Diagnostics with Dwight

PSYCHOLOGICAL REPORT

Name: Dwight Kurt Schrute III
Date of Birth: January 20, 1968
Ethnicity/Race: Caucasian
Education: High school diploma
Employment:  Assistant to the Regional Manager, Dunder Mifflin, Scranton (past)
Paper Salesman, Staples (past)
Beet Farmer, Schrute Farms (current)
Regional Manager, Dunder Mifflin, Scranton (current)
Date of Initial Interview: 09/23/2010
Date of Report: 05/16/2013
Therapists: Brandon Saxton, M.S., Katie Gordon, Ph.D.

Presenting Problem
Dwight Schrute presented as a 42-year-old male who was referred by his boss, Michael Scott, via the Dunder Mifflin Paper Company. Michael had some concerns that Dwight was “kind of weird” and seemed to “not get along with others.” We’re not sure of the scientific validity of that assessment, so we decided to continue with an assessment of our own. Behavioral symptoms seem to include a variety of interpersonal conflicts that have influenced Dwight socially and vocationally.

Social/Family History
Dwight comes from a large and eccentric family. He recalls his own birth, stating specifically that his father, Cody Schrute, removed him from the womb and his mother bit off the umbilical cord. Dwight has one brother and one sister. Beyond that, he stated that he also had a twin in the womb, but he “reabsorbed” his twin giving him “the strength of a grown man and a little baby.” Dwight was born weighing 13 pounds and five ounces and performed his own circumcision. Growing up, Dwight reports that, as per family tradition, the youngest child raised the other children.

Dwight did not seem to want to spend much time describing his childhood. He did mention that he was shunned by his family from approximately age four through age six after he failed to save the extra oil from a can of tuna. He also reported losing an elementary school spelling bee by misspelling the word “failure.” This writer wonders whether these negative events created an avoidance in Dwight when it came to discussing his childhood. At any rate, Dwight was quick to begin describing his life as an adult and time working at Dunder Mifflin.

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Currently Dwight lives in a nine-bedroom, one-bathroom home located on a 60 acre beet farm that he inherited from his family. Dwight currently lives with his cousin Mose. Beyond growing beets on their farm, they also operate a small bed and breakfast and host events including weddings and garden parties. Currently, Dwight is employed as Assistant Regional Manager (it should be noted that his boss, Michael Scott, clarified that Dwight’s actual title is Assistant to the Regional Manager) at the Dunder Mifflin Paper Company. Dwight has been employed with Dunder Mifflin for several years and is considered one of the top sales staff in the company.

Interpersonally, Dwight seems to have a higher than average amount of conflict with his coworkers. This information was primarily obtained through collateral sources (i.e., Dwight’s coworkers and his personnel file). When asked about some, or most, of these incidents, Dwight seemed to not understand why his coworkers reacted the way that they did. A select list of these conflicts follows (for a more thorough review of these conflicts, please consult the large, surprisingly full, manila folder next to Dwight’s medical file). In one instance, Dwight attempted to test his coworkers’ emergency preparedness by locking them all in the office, simulating a fire, and yelling commands to them through a microphone. His coworker, Stanley, had a heart attack. During a subsequent CPR training, Dwight cut the face off the CPR dummy and wore it a la Silence of the Lambs.

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In another instance, Dwight tricked his coworker Phyllis into coming with him on a sales call. He actually drove her to a bad part of town, took her phone and wallet, and left her to walk home. He did this to help his branch win a corporate weight loss competition by forcing her to exercise. A final example included Dwight asking his coworker, Stanley, to join him on a sales call. Stanley declined. As such, Dwight shot Stanley with a bull tranquilizer, wrapped him in bubble wrap, slid him down the stairs, and loaded him into the car. Dwight then took Stanley, unconscious, with him on the sales call. These three examples are a fairly representative example of the types of behaviors in which Dwight engages at his workplace.

