An Interview with 2016 Block Award Winner Lee Anna Clark

by Leonard Simms

University at Buffalo

Leonard Simms








Lee Anna Clark

You're a clinical psychologist who studies personality disorder. When did you get your first inkling that this was what you wanted to study?

There were a couple of stages. First, as an undergraduate, I went to Cornell partly to study Japanese, and that got me interested in linguistics. This led to my studying psycholinguistics, which I ended up designing as my own major. Between college and graduate school, I went back to Japan and taught English for a while. By the time I got back, however, psycholinguistics had become less interesting to me, so I applied to graduate school in psychology instead. Why Clinical? I simply thought that I'd have more options. I was naively optimistic, but fortunately I was accepted at the University of Minnesota. On interview there, I remember Jim Butcher telling me about his cross-cultural MMPI work. He probably already knew what my dissertation would be about — something on Japanese translations of the MMPI — and that's what it did end up being on. Around the same time, in 1980, DSM-III had come out. I remember looking through it and seeing this "Axis II" that raised the possibility of studying personality in a clinical way that I had never seen before. It married two things that I was interested in: Clinical psychology and personality. I thought, "This is what I'm going to do my research on." As I looked closer at Axis II, I noticed that it didn't have much actual personality in it. The operationalization of it clearly was not based in fundamental personality principles, so that is what I set out to do, to revamp personality disorder in the DSM based more fundamentally on the structure of personality as it was emerging to be represented in the psychology literature.

Other than DSM-III coming out, what/who influenced your ideas about personality?

Tellegen. Plain and simple. At Minnesota, we had a personality seminar with Tellegen. I remember a particular class in which he talked off the cuff about the development of the MPQ. It was just fascinating. From Tellegen, I developed an appreciation for structure. Jim Butcher also influenced me as my advisor. Mostly what I took from him was the cross-cultural aspect of personality and being very steeped in the MMPI. Also from both Butcher and Tellegen, I learned that the constructs on which the measures lay were the important thing. One of my pet peeves is people who try to develop a measure of every adjective they encounter in their daily lives, like "heart" and "grit," which Tellegen refers to as folk concepts. As psychologists we need to transcend folk concepts to develop cross-cultural universals. We want something that is about human psychology and not just about the psychology of a particular human language.

If you hadn't gone down the clinical psychology and personality path, what would you have been? Was there some other path you might have pursued?

I could have stayed with psycholinguistics and gone to Berkeley, which was one opportunity available to me at the time. Other than that, within clinical, I always had in the back of my mind that I could have gone the clinical practice route had the academic track had not turned out. I always liked clinical work, but I know now that I couldn't have done it full-time.

Tell me about a particularly proud moment in your career.

Other than winning the Block Award, winning the Regent's Award for Faculty Excellence at the University of Iowa, partly I think because the Dean of the Business School made a lot out of it. He kept emphasizing that there's nothing like the recognition of your peers. Another proud moment also occurred when I was working in the Provost's office at Iowa. It was a couple years after I "invented" the first-year seminar in the clinical program, which languished when I went to the Provost's office. A bit of a crisis emerged, resulting in a town hall meeting in which the students spoke up to say, "Well, LAC used to do this and that…" So I started teaching that class again in the evenings, since I was doing administrative work during the day. It really pleased me that the students valued the class enough to say they wanted it back.

To me, it seems that one of the biggest contributions you've had has been as a mentor.

I really do value that role. I'm pleased at how former students even now come back and ask me for advice.

How would you describe your mentorship model?

That's interesting. Mentorship is something that I simultaneously am pleased to have done but wish I could've done it better. I think the best mentors are those who are nimble and flexible and who can adapt their model to the student, and I don't think I do that enough. That said, my model is to make sure that the students have the fundamentals and then give them their head, and let them go where they want to go.

Is there a low point, a discouraging moment, in your career?

You might say that my decision to go into administration for a while was due to a low point in my scholarly career. There were a number of years when our kids were growing up that, relative to what I would have done otherwise, I put a fair amount of time into supporting my kids. Probably the high point of that was when I became involved in the local youth soccer league. I served as the president for three years, which was a huge time sink-lots of meetings and putting bylaws together and scheduling more meetings. Because of that, my energy for research was low, and I wasn't coming up with new ideas I wanted to research. At that time, I got several invitations to apply for administrative positions. I turned two down, but the one in the Provost's office seemed like a strong opportunity so I applied and got the position. Interestingly, by the time I went back to my faculty position, which I was ready for, there really had become a movement toward the ideas I envisioned earlier in my career. I was able to throw myself back into that effort, and that has carried me through to today. You might say that my time away allowed the field to catch up to the way I had been thinking before I went into the administrative position.

Who were some other big influences on your career and research program?

