“House, M.D.” An Analysis and Appreciation

Mario Sikora
Jun 30, 2012
(Note: This article will be published in the upcoming edition of “Nine Points Magazine,” the quarterly publication of the International Enneagram Association (IEA). For more on the IEA, go to www.internationalenneagram.org.)

On May 21, 2012, the television show, “House, MD,” aired its season finale in the US. Admittedly, the show had lost some steam in recent years as its writers have had to come up with more and more outlandish plot twists, but it still deserves credit for great writing, an unwillingness to compromise, and being able to effectively mix humor with challenging intellectual content. Mostly, actor Hugh Laurie deserves credit for breathing life and complexity into a character that could be (and probably is to many) highly unlikable.

House, as the character was called by everyone except his mother, was compelling for a number of reasons: he was misanthropic but profoundly human, brilliant but unable to connect, fascinated by people but seemingly indifferent to their plight. He was also, I believe, a great example of an Ennea-type Five and in this article I’d like to explain how I came to that conclusion.

I’ve written before about the caveats that go along with typing public figures: any assessment is speculative and provisional.  No one should ever insist that they know another person’s Ennea-type. Those caveats are all in place here—I guess with the added caution that House is not a real person—so this is a purely speculative exercise. In some ways, the assessment is somewhat easier in that there is no “behind-the-public-image” person who may have characteristics that we can’t see. However, any fictional character is susceptible to the whims of the writers and actor. An actor who misplays the character or different writers shaping the character in different episodes can alter the character. For example, Homer Simpson, one of my other favorite TV characters, seems to be written as a Nine on some occasions (the couch-potato Homer) and a Seven on others (the bright-shiny-object-chasing Homer).

I’ve also written recently about why it is important to identify criteria for typing and an explanation of the models being used.[i]My approach is to assess the most noticeable characteristics of the subject and then correlate them to which of the nine Ennea-type strategies they seem to fit most logically. I also look at what instinctual bias seems to be demonstrated by the subject to further help discriminate between Ennea-types (this helps to rule out look-alikes). Finally, I cross-check my Ennea-type assumption against a list of behavioral derailers common for each Ennea-type.

I’ve seen every episode of “House, M.D.” (most more than once, I’ll add) and I’ve watched it in English, German, Spanish, and French as I’ve traveled in different countries, and the character is remarkably consistent—even in his contradictoriness. House is contradictory in that he is both reclusive and attention-seeking. I’ve seen online discussions about House’s MBTI type where the discussers said he did not fit the MBTI model because he was both an introvert and an extrovert, and while I agree that he is both, I don’t think it contradicts my assessment of his Ennea-type. While these qualities might seem inconsistent, they are typical of the sexual subtype of the Five.

Watching the final episode, I admired how even over the course of 8 years, the character has not changed much. He has not grown into being a better person. He is still combative, he is still unable to connect with people with any degree of emotion, he still intellectualizes the world around him and ferociously works to dispel ignorance, illogic, and superstition. Neither he nor the show ever giving in to the embrace of “fuzzy woo” so common in Hollywood productions. House was a rigorous skeptic. While most skeptics in movies or TV shows end up having a “wait, maybe I was wrong; maybe there is something more” moment; House was spared that indignity.

The adaptive strategy that I correlate to Ennea-type Five is, “striving to be detached.” Let’s look at some characteristics of House and see if they seem to be indicative of that strategy.


In the penultimate episode of “House, M.D.,” a behind-the-scenes tribute episode entitled “Swan Song,” Robert Sean Leonard, who plays House’s friend and sidekick Dr. James Wilson, says: “The thing I find interesting about House, the character, is his distance, his apathy, and his removal from any kind of connection.”

This statement sums up House’s personality as well as any. Watching one of the final episodes, I was struck by a scene where House’s Ukrainian bride-of-convenience, whom he has fallen in love with, is walking out on him and he is silently coping with the loss of yet one more person he loved but drove away through his inability to connect. Many episodes end with House retreating to his lair, looking into space with a vibrant self-restraint that is heartbreaking to watch. Being alone is House’s preferred response to the world.

Houses psychological dysfunction is most on display in his romantic relationships and he has driven away every woman he has ever loved. (He literally drove a car through the front wall of the home of Dr. Lisa Cuddy, with whom he had an on-again, off-again romance for the first seven seasons.) Each of the women in his life tried to reach him emotionally, only to be met with withdrawal, resistance, and—when necessary to maintain the distance—hostility. House was much more comfortable with prostitutes; women that will come and go at his whim and will.

House had no friends except for the long-suffering oncologist, Wilson, a merged Ennea-type Nine who serves as House’s conscience, sounding board, and sometime punching bag. His staff consists of intellectually gifted, but flawed and emotionally complex, doctors who are as important to House for the opportunities they provide to satisfy his curiosity about human nature as for their medical knowledge. They are in awe of his brilliance and endure his manipulation, intellectual arrogance and hostility, lack of compassion, and reclusiveness in exchange for learning from him.

Whenever someone gets to close to House, he pulls away. Or he drives them away.