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Psychiatric/Medical History
Dwight has not received any formal psychological assessment or treatment. Despite this, there is some indication that he may have suffered from mental health symptoms in the past. For example, in episode 6.12, “Secret Santa,” Dwight says “… I’m just tired. The days are short. I don’t know. Maybe I’m depressed.” In addition, in episode 9.5, “Here Comes Treble,” Dwight says “You don’t think I have anxiety? I have anxiety all the time. Every waking moment of my life is sheer torture.” Taken together, these quotes suggest that Dwight may have previously struggled with an undiagnosed mood or anxiety disorder.

Diagnostic Impressions
All diagnostic assessment information was obtained through an interview with Dwight, his manager, and his workers. Beyond that, we reviewed his HR personnel file (i.e., we watched every episode of The Office. Multiple times). Based on the client’s history and presenting problems, diagnoses related to Cluster B and Cluster C personality disorders were considered. Diagnoses related to depressive and anxiety disorders were not further considered, as the symptoms related to each appeared very brief and not distressing.

A diagnosis related to Cluster B personality disorders, specifically a Narcissistic Personality Disorder, was considered. Dwight only meets the requirement for two of the five or more symptoms required to make the diagnosis. Dwight does exhibit a “grand sense of self-importance.” One example of this behavior in the way in which Dwight persists in calling himself Assistant Regional Manager as opposed to Assistant to the Regional Manager (much to the chagrin of his boss). Dwight also exhibits “arrogant, haughty behaviors or attitudes.” This seems to occur quite often, with Dwight often commenting on how he is a better salesman than his coworkers.

When fully considered, the symptoms that Dwight Schrute is experiencing are best captured by an obsessive-compulsive personality disorder. He exhibits 1) an excessive devotion to work and productivity to the exclusion of leisure activities and friendships (Dwight once comments on a sale that he never takes vacations, sick days, nor celebrates any major holidays – a pattern of behavior that is reinforced when he is named Northeastern Pennsylvania Salesman of the Year), 2) is overconscientious, scrupulous, and inflexible about matters of morality, ethics, or values (Dwight allows himself to be fired to respect his girlfriend, Angela’s, prioritization of privacy in the office; he instigates a formal investigation, including drug testing of every employee of the office, after finding a small amount of marijuana in the parking lot; he goes to excessive lengths to act consistently with his highest personal value, which is respect for authority and hierarchical systems), 3) is reluctant to delegate tasks or to work with others unless they submit to exactly his way of doing thinks (do we need to explain this one?? If you’ve watched the show, you’ve seen this!), 4) shows rigidity and stubbornness (Dwight trying to impress a manager for a promotion despite experiencing acute appendicitis and consistently refuses any flexibility in his actions despite extremely reasonable requests from his coworkers).

 Treatment Recommendations
Currently, there are not any well-established treatments for obsessive-compulsive personality disorder that have been tested in large randomized clinical trials (the gold-standard for testing what treatments work best!) It is worth noting that obsessive-compulsive personality disorder is different from obsessive-compulsive disorder, which is a disorder that does have clear evidence-based treatment for it. Approaches that have been used effectively include cognitive therapy, which focuses on challenging maladaptive thoughts related to the disorder. It’s possible that Dwight developed his personality characteristics as a consequence of being raised according the Schrute Family Rules (as Dwight reports, “Schrute boys must learn 40 rules before the age of five. They are told that if they don’t learn their rules, they will be eaten in their sleep.”) Dwight would likely benefit from therapy focused on flexibility and balance to decrease his rigidity with this rule-set.

Status at Termination (last episode)
Sometime later, Dwight returned to our office for a booster session, although this writer wonders whether the session was necessary. It seemed, perhaps, that Dwight more so wanted to share with us his new station in life. He reported having finally achieved the position of Regional Manager at the Dunder Mifflin Scranton office. Dwight reported that he is currently happily married to Angela. The two of them, and their son, Philip, live at Schrute Farms. In addition, Dwight reported that his relationships with this subordinates (yes, he did use that term) had improved dramatically. He said he now considered them all friends (despite firing Kevin Malone). All in all, it seemed that Dwight had experienced significant symptom reduction and was operating and feeling much happier in life.

