Personality Disorders

The unhealthy expressions of the nine Enneagram types, as defined by the levels of

development, and the ten personality disorders of the DSM-TR-IV bear a striking resemblance to

one another. Although Bland (2010) proposes a different correlation than that described below,

the obvious similarities between the motivations, actions, beliefs and fears of the types and

personalities discussed together here seem apparent. Undoubtedly this is a hypothesis, and

caution should be advised in leaping to hasty conclusions. However, the need for further research
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 15

on the topic will at least be demonstrated by a side-by-side comparison of each Enneagram type

to the similar DSM-IV-TR disorder.

The Unhealthy One: Obsessive-Compulsive Personality Disorder

Generally called either the reformer or the perfectionist, the central mindset of a one is

always measuring everything to the highest standard (Palmer, 1995; Riso & Hudson, 1996). An

ethical code is always considered, which can result in a “good” person, but may also become

arrogance and disapproval of others (Palmer; Riso & Hudson). The sin associated with the one

personality type is pride (Riso & Hudson). Ones often take on too much, believing they should

be able to do it all, and then get angry about it without knowing why (Palmer; Riso & Hudson).

To a one everything is black and white, and everyone should always do what’s right (Palmer;

Riso & Hudson). As a result they often worry and agonize about decisions, even after they are

made (Palmer; Riso & Hudson). Other words used to describe ones might be principled, orderly

or self-righteous (Palmer; Riso & Hudson). Riso explains that when ones become unhealthy,

they are disillusioned about their ideals and realize they can never live up to their own standards

(1993). In addition, when ones follow the direction of integration and start exhibiting type four

unhealthy characteristics, they can also become self-destructive (Riso).

According to the APA, obsessive-compulsive personality disorder is characterized by a

rigid preoccupation with perfectionism, at the expense of efficiency and flexibility (2000). An

unhealthy one could be compared to the DSM-IV-TR obsessive-compulsive criterion in various

ways. For instance, unhealthy ones may also become preoccupied by rules, exhibit an excessive

devotion to productivity, and display overconscientiousness and inflexibility in matters of

morality (APA). In their desperate attempt to live up to impossible self-imposed standards, ones
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 16

become self-destructive in their inability to complete tasks, reluctance to schedule leisure time,

and incapacity to let things go, all descriptions of obsessive-compulsive personalities (APA).

The Unhealthy Two: Dependent Personality Disorder

Twos are those immediately recognizable as people-pleasers (Palmer, 1995; Riso &

Hudson, 1996). Described as “helpers” or “givers,” twos find their worth in supporting their

loved ones (Palmer; Riso & Hudson). Other words used to describe twos might be caring,

generous, possessive or manipulative (Palmer; Riso & Hudson). Twos will often change their

personality, depending on the company they are in, to gain acceptance or to empathize (Palmer;

Riso & Hudson). They can be very generous and altruistic, but can also give things specifically

to get things in return (Palmer; Riso & Hudson). It is very important for twos to feel needed, and

they can neglect their own needs in order to meet the needs of others (Palmer; Riso & Hudson).

Oddly, they often feel restricted by the needs of others as well, and want freedom from their self-

imposed obligations (Palmer; Riso & Hudson). Unhealthy twos also begin to resent those who

have been unappreciative of their servitude, and as they move in the direction of disintegration

toward type eight, they can strike out and attempt to control those who have not reciprocated

their “giving” (Riso, 1993).

The need to be needed is the element of a two’s personality that most readily corresponds

to the DSM-IV-TR dependent personality disorder. A dependent personality is described as

having an excessive need to be taken care of, as well as a tendency to go to great lengths (even

becoming manipulative) in order to obtain relationships, to the point of volunteering to do

unpleasant things (APA, 2000). It is easy to envision how a two could quickly become clingy,

submissive and dependent because they fear the loss of approval, the source of their self-worth

(APA). As a result, twos are probably likely to develop dependent personalities (Riso & Hudson,
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 17

1996). As they move downward in the levels of development, twos will have trouble doing

things on their own, be unrealistically preoccupied with fears of abandonment, and feel helpless

and unable to care for themselves (APA).

The Unhealthy Three: Narcissistic Personality Disorder

Threes are constantly trying to achieve (Palmer, 1995; Riso & Hudson, 1996).

