Type at the Family Conference Table: Extraverted Thinking

28 Apr 2016

Written by Mathew David Pauley, JD, MA, MDR

In my previous post I discussed how I’ve found type to be a useful tool for working with individuals who need to make difficult decisions or who are in conflict. When discussing matters such as whether to continue aggressive interventions or consider more palliative approaches, or when disclosing bad news (e.g., a new life-limiting diagnosis, an unsuccessful surgery, a medical error or medication mistake, or an unanticipated injury or death), the patients, family members, and care providers in the room may not be demonstrating their best self. More likely, they are exaggerating their type preferences or are fully in the grip of their least preferred mental process. What might this look like?

Beginning with individuals with preferences for ESTJ or ENTJ—who at their best are decision makers, naturally driving toward doing what needs to be done in a clear and decisive manner—we would keep in mind that Extraverted Thinking is their favorite mental process—the process they use and rely on most. Whether as patient, family member, or care provider, they tend to feel comfortable in, and often seek, a leadership role—and are comfortable with being expected to make decisions.

Imagine, though, a husband with preferences for ESTJ whose spouse has been in the ICU for a monthiStock_Doctor Checking on Patient_Small without much improvement, while the doctors frequently want to keep talking about “what to do?” The man’s prospect of losing his spouse is daunting: His children and other close family members are often expressing emotions of sadness and distress, and he constantly feels the pressure to decide from both family and from physicians. He also likely is faced with a very common moral dilemma: his duty as husband to fight for and defend his spouse, and to prevent his spouse from suffering. For this natural leader, so much of what happens is beyond his ability to control. These are all triggers for an ESTJ’s least used Introverted Feeling.

Whereas ISFPs and INFPs are at home when reflecting internally about what is important and how to feel about things, ESTJs and ENTJs will likely experience more inner turmoil.  And because it is inner (or introverted), their distress may not be noticed readily. Emotions come forth unbidden, and their decisiveness is diminished. Thus, those employing type in healthcare environments would do well to get to know their patients’ family members as well as the patients. On first glance, individuals with preferences for ESTJ and ENTJ can possibly be considered as “overly emotional” due to the stress of the situation. Giving them personal space to reflect and time to process their emotions will help allow these leadership types to show their strengths.

Want to read more? Check out my previous blog in this series:



About the Author:

Mathew David Pauley, JD, MA, MDR is going into his 10th year as a practicing clinical ethicist. His background has primarily focused on conflict resolution, negotiation and mediation as it relates to ethical decision-making and values-based disputes. Last year, Mathew became a MBTI Master Practitioner and has been applying type to his practice.

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