The Office - Season 9

THE GORDON/SAXTON TEST

Was the portrayal of mental illness accurate?
Full disclosure: some of Dwight’s behaviors are exaggerated. And we’re thankful for it. He is easily one of our favorite fictional characters for this very reason. Despite this exaggeration, some of the behaviors that Dwight exhibits are not entirely out of the question. Oftentimes individuals who grow up in strict, rigid homes develop these characteristics themselves. This does not always lead to the formation of a mental health disorder, but in Dwight’s more extreme case, it certainly seemed to.

Was the character struggling with mental health issues depicted with compassion?
Overall, we do find the portrayal of Dwight to be a compassionate one. Yes, sometimes he is a nuisance to his coworkers. One could even argue that, at times, he is a danger to them! But overall, as the series progresses we see Dwight develop and evolve into a really caring individual and a capable leader. This is the kind of progression that we hope to see with clients in therapy, so seeing it in one of our favorite fictional characters just seems right.

Overall rating:
Overall, from a rating scale from Toby (yuck) to Dwight (oh, yeah!), we would rate the portrayal of Dwight as Dwight K. Schrute, Manager! The Office is one of our favorite shows and Dwight is a main reason for that. He starts off as a rough-around-the-edges kind of person. Throughout the nine seasons, we see him experience a lot and grow into a really lovable character. By the end, Dwight gets along well with his coworkers, has a family, and finally leads the branch!

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Diagnosing Dunder Mifflin’s Finest

PSYCHOLOGICAL REPORT

Name: Michael Gary Scott
Date of Birth: March 15, 1964
Ethnicity/Race: Part English, Irish, German, and Scottish, 2/15 Native American Indian
Education: High school diploma
Employment: Regional Manager, Dunder Mifflin Scranton (past), CEO, Michael Scott Paper Company (past), Director of Paper Distribution, Department of Natural Resources (current)
Date of Initial Interview: 09/23/2010
Date of Report: 05/16/2013
Therapists: Katie Gordon, Ph.D., Brandon Saxton, B.S.

Presenting Problem
Michael Scott presented as a 46-year-old man who was referred, interestingly, by all of his employees and supervisors at the Dunder Mifflin Paper Company. Michael was referred primarily due to problems related to a consistent pattern of interpersonal conflicts. The behavioral symptoms Michael was exhibiting have resulted in financial, vocational, and social impairment.

History of Presenting Problem
Behavioral observations were gathered to determine the extent and severity of Michael’s presenting problem. We selected a few of the more diagnostic moments to outline in further detail. An exhaustive outline can be gleaned through watching The Office.

Some of the specific examples that we observed included:

  • Experiencing emotions that are unstable, intense, and/or out of proportion with the given circumstances
    1. When Michael asks Carol (his realtor and, at the time, short-term significant other) to marry him spontaneously at a Diwali celebration
    2. When Michael photoshops himself into a picture of Carol and her children by putting his face over the face of her ex-husband and uses it as a Christmas card
    3. When Michael locks all of his co-workers in the office after they joke that jail seemed better than the office
    4. When a pizza delivery boy does not accept Michael’s coupons and he won’t let him leave the building
    5. Demanding one of his gift baskets back when potential customers won’t give Dunder Mifflin their business
  • Attention-seeking in ways that antagonize others
    1. Getting an iPod for the office Secret Santa exchange instead of sticking to the $20 limit
    2. Buying himself a World’s Best Boss mug
    3. Taking over the corporate-mandated diversity training and making his own “diversity training”
    4. Calling meetings others have to attend, often times for personal reasons
    5. Insisting on being in Phyllis’ wedding party and giving an uninvited toast
  • Behaving irresponsibly, impulsively, and engaging in dangerous risk taking
    1. Quitting his job to start his own paper company on a whim
    2. Reconciling with his ex-girlfriend Jan because she gets breast implants
    3. Promising economically disadvantaged children that he will pay for their college tuition if they graduate from high school when he does not have the resources
    4. Playing with the baler in the warehouse despite how unsafe it is and being explicitly told not to
    5. Planning to jump off a building onto a bounce house