Characterized by intense motivation, they always want to be first and best, and they are goal

oriented to the extreme (Palmer; Riso & Hudson). Threes have a hard time separating what they

do from who they are and may start to “do” emotions instead of feeling them (Palmer; Riso &

Hudson). Often threes will suppress feelings to get the “job” done, whether it is at work or in

their personal life (Palmer; Riso & Hudson). Words used to describe threes might be adaptable,

ambitious, image-conscious or hostile (Palmer; Riso & Hudson). Threes are very sensitive to

status and relationship dynamics (Palmer; Riso & Hudson). They will often produce a façade of

significance, and are usually perceived as more important than they are, sometimes even

deceiving themselves (Palmer; Riso & Hudson). The addition of deception to the list of the seven

deadly sins during the construction of the modern Enneagram theory was necessary to describe

threes (Riso & Hudson). As unhealthy threes move along the line of disintegration toward nine,

they begin to dissociate and separate from their self-concept and feelings, and become

completely consumed by their veneer of impressiveness in order to “conquer” what they see as a

hostile environment (Riso, 19993; Riso & Hudson).

This lack of emotions and pension for grandiosity translate directly to narcissistic

personality disorder (APA, 2000). According to the DSM-IV-TR narcissists need admiration,

may create fantasy personas, and lack empathy (APA). They are self-important, exaggerating

their success and accomplishments; they behave superior, they are obsessed with gaining more
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 18

prestige, and they believe they are entitled and deserve admiration (APA). Driven to succeed, but

faced with the reality that their success is sometimes prevented, unhealthy threes can eventually

spiral into all of these behaviors.

The Unhealthy Four: Borderline Personality Disorder

Fours are usually called either the individualist or the romantic (Palmer, 1995; Riso &

Hudson, 1996). Fours are always in search of things to which their hearts connect (Palmer; Riso

& Hudson). Their romanticism also produces a unique creativity (Palmer; Riso & Hudson).

Fours are passionate and feel deeply; they long for the unattainable and avoid the ordinary

(Palmer; Riso & Hudson). Often they almost seem to enjoy the melancholy, which is at least

better then boredom (Palmer; Riso & Hudson). Fours can be very dramatic, sometimes acting as

if everything is extreme (Palmer; Riso & Hudson). They often fool themselves into believing

things are more then they are, and are disappointed with reality (Palmer; Riso & Hudson). When

they do find something truly great, they often push it away in attempt to experience the longing

of loneliness again (Palmer; Riso & Hudson). Other words used to describe fours might be

expressive, self-absorbed or depressive (Palmer; Riso & Hudson). Riso explains that as

unhealthy fours despair of ever seeing their grand dreams of beauty come to fruition, they are

unable to function, lacking the will to survive, and depend on others to take care of them (Riso,

1993).

The comparison between the unhealthy four and the DSM-IV-TR borderline personality

disorder is slightly obscured by the unpredictable nature of fours in general. Unhealthy fours can

display a varied array of abnormal thought and behavior. However, a wide range of possible

expressions across multiple areas of life also characterizes borderline personality disorder, so

perhaps it is a better fit than it seems (APA, 2000). Those with borderline personality disorder
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 19

are usually impulsive, have trouble maintaining stable interpersonal relationships, and their

erratic self-image results in intense affect (APA). Elements of the DSM-IV-TR description that

correspond most neatly to the Enneagram four are chronic feelings of emptiness, paranoid

ideations, moodiness, and pattern of extreme aggrandizement and devaluation in interpersonal

relationships (APA; Riso & Hudson, 1996).

The Unhealthy Five: Schizoid and Schizotypal Personality Disorder

Fives often live detached lives focused on intellectual pursuits (Palmer, 1995; Riso &

Hudson, 1996). Because of this they are usually described as observers or intellects (Palmer;

Riso & Hudson). Their emotions are hardly ever expressed unless they are alone (Palmer; Riso &

Hudson). However, when they do share their conceptions it is apparent that they can produce

amazing clarity of thought (Palmer; Riso & Hudson). Fives praise privacy, noninvolvement,

structure and independence, often sacrificing other pleasures to maintain these qualities (Palmer;

Riso & Hudson). This often alienates others. Other words used to describe fives might be

perceptive, original, detached or eccentric (Palmer; Riso & Hudson). The unhealthiest of fives

become so detached and isolated they are incapable of interaction with their environment (Riso,

1993). Additionally, as they move in the direction of disintegration toward seven, they become

increasingly unpredictable, impulsive and peculiar (Riso).

