Dr.House MD Psychological Analysis

            House MD is a former Fox prime time medical drama that ended last year after 8 seasons. The show featured the witty and sarcastic Dr. Gregory House. House is a character described as heartless and genius. His personality can seem very straightforward at first: a jerk. However, a deeper look reveals that House has many layers and is in fact a complex individual, with a heart in there somewhere.

            House was raised by his parents John and Blythe House. He described himself as a “military brat” with a loving, nurturing, slightly over-protective mother, and a strict and blatantly honest father. His father’s punishments were borderline abusive and took away from House’s feeling of security at home. This form of parenting probably started at birth. The lack of security led to trust issues, which are probably the stem to his personal maxim “Everybody lies.” If you go by the Freudian theory, this strict/borderline abusive parenting during the anal stage made him anal-retentive, making him obsessive, which is shown by the way he obsesses over cases or his peers and team. However, while this is true, he also shows some traits of an anal-expulsive personality exhibited by his self-destruction and disorganization. This means that his mother may have tried to overcompensate for the father’s abuse during this stage  by showing too much leniency when the father was away. Throughout his life, his father may have became a symbol of bad people or bad situations due to the harsh punishments and strict nature. This probably led house to rebel and become as little like his father as possible. His father was obsessed with order, discipline and following authority (all traits common of those in the military), and House rejects and rebels against all of these things. From a young age, he also suspected his father was not his father. This was probably a byproduct of the trust issues, and those issues probably were not helped when he found out that he was right. House also seems to not act on his super ego, which according to Freud is he part of our personality that makes us adapt to social norms and gives us our human sense of morality. House’s ego seems to be in control. The ego is what keeps us in tune with reality, and controls the strong urges of the id. House releases the id’s tendencies of aggression and immediate gratification through his self-destructive use of Vicodin. The addiction also feeds his biological impulse to avoid pain and seek pleasure. His feelings of anger towards his father may have also been added to by an Oedipus complex in the phallic stage, where he mentally fought his father for the affection of his mother. Because of these trust issues as a child, he developed many defense mechanisms that are apparent throughout the show.

            Five years before the pilot episode, House suffered an infarction in his right quadriceps. He came into the clinic during a game of golf with excruciating pain being his only symptom. This led the doctors to believe he was a drug seeker (which hints at drug use before his leg injury, possibly considering his obsessive/addictive personality). However, when they try to get a urine sample they find that his kidneys are failing. Three days pass and House eventually comes up with the diagnoses himself. However by this point, a large portion of his thigh muscle had died. The doctors (including Lisa Cuddy) told him that his best treatment option was amputation. House rejected this because of his stubborn nature and he did not want to be cripple (probably to avoid vulnerability). He opted for a surgical bypass to remove the clot. However, the dead muscle would release chemicals that would probably kill him. He opted for this option mostly to avoid the vulnerability and pity that an amputation would bring him but it also hints at a risky personality trait, seen throughout the show by how he treats his patients and takes risks himself. The post-operative pain of this operation made House require a medically induced coma to sleep off the worst of the pain. However, his wife-at-the-time Stacy was scared of the possibility of death, so she, as House’s medical proxy, requested a surgical middle ground, that let house keep the leg while removing the clump of dead muscle. This left him in constant pain and a distinctive limp that made him require a cane. Of course, he was not very happy with Stacy about this (despite her tries to help him through it and obvious guilt) and they divorced. The divorce was a big thing for House because aside from Wilson, Stacy was one of the few people he could identify with on a personal level. His trust issues caused antisocial behavior throughout his life, so losing the only women he had loved up to that point went lengths to enforce his defense mechanisms, as did his new reality of being a cripple. Throughout the show, House displays many defense mechanisms such as: denial, regression, deflection, displacement, intellectualization, and compensation. House displays denial over his Vicodin habit. In season one’s “Detox”, and throughout the Tritter arc in season three, House claims that the pills make him normal and allow him to do his job. Similar to functioning alcoholics, he claims that the pills allow him to function. However, as shown by his mental decline in the end of season five, he does have a problem. Denial is his way of coping with his addiction. He displays regression throughout the series with his immature behavior whenever personal matters are brought up. House likes to view the world and see/do whatever interests him. He hides from his emotions, numbing them with Vicodin and distracting himself from them with puzzles.  He likes to snoop through other’s personal lives but when his is brought up he either deflects or reacts with immaturity, sometimes a combination of both. For example, after the stabbing of Chase in season eight, he focused his attention on any case load he had and pranks on Taub. This exhibits a combination of deflection and regression. Also, in season seven when his relationship with Cuddy ends, instead of dealing with his feelings he shows random acts of immaturity (the segway and the sham marriage with Dominka). The defense mechanism displayed most frequently by House is deflection. This is present in almost any episode when and aspect of his personal life, emotions, plans or past are brought up, and is pretty self-explanatory. By deflecting, he avoids talking about and dealing with things that would cause him pain. This prevents him from having to actually think about it or even acknowledge that it even happened in many cases. He also exhibits displacement. During the Tritter arc, his anger at Tritter is directed not only at Tritter, but at his team, Cuddy and Wilson. Part of this anger is withdrawal, but mostly it is due to the conflicts and accusations and threats to his way of life. Tritter also represents a lot of House’s feeling towards his disability. In season three’s “Fools for Love”, Tritter trips House by knocking away his cane as he leaves the exam room in the clinic. When House falls, it makes him feel vulnerable. He puts a lot of effort into hiding his disability in the hospital. He always tries to walk as fast if not faster than his team, and  he tries hides any other health issues. When he is at home, you can see his gait is a lot slower and his limp is more pronounced. He also intellectualizes. When Wilson gets cancer, he focuses on his chances, his treatments, and his condition, rather than the emotional toll of losing his best friend. He eventually focuses on their friendship and how to make the last five months of life good, but in the beginning he tries to numb himself to the emotional side of the situation. He does the same when he is faced with the hallucinations of Amber Volakis. He first has numerous guesses and conclusions, before admitting that he may have mental issues. He intellectualizes that he must have something physically wrong, to avoid dealing with the possibility that his Vicodin problem may be affecting his psyche.  He displays compensation through his medical practice. This could be seen as a good thing for him, because he compensates for the fact that he can barely walk by diagnosing so many difficult cases. It is also possible that he obsesses over these medical cases because his disability is caused by delayed treatment due to misdiagnoses. Of course he probably displays others in ways, but I feel these are the most often exhibited in the show.

