The Personality of Homeopaths: A Cross-Sectional Survey of the Personality Profiles of Homeopaths Compared to a Norm Sample

Introduction

V arious occupations involve diverse job demands that require formal training, interpersonal skills, work experience, and specific personal characteristics. In particular, personal characteristics such as personality traits interact with the demands and features of the work environment (e.g., the work task and the social and organizational level) in various ways and result in different levels of work performance. ¹ The concept of “fitting” the person to the occupation is timeless; personality traits have been found to predict vocational interest ² as well as occupational choice. ^1,3

Holland's theory on occupational choice attempts to answer which personality characteristics lead to satisfactory choice, engagement, performance, and stability within different occupational categories. ² Studies show that a good match between personality and choice of occupation typically result in a higher degree of job satisfaction. ^3,4 Knowledge about the personality characteristics of employees in different occupations contributes to better understanding predictors of occupational choice as well as providing invaluable information to facilitate career counseling. If personality traits are important predictors for career choices and vocational interest, we can reasonably expect this relationship to be associated with specific occupational groups.

Use of complementary and alternative medicine (CAM) has become widespread, ⁵ and providers of CAM therapies likely represent a substantial occupational group. One of the most commonly used CAM therapies in Norway and other parts of the world is homeopathy. ⁶ However, homeopathy is also a controversial therapy due to the perceived biologic implausibility of any effect from highly diluted medicines. Most homeopaths work in private practices outside public health services with no financial support from the government. Homeopaths are thus representing the average CAM practitioner, given that they are well-known and much used, but viewed with skepticism from the establishment. It would therefore be interesting to know who chooses homeopathy as an occupation, and to investigate whether homeopaths' personality profiles differ from that of other health workers. Knowledge in this area would also be important when offering occupational advice to people interested in this career choice and for learning institutions in the evaluation of current and future students.

To date there are no studies on the personality traits of CAM practitioners. Therefore, the aim of this study was to map the personality scores of homeopaths and compare them with the general Norwegian population. Good job performance is predicted by a good match between the employee's personality and requirements of the occupation. ¹ Based on existing knowledge, it was hypothesized that homeopaths would score higher than the norm sample on Openness, Agreeableness, and Conscientiousness, as described in detail below.

Personality Traits

People have long-term dispositional traits that influence their behavior in work settings. The Five Factor Model of Personality (FFM) has been operationalized via the Revised NEO Personality Inventory (NEO-PI-R) and provides a theoretical and conceptual framework for understanding cognitive, emotional, and behavioral dispositions. ⁷ The FFM consists of five broad personality dimensions, namely, Neuroticism, Extraversion, Openness, Agreeableness, and Conscientiousness, and the NEO PI-R scale measures these dimensions within the healthy personality.

The tendency to experience negative affects, such as fear, sadness, embarrassment, anger, guilt, and disgust, is the core of the Neuroticism domain. Men and women with high scores are prone to have irrational ideas and have less ability to control their impulses. Neuroticism is also associated with cognitive stress processes, such as evaluating the self and daily events pessimistically and coping poorly with stress. ⁸ Neuroticism correlates with a variety of generally ineffective coping mechanisms, ⁹ and high scores on this trait predict poor job performance across all job criteria and occupational groups. ¹⁰

High scores on Extraversion indicate that the individual is sociable, likes people, and prefers large groups and gatherings; moreover, he/she is most likely assertive, active, and talkative. High scorers are often upbeat, energetic, and optimistic. Extraversion is found to cross-culturally correlate with happiness ¹¹ and leadership effectiveness. ¹² Extraversion predicts good job performance in some occupational groups (i.e., those where interpersonal abilities are important). ¹⁰

Individuals who score high on Openness often have an active imagination, aesthetic sensitivity, attentiveness to feelings, intellectual curiosity, independence of judgment, and a preference for variety. High scorers in this domain often rethink problems from different perspectives, seek new information, and try novel solutions, thereby demonstrating adaptive coping responses. ⁹ High scores on Openness predict a thorough approach to work and learning processes in general. ¹³

A person who scores high on the Agreeableness is often altruistic, sympathetic to others, eager to help, and believes that humans are fundamentally good. People with high scores on Agreeableness tend to be genuinely interested in other people and to listen more than they talk. ¹⁴ Agreeableness is associated with positive health perceptions ¹⁵ and effective leadership. ¹² However, high scorers are more likely to report interpersonal problems associated with not being able to confront others and a tendency to be too submissive. ¹⁶

The last of the FFM traits is Conscientiousness. This domain refers to the process of planning, organizing, and carrying out tasks. The conscientious individual is purposeful, strong-willed, and determined; additionally, he/she reaches goals set for him/her and keeps promises and appointments. ¹⁴ Conscientiousness is found to be the most consistent predictor of work performance ⁸ and of performance across all job criteria and occupational groups. ¹⁰