The unhealthy Enneagram five corresponds to two personality disorders of the DSM-IV-

TR: schizoid and schizotypal. The reason for this is that schizotypal disorder is similar to

schizoid disorder, except that cognitive and perceptual distortions are also apparent (APA, 2000).

Unhealthy fives are similar to schizoid personalities because they display a similar pervasive

pattern of detachment from relationships, extreme isolation from others, and emotional coldness

and indifference (APA). These elements are also found in the DSM-IV-TR description of
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 20

schizotypal personality disorder (APA). However, unhealthy fives may also express odd beliefs,

dress and speak in eccentric or peculiar manner, and experience unusual perceptual phenomena,

all additional criteria for schizotypal personality disorder (APA; Riso & Hudson, 1996).

The Unhealthy Six: Paranoid Personality Disorder

Sixes are all about relationships, and the security and reassurance they can provide

(Palmer, 1995; Riso & Hudson, 1996). The three type is generally referred to as the “loyalist”

(Palmer; Riso & Hudson). Other words used to describe sixes might be engaging, committed,

defensive or paranoid (Palmer; Riso & Hudson). They are afraid of betrayal and often doubt

certainty, but are completely loyal themselves (Palmer; Riso & Hudson). Sixes also have

authority problems, mistrusting the motives of powerful figures and identifying with the

underdog (Palmer; Riso & Hudson). Although continually questioning their direction produces

clarity of purpose in sixes, sometimes they are too doubtful to continue on the path they have

discovered, which often manifests as procrastination (Palmer; Riso & Hudson). Sixes can be

paralyzed with fear, the “ninth” deadly sin the Enneagram uses to describe the six (Riso &

Hudson). When sixes do succeed they become anxious because they have more to lose, and

forgetting the good things that come with success and happiness they devalue acquired benefits

(Palmer; Riso & Hudson). Unhealthy sixes struggle with feeling inferior and are extremely self-

defeating, mistrusting even themselves (Riso, 1993). If they move in the direction of

disintegration toward the three point, they may lash out violently at anyone they perceive as a

threat (Riso).

Paranoid personality disorder describes this unhealthy six perfectly. The DSM-IV-TR

portrays those with this personality disorder as experiencing consistent mistrust and

suspiciousness of the motives of others, which are usually interpreted as malevolent (APA,
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 21

2000). Especially descriptive of unhealthy sixes is the second criterion for paranoid personality,

which reads, “Is preoccupied with unjustified doubts about the loyalty or trustworthiness of

friends or associates” (APA, pp. 288-289). In addition, if a paranoid personality perceives an

attack, they are likely to react with rage, and may launch a counterattack, just as an unhealthy six

might (APA).

The Unhealthy Seven: Histrionic Personality Disorder

As the “epicure” the seven considers life a fun adventure and is constantly seeking

stimulation (Palmer, 1995; Riso & Hudson, 1996). Sevens are often full of enthusiasm, and want

to be seen as the “fun one” (Palmer; Riso & Hudson). They love being the center of attention

(Palmer; Riso & Hudson). Sevens live life in excess, which is why their associated deadly sin is

gluttony (Riso & Hudson). Usually charming and funny, sevens can often talk their way out of

trouble (Palmer; Riso & Hudson). They are optimistic, believing in a positive future as long as

they keep their options open (Palmer; Riso & Hudson). Sevens can find connections, loopholes

and ideas that would normally not be obvious, but this can also cause them to avoid commitment

(Palmer; Riso & Hudson). Sevens avoid or deny pain by trying extreme activities to achieve

excitement (Palmer; Riso & Hudson). Other words used to describe sevens might be enthusiastic,

accomplished, uninhibited or manic (Palmer; Riso & Hudson). Riso asserts that unhealthy sevens

lose control of their thoughts and actions, and respond with manic anxiety (1993).

The DSM-IV-TR description of histrionic personality disorder includes excessive

attention seeking and emotionality, which are both descriptive of an unhealthy seven (APA,

2000). Histrionic personality disorder developed from the DSM-I classification of “emotionally

unstable,” and the DSM-II classification of “hysterical,” which are both apt descriptions of

disintegrating threes (Oldham et al., 2009). Other elements of histrionic personality disorder
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 22

include rapidly shifting emotions, theatricality and exaggerated expressions of emotion, and

extreme suggestibility (APA). All of these elements may also result from the manic anxiety of

sevens when their attempts to achieve excitement and attention are frustrated.