            House has trouble relating to and empathizing with others, and is often described as a jerk. I have also heard him described as a sociopath, although he does not quite fit the diagnosis in many ways and thus the description of “sociopath” is inaccurate. He displays a few symptoms, such as: need for stimulation, pathological lying, irresponsibility, secretiveness, and extreme narcissism. However, he has the ability for guilt, love and other deep emotions. He loved Stacy, Cuddy, and Dominka towards the end. Also,  in the season six opener “Broken”, he feels guilt when a fellow patient at Mayfield jumps off a roof largely because of him encouraging his delusions. Sociopaths do not feel deep emotions, while House feels such emotions but numbs them with Vicodin and ignores them by focusing on puzzles and cases instead. Therefore, he is not a sociopath, even though he displays some sociopathic tendencies.

            House has one true friend, and that is Wilson. They met years before the show at a medical conference. They became friends after House bailed Wilson out of jail. When asked by Wilson about why, he replied that Wilson had seemed interesting. This friendship is House’s longest lasting connection with the rest of humanity. Aside from House himself, Wilson is in the most episodes, appearing in all except the season eight opener “Twenty Vicodin”. Wilson acts as an enabler for House and he tries to teach House. House (though claiming to be purely annoyed) clings to Wilson almost as a father figure, to replace his own. This also fits into House’s beliefs that his father isn’t his father (which he proved to be true after his father’s death in “Birthmarks”), and is possibly giving himself a father figure he accepts more. This probably goes on in his subconscious or unconscious mind. House’s conscious mind had already picked a neighbor as a logical choice for his biological dad. Nevertheless, House clutches on to Wilson almost like a life raft. When he temporarily loses the friendship in the beginnings of seasons 4  and 8, he goes to great lengths to get it back. Also, when Wilson gets his cancer diagnosis it is easy to see the human side of House coming through. The friendship works because of one of the most basic concepts: opposites attract. Wilson is over-caring, trying to moralize and humanize everything. He sees the person in everybody he treats. House tries not to ever care. He dehumanizes and sees patients as mysteries, or puzzles for him to solve. They balance each other out, with Wilson being House’s conscious (probably making up for an under-developed super-ego), and House being Wilson’s way to see reality as opposed to what he wants to see in people. This is a lot like how House influences Dr. Cameron.