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Family History
Michael was born in Scranton, PA. He reportedly came from a single-parent home (though his mother eventually did remarry) and described his childhood as lonely. Michael stated that he has an older brother as well as a half-sister with whom he had a tumultuous relationship. However, the two did eventually reconcile leading to Michael hiring his nephew Luke as an intern. Michael does not talk much about his childhood but does offer a few memories that seem to stand out to him. For example, Michael was once featured on an episode of the television show Fundle Bundle. On the episode, when asked what he would like to do when he grows up, Michael replies,“I wanna be married and have 100 kids so I can have 100 friends. And no one can say no to being my friend.” Another childhood memory Michael has is attending a baseball game with Jeff, who he identifies as his “mother’s boyfriend, who she married.” Michael went on to say that during the game he “… felt really bad, because the pitcher wasn’t able to play with his friends anymore. But Jeff said that the manager was making a really good move, by taking the pitcher out. He really respected the manager.”

Educational/Employment History
Michael graduated high school on time in Scranton, PA. He was not able to attend college though, as he lost his tuition money in a pyramid scheme. Michael seemed to hold a variety of jobs during/after high school, including a position as a greeter at Men’s Warehouse. He reported receiving his position at Dunder Mifflin after following an attractive women to the office park, where the Scranton office is located. Michael started with the company as a salesman, a position in which he excelled. After becoming the best salesman in the company, evidenced by his winning consecutive awards for best salesman, Michael was promoted to a regional manager position. Unfortunately, it seemed that the qualities that made Michael great at sales did not translate to the managerial position.

Psychiatric/Medical History
After Michael physically reprimanded his nephew, Luke, for being insubordinate, the corporate office mandated that he attend six hours of counseling with Toby Flenderson from the Human Resources department of the Scranton branch. Due to Michael’s strong dislike of Toby, he refused to engage in the counseling process. Michael began the session by refusing to speak and then reporting fictional stories as his own life. Over time though, Michael began to inadvertently share details from his life with Toby. Once he realized this, Michael got angry and refused to participate. Toby eventually gave up on the entire process and allowed Michael to fill out the counseling report himself. The records indicated that Michael was severely depressed and homicidal. We have chosen not to include these results further in this assessment as we question their validity.

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Diagnostic Impressions
As mentioned above, information about the presenting problem was obtained through behavioral observations (i.e., viewing The Office repeatedly) and by filling out a self-report personality questionnaire as we imagined Michael Scott would (this is not a valid method and should not be used in real life).

Because Michael exhibited a persistent pattern of interpersonal problems, it was hypothesized that he might meet criteria for a personality disorder. While Michael had substantial distress and impairment from issues associated with his personality characteristics, he did not meet diagnostic criteria for any of the ten personality disorders that are specified in the current version of the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5). Rather, his symptoms were best captured by a category that is used when there are significant personality issues that do not fit within the other categories: other specified personality disorder.

A diagnosis of other specified personality disorder does not provide nuanced details about Michael’s specific presentation, so we utilized the alternative model for personality disorders in the appendix of DSM-5 to further explore his presentation. This model moves away from the traditional categorical models of personality disorder (i.e., you either have a personality disorder or do not, with no in-between) through its focus on dimensional measures of 1) personality functioning impairment in four domains and 2) five research-derived pathological personality traits.

We rated personality functioning impairment on the DSM-5 scale from 0 (little or no impairment) to 4 (extreme impairment) based on the match between our behavioral observations and one or more of the descriptions at each level. The results are presented and described below:

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  • Identity (moderate impairment): “Has vulnerable self-esteem controlled by exaggerated concern about external evaluation, with a wish for approval” and “Emotional regulation depends on positive external appraisal. Threats to self-esteem may engender strong emotions such as rage or shame”
  • Self-Direction (some impairment): “May have an unrealistic or socially inappropriate set of personal standards, limiting some aspects of fulfillment”
  • Empathy (severe impairment): “Ability to consider and understand the thoughts, feelings, and behavior of other people is significantly limited” and “is confused about or unaware of impact of own actions on others”
  • Intimacy (severe impairment): “Relationships are based on a strong belief in the absolute need for intimate others”

Pathological personality trait scores were derived from the self-report questionnaire that we filled out as we thought Michael would (again, you should not do this in real life ever). Scores ranged from a minimum of 0 (reflecting low levels of a trait) and a maximum of 3 (reflecting high levels of a trait) and were believed to underlie the functional impairment described above. The results are presented and facets that fit Michael are listed:

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  • Negative Affect: “instability of emotional experiences and mood; emotions that are easily aroused, intense, and/or out of proportion to events and circumstances”
  • Detachment: This refers to a tendency to generally avoid interpersonal experiences and does not apply to Michael.
  • Antagonism: “engaging in behavior designed to attract notice and to make oneself the focus of others’ attention and admiration”
  • Disinhibition: irresponsibility, impulsivity, distractibility, dangerous risk-taking
  • Psychoticism: This reflects odd or bizarre thought processes and behavior and does not apply to Michael.

Treatment Recommendations
In summary, the most appropriate categorical diagnosis for Michael Scott was other specified personality disorder. His significant distress and impairment appeared to be most related to his persistent pattern of speaking and behaving impulsively (reflecting his high levels of disinhibition), paired with an intense need to be liked. When he believed that someone disapproved of him or his behavior (often because he had offended them with his impulsive behavior due to impaired perspective-taking), he tended to spiral into a dysregulated, negative emotional state (consistent with his elevated level of negative affect). He then coped with this painful emotional state by engaging in attention-seeking (reflected in his elevated level of antagonism), and sometimes vengeful, behavior which usually exacerbated the problem.

While there is not a specific scientifically-tested and supported treatment for other specified personality disorder, there are therapeutic strategies designed to specifically strengthen impulse control, increase interpersonal skills, and build adaptive emotional coping. Michael would likely experience improvement in his symptoms if he worked with a therapist in these areas, while capitalizing on his strengths: being a fun-loving person who cares a lot about his relationships with others.

Status at Termination (last episode)
At follow-up, Michael exhibited substantial improvement in his personality functioning. While he retained his unique (and sometimes inappropriate) sense of humor and life perspective, he appeared to become more skilled at navigating interpersonal relationships and formed meaningful relationships with his co-workers. Their affection for Michael was evident as they said good-bye to him when he moved to Colorado to be with his wife, Holly, and their excitement at seeing him a few years later at Dwight & Angela’s wedding. He reported that he and Holly had a fun and mutually supportive marriage and that he enjoyed being a father very much.

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THE GORDON/SAXTON TEST
Was the portrayal of mental illness accurate?
Michael Scott was created as a comedic character who repeatedly offends people by speaking and acting in incredibly inappropriate ways. While the creators of the show were likely aiming to make a character who would make people laugh because of his unusual personality, it is highly doubtful that they had a personality disorder in mind. Thus, by design, Michael Scott is not a realistic representation of someone suffering from a mental disorder. That being said, some of the aspects of his personality that lead to problems (excessive and intense need for others’ approval, disinhibited behavior, marked emotional fluctuation) do represent realistic components of some mental disorders. However, these pathological personality traits do not typically present in the extreme and silly manner that is portrayed in The Office. In conclusion, no, it is not an accurate portrayal of mental illness, but Michael Scott is an incredibly entertaining character.

Was the character struggling with mental health issues depicted with compassion?
In the earlier episodes of The Office, Michael is not presented as a sympathetic character. He ridicules numerous people based on personal qualities (e.g., appearance, age, ethnicity, sexual orientation, ability, gender) and acts in an irrational manner. However, as the seasons progress, the audience sees more of Michael’s sweet, caring, fun side, and this results in more compassion for his struggles and more sympathy about his lack of insight into his role in his own struggles.

Overall rating:
When considered overall, we award The Office with a Dundie for the “Best Television Show Ever!” Although the portrayal of mental illness is not entirely accurate, the writers did not set out with this goal in mind. We can’t fault them for missing a goal that they never had. Beyond that, the show does not seem to add to the stigmatization of mental disorders. In fact, in the episode Here Comes Treble (Season 9, Episode 5) Nellie helps to dispel some of the misconceptions that Dwight holds about individuals suffering from anxiety. And in the episode Stairmageddon (Season 9, Episode 19), Jim approaches Toby to ask what he and Pam can expect from couples counseling. Both episodes normalize experiences related to receiving mental health services.