Having John Livesley as a colleague was very important to me. He was farther along, more established, and when I discovered his work and saw how overlapping, but different enough, his work was, it really felt like I'd found a kindred spirit. We corresponded via letters and phone, then met for the first time in 1990 at a conference, and we've been good colleagues since then.

Robin Jarrett also was a big influence, partly as a mentor early on, but fairly quickly turning into a colleague. She introduced me to the idea of NIMH conferences and urged me to try to attend one about personality disorders. She said that these conferences have both participants and observers, and encouraged me to get in touch with the program officer in charge of PDs. They actually had a PD unit back then. So I did. It turned out that the PO was a friend of Tellegen's, and I was invited to speak instead of just being an observer. That was very influential for me, because it introduced me to the biggest names in PD research in psychiatry, such as John Gunderson, Tom McGlashan, Andy Skodol, and John Oldham.

Also, Bruce Pfohl was a big influence, even before I got to Iowa. We found a common interest in personality disorder measurement, and he was a big factor in our moving to Iowa. Bruce introduced me to Peter Tyrer, who also has been a big influence on my career, as he introduced me to the international PD community. And we have been good friends ever since we first met.

Is there a particular line of work or paper that you're most proud of?

The 1991 tripartite model paper has got to be it. That was my first real breakthrough paper. With the 1984 negative affectivity paper, David clearly took the lead. With the tripartite model, that was mine. It came after writing several chapters which, in hindsight, I can see the model in there but I had not really discovered it yet myself. It reminds me about how sculptors talk about seeing the form in the rock. It was really a matter of looking at the data, trying to rearrange it to see the patterns that would make it all make sense. Then, it was really an intellectual leap. I said to David, "you know what I think is going on? I think this is a common factor and these are separate factors." It was the specific anxiety factor that was hardest to find. But I took the leap and went with it, and it obviously has had a large impact. It's the second most cited paper in Abnormal in the past 10-15 years. More recently, it would be my 2007 Annual Review paper on personality disorders. The really hard but rewarding intellectual work is taking something that I don't understand and digging down until I do.

Is there a research area or topic that secretly interests you that you think you'd might like to get into?

If I had it to do over again, I would study more quant and statistics. I envy those who have those skills. Also, I really wish I had the expertise to move everything I research in the direction that RDoC is going, with more of a biological bent. I think there is a huge gap between those who know the biology and those who know the phenomenology of it all. And we have to get those two groups together. At this point, there is limited time left for me to do it, but I'd like to lay enough groundwork to guide others who might wish to bridge the two.

Do you have other advice for new scholars in the personality field?

Today I tell young people in the field to think about starting a longitudinal study as early as they can in their career despite the pressures to publish. Also, don't limit yourself. Start setting up the connections. We cannot afford to be silos. Learn about or work with biological and quant people from the beginning. Make those connections. Co-design studies with other people who can extend your work meaningfully.

Is there an understudied topic in personality that personality psychologists and personality disorder researchers should be studying but are not? Where should the field be going?

We know a lot about the pieces, but we need to get more serious about putting them together. Take for example the alternative model for personality disorder (AMPD) in DSM-5. The thing that I'm currently interested in is the extent to which Criterion A is separable or inseparable from the traits. Really, what is personality pathology? I worry that there might not be any "there" there. I think we really need to work on that. I think it's possible that the network analysis people have it right, because part of what they're saying is that there might not be any "there" there, that our attempts to carve out constructs are for our own benefit and that they're not necessarily really there in nature. I think if that's true, then we need to recognize that and live in both worlds at the same time. You can't forget the utility of constructs, but you also can't reify them.

Final thoughts?

Well, over the course of my career, I have thought of myself as a synthesizer. Some people are more analytic, they break things down finer and finer, and that's an absolutely necessary step. But I'm convinced that anytime there are two opposing sides on an issue, they're both right, and what we need to do is figure out how they're both right and how we can live in the world in between them. So, for example, I have fought very hard for dimensional approaches to personality disorder. And I absolutely believe in them. I think it was very important to say that over and over and over again. Because it's easy to get sucked into categories for lots of reasons, not the least of which is that they're instantiated in a book. Although they aren't true, they nevertheless might be important. I've fought as hard as I have because I needed to be sure that the dimensional side was considered a legitimate argument before I could back off and talk about synthesizing. When one side is the absolute dominant, you need to make sure the other side has just as loud a voice and is an equal player. Otherwise it'll just get absorbed again. In recent years, it has become clear to me that it's time to begin to back off my adversarial stance and be comfortable now that the dimensional view is well enough established that we can begin to back away from that one-sided approach and take a more synthesized point of view. It's like a kid leaving home. You absolutely have to establish your independence separate from your parents before you can go back and have a relationship with them.