            In the season 6 opener, “Broken”, we see a new side to Dr. House. His defense mechanisms eventually crumple and he has a new goal of happiness. His denial shows itself in the beginning, where he tries to check out of Mayfield after his painful detoxification. He has gone from thinking all his problems beginning in his leg, to all his problems beginning in his Vicodin abuse. He is scared of being broken, scared of having problems because that would make him vulnerable and human in ways he had never been. He doesn’t like to think that the deaths of Kutner and Amber affected him, because in his mind, he doesn’t like to think he cared about them in any way. He tries to see them as nothing more than employees. When they die, it becomes harder for him to dehumanize them and this breakdown of what he had always seen probably caused his hallucinations. The hallucination of his night with Cuddy is fairly self explanatory. He had obviously been storing up feelings towards her for a while, and his poor mental state took these feelings and made them into his reality. This also was a way for him to “fix” his problems. He had finally come to terms with the fact that his Vicodin habit could have caused his problems, but he didn’t want to need help because of the vulnerability that entailed. He was also both consciously and subconsciously scared of the pain of detoxification. That goes back to the id’s biological tendencies to avoid pain and seek pleasure. Once in Mayfield, his denial at first prevented him from seeing that he had real issues. He then turned to regression. He basically became the bully, first turning on his fellow patients, then on the doctors. The level of immaturity was evident and the pranks also gave him something to focus on other than his mental state. He thwarts against the doctors, thinking of nothing except getting out of there. Eventually, though, he cracks. The thing with House, is that he only pretends not to care. A fellow patient who was under the delusion that he was a superhero was being treated in a way that to House appeared downright mean. If House was as apathetic and selfish as he always makes himself appear to be, he would shrug it off and remain focused on getting out of Mayfield. However, House has his own set of morals. His morals are often seen as lacking, while really they just aren’t the same as other’s. He tries to help this man, by taking him out of Mayfield to an amusement park where they go on a ride that makes them feel like they are flying. House feels better about himself for helping someone and going back to his principals, but he really just encouraged the man’s psychosis. The man then begins to actually believe he can fly. This motivates him to jump off a roof, which leaves him seriously injured. This causes House to feel guilt, which actually helps him realize that he is broken. He begins one-on-one sessions with a psychiatrist who understands House surprisingly well. He allows House to think and heal himself, while helping in the right ways. He doesn’t treat House like an inferior person, which does a lot for House. House agrees to start taking meds. At first however, he reacts by comparing himself to Van Gogh, saying that if Van Gogh was his patient, he would be happy painting peaceful village scenes instead of his artistic rendering of the night sky. The psychiatrist replies by saying that Van Gogh would still be himself, but he would have both ears on his head and be a lot happier. In the end, House was able to take meds, be happy and still see the unique connections that always made him a great doctor. Of course, this happiness does not last, probably due to him returning to his old environment and reverting to  a lot of his old habits that made him have a mental break in the first place.  One of the main habits (which is brought up by the psychiatrist) is his tendency to “fix” things instead of moving on. This habit is shown in season five’s “Simple Explanation” when it is discovered that Kutner had killed himself. Instead of dealing with this and trying to move on, he tries to rationalize Kutner’s death by attempting to prove it was homicide instead of suicide.

            While seen as uncaring and apathetic, House has shown levels of compassion in many episodes. First, there is the example mentioned above from “Broken”. Also, in the episode “Son of a Coma Guy” from season three, he helps the father kill himself in an effort to save the son. This can be viewed as a ploy by House just to keep the son alive so he can diagnose him, but it is also possible and likely that he felt a level of empathy/compassion for the family. Another example is in season two’s “Euphoria” where it is obvious he shows compassion for Foreman. He goes back to the House where Foreman got infected, risking his life in order to save Foreman. The same feelings are shown by the way he fights to get the biopsy. In this episode it is easy to tell that it is more than a puzzle to him. His level of caring for Wilson is shown in the season four finale “House’s Head/Wilson’s Heart”. House risks his life over and over to try to remember the information that could save Amber’s (Wilson’s current girlfriend) life. Also, he consistently fights to save the lives of his patients even after he has the answer to the puzzle.

            Another way to view the personality and psychology of House, is how he correlates to Sherlock Holmes. They both have a drug of choice, and a need for puzzles. Another correlation is that Dr. Wilson can be viewed in correlation to Dr. Watson. If familiar with both characters, it is easy to see the similarities. Overall, House is multi-layered character with character flaws, but also many redeeming qualities, and is without-question an amazing doctor.