I recently interviewed Dr. Dr. Scott Mark Harrington by email about his Enneagram-based weight loss programs. He is a board-certified family physician and doctor of osteopathic medicine (D.O.). Full disclosure: I have not participated in any of his programs and did not get any compensation for this interview except the joy of meeting another person who understands the power of the Enneagram!
When and how did you hear about the Enneagram?
First, I heard about the Myers Briggs Type Indicator during medical school, where I learned that different medical specialties attract specific personality types. It was then that and I saw the functionality and application of personality systems. When I tried to use this knowledge for my day-to-day benefit, though, I felt that the system fell short. I later learned about the Enneagram during residency from a psychotherapist, who used it as a tool to get a quick understanding of her patient’s inner motivations. I took one look and instantly became hooked.
I was impressed after learning my Enneagram Type, because while reading the descriptions, it felt like someone who knew me well was describing me. Soon I asked all of my friends and family to take the Enneagram Institute’s test, and I became familiar with each Type in someone close to me. Having my loved ones as living examples helped me understand the basic ideas like the Levels of Development and the Line of Integration and Disintegration. This understanding was very helpful, because I started to forgive myself and others for the way we behaved, and I saw that behavior could be explained as a reaction to inner fears and desires. A new paradigm had been given to me; a new language with which to describe the world of people.
When did it occur to you that the Enneagram could be used to help people lose weight/gain health?
The idea of applying the Enneagram to weight loss came almost immediately. When you find a new tool, you first experiment and see how it makes your life easier. The idea that I could distill the myriad of weight loss advice and provide specific weight loss prescriptions was thrilling. Besides, I would rather prescribe specific skills and not more pills to people. I started asking my patients to check it out. Like the psychotherapist who used it, I found out that if the patient would learn their Type, then it was easier for me to pinpoint problem behaviors and beliefs. As a family doctor, I’m practically a mini-psychologist, because the main focus is encouraging people to change to healthy behaviors. I did not sit down and write my findings until 2006 (two or three years later). It wasn’t until 2011 that I actually started putting my ideas online.
In developing weight loss plans for each Type, I started with collecting all the evidence-based behavioral strategies that people use to lose weight. Some example include calorie counting, social support, peer pressure and meal planning. Then I used my Enneagram knowledge to label each skill as easy or difficult for each Type. I liked the idea of having innate skills that you could rely on. And, more impressively, just as the Enneagram system offers a guide to improvement, the natural skills demonstrated by your Line of Integration were skills that each Type needs to master in order to maintain their weight loss. Later, I came up with the name Dietnosis, which I thought concisely summed up this concept.
Describe the process you take a client through.
Most of my patients are unfamiliar with the Enneagram. so I don’t use this technique up front. Instead, I use my intuition into their personality and have them to tell me their sticking points. When they have a typical hang-up, then I would use my knowledge of personality to make specific weight loss recommendations. I choose behavioral strategies that they would likely find easy and start there. After I see the patient multiple times, then I would show the Enneagram concepts and have them learn their Type at home. I would usually wait until I had earned their trust before I told them about the Enneagram. I found that many people are turned off by it because of the pentagram-like shape of the diagram, and it can scare away the less curious individuals.
Once I know their type, it is easy to make recommendations. Each Type might be best at certain skills. I also knew from my work with smoking cessation that each person comes to me at a different place in their journey – a different “stage of change.” The stages of change model is an evidence-based method for healthy lifestyle changes. Someone might not be considering weight loss, and another person could be stuck in the getting started phase. These people need different counseling. I had hoped that I could “prescribe” different skills for each Enneagram Type for each stage of change.
So, I superimposed the stages onto the Enneagram lines of Integration and Disintegration. I called the first phase (Step 1) their “Power” phase. I would have them use the strategies that were easiest for their personality to master. Then, if they hit a plateau in their weight loss, I would suggest following the Line of Disintegration and trying that Type’s strategy. I theorized that, since we sometimes will behave this way during stress, we could tap into the skills demonstrated by these Types more easily than the others. I called it the Action Phase (Step 2). Finally, the stages of change model has “Maintanence,” and in this stage you are trying to prevent relapse into your old ways. I theorized that it would be hardest to perform skills along the Lines of Integration, but that these skills were essential to maintain the benefits that you achieved.
For instance, Type 2 benefits by using their natural tendency to help others as a way to lose weight, by being a good workout partner or by ensuring healthy meals are prepared. Here are the specific behavioral strategies, busing the “Stages of Change” model superimposed on the Lines of Disintegration/Integration for Type 2.
Power Skills: Social Support, Coaching, and Labeling Saboteurs
Action Skills (Modeled by Type 8/Line of Disintegration): Assertiveness, Channel Your Anger Positively, Gamify Your Weight
Maintenance Skills: (Modeled by Type 4/Line of Integration): EE: Environmental Engineering and RRR: Routines, Rituals and Reminders
The Skills Modeled and demonstrated best for each Type are located on my Skills page.
I’m guessing that the level of interaction you have with each client depends on their type. For instance, a Six may want a lot of guidance. Is that the case?
This is true, but there is a surprise around every corner so to speak. The patient’s home environments can be so different, even for same personality Type. And each person could be dealing with significant emotional pain or be stuck in a very cyclic pattern of life. As for making generalizations for each Type, I do this on my site. Sixes do prefer specific guidance for instance. They like practical advice and may like to see multiple sources of evidence. Sixes like tried-and-true methods. They also like to eat traditional foods when dieting. They flourish in systems that have social support, rules and charting methods.
Be sure to catch Part 2 of this interview, where Dr. Harrington shares his own health journey and more.