The Unhealthy Eight: Antisocial Personality Disorder

Eights are variously described as the “leader” or the “boss” (Palmer, 1995; Riso &

Hudson, 1996). Eights are most often the individuals with power and have a distinctive take-

charge attitude (Palmer; Riso & Hudson). Other words used to describe eights might be self-

confident, decisive, dominating or combative (Palmer; Riso & Hudson). They never shy away

from conflict, even enjoying the truth that comes out in a fight (Palmer; Riso & Hudson).

Although this can come off as aggressive, they most often have a just cause and stand up for

those who need protection (Palmer; Riso & Hudson). Power and control play a large role in their

motivations, causing them to gravitate to positions of authority and influence (Palmer; Riso &

Hudson). Eights may use their sway for either altruistic or selfish purposes (Palmer; Riso &

Hudson). They may confuse objective truth and mere opinion (Palmer; Riso & Hudson). Highly

impulsive, eights sometimes feel they need to set boundaries, but have difficulties finding the

balance between aggression and self-defense (Palmer; Riso & Hudson). Often they ignore softer

or more vulnerable emotions in their avoidance of weakness (Palmer; Riso & Hudson).

Unhealthy eights may attempt to dominate their environment completely and subsequently

become paranoid by the thought of being manipulated or controlled by their enemies (Riso,

1993).

This description is most similar to the DSM-IV-TR antisocial personality disorder.

Antisocial personalities disregard the rights of others, and display aggressiveness, illegal

behavior, reckless disregard for the safety of others, and a lack of remorse (APA, 2000). In their
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 23

quest for power, the unhealthy eight would certainly exhibit these traits. Unhealthy eights might

also rationalize their misbehavior, become impulsive, and consistently deceive others, all criteria

for antisocial personality disorder (APA). If entirely consumed by their desire for dominance,

eights may even become completely psychopathic.

The Unhealthy Nine: Avoidant Personality Disorder

The final Enneagram personality is the peacemaker or mediator (Palmer, 1995; Riso &

Hudson, 1996). Nines are driven by a need to “merge” with others, and feel that disagreement

and opposition inhibit that (Palmer; Riso & Hudson). Because of this drive to live in harmony

with everyone, they will often watch others closely and support their actions (Palmer; Riso &

Hudson). Other words used to describe nines might be peaceful, reassuring, complacent or

neglectful (Palmer; Riso & Hudson). Nines dislike change and avoid it by acting out of habit,

repeating familiar solutions to new problems (Palmer; Riso & Hudson). They also have no

problem waiting it out to avoid a decision (Palmer; Riso & Hudson). Indecisive or unwilling to

express their opinion, nines avoid commitment to their own perspective, but are also objective

enough to see all sides of the issue (Palmer; Riso & Hudson). However, nines are characterized

by an avoidance of the definite, which they believe causes conflict (Palmer; Riso & Hudson).

This type most often becomes stubborn instead of irritated in response to opposition, detaching

or postponing their anger and becoming passive-aggressive (Palmer; Riso & Hudson). Extremely

unhealthy nines will dissociate and become socially withdrawn, unable to cope with their

conflicting and self-defeating emotions (Riso, 1993).

The DSM-IV-TR describes the avoidant personality disorder as hypersensitivity to

negative emotions, excessive social inhibition, and extreme perceptions of inadequacy (APA,

2000). Those with this disorder fear criticism, rejection and disapproval so much that they
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 24

remain uninvolved and restrained (APA). They view themselves as unappealing and inferior, and

are usually unwilling to take risks or seek out new experiences (APA). Although the similarities

between these elements and the unhealthy nine may seem vague, small correlations are apparent.

For instance, the fear of opposition and disapproval, and a poor self-image could both be

descriptive of an unhealthy nine as well.

Conclusion

Following this extensive discussion of the background and structure of the Enneagram

and the DSM-IV-TR, and the comparison of each Enneagram personality type to one (or two) of

the personality disorders, a few conclusions begin to emerge. First, the similarities between these

two systems of describing psychology may indicate a misconception of the nature of

psychopathology in general. Second, the agreement of the two systems increases their validity,

and may suggest simultaneous use. Finally, the necessity for further research in certain directions

is clear.