How House Thinks

The character of House is modeled after Arthur Conan Doyle’s “Sherlock Holmes”  (“Holmes”, “House;” get it? Further, House’s sidekick is “Wilson;” Holmes’s was “Watson.”) They lived at the same address (221B Baker Street). Both were drug addicts (Holmes, cocaine; House, vicodin.) Rather than solving crimes, House solves medical mysteries. He is brilliant, of course, but it is the way he thinks and the way he thinks about thinking that make him singular in his ability to find the root of the patient’s maladies that no one else can find. He has no interest in the patients themselves, and only takes on cases that he finds intellectually interesting or challenging. (House rarely even sees the patient he is diagnosing until the end of the episode, believing that since emotions distract the intellect and “everybody lies”[ii] anyway, he is more effective when unencumbered by actual contact with the patient.)

He seeks out puzzles that he doesn’t know the answer to, and throws himself passionately into trying to find that answer. He only takes cases that are interesting challenges, leaving it to lesser minds to deal with the mundane cases. The hospital administration uses the threat of mandatory clinical hours as a punishment for House; the worst thing they can do to him is force him to interact with boring people with simple problems. He endures these interactions by resorting to insulting and humiliating the patients.

With each case that he takes, House conducts a vigorous and combative differential diagnosis of the patient, listing the symptoms  on his white board and badgering his staff to come up with explanations for an underlying cause of the symptoms. When one fits, House barks out orders to start a treatment, using the treatment as an experiment to either confirm or disconfirm the hypothesis. House is a persistent advocate of the principle of Occam’s Razor. Occam’s Razor is a philosophical principle that grew out of William of Occam’s 11th-century debates with St. Anselm of Canterbury over the existence of God. It is usually interpreted to mean that the simplest explanation is usually the correct explanation, but what Occam really meant was that we should practice explanatory parsimony. If we can explain a phenomenon using x number of factors we should not use X+1. If the common cold explains the patient’s symptoms, don’t assume he or she has a rare virus, prescribe fluids and bed rest and send them on their way. (Occam is a common reference in the show. Once, House was playing a video game and his avatar was named “Occam’s Chainsaw.”)

Of course, for dramatic purposes the first explanation is not usually the correct one so the team has to reconvene and re-evaluate the evidence based on the confounding variables identified in the experiment. The central theme here? To House, emotion and sentiment are a distraction and logic and reason are to be valued above all else.

Introversion and Extraversion

As mentioned earlier, House displays characteristics of both extreme introversion and extreme extraversion. The introversion is clear from the preceding paragraphs. The extraversion manifests as a need for display and sexual bravado, however, rather than a desire to draw energy from other people (except when he needs people to serve as a sounding board/audience for his differential diagnoses). He likes fast motorcycles, his cane has flames painted onto it; he is constantly badgering the women who cross his path (and the men as well) about their sex lives.

This contradictory quality is consistent with the sexual subtype of the Five[iii], which combines a need for attention and opportunity for display with a desire to withdraw and detach. They can seem like they have a binary temperament, seeking attention one moment and shunning it the next.

Office politics

While House is a keen observer of human nature, he is indifferent to (if not downright dismissive of) rules, mores, and social hierarchies. He is uninterested in organizational power, craving only autonomy and independence to pursue what he finds intellectually stimulating and avoiding all the other complications of organizational life. House views his coworkers as little more than occasionally useful resources—sources of entertainment when he is bored and partly as ways to kick-start his thinking. He thinks nothing of playing with people, partly to amuse himself, partly to understand them better while winnowing out of his life those who fail to intrigue him. Coworkers are fodder for the intellectual curiosity that drives and obsesses House. 

All of these characteristics combined seem to strongly correlate with the strategy of “striving to be detached”, so it is reasonable to hypothesize that House is a Five. (The need for display and House’s occasional apparent extroversion correlate with the Sexual subtype.) To test the hypothesis, let’s see if the typical derailers for the Five seem to fit as well. Those derailers, identified in appendix D of our book[iv], are:

  •      Thinking too much, doing too little: Preferring analysis to action and allowing that preference to affect performance.
  •      Not nurturing relationships: Neglecting to make contact with others and identify needs; avoidance of networking and social connection.
  •      Unaware of their surroundings and their own impact: Constant inward focus leads to not noticing the effects of your actions (or lack of action) on those around you.
  •      Needing to show off intellect: Showing off knowledge; too much attention to detail, hyper-verbosity in areas of expertise; “know-it-all-ism.”
  •      Not sharing information: Not communicating with others either through neglect or because you simply don’t want to share.
These derailers fit House like a glove.

I’ll miss “House, M.D.;” it has been “appointment TV” for me for years. The sexual Five is one of the most contradictory and often-misunderstood of the Ennea-types. The show was a great exemplar of that subtype, something rarely seen in the public arena, and it will be a shame not to have House around as a handy reference. I wish Dr. Gregory House a fond farewell, with the full knowledge that he would be utterly indifferent to my well wishes and how much I’ll miss him.

[ii] “Everybody lies” is one of House’s mottos. He believes that everyone lies, either consciously or unconsciously, a view strongly supported by the work of Robert Trivers on self-delusion (see his book, “The Folly of Fools”). Thus, it is better to rely on logic and evidence when diagnosing someone, rather than what the patient tells you.

[iii] I refer to the “sexual” instinct as “Transmitting,” because it is rooted in a need for display and bonding, allowing the individual to transmit some part of themselves to others—their genes, their ideas, their artifacts.
[iv] Tallon, Robert & Sikora, Mario (2007) Awareness to Action: The Enneagram, Emotional Intelligence and Change Chicago: University of Chicago Press

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