The personality traits in the FFM are inheritable, and the stability coefficients are relatively high. ¹⁴ Gender differences are small but stable across different cultures ¹⁷ ; on average, women tend to score somewhat higher than men on Neuroticism and Agreeableness. This aspect is important to consider when investigating personality characteristics for an occupational group dominated by women, such as homeopathy. From a lifespan perspective, Extraversion, Openness, and Neuroticism slightly decrease with age, while the opposite is true for Conscientiousness and Agreeableness. ¹⁸ However, personality traits generally tend to be very stable. ¹⁹

Hypothesis 1:

Health Work and Openness

Studies have demonstrated the connection between personality, different areas of interest, abilities, and vocational choices, ^2,20,21 but none of them have focused on the field of homeopathy. The occupation of a homeopath might still appear rather exotic; thus, people who take an interest in such fields of work might generally be open to new experiences, ideas, and ways of thinking. The personality trait Openness describes a person's ability to be intellectually and emotionally curious, explorative, and adventurous. Those who score high in the Openness domain are often creative, innovative, and imaginative. ²² They are described as unconventional and open minded; they are willing to consider new ideas, pursue intellectual interests, and re-examine social, political, and religious values. ²³

High Openness scores have been linked to occupational choices in medicine. A study on specialty choices in medicine showed that graduates entering psychiatry had higher scores in the Openness domain than those choosing other specialities. ²⁴ Additionally, urology residents had significantly higher Openness scores than the general population, ²⁵ and high Openness scores have been associated with psychotherapists' theoretical orientations (i.e., those who use humanistic and gestalt therapies ²⁶ ). High Openness scores also seem to predict CAM use. Those with high scores are generally more willing to use CAM, ²⁷ and such scores are found to be positively associated with use of most CAM therapies. ²⁸ Those with high scores on Openness also consult CAM practitioners to a greater extent, have tried a greater variety of CAM providers, and have holistic and proactive health motivations. ²⁹

Comparisons between the Openness domain and different categories of work have shown that high scorers more often choose occupations described as investigative and artistic. ^3,20,30 Artistic occupations include creative, original, and innovative work. ² People choosing artistic occupations are described as open to new ideas; moreover, intuition and originality is very important to them. Investigative work includes thinking and analysis: for instance, as a researcher or investigator. Persons in investigative occupations often relate to symbols, associations, and philosophical thinking. Homeopaths try to find associations between various symptoms in patients, they need to be creative when approaching each person, and they must be open to the differing views and values of their patients. Hence, it was hypothesized that homeopaths would score higher on Openness than the norm sample did.

Hypothesis 2:

Therapeutic Work and Agreeableness

Homeopathy is first and foremost therapeutic work. Building a good clinical practice depends on a homeopath's ability to achieve good treatment results, thereby satisfying patients. The personality domain Agreeableness describes the way a person relates to other people. A high score typically indicates that a person is trusting, kind, altruistic, and caring. ³¹ The abilities to listen, understand, care, and comfort are vital in therapeutic work; therefore, it can reasonably be concluded that a relatively high score for this domain is a necessity when working as a homeopath.

Agreeableness has been found to predict vocational interest in careers that Holland calls “social occupations”. ³ Social occupations are described as work that involves language, communication, and interacting with people. Holland also describes that persons who are interested in social occupations want to help, train, or heal others and are generally described as friendly, cooperative, helpful, idealistic, social, understanding, responsible, and warm. ² High scorers on Agreeableness include medical students, ³² psychologists, ²⁶ and CAM users. ²⁹ Based on knowledge about personality characteristics associated with other occupational groups in health care as well as the nature of the job in question, it was hypothesized that homeopaths would have higher scores on Agreeableness than the norm sample did.

Hypothesis 3:

Self-Employment and Conscientiousness

Most homoeopaths build their own practices through years of therapeutic work, running single or joint practices without any support from health authorities. This activity involves entrepreneurship, i.e., the creation of a new business venture. Entrepreneurs take responsibility for all parts of establishing a firm, including investing money and hard work, without a substantial safety net. ²² Self-employment means extra work and accountability and includes a broader range of responsibilities. ³³

Homeopaths running single practices often undertake all administrative work themselves instead of hiring outside help. ³⁴ Therefore, the work in their practice also includes tidy, precise, and rule-driven work, such as bookkeeping and filing. This suggests that working as a homeopath requires personal characteristics associated with high scores in Conscientiousness. Thus, it was hypothesized that homeopaths would score higher on Conscientiousness than the norm sample did.

Materials and Methods

This study is a cross-sectional survey conducted among all members of the Norwegian association for homeopaths (Norske Homeopaters Landsforbund), the only Norwegian association solely for homeopaths. All members have completed a standardized education in both homeopathy and conventional medical subjects with an emphasis on pathology.

Results

Of the 325 homeopaths invited to participate, 128 (39%) returned the questionnaire after one reminder. The sample size of n=128 with an average observed standard deviation (SD) of 8.3 made it possible to identify a difference larger than 2.1 in the NEO-PI-R score (α=0.05, β=0.80). This corresponds to an effect size of 0.25.