Similarities Suggest Pathology is a Continuum from Unhealthy to Healthy, Not a

Dichotomy of Disordered and Not-Disordered

Oldham and colleagues emphasize that “there is growing debate about…whether a

dimensional or a categorical system of classification is preferable” (2009). This debate is

illustrated in the theoretical disagreement between the Enneagram and the DSM-IV-TR. Where

the DSM-IV-TR sees someone who either does or does not have a disorder, the Enneagram is

able to describe the entirety of humanity and to elucidate information about each individual’s

mental health. The DSM-IV-TR is objective but limited, and the Enneagram is subjective but

holistic.
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 25

Although Axis V of the DSM-IV-TR provides a description of how functional a patient

is, widening the DSM-IV-TR’s range of application slightly, it may be a false separation to

measure personality disorders and ability to cope on two axes. Krueger and Tackett cite research

that indicates the large majority of patients who need clinical care are able to function, so they

are generally excluded from the diagnoses for personality disorders (2006). However, their

symptoms are very similar, only less debilitating (Krueger & Tackett). It is possible that trying to

separate the type of sickness someone has, and the severity of their pathology, may be an attempt

to separate two elements of the same personality. The similarities between the Enneagram types

and the personality disorders lend support to this way of viewing pathology as a viable option.

The Agreement of the Two Systems Lends Validity to Both Classification Systems

Although the two systems do not line up perfectly, and there is room for debate about the

similarities that have been identified, the agreement between the Enneagram and DSM-IV-TR

lends validity to both classification systems. Because both methods have been shown to have

immense practical value, their ability to measure the same variables should be expected, but is

nonetheless reassuring. The Enneagram is bolstered by the support of the objective DSM-IV-TR,

and the DSM-IV-TR is enriched by the encompassing perspective of the Enneagram.

This beneficial partnership of theories may point to the possibility of some type of

combination of these two theories, or at least simultaneous use of these theories, as a more

accurate and helpful way to view psychopathology. Krueger and Tackett (2006), emphasize that

clinical approaches to psychopathology are useful and indispensible. However, they propose that

a clinically useful theory of the personality of psychopathology would be desirable, as long as it

was able to produce interpretive understating and accurate predictions (Krueger & Tackett). This

may be possible to accomplish if the efforts of the Enneagram and the DSM-IV-TR were used in
THE ENNEAGRAM TYPES AND PERSONALITY DISORDERS 26

combination. If a functional system could be developed for this union, mental disorders may be

conceptualized as “hybrids of stable personality traits and less stable symptomatic behavior”

(Oldham et al., 2009, p. 383).

Suggestions for Further Research

The observations and conclusions provided contain a myriad of inquiries and hypotheses

that deserve further research. Several research directions would be of particular interest and

consequence. First, a statistical analysis comparing the unhealthy Enneagram types and the

DSM-IV-TR personality disorders is necessary to solidify the connections between the two

systems. The descriptions above were based mainly in common sense, and further investigation

would be appropriate.

Second, inquiry into whether the two personality disorders described in the appendix of

the DSM-IV-TR have any correlation to the Enneagram types would be appropriate. The two

additional personality disorders are depressive personality disorder and passive-aggressive (or

negativistic) personality disorders. It is possible that depressive personality disorder corresponds

to type four on the Enneagram, and that passive-aggressive personality is similar to an unhealthy

nine personality, but further discussion of the topic is necessary.

Thirdly, one problem the DSM-IV-TR consistently struggles with is comorbitity. The

current DSM system is unable to account for the possible effects various disorders may have on

each other. One possible solution to this gap in the measure is the Enneagram description of the

direction of disintegration. Because one type begins to exhibit traits of another type as they

become less healthy, this may prove to be an apt tool to use in defining the effects of

comorbitity. Further research should be conducted to explore this possibility.

Finally, the feasibility of simultaneous use or combination of the Enneagram and the

DSM-IV-TR to create a comprehensive and useful diagnostic tool should be explored. Although

the systems are from two separate theoretical poles, it is evident that these two perspectives

could benefit from fusion with one another. Where the Enneagram is able to address

psychopathology without resorting to blind use of predetermined procedures, and to encourage

client’s self-reflection and health, the DSM-IV-TR is an example of exact measurement and

standardization (Bland, 2010). If possible, synthesis of these advantages would be valuable.

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