Eighty percent (80%) of respondents were women, reflecting the gender distribution among Norwegian homeopaths. The mean age in the sample was 45.7 (SD 10.0, range 20–75 years). Thirteen percent (13%) of the sample reported using methods other than homeopathy in their practice, and 56% of respondents reported working in group practices. Cronbach α for the NEO-PI-R scales ranged from 0.72 to 0.85 (Table 1). The population average for all domains is 50. The results (Table 1) show that homeopaths scored significantly higher than the population on Openness (54.7), Agreeableness (58.0), and Conscientiousness (52.3). The sample mean score on Neuroticism did not differ from the population (49.7), and a small but significant lower score on Extraversion (48.3) was observed. The differences in the effect size for Openness and Agreeableness were medium (0.57) and large (0.91), respectively.

Discussion

It was hypothesized that homeopaths would score higher than the norm sample on Openness, Agreeableness, and Conscientiousness. Results show that homeopaths differed from the population with significantly higher scores on Openness and Agreeableness. Homeopaths also had statistically different scores on Extraversion (specifically, lower than average) and Conscientiousness (specifically, higher than average), but these differences were too small to be relevant.

The high Openness scores confirm that homeopaths share similar characteristics with other medical professionals. ^{24 –26} It also confirms that homeopaths are explorative, imaginative, unconventional, and innovative, and that the occupation of a homeopath can be considered investigative and artistic. This result is intuitive and expected, as Openness to experience reflects capability of complex thinking and willingness to approach untraditional perspectives and new ideas. ²¹ Such abilities can be considered a central prerequisite for working as a homeopath. Since homeopathy still is a rather untraditional occupational choice, Openness could predict both an interest in homeopathy and choosing homeopathy as an occupation.

The most prominent finding in this study, however, is the homeopaths' high score on Agreeableness. Given that high scores on Agreeableness have also been found among medical students, ³² psychologists, ²⁶ and CAM users, ²⁹ this result was not surprising, but the magnitude of the effect was larger than expected. Social occupations, which includes working in health care, are described as people oriented and work in which language and communication is important. ² Holland describes persons who are interested in social occupations as helpful, understanding, and interested in taking care of and assisting others. The high Agreeableness scores by the participating homeopaths confirm the idea that many homeopaths are “people persons” with a sense of altruism, care, and idealism. People with higher scores on Agreeableness are described as seeking cooperation rather than competition, ³ and studies on physicians show that a high Agreeableness score predicts experiencing the work environment as supportive and sensitive. ¹³

However, a high Agreeableness score might imply a lack of ability to focus on selfish interests and to negotiate on one's own behalf. ^16,22 Therefore, those who score high on Agreeableness may experience difficulty in making unpopular decisions and setting limits. Successful, self-made business people generally have lower scores on Agreeableness, ²² and studies have shown that high scores on Agreeableness might be connected to low income and low job satisfaction. ^22,40 Someone with a high Agreeableness score might thus face challenges in trying to earn a decent income, expressing his or her opinion in work settings, and rejecting requests for help by other colleagues or patients, thereby leading to work overload and dissatisfaction. Homeopaths are more vulnerable than other medical professions to these pitfalls since they are self-employed and thus work without a financial safety net. Homeopaths working in single practices also do not have colleagues on whom they can lean for moral and financial support when business is slow.

A high score on Conscientiousness describes the ability to be tidy, punctual, and self-disciplined as well as the capability to work hard and keep focused ²² and predicts good work performance in most occupations. ¹⁰ Compared to the norm sample, homeopaths had a higher score on Conscientiousness, but the difference was too small to be relevant.

Homeopaths in this study had a small but significantly lower score on Extraversion. A high score is found to predict interest in occupations characterized as social work ³ and is also associated with higher work performance in occupations where human relationships are important. ¹⁰ Therefore, the fact that the results in this study showed a trend toward a lower score on Extraversion by homeopaths is somewhat surprising. People with high scores on Extraversion often like to influence other people and to achieve their goals. A very extroverted person is outgoing, determined, talkative, and enthusiastic, which are all characteristics that might be important in occupations involving sales. ²² Being extroverted might, therefore, help contribute to making a substantial income in a treatment practice. In the current sample, homeopaths scored lower on this personality trait. Even though the difference is small, it might partially explain why most homeopaths have low incomes and work less than they would like. ³⁴

The major strength of this study is that it is the first study to investigate personality profiles for a group of CAM practitioners. A limitation of the study is the response rate (40%), which was probably due to the extensive questionnaire. Self-report measures require the consideration of positive self-representation as a bias, but since these data are not collected in a personnel selection process, this is not likely to have compromised the validity of the results. The mean age is also somewhat higher for this sample than that in a previous survey of the association members. ⁴¹ The gender distribution is similar to that of the overall homeopath association (78 % female). ⁴¹

Conclusions

This study provides the first investigation on personality profiles of homeopaths. The results confirmed the hypothesis that homeopaths would score significantly higher on Openness and Agreeableness as compared to the general population. The hypothesized higher score on Conscientiousness was not confirmed. Differences were high or moderately high in terms of effect sizes and were not attributable to gender differences. People who work as homeopaths can thus be described as open to new and different ideas, and as caring, understanding, and altruistic persons. There is reason to believe that these dispositions are central in choosing homeopathy as an occupation. Further research should investigate whether personality traits are associated with important occupational areas, such as job satisfaction, occupational